Anesthesia and analgesia
-
Anesthesia and analgesia · Sep 2024
Association of Obstructive Sleep Apnea With Unanticipated Admission Following Nonotolaryngologic Pediatric Ambulatory Surgery.
Approximately 2% of ambulatory pediatric surgeries require unanticipated postoperative admission, causing parental dissatisfaction and suboptimal use of hospital resources. Obstructive sleep apnea (OSA) occurs in nearly 8% of children and is known to increase the risk of perioperative adverse events in children undergoing otolaryngologic procedures (eg, tonsillectomy). However, whether OSA is also a risk for unanticipated admission after nonotolaryngologic surgery is unknown. The objectives of this study were to determine the association of OSA with unanticipated admission after pediatric nonotolaryngologic ambulatory surgery and to explore trends in the prevalence of OSA in children undergoing nonotolaryngologic ambulatory surgery. ⋯ Children with OSA were significantly more likely to require unanticipated admission after a nonotolaryngologic surgery scheduled as ambulatory or observation status than those without OSA. These findings can inform patient selection for ambulatory surgery with the goal of decreasing unanticipated admissions, increasing patient safety and satisfaction, and optimizing health care resources related to unanticipated admission.
-
Anesthesia and analgesia · Sep 2024
Observational StudyEffect of Sevoflurane Anesthesia on Diastolic Function: A Prospective Observational Study.
The effect of sevoflurane on left ventricular diastolic function is not well understood. We hypothesized that parameters of diastolic function may improve under sevoflurane anesthesia in patients with preexisting diastolic dysfunction compared to patients with normal diastolic function. ⋯ In this study, echocardiographic parameters of diastolic function, including septal e', E, E/A, and DT, improved with sevoflurane anesthesia in patients with preexisting diastolic dysfunction, but remained unchanged in patients with normal diastolic function.
-
Anesthesia and analgesia · Sep 2024
Anesthesia-Related Closed Claims in Free-Standing Ambulatory Surgery Centers.
As higher acuity procedures continue to move from hospital-based operating rooms (HORs) to free-standing ambulatory surgery centers (ASCs), concerns for patient safety remain high. We conducted a contemporary, descriptive analysis of anesthesia-related liability closed claims to understand risks to patient safety in the free-standing ASC setting, compared to HORs. ⋯ This analysis of medical malpractice claims may indicate higher-than-expected patient and procedural complexity in free-standing ASCs, presenting patient safety concerns and opportunities for improvement. Ambulatory anesthesia practices should consider improving safety culture and communication with families while ensuring that providers have up-to-date training and resources to safely perform routine anesthesia procedures.
-
Anesthesia and analgesia · Sep 2024
"Alexa, Cycle The Blood Pressure": A Voice Control Interface Method for Anesthesia Monitoring.
Anesthesia monitors and devices are usually controlled with some combination of dials, keypads, a keyboard, or a touch screen. Thus, anesthesiologists can operate their monitors only when they are physically close to them, and not otherwise task-loaded with sterile procedures such as line or block placement. Voice recognition technology has become commonplace and may offer advantages in anesthesia practice such as reducing surface contamination rates and allowing anesthesiologists to effect changes in monitoring and therapy when they would otherwise presently be unable to do so. We hypothesized that this technology is practicable and that anesthesiologists would consider it useful. ⋯ The use of voice recognition to control operating room monitors was well-received anesthesia providers. Additional commands are easily implemented on the prototype controller. No adverse relationship was found between acceptability and level of anesthesia experience, pitch of voice, or presence of accent. Voice recognition is a promising method of controlling anesthesia monitors and devices that could potentially increase usability and situational awareness in circumstances where the anesthesiologist is otherwise out-of-position or task-loaded.