Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study
A randomized placebo-controlled trial of two doses of pregabalin for postoperative analgesia in patients undergoing abdominal hysterectomy.
Acute pain after open abdominal hysterectomy limits the function of patients in the postoperative period, but data regarding the analgesic efficacy of a low dose of pregabalin (75 or 150 mg) have been conflicting. This study was performed to determine if a low dose of pregabalin could decrease postoperative opioid use following abdominal hysterectomy when compared with placebo. ⋯ At the doses used in this study, pregabalin treatment may not be effective in reducing opioid use up to 24 hr postoperatively following abdominal hysterectomy. This trial was registered at www.ClinicalTrials.gov : NCT00781131.
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The dynamic change in arterial pulse pressure during mechanical ventilation (PPV) predicts fluid responsiveness in adults but may not be applicable to pediatric patients. We compared PPV during hemorrhage and reinfusion in immature vs mature piglets at two clinically relevant tidal volumes (VT). ⋯ Pulse pressure variability values are lower and less sensitive to VT in immature vs mature pigs. Adult PPV thresholds do not apply to pediatric patients, and a single PPV value representing fluid responsiveness should not be assumed.
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Multicenter Study
The influence of anesthesia-controlled time on operating room scheduling in Dutch university medical centres.
Predicting total procedure time (TPT) entails several elements subject to variability, including the two main components: surgeon-controlled time (SCT) and anesthesia-controlled time (ACT). This study explores the effect of ACT on TPT as a proportion of TPT as opposed to a fixed number of minutes. The goal is to enhance the prediction of TPT and improve operating room scheduling. ⋯ Efficient operating room (OR) management demands the accurate prediction of the times needed for all components of care, including SCT and ACT, for each surgical procedure. Supported by an extensive dataset from six UMCs, we advise grossing up the SCT by 33% to account for ACT (revised prediction of TPT = SCT × 1.33), rather than employing a methodology for predicting ACT based on a fixed number of minutes. This recommendation will improve OR scheduling, which could result in reducing overutilized OR time and the number of case cancellations and could lead to more efficient use of limited OR resources.