British journal of anaesthesia
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Randomized Controlled Trial Clinical Trial
Fast-tracking (bypassing the PACU) does not reduce nursing workload after ambulatory surgery.
Postoperative day-case patients are usually allowed to recover from anaesthesia in a postanaesthesia care unit (PACU) before transfer back to the day surgical unit (DSU). Bypassing the PACU can decrease recovery time after day surgery. Cost savings may result from a reduced nursing workload associated with the decreased recovery time. This study was designed to evaluate the effects of bypassing the PACU on patient recovery time and nursing workload and costs. ⋯ Bypassing the PACU after these short outpatient procedures significantly decreases recovery time without compromising patient satisfaction. However, the overall nursing workload and the associated cost were not significantly affected.
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Recent studies support the use of alpha-agonists during regional anaesthesia in uncomplicated term pregnancies. We hypothesized that ephedrine and phenylephrine, administered for maternal hypotension following fetal hypoxaemia, are equal in respect of fetal outcome. ⋯ Despite the more favourable effects on uterine and placental circulations of ephedrine over phenylephrine, no significant differences in fetal acid-base status or lactate concentrations were observed.
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To determine the effect of an intensive care management protocol on the intensive care unit (ICU) and hospital mortality of severely head-injured patients, we designed a longitudinal observational study of all patients admitted with a head injury between 1992 and 2000. ⋯ The introduction of an evidence-based protocol to guide the ICU management of patients with severe head injury has been associated with a significant reduction in both ICU and hospital mortality.
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Left ventricular stroke volume variation (SVV) has been shown to be a predictor of fluid responsiveness in various subsets of patients. However, the accuracy and reliability of SVV are unproven in patients ventilated with low tidal volumes. ⋯ In patients after CABG surgery who were ventilated with low tidal volumes, SVV enabled prediction of fluid responsiveness and assessment of the haemodynamic effects of volume loading.