Anesthesiology Commons^™

Duration Of Cessation Of Smoking Before Elective Surgery: Impact On Intraoperative Hemodynamics And Early Postoperative Pain In Developing Country, Mohsin Nazir, Gauhar Afshan, Muslima Ejaz, Amir Raza

Department of Anaesthesia

Aim and Background: It is estimated that up to 20% of patients coming for elective surgery are smokers and carry a risk of perioperative complications. Though smoking cessation and its impact on perioperative outcome are widely investigated worldwide we were unable to find any data in Pakistan. The objective of the study is to determine the impact of the duration of smoking cessation before elective surgery on intraoperative hemodynamics and postoperative pain in Pakistani population.
Methods: It was a prospective cohort study conducted at the Aga Khan University Hospital Karachi, Pakistan, for one-year duration. A total of 260 patients scheduled …

Persistent Post-Surgical Pain Following Breast Cancer Surgery: An Observational Study In A Tertiary Care Hospital, Ali Sarfraz Siddiqui, Sana Zeeshan, Aliya Ahmed, Shaista Khan

Department of Anaesthesia

Objective: To determine the frequency of persistent pain in patients after breast cancer surgery, and to assess the distribution and characteristics of pain in such patients.
Methods: The prospective observational single cohort study was conducted at the Department of Anaesthesiology and in the Breast Clinic of the Department of Surgery, Aga Khan University Hospital, Karachi, from August 2016 to January 2017, and comprised adult female patients with biopsy-proven carcinoma of breast who were scheduled for elective definitive breast cancer surgery. The patients were followed up for up to three months post-surgery and those with persistent pain were followed up for …

Epidemiological Characteristics, Ventilator Management, And Clinical Outcome In Patients Receiving Invasive Ventilation In Intensive Care Units From 10 Asian Middle-Income Countries (Provent-Imic): An International, Multicenter, Prospective Study, Luigi Pisani, Anna Geke Algera, Ary Serpa Neto, Areef Ahsan, Abigail Beane, Kaweesak Chittawatanarat, Abul Faiz, Rashan Haniffa, Seyed Mohammadreza Hashemian, Madiha Hashmi

Department of Anaesthesia

Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [V T] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, …

Blood Pressure Monitoring Following Individual Carpules Of Anesthetic Utilizing Computer-Controlled Anesthetic Delivery, Kristi M. Soileau, Adam E. Degenova, Qingzhao Yu

School of Dentistry Faculty Publications

To date, no study has evaluated blood pressure following administration of each carpule given for dental procedures using a computerized dental anesthesia system. Blood pressures taken prior to performing invasive periodontal procedures were compared with those readings measured following delivery of each of up to three consecutive carpules of Marcaine or Xylocaine in varying order. Pressure differences were also adjusted for age, sex, race, and whether a prescribed anxiolytic was taken beforehand. Neither systolic nor diastolic blood pressures changed significantly as compared to initial blood pressure readings. However, compared with Whites, Hispanics, and Middle Easterners, Blacks had significantly higher systolic …

The Effect Of The Implementation Of A Quarterly Triad Tool In The Pain Clinic Setting On The Assessment And Mitigation Of Risks In Patients On Chronic Opioid Therapy, Caroline Asava

Evidence-Based Practice Project Reports

The concurrent use of opioids and benzodiazepines (BZDs poses a formidable challenge for clinicians who manage chronic pain. While the escalating use of opioid analgesics for the treatment of chronic pain and the concomitant rise in opioid-related abuse and misuse are widely recognized trends, the contribution of combination use of BZDs, alcohol, and/or other sedative agents to opioid-related morbidity and mortality is underappreciated, even when these agents are used appropriately. Patients with chronic pain who use opioid analgesics along with BZDs have a defined increase in rates of adverse events, overdose, and death, warranting close monitoring. To improve patient outcomes, …

