Acta anaesthesiologica Belgica
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Acta Anaesthesiol Belg · Jan 2001
ReviewTransition between anesthesia and post-operative analgesia: relevance of intra-operative administration of analgesics.
The rapid awakening without residual analgesic effect seen with the new "fast-in-fast-out" anesthetic agents forces us to anticipate post-operative pain management. More then ever, "balanced analgesia" appears the key for successful transition between anesthesia and post-operative analgesia. This review focuses on practical aspects seeking to answer the following questions: which analgesics should be used?; how should they be given?; at what stage of the anesthetic time should they be injected? In the absence of a loco-regional technique, analgesics must be given before the end of surgery to obtain a quiet awakening. ⋯ All non-opioid analgesics (propacetamol, NSAIDs, tramadol) must be given according to their pharmacokinetic characteristics, indications and contraindications to ensure the required analgesic effect is effective at the time of awakening. If tramadol is not used, an initial dose of a long-acting opioid should be given 20-30 minutes before the end of surgery. Insufficient analgesia must be corrected by titrating an opioid intravenously before allowing the patient to control his/her analgesia using a PCA pump.
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Acta Anaesthesiol Belg · Jan 2001
Safety first--five years later. Belgian standards for patient safety in anaesthesia revisited.
Belgian Standards for Patient Safety in Anaesthesia, established in 1989 by a joint effort of the Belgian Professional Association of Anesthesiologists and the Belgian Scientific Society of Anaesthesia and Resuscitation, were intended to be fully implemented within hospital practice by January 1st, 1995. In order to gather follow-up data with regard to this deadline, the Professional Association of Anesthesiologists conducted a survey in 1995: a questionnaire was circulated to all Belgian anaesthetists in order to evaluate the extent to which these guidelines had been implemented in clinical practice and to determine the areas in which residual noncompliance remained. 71% of responders complied with the safety guidelines as far as monitoring in the operating room was concerned. ⋯ The survey reveals that 65% of responders do not totally comply with this guideline of continuous attendance by a doctor. Many of them propose professional assistance by nursing staff with a specific education and training in anaesthesia.
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Acta Anaesthesiol Belg · Jan 2001
Randomized Controlled Trial Clinical TrialComparative study of the TOF-ratio measured by the ParaGraph versus the TOF-Guard, with and without thumb repositioning.