Articles: anesthesiology.
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
[Predictability and precision of "target-controlled infusion" (TCI) of propofol with the "Disoprifusor TCI" system].
In Germany a TCI-system for propofol (Disoprifusor-TCI) has been commercially available since spring 1997. We investigated the prediction error and precision of this TCI system as part of a multicentre study. Bias, precision, blood concentrations and dosage of propofol were compared with patients receiving propofol via a manually controlled infusion device. ⋯ With a precision of 27.5% the investigated TCI system (Diprifusor-TCI) showed an acceptable inaccuracy, as for TCI-systems a median prediction error of +/- 30% has to be expected due to the inherent variability of pharmacokinetic parameters. Further studies will be necessary to find out whether the investigated TCI system for propofol may offer substantial advantages.
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A study involving 2738 patients in 15 hospitals in the United Kingdom was undertaken to evaluate the effect of simple methods of pain assessment and management on postoperative pain. The study consisted of four parts: a survey of current practice in each hospital; a programme of education for staff and patients regarding pain and its management; the introduction of formal assessment and recording of pain and the use of a simple algorithm to allow more flexible, yet safe, provision of intermittent intramuscular opioid analgesia; and a repeat survey of practice. One hospital from each of the former health regions of England and Wales was selected for inclusion in the project. ⋯ Similar decreases were seen in the incidence of nausea and vomiting. There was also a slight reduction in the incidence of postoperative complications. This study shows that simple techniques for the management of postoperative pain are effective in reducing the incidence of pain both at rest and during movement and should form part of any acute pain management strategy.
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Anesthesia and analgesia · Aug 1996
Multicenter StudyPercutaneous injuries in anesthesia personnel.
Anesthesia personnel are at risk for occupationally acquired blood-borne infections from human immunodeficiency virus, hepatitis viruses, and others after percutaneous exposures to infected blood or body fluids. The risk is greater after an infected, blood-contaminated, percutaneous injury, especially from a hollow-bore blood-filled needle, than from other types of exposures. Few data are available on the specific occupational hazards to anesthesia personnel from needles and other sharp devices. ⋯ Most CPI occurred between steps of a multistep procedure (8%), were recapping related (13%), or occurred at other times after use (41%). No CPI were reported from use of needlestick-prevention safety devices. The devices and mechanisms of injury identified in this study provide specific data that may lead to prevention strategies to reduce the risk of PI.
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Multicenter Study
Use of esophageal or precordial stethoscopes by anesthesia providers: are we listening to our patients?
To ascertain current anesthesia utilization of esophageal and precordial stethoscopes in U.S. anesthesia training programs. ⋯ Our data suggest infrequent utilization of esophageal and precordial stethoscopes in anesthesia training institutions. Thus, current anesthesia training may be fostering an environment where providers overlook a valuable minimally invasive, and cost-effective continuous monitor of patients' dynamic vital organ function.
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Acta Anaesthesiol Belg · Jan 1995
Multicenter Study Comparative StudyPerformance of the anesthesiologists in 12 Departments of Anesthesia in Greece.
To assess the performance of anesthesiologists in 12 Departments of Anesthesia a questionnaire was completed by 132 anesthesiologists. The questionnaire included preoperative visit, preoxygenation, the anaesthetic record, time of stay in the operating room, management of apnea at the end of surgery and rapid sequence induction. Anesthesiologists were also asked if they keep update and how. ⋯ To induce anesthesia in patients with full stomach, 89% give thiopentone and succinylcholine, 4% thiopentone and nondepolarizing relaxant, 76% apply cricoid pressure and 5% inflate the lungs via a face mask, (P < 0.0001, P = 0.018 and P < 0.0001 respectively). Eighty-seven percent of the anesthesiologists keep update attending congresses, 76% departmental meetings (P = 0.0015 within the 12 Hospitals), 86% reading journals and 78% reading textbooks. The 12 Departments of Anesthesia presented a uniformity in updating knowledge but not in practicing anesthesia.