AANA journal
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The present study used a meta-analysis to examine 4 questions about intraoperative hypothermia. The questions addressed were as follows: (1) Is the difference in adverse patient outcomes between normothermic and mildly hypothermic patient groups significant across studies and within studies? (2) What is the magnitude of the difference in adverse patient outcomes across studies? (3) What are the costs resulting from the difference in adverse patient outcomes? (4) Does a significant difference exist in effectiveness of modality for maintaining intraoperative normothermia? The results of this meta-analytic study provide evidence that the difference in adverse patient outcomes between the normothermic and mildly hypothermic patients is significant across studies for all adverse outcomes examined. The magnitude of this difference and the costs resulting from these adverse outcomes are presented. ⋯ Meta-analytic results allowed us to conclude that hypothermia averaging only 1.5 degrees C less than normal resulted in cumulative adverse outcomes adding between $2,500 and $7,000 per surgical patient to hospitalization costs across a variety of surgical procedures. In conclusion, patients whose temperatures have been maintained at normal levels during the intraoperative period experience fewer adverse outcomes, and their overall hospital costs are lower. Intraoperative normothermia is maintained more effectively with the use of forced air warming.
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Randomized Controlled Trial Comparative Study Clinical Trial
Postoperative sore throat: incidence and severity after the use of lidocaine, saline, or air to inflate the endotracheal tube cuff.
Postoperative sore throat occurs in up to 90% of intubated patients and is the most common complaint of patients after endotracheal intubation. A recent study suggested that the use of lidocaine to inflate the endotracheal tube cuff would decrease the incidence of postoperative sore throat. The purpose of this prospective randomized study was to compare the incidence and severity of sore throat after using lidocaine, saline, or air to inflate the endotracheal tube cuff. ⋯ The researcher administered the verbal analogue scale, Melzack's Present Pain Intensity Scale of the McGill Pain Questionnaire, to the 75 participants at two intervals, 1 to 3 hours postoperatively and 22 to 25 hours postoperatively, to assess postoperative sore throat. Analysis using the Kruskal-Wallis test suggested that there was no statistical difference in postoperative sore throat among the 3 groups. Lidocaine, saline, and air had similar effects on postoperative sore throat.
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Electroconvulsive therapy (ECT) is an effective treatment for some types of depression and psychotic disorders. Although ECT is considered effective and relatively safe, the treatment team must know how to deal with adverse effects. The American Psychiatric Association recognizes no absolute contraindication except brain tumor with increased intracranial pressure. ⋯ Muscle relaxants, barbiturate anesthesia, anticholinergic agents, and oxygenation are used to reduce the risk of complications. The use of ECT requires a knowledge of the effect of anesthetic agents on seizure activity. This article reviews ECT, anesthesia for ECT, and the effect of propofol and methohexital on seizure duration and seizure efficacy.