AANA journal
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There is an absence of systematic study regarding the authenticity of the simulation experience in anesthesia except for bias prone "participant perception" assessments. Forty-two senior level graduate nurse anesthesia students were videotaped as they were exposed to short (20-30 minutes) but intense simulated crisis situations. Three observers with intimate knowledge of the operating room (OR) evaluated the films using a pilot-tested authenticity tool. ⋯ There was concern that the brevity of the scenarios did not reflect the realities of patient care during procedures of average length. Simulation is likely of maximal benefit if the participant perceives it as legitimate and authentic. Our study indicates the authenticity of anesthesia simulation is in evolution with much potential for improvement.
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Randomized Controlled Trial Comparative Study Clinical Trial
A comparison of rocuronium and lidocaine for the prevention of postoperative myalgia after succinylcholine administration.
The incidence of postoperative myalgia (POM) after succinylcholine administration has been reported to range from 5% to 83%. The administration of small doses of nondepolarizing muscle relaxants or lidocaine before the administration of succinylcholine has been shown to decrease the incidence and severity of POM experienced by patients. The purpose of this investigation was to compare the severity of POM in subjects receiving pretreatment with rocuronium or lidocaine. ⋯ Of the lidocaine group, 21 (72%) of 29 reported no myalgia at 48 hours compared with only 9 (38%) of 24 in the rocuronium group (P = 0.023). Satisfaction was similar between the groups. Based on the results of this study, pretreatment with lidocaine may provide better relief from myalgia than rocuronium at 48 hours after surgery.
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Anesthesia outcomes and related risk factors have been studied for more than 100 years. Varying sample sizes and research methods have been used, with research findings that were open to multiple interpretations. Research with closed malpractice claims demonstrates that American Society of Anesthesiologists physical status II patients undergoing elective procedures are most likely to experience damaging events intraoperatively with resultant postoperative adverse outcomes. ⋯ These files were analyzed by 10 CRNA investigators on the AANA Closed Claims research team. Variables such as inadequate preinduction activities, e.g., incomplete preanesthetic assessments, and use of cognitive biases and inaccurate probability estimation were associated with adverse outcomes in this research sample. Teaching of decision science in basic and continuing nurse anesthesia education is advocated.