Anaesthesia
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Randomized Controlled Trial Multicenter Study Clinical Trial
Dreaming during anaesthesia in patients at high risk of awareness.
Dreaming during anaesthesia is commonly reported but remains poorly understood. In this study, adult surgical patients at high risk of awareness were randomly assigned to receive bispectral index (BIS)-guided anaesthesia or routine care, and were interviewed about dreaming three times postoperatively. Dreaming patients (n = 134) were compared with all other patients who were interviewed at least once (n = 2251). ⋯ Fewer BIS-monitored patients reported intra-operative dreaming at 2-4 h than control patients (2.7% vs. 5.7%; p = 0.004). Reports of dreaming were similar in the two groups at 24-36 h and 30 days. Dreaming patients were younger (p = 0.001); healthier (p < 0.001) and more likely to be women (p < 0.001), and were less satisfied with anaesthetic care (p = 0.004) than other patients.
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Letter Case Reports
Failure to open outer casing of prefilled succinylcholine syringe.
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There is an increasing recognition that medication errors are causing a substantial global public health problem, as many result in harm to patients and increased costs to health providers. However, study of medication error is hampered by difficulty with definitions, research methods and study populations. ⋯ Steps are being taken to determine the extent of the problem of medication error in anaesthesia. New technology, theories of human error and lessons learnt from the nuclear, petrochemical and aviation industries are being used to tackle the problem.