British journal of anaesthesia
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Editorial Historical Article
I. The Cochrane Collaboration and its worldwide contributions to anaesthesia research and care.
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Comparative Study
Evaluation of two delirium screening tools for detecting post-operative delirium in the elderly.
Postoperative delirium in the elderly is common and associated with poor outcomes, but often goes unrecognized. Delirium screening tools, validated in postoperative settings are lacking. This study compares two screening tools [Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and Nursing Delirium Symptom Checklist (NuDESC)] with a DSM-IV-based diagnosis of delirium, conducted by neuropsychiatric examination in postoperative settings. ⋯ While highly specific, neither CAM-ICU nor NuDESC (threshold ≥2) are adequately sensitive to identify delirium post-operatively; NuDESC (threshold ≥1) increases sensitivity, but reduces specificity.
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Clinical Trial
Analgesia nociception index: evaluation as a new parameter for acute postoperative pain.
A means of identifying the presence and severity of pain that is not reliant on the subjective assessment of pain is desirable whenever a patient self-rating of pain cannot be easily obtained (e.g. sedated patients, very young children, individuals with learning difficulties). The heart rate variability based analgesia nociception index (ANI) has been proposed to reflect different levels of acute pain. The aim of this study was to compare ANI scores with a numeric rating scale (NRS, 0-10) based on self-assessment of pain in the recovery room. ⋯ ANI did not reflect different states of acute postoperative pain measured on a NRS scale after adult sevoflurane-based general anaesthesia.