Articles: anesthesia.
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Multicenter Study
The Thai Anesthesia Incidents Study (THAI Study) of oxygen desaturation.
To examine incidents, contributory factors, treatment and outcomes associated with oxygen desaturation during anesthesia practice in Thailand. ⋯ Incidents associated with oxygen desaturation were distributed throughout all phases of anesthesia. Most of them were preventable and correctable. Therefore, anesthesia care providers should be alert in looking for incidents, and manage them promptly before they were in serious adverse events.
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Anesthesia and analgesia · Sep 2005
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialSpinal versus epidural anesthesia for cesarean delivery in severe preeclampsia: a prospective randomized, multicenter study.
In this randomized, multicenter study we compared the hemodynamic effects of spinal and epidural anesthesia for cesarean delivery in severely preeclamptic patients. The epidural group (n = 47) received 2% lidocaine with epinephrine 1:400,000, 18-23 mL, followed by 3 mg of morphine after delivery. The spinal group (n = 53) received 2.2 mL of 0.5% hyperbaric bupivacaine plus 0.2 mg morphine. ⋯ Neonatal outcomes assessed by Apgar scores and the umbilical arterial blood gas analysis were similar in both groups. Adverse neonatal outcomes (5-min Apgar score < 7 and umbilical arterial blood pH < 7.20) were found in only 2 premature newborns (weight < 1500 g) who were born without maternal hypotension after regional anesthesia. We conclude that the results of this large prospective study support the use of spinal anesthesia for cesarean delivery in severely preeclamptic patients.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia.
This multicenter study evaluated the effect of a new depth of anesthesia-monitoring device based on time-frequency-balanced spectral entropy of electroencephalogram monitoring (GE Healthcare Finland, Helsinki, Finland) on consumption of anesthetic drugs and recovery times after anesthesia. ⋯ Entropy monitoring assisted titration of propofol, especially during the last part of the procedures, as indicated by higher entropy values, decreased consumption of propofol, and shorter recovery times in the entropy group.
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Anaesth Intensive Care · Aug 2005
Randomized Controlled Trial Multicenter StudyRecovery from bispectral index-guided anaesthesia in a large randomized controlled trial of patients at high risk of awareness.
Electroencephalographic monitors of anaesthetic depth are reported to assist anaesthetists in reducing recovery times. We explored the effect of bispectral index (BIS) monitoring on recovery times in a double-blind, randomized controlled trial of 2,463 patients at high risk of awareness. Patients were randomized to BIS-guided anaesthesia or routine care. ⋯ In multivariate models, BIS monitoring, female gender, lower American Society of Anesthesiologists' physical status and shorter duration of anaesthesia predicted faster time to eye-opening after anaesthesia, and faster time to post-anaesthesia care unit discharge. BIS monitoring did not affect times to tracheal extubation among patients admitted to the intensive care unit. We conclude that BIS monitoring has statistically significant, but clinically modest, effects on recovery times in high risk surgical patients.
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The Anaesthesiological Questionnaire (ANP) is a self-rating method for the assessment of postoperative complaints and patient satisfaction. The questionnaire was adapted for use in cardiac anaesthesia (ANP-KA). The study was conducted to show the value of ANP-KA as a practicable means of assessing the patient's state after cardiac anaesthesia and for its use in quality assurance. ⋯ The results demonstrate the practicability and validity of the ANP-KA for the assessment of postoperative complaints and patient satisfaction after cardiac surgery.