Anesthesia and analgesia
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Anesthesia and analgesia · Jul 2014
Emergency Pages Using a Computer-Based Anesthesiology Paging System in Ambulatory Surgical Centers: A Retrospective Review.
The nature of pages associated with periprocedural emergency events in ambulatory centers has never being examined. Our institution has a proprietary anesthesiology paging system with hierarchical paging capabilities (emergency versus routine) and maintains a log of all events. Here, we describe emergency pages in our ambulatory surgery centers. ⋯ The rates of emergency page activations, especially those that are critical events, in our surgical ambulatory center are rare. Many emergency pages originated outside the procedural room; therefore, providers within these areas should be trained to promptly recognize and treat these events.
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Anesthesia and analgesia · Jul 2014
Sequence-Dependent Anesthesia-Controlled Times: A Retrospective Study in an Ophthalmology Department of a Single-Site Hospital.
Anesthesia-controlled time (ACT) generally refers to the time durations before and after the period of surgery. The ACT is typically dependent on the sequence of 2 consecutive surgeries and thus adds to the complexity of operating room scheduling. We report a study on sequence-dependent ACTs at the West China Hospital (WCH), focusing on elective surgeries (also referred to as "procedures" below) performed by the ophthalmology department of WCH over a 5-year period, 2007 to 2012. ⋯ ACTs are usually sequence dependent and hence should be considered in operating room scheduling. Although identifying the best sequence in general is a difficult optimization problem, in certain departments (such as the ophthalmology department of WCH) where a set of high-volume small-variety procedures is present, the best sequences can be systematically identified using a combination of statistical tests and Monte Carlo simulation as illustrated in this study.
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Anesthesia and analgesia · Jul 2014
Observational StudyA Prospective Observational Study of Ethnic and Racial Differences in Neuraxial Labor Analgesia Request and Pain Relief.
As ethnic and racial diversity increases, it is important that anesthesia providers understand the expectations and concerns of this changing population regarding labor analgesia. Our objective was to evaluate ethnic/racial differences in labor analgesia characteristics with regard to the timing of request for neuraxial analgesia. ⋯ Our data indicate that ethnicity/race plays a small role in acceptance and request for neuraxial labor analgesia.
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Anesthesia and analgesia · Jul 2014
Case ReportsWrong site frenulectomy in a child: a serious safety event.
Wrong site surgery is a serious safety event that can result in temporary or even permanent harm. Various safety checklists and procedures have been added to our standard work in the operating room, but errors still get through our safety nets and patients are harmed. In this case report, we describe a wrong site frenulectomy in a child and discuss the root cause analysis of this error and also SMART (specific, measurable, achievable, realistic, timed) preventative actions that could be put into place to prevent a recurrence.
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Anesthesia and analgesia · Jul 2014
A Prospective Evaluation of the Incidence of Adverse Events in Nurse-Administered Moderate Sedation Guided by Sedation Scores or Bispectral Index.
Moderate sedation is routinely performed in patients undergoing minor therapeutic and diagnostic procedures outside the operating room. The level of sedation is often monitored by sedation nurses using clinical criteria, such as sedation scores. The Bispectral Index (BIS) is derived from changes in the electroencephalograph profile that may provide an objective measure of the level of sedation. In this prospective observational study, we investigated whether using BIS values to guide sedative drug administration influences the level of sedation and the incidence of adverse events compared with using Ramsay sedation scale (RSS) only in nurse-administered moderate sedation. We hypothesized that both depth of sedation and the incidence of adverse events related to oversedation would decrease when sedation nurses used BIS values to help guide sedative drug administration. ⋯ Nurse-administered moderate sedation using midazolam and fentanyl was usually associated with appropriate levels of sedation as assessed by both the RSS and BIS with an overall low incidence of adverse events. The use of BIS did not change the mean level of sedation significantly, although the number of sedation-related adverse events appears to be lower when BIS was used.