Articles: anesthesia.
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Randomized Controlled Trial Multicenter Study
General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial.
The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under general anaesthesia. ⋯ The Health Foundation (UK) and European Society of Vascular Surgery.
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Multicenter Study Comparative Study
Multicentered study of model of difficult endotracheal intubation by incident reports from university and non-university hospitals.
To compare the characteristics, causative factors, outcomes, prevention, and suggested preventive strategies of difficult intubation between university (U) and general community (non-U) hospitals. ⋯ Half of DI cases were preventable. DI cases in Non-U hospitals were mostly caused by inadequate preanesthetic evaluation. This indicates the necessities of providing practice guidelines and experienced assistants. In U hospitals, in-training practice of intubation should be performed under supervision. More advanced substitution techniques were applicable in U hospitals.
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Multicenter Study
The Thai Anesthesia Incident Monitoring Study (Thai AIMS) of endobronchial intubation: an analysis of 1996 incident reports.
To analyze the clinical course, outcomes, contributing factor, corrective and preventive strategies of accidental endobroncheal intubation (EBI) in the Thai Anesthesia Incident Monitoring Study (Thai AIMS). ⋯ Accidental endobronchial intubation was reported as 1.6% of anesthetic adverse event in Thai AIMS. Majority of the incidents were contributed by anesthesia and system factors. High awareness, experience of performers and additional training would decrease the incidents and improve anesthetic outcome.
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Anesthesia and analgesia · Nov 2008
Multicenter StudyCardiac arrest after spinal anesthesia in Thailand: a prospective multicenter registry of 40,271 anesthetics.
As part of the Thai Anesthesia Incidents Study of anesthetic adverse outcomes, we evaluated the incidence and factors related to cardiac arrest during spinal anesthesia. ⋯ The incidence of cardiac arrest during spinal anesthesia was infrequent, but was associated with a high mortality rate. If the surgeon performed the spinal anesthetic, this was a significant factor associated with cardiac arrest. Increasing the number of anesthesiologists, improving monitoring guidelines for spinal anesthesia and improving the nurse-anesthetist training program may decrease the frequency of arrest and/or improve patient outcome.
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Multicenter Study Comparative Study
Methodological issues in explaining maternal outcomes: anesthesia provider characterizations and resource variation.
Anesthesia provider models were characterized based on responsibilities and technique privileges and the distribution of clinical resource and process variables using a survey of 1,135 hospitals offering obstetric care in eight representative states. The resulting models were then analyzed by resource availability. ⋯ Traditional characterizations of provider fail to capture differences in technique privileges. Clinical resource variables and the scope of technique privileges should be included in the study of anesthesia provider credentials on outcomes.