Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2013
Randomized Controlled TrialEffect of an anaesthesia information video on preoperative maternal anxiety and postoperative satisfaction in elective caesarean section: a prospective randomised trial.
Video-based patient information supplementing clinician interview has been shown to reduce anxiety and improve satisfaction in patients undergoing procedures. In Queensland more than 90% of caesarean sections are performed under regional anaesthesia. We aimed to assess the effect of using an information video about neuraxial blockade in patients having regional anaesthesia for elective caesarean section. ⋯ There was no difference in anxiety score (41.2 versus 39.8, P=0.50), maternal satisfaction score (118.5 versus 122.7, P=0.22) or interview duration (16.3 versus 15.8 min, P=0.69) between the two groups. The use of an anaesthesia information video does not reduce preoperative anxiety or increase the duration of the anaesthetic interview. Maternal satisfaction with neuraxial blockade for elective caesarean is high and not improved by an anaesthesia information video.
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Anaesth Intensive Care · Nov 2013
Case ReportsUtility of thromboelastography in managing acquired Factor VIII inhibitor associated massive haemorrhage.
Disorders of clotting and coagulation are common in the intensive care unit. Diagnosis, treatment and monitoring of these disorders are traditionally based on conventional coagulation tests such as activated partial thromboplastin time (APTT) and international normalised ratio (INR). We present here a patient who developed massive postoperative haemorrhage secondary to an acquired factor VIII inhibitor. The case highlights the utility and sensitivity of thromboelastography (TEG) in the diagnosis of the condition and monitoring the response to therapy.
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Anaesth Intensive Care · Nov 2013
Intraoperative hypothermia is associated with an increased intensive care unit length-of-stay in patients undergoing elective open abdominal aortic aneurysm surgery: a retrospective cohort study.
Intraoperative hypothermia in open elective abdominal aortic aneurysm repair may be associated with increased hospital morbidity. This retrospective, single centre study investigated whether there was an association between intraoperative hypothermia in open elective abdominal aortic aneurysm repair and postoperative in-hospital morbidity. The data of 119 patients who underwent open infrarenal abdominal aortic aneurysm repair between January 2006 and January 2011 were collected. ⋯ Intraoperative temperature was not predictive of hospital length-of-stay or any of the other perioperative complications such as acute renal failure, acute respiratory complications, acute myocardial infarction, transfusion requirements or postoperative infection. In the normothermic group, the number of hours in the intensive care unit was 35% lower (ratio of means=0.65; 95% confidence interval 0.51 to 0.84; P=0.0008), even after adjusting for possible confounders such as age, duration of anaesthesia, size of aneurysm, comorbidities and transfusion. Intraoperative hypothermia is a persisting problem and more aggressive warming strategies may need to be identified and employed to achieve normothermia.
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The primary objective of this survey was to investigate the prevalence of insomnia among anaesthetists in Hong Kong. The use of sleeping aids, factors associated with insomnia and the effect of insomnia on work performance were also studied. We surveyed all locally registered anaesthesia specialists and trainees by post. ⋯ However, it was not associated with the tendency to fall asleep at work. The results of this survey suggest that insomnia is a common problem among the anaesthetists of Hong Kong. By restricting the amount of on-call duty and improving relationships with supervisors, the prevalence of insomnia may be reduced and the quality of patient care improved.