Anesthesia and analgesia
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Anesthesia and analgesia · Dec 2015
Review Case ReportsObstetric Neuraxial Drug Administration Errors: A Quantitative and Qualitative Analytical Review.
A systematic review of 29 published cases of neuraxial obstetric drug errors, including four maternal deaths related to inadvertent intrathecall tranexamic acid.
What’s the first warning sign of an intrathecal drug error?
Block failure was the most frequent reported complication.
What were the most common human factors causing the errors?
- Similar drug ampoule appearance.
- Drug storage problems.
Any recommendations to reduce the risk of drug errors?
- Carefully read the ampoule before drawing up, and the syringe label before administering.
- Label syringes!
- Check labels with a second person or a device.
- Use non–luer lock connectors on all neuraxial catheters & devices.
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Anesthesia and analgesia · Dec 2015
Meta AnalysisPreoperative Acute Normovolemic Hemodilution for Minimizing Allogeneic Blood Transfusion: A Meta-Analysis.
Previous studies have evaluated the efficacy of preoperative acute normovolemic hemodilution (PANH) in reducing the need for allogeneic blood transfusion. However, the results to date have been controversial. In this study, we sought to reassess the efficacy and safety of PANH based on newly emerging evidence. ⋯ Although these results suggest that PANH is effective in reducing allogeneic blood transfusion, we identified significant heterogeneity and publication bias, which raises concerns about the true efficacy of PANH.
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Anesthesia and analgesia · Dec 2015
Randomized Controlled TrialA Randomized Trial of a Supplemental Alarm for Critically Low Systolic Blood Pressure.
Intraoperative hypotension is associated with complications that might be ameliorated by earlier intervention. We therefore tested the primary hypothesis that a supplemental decision support alert for critically low systolic blood pressure (SBP) decreases the duration of intraoperative hypotension. ⋯ An additional warning for severe hypotension did not reduce the duration of hypotension or hospitalization. Decision support alerts may be more useful for more complicated situations.