Journal of clinical anesthesia
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Comparative Study
Effectiveness of an acute pain service inception in a general hospital.
To assess the effects of an Acute Pain Service (APS) inception on postoperative pain management in a general teaching hospital using pain indicators as performance measures. ⋯ This study validates the benefits of a formal APS, using continuous monitoring of rest pain intensity and analgesic consumption in the postoperative period. Results not only support previous research findings but also offer outcome-based tools to evaluate current practices as compared with desired outcomes.
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To examine whether the establishment of dedicated pediatric operating rooms (ORs) staffed exclusively by pediatric anesthesiologists has had a significant impact on anesthetic efficiency during surgery. ⋯ The establishment of dedicated pediatric ORs resulted in significantly shorter anesthesia induction and emergence times. Furthermore, the decreased variability of anesthesia-controlled time may allow for better scheduling of surgical cases and for better surgeon and patient satisfaction.
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Randomized Controlled Trial Comparative Study Clinical Trial
Ondansetron/promethazine combination or promethazine alone reduces nausea and vomiting after middle ear surgery.
To determine the incidence of postoperative nausea and vomiting when a combination of ondansetron and promethazine is given prophylactically, and to ascertain the effect of postoperative nausea and vomiting on recovery room duration and patient satisfaction. ⋯ The prophylactic use of an antiemetic with middle ear surgery may reduce postoperative nausea and vomiting over 24 hours, and the ondansetron/promethazine combination or promethazine alone are cost-effective choices. Finally, the combination reduced significantly the severity of vomiting.
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Randomized Controlled Trial Clinical Trial
Hemodynamic response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with different concentrations of sevoflurane.
To evaluate the blood pressure (BP) and heart rate (HR) response to tracheal intubation after vital capacity rapid inhalation induction (VCRII) with four concentrations of sevoflurane followed by nitrous oxide (N2O) 50% and sevoflurane in concentrations administered by clinical judgment. ⋯ VCRII with sevoflurane 3% to 6% following fentanyl 3 micrograms/kg can be considered for blunting the hemodynamic response to tracheal intubation in healthy patients.
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To determine whether using only previous cases' surgical times for predicting accurately surgical times of future cases is likely to reduce the average length of time cases finish late (after their scheduled finish times). ⋯ An OR manager considering using only historical surgical times to estimate future surgical times should first investigate, using data from their own surgical suite, what percentage of cases do not have historical data. Even if there are sufficient historical data to estimate future surgical times accurately, relying solely on historical times is probably an ineffective strategy to have future cases finish on time.