European journal of anaesthesiology. Supplement
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In the future we may anticipate continued efforts to define standards addressing anaesthesia equipment, organization, and the qualification of personnel. Many standards will be revised and/or expanded, as experience with these standards accumulates. In addition to these external standards, we foresee efforts to seek consensus among clinicians on the definition of appropriate clinical patterns. In the long run, these efforts to define practice guidelines may lead to re-assessment of what and how we teach newcomers to anaesthesia, and how to assess the quality of anaesthesia care.
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The International Task Force on Anaesthesia Safety was formed in 1989 to institute a new international effort to improve anaesthesia safety worldwide. Membership was by invitation to individuals with strong credentials in the anaesthesia safety movement in their own countries. ⋯ Consultation from a variety of individuals and groups not represented on the Task Force was actively sought. In June 1992, the World Federation of Societies of Anaesthesiologists adopted the Task Force's international standards document and commended it to its 98 member societies worldwide.
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Recent advances have reduced the risks of anaesthesia to a virtually immeasurable level. However, if the specialty wishes to continue to foster support, it will require active promotion of the benefits, not hazards, of our practice. The few published surveys of the image of the anaesthetist show that the public poorly understands either our background training or education, or the responsibility we bear in their care. ⋯ It is certain that we cannot tolerate the sensationalized tragedies resulting from anaesthetic neglect in bygone years; we must effectively discipline ourselves if standards are not being met. We should lose no opportunity to become involved outside the operating room, whether in pre-admission clinics, pain management, obstetrics, critical care, or by becoming actively involved as full members of the medical staff. Doing so will further our professional image in the eyes of other physicians and, ultimately, the public we seek to influence.
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Eur J Anaesthesiol Suppl · Nov 1992
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialOndansetron in the treatment of postoperative nausea and vomiting in ambulatory outpatients: a dose-comparative, stratified, multicentre study.
The safety and efficacy of ondansetron were evaluated in the treatment of postoperative nausea and vomiting. Five hundred patients who experienced nausea or vomiting in the Post-Anaesthesia Care Unit within the first 2 h of recovery were randomized to receive either 1, 4, or 8 mg of ondansetron, or placebo. All patients had undergone ambulatory surgery with general endotracheal anaesthesia. ⋯ The optimal dose of ondansetron for the treatment of postoperative nausea and vomiting was found to be 4 mg. All doses of ondansetron were well tolerated. No clinically significant increases in laboratory parameters or alterations in haemodynamic stability occurred in the ondansetron groups compared to placebo.
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Eur J Anaesthesiol Suppl · Nov 1992
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialProphylactic intravenous ondansetron in female outpatients undergoing gynaecological surgery: a multicentre dose-comparison study.
The efficacy and safety of prophylactic intravenous ondansetron in preventing postoperative nausea and vomiting was investigated in a randomized, stratified, double-blind, placebo-controlled, dose-comparison study of 580 ASA physical class I and II female outpatients undergoing gynaecological surgery and receiving general anaesthesia. Patients received either ondansetron 1, 4 or 8 mg, or placebo i.v. immediately prior to a standardized technique for induction and maintenance of anaesthesia. All patients were intubated and received nitrous oxide and a narcotic. ⋯ Ondansetron was generally well tolerated, as evidenced by an adverse event, laboratory safety, and vital sign profile similar to placebo. Ondansetron 4 mg was found to be the optimal prophylactic i.v. dose for female outpatients over the entire 24 h postoperative period. Higher doses may offer an added benefit in some patients, such as those with a history of nausea and vomiting following general anaesthesia.