Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2014
Observational StudyQuality of post-operative patient handover in the post-anaesthesia care unit: a prospective analysis.
Anaesthesiology plays a key role in promoting safe perioperative care. This includes the perioperative phase in the post-anaesthesia care unit (PACU) where problems with incomplete information transfer may have a negative impact on patient safety and can lead to patient harm. The objective of this study was to analyse information transfer during post-operative handovers in the PACU. ⋯ The study shows that post-operative handovers in the PACU are in most cases incomplete. It appears useful to optimise the post-operative handover process, for example by implementing a standardised handover checklist.
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Acta Anaesthesiol Scand · Feb 2014
Randomized Controlled TrialHeart rate variability dynamics during controlled hypotension with nicardipine, remifentanil and dexmedetomidine.
This study was done to investigate how nicardipine, remifentanil and dexmedetomidine affect the balance of the autonomic nervous system in patients receiving controlled hypotension under general anaesthesia by evaluating heart rate variability indices. ⋯ Remifentanil and dexmedetomidine did not have sympathetic nervous system-stimulating effects during controlled hypotension, while remifentanil seemed to be superior in preserving the overall balance in autonomic nervous system activity. Nicardipine was found to stimulate the sympathetic nervous system, which may be problematic in patients vulnerable to disturbances in the autonomic nervous system.
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Acta Anaesthesiol Scand · Feb 2014
Multicenter StudyAssessment of early cognitive recovery after surgery using the Post-operative Quality of Recovery Scale.
Cognitive problems early after surgery are often considered transient in nature. Neuropsychological performance and its relation to other recovery parameters have rarely been systematically assessed during this period. ⋯ Failure of cognitive recovery is reasonably common 3 days after surgery, can fluctuate and is associated with poorer early recovery in the activities of daily living, nociceptive and physiological domains.
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Acta Anaesthesiol Scand · Feb 2014
Review Meta AnalysisSingle dilator vs. guide wire dilating forceps tracheostomy: a meta-analysis of randomised trials.
Single dilator technique (SDT) and guide wire dilating forceps (GWDF) are the two most commonly used techniques of percutaneous dilatational tracheostomy (PDT) in critically ill adult patients. We performed a meta-analysis of randomised, controlled trials comparing intraoperative, mid-term and late complications of these two techniques. ⋯ GWDF technique is associated with a higher incidence of intraprocedural bleeding and of technical difficulties in completing the procedure (difficult cannula insertions/difficult dilations or failures) compared with the SDT technique. No differences were identified in mid-term and long-term complications. Further studies comparing SDT and GWDF in the general population and in subgroups of high-risk patients (like obese or hypoxaemic patients) are warranted.
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Acta Anaesthesiol Scand · Feb 2014
Randomized Controlled Trial Comparative StudyIntrathecal chloroprocaine vs. lidocaine in day-case surgery: recovery, discharge and effect of pre-hydration on micturition.
Spinal chloroprocaine may be more suitable for day-case surgery than lignocaine because of faster block resolution and time to discharge.
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