Anesthesia and analgesia
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Anesthesia and analgesia · May 2017
A Predictive Model for Extended Postanesthesia Care Unit Length of Stay in Outpatient Surgeries.
A predictive model that can identify patients who are at an increased risk for prolonged postanesthesia care unit (PACU) stay could help optimize resource utilization and case sequencing. Although previous studies identified some predictors, there is not a model that only utilizes various patients demographic and comorbidities, that are already known preoperatively, and that may affect PACU length of stay for outpatient procedures requiring the care of an anesthesiologist. ⋯ We developed a predictive model with excellent discrimination and goodness-of-fit that can help identify those at higher odds for extended PACU length of stay. This information may help optimize case-sequencing methodologies.
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As the number of operative cases increases, there is a greater emphasis on reducing inefficiency while maintaining patient safety. Recently, the issue of prespiking intravenous (IV) bags was raised. No study has assessed whether the risk of infection is related to the length of time a sterile (IV) fluid bag has been spiked. After completion of a pilot study revealed no microbial growth within 24 hours of an IV spike, a larger formal study was undertaken to determine whether there was an increased infection risk within 4 hours of spiking an intravenous fluid bag. ⋯ There was no bacterial growth in prespiked normal saline IV bags in a perioperative environment. Thus, prespiking of normal saline IV bags in advance should pose no risk of infection to a patient if prepared within 4 hours.
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Anesthesia and analgesia · May 2017
Topical Ropivacaine in Prevention of Post-Tonsillectomy Pain in Adults.
Post-tonsillectomy pain is 1 of the most intense postoperative pain conditions. However, optimal and sufficient postoperative analgesic treatment remains unclear. We investigated the effect of topical ropivacaine for post-tonsillectomy pain in 160 adult outpatient surgery patients over 2 postoperative weeks. ⋯ Topical ropivacaine failed to reduce pain intensity during the first postoperative week. We observed no major adverse effects.
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Anesthesia and analgesia · May 2017
In the Beginning-There Is the Introduction-and Your Study Hypothesis.
Writing a manuscript for a medical journal is very akin to writing a newspaper article-albeit a scholarly one. Like any journalist, you have a story to tell. You need to tell your story in a way that is easy to follow and makes a compelling case to the reader. ⋯ Therefore, in most clinical and basic science studies and manuscripts, the alternative hypothesis is stated, not the null hypothesis. Also, in the Introduction, the alternative hypothesis is typically stated in the direction of interest, or the expected direction. However, when assessing the association of interest, researchers typically look in both directions (ie, favoring 1 group or the other) by conducting a 2-tailed statistical test because the true direction of the effect is typically not known, and either direction would be important to report.