Surgery
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Calls are increasing for physicians to disclose harmful medical errors to patients, but little is known about how physicians perform this challenging task. For surgeons, communication about errors is particularly important since surgical errors can have devastating consequences. Our objective was to explore how surgeons disclose medical errors using standardized patients. ⋯ The patient safety movement calls for disclosure of medical errors, but significant gaps exist between how surgeons disclose errors and patient preferences. Programs should be developed to teach surgeons how to communicate more effectively with patients about errors.
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Randomized Controlled Trial Comparative Study
Superiority of postoperative epidural over intravenous patient-controlled analgesia in orthopedic oncologic patients.
Surgery for bone malignancy is associated with intense postoperative pain. Patient-controlled epidural analgesia (PCEA) and intravenous patient-controlled analgesia (IV-PCA) are used currently for postoperative pain control. ⋯ Postoperative ropivacaine + fentanyl via PCEA reduces pain better and affords better subjective feelings than IV morphine via PCA after resection of bone malignancy carried out under combined general and epidural anesthesia.