Anesthesia and analgesia
-
Anesthesia and analgesia · Mar 2022
ReviewNarrative Medicine: Perioperative Opportunities and Applicable Health Services Research Methods.
Narrative medicine is a humanities-based discipline that posits that attention to the patient narrative and the collaborative formation of a narrative between the patient and provider is essential for the provision of health care. In this Special Article, we review the basic theoretical constructs of the narrative medicine discipline and apply them to the perioperative setting. ⋯ We then examine the importance of incorporating narrative medicine into medical education and residency training and evaluate the literature on such narrative medicine didactics. Finally, we discuss applying health services research, specifically qualitative and mixed methods, in the rigorous evaluation of the efficacy and impact of narrative medicine clinical programs and medical education curricula.
-
Anesthesia and analgesia · Mar 2022
Performance of the Hypotension Prediction Index With Noninvasive Arterial Pressure Waveforms in Awake Cesarean Delivery Patients Under Spinal Anesthesia.
Arterial hypotension is common after spinal anesthesia (SA) for cesarean delivery (CD), and to date, there is no definitive method to predict it. The hypotension prediction index (HPI) is an algorithm that uses the arterial waveform to predict early phases of intraoperative hypotension. The aims of this study were to assess the diagnostic ability of HPI working with arterial waveforms detected by ClearSight system in predicting impending hypotension in awake patients, and the agreement of pressure values recorded by ClearSight with conventional noninvasive blood pressure (NIBP) monitoring in patients undergoing CD under SA. ⋯ HPI provides an accurate real time and continuous prediction of impending intraoperative hypotension before its occurrence in awake patients under SA. We found acceptable agreement between ClearSight MAP and NIBP MAP.
-
Anesthesia and analgesia · Mar 2022
The Association Between Timing of Elective Surgery Scheduling and Operating Theater Utilization: A Cross-Sectional Retrospective Study.
Overutilization of operating theaters (OTs) occurs when actual surgery duration exceeds scheduled duration, which could potentially result in delays or cancelations in subsequent surgeries. We investigate the association between the timing of elective surgery scheduling and OT overutilization. ⋯ Elective surgeries scheduled within 7 days of surgery were associated with significantly higher likelihood of OT overutilization for surgical patients who will be admitted after surgery. Further studies at other hospitals and a longer period of time are needed to ascertain a potential "squeeze-in" effect.
-
Anesthesia and analgesia · Mar 2022
Editorial CommentMaternal Critical Care: The Story Behind the Numbers.