British journal of anaesthesia
-
Distractions are a potential threat to patient safety. Previous research has focused on parts of the anaesthetic process but not on entire cases, and has focused on hazards rather than existing defences against error ⋯ Distractions are common in anaesthetic practice and managing them is a key professional skill which appears to be part of the tacit knowledge of anaesthesia. Anaesthetists should also bear in mind that the potential for distraction is mutual and reciprocal and their actions can also threaten safety by interrupting other theatre staff.
-
Target controlled infusion (TCI) with sufentanil is usually performed using the Gepts model, which was derived from patients undergoing general surgery. It is, however, known that pharmacokinetics of sufentanil can be changed during cardiopulmonary bypass (CPB). We tested whether TCI during coronary artery bypass surgery with CPB produces constant total, unbound sufentanil concentration-time course or both. ⋯ Neither total nor unbound sufentanil concentrations remained constant when performing a TCI with the Gepts model in coronary artery bypass surgery with CPB. A pharmacokinetic model derived from patients undergoing cardiac surgery with CPB might improve the performance of TCI in this population.
-
Estimation of the nares-to-epiglottis and nares-to-vocal cords distances would facilitate the selection of properly sized nasopharyngeal airways and appropriate positioning of a fibreoptic bronchoscope in young children. The purposes of this study were to measure the nares-to-epiglottis and nares-to-vocal cords distances and to create an algorithm to predict these distances based on anatomical landmarks and paediatric characteristic data. ⋯ Clinical Research Information Service KCT0000150.
-
Cardiopulmonary exercise testing (CPET) is used to assess perioperative risk in surgical patients. While previous studies have looked at short-term outcomes, this paper explores the ability of CPET to predict 5 yr survival after major surgery. ⋯ Multivariate analysis and model generation techniques can be applied to CPET data to predict 5 yr survival after major surgery more accurately than is possible with single variable analysis.