Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Disruptive intraoperative behaviour has detrimental effects on clinicians, institutions, and patients. Abusive behaviour is an egregious form of disruptive behaviour that has a particular risk of detrimental consequences. The prevalence of abusive behaviour in the operating room (OR) is uncertain. We therefore examined the prevalence and frequency of exposure to abusive behaviour in a cohort of Canadian and US OR clinicians. ⋯ Both the number of clinicians who are exposed to abusive behaviour and the large number of reported events are concerning. Since these events can undermine team-work and affect patients, coworkers, and institutions, efforts are needed to further evaluate and manage the problem.
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Randomized Controlled Trial
Intravenous dexmedetomidine for the treatment of shivering during Cesarean delivery under neuraxial anesthesia: a randomized-controlled trial.
About 55% of patients undergoing a Cesarean delivery under spinal or epidural anesthesia will experience shivering, which may interfere with the monitoring of vital signs. Recent studies have shown that dexmedetomidine could potentially help to alleviate shivering associated with anesthesia. We investigated whether dexmedetomidine, an alpha 2-adrenergic agonist, reduces the duration of shivering associated with neuraxial anesthesia during Cesarean delivery. ⋯ A single intravenous bolus of dexmedetomidine decreased the duration of shivering for up to 15 min during Cesarean delivery under neuraxial anesthesia.
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Randomized Controlled Trial
Intravenous lidocaine in the management of chronic peripheral neuropathic pain: a randomized-controlled trial.
Neuropathic pain, resulting from injury to the peripheral or central nervous system, is due to upregulation of aberrant sodium channels with neuronal hyperexcitability. Lidocaine blocks these channels and several studies show that intravenous (IV) lidocaine infusion provides significant relief in patients with chronic peripheral neuropathic pain in the short term (for up to six hours). Our objective was to determine if IV lidocaine provides significant pain relief and overall improvement in quality of life in the longer term (for up to four weeks). ⋯ We found no significant long-term analgesic or quality of life benefit from IV lidocaine relative to control infusion for chronic peripheral neuropathic pain.
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Multicenter Study
Prevalence and predictors of exposure to disruptive behaviour in the operating room.
Disruptive intraoperative behaviour ranges from incivility to abuse. This behaviour can have deleterious effects on clinicians, students, institutions, and patients. Previous investigations of this behaviour used underdeveloped tools or small sampling frames. We therefore examined the prevalence and predictors of perceived exposure to disruptive behaviour in a multinational sample of operating room clinicians. ⋯ Perceived exposure to disruptive behaviour was prevalent and frequent, with the most common behaviours involving speaking ill of clinicians and patients. These perceptions, whether accurate or not, can result in detrimental consequences. Greater efforts are required to eliminate disruptive intraoperative behaviour, with recognition that specific groups are more likely to report experiencing such behaviours.
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Safe perioperative care remains a large public healthcare problem in low- and middle-income countries. Anesthesia care provided by trained professionals is one of the essential determinants to address this situation. This article reports the design and implementation of a focused anesthesia educational program for nurses in Chad. ⋯ This is a novel south-south academic cooperation program for nurses in Chad. The program evaluation indicated a high level of satisfaction, effective cognitive and skills learning, and changes in clinical behaviour. Addressing the lack of adequate provision of anesthesia care is a task still to be faced, and this program depicts a bridge alternative until formal educational programs are implemented in the country.