Changing Healthcare Provider And Parent Behaviors In The Pediatric Post‐Anesthesia‐Care‐Unit To Reduce Child Pain: Nurse And Parent Training In Postoperative Stress (Np‐Tips), Brooke N. Jenkins, Michelle Fortier, Robert S. Stevenson, Mai Makhlouf, Paulina Lim, Remy Converse, Zeev N. Kain

Psychology Faculty Articles and Research

Background

Children who undergo surgery experience significant pain in the post anesthesia care unit. Nurse and parent behaviors in the post anesthesia care unit directly impact child postoperative pain. Therefore, we have developed and evaluated (Phase 1) and then tested (Phase 2) the feasibility of a new intervention (Nurse and Parent Training in Postoperative Stress) to alter parent and nurse behaviors in a way consistent with reducing child postoperative pain.

Methods

In Phase 1, a multidisciplinary team of experts (physicians, nurses, and psychologists) developed an empirically‐based intervention which was then evaluated by experienced nurses (N = 8) and parents …

Outcomes Reporting In Regional Anesthesia Patients: A Comparison Of Manual Phone Calls Versus Automated Phone App Messaging, Gavyn Ooi, Mba, Eric Schwenk, Md, Fasa, Jeffrey Mojica, Do, Alexander Grant, Md, Max Shilling, Md, David Barnabei, Md, Jennifer Lessin, Ba, Rn, Ccrc, Marc Torjman, Phd, Kent Berg, Md, Mba

Phase 1

Automation of patient follow-up via mobile phone apps have the potential to save time for physicians, standardize responses from patients, and increase the patient response rate. Studies that assess the effectiveness of mobile phone-based surveys have been favorable, with completion rates of about 60% in the surgical population. The impact of mobile phone-based patient management in anesthesia deserves further study. This study examines the follow-up success rates of (1) manual phone calls (the current standard of care) vs. (2) automated patient outreach (APO) in patients who receive a regional anesthesia block procedure.

As part of normal follow up, anesthesia team …

Patient Perceptions And Expectations About Postoperative Analgesia, Carrie Mok, Nirmal Shah, Do, Stephen F. Goldberg, Md, Amir C. Dayan, Md, Marc Torjman, Phd, Jaime L. Baratta, Md

Phase 1

Introduction

Opioid overdose deaths have nearly quadrupled since 1999. Nearly 2 out of 3 persons being prescribed medications are prescribed an opioid. Physicians may be prescribing opioids for more than what is required for postoperative pain control, leading to increased risk for opioid abuse and addiction. Patient perceptions of perioperative pain medications are poorly understood.

Objective

This survey aims to understand patient expectations of perioperative analgesics.

Methods

Following IRB approval, patients 18 years of age or older, were given a 13-question survey prior to their surgery at Thomas Jefferson University Hospital, to evaluate the perception of pain medications, medication efficacy, …

Anaesthesia Error In United States: Reasons For Mismanagement, Abby Wolfe, Anh Nguyen, Ashleigh Galles, Madison Wolfe, Ben Lundberg

Posters and Presentations: College of Public Health

A poster from the UNMC Undergraduate Public Health Workshop

Monitoring Intra-Abdominal Pressure : Should It Be A Routine For Critically Ill?, Madiha Hashmi

Department of Anaesthesia

No abstract provided.

Remote Video Auditing With Real-Time Feedback In An Academic Surgical Suite Improves Safety And Efficiency Metrics: A Cluster Randomised Study, F. J. Overdyk, O. Dowling, S. Newman, D. Glatt, M. Chester, D. Armellino, B. Cole, G. S. Landis, D. Schoenfeld, J. F. Dicapua

Journal Articles

IMPORTANCE: Compliance with the surgical safety checklist during operative procedures has been shown to reduce inhospital mortality and complications but proper execution by the surgical team remains elusive. OBJECTIVE: We evaluated the impact of remote video auditing with real-time provider feedback on checklist compliance during sign-in, time-out and sign-out and case turnover times. DESIGN, SETTING: Prospective, cluster randomised study in a 23-operating room (OR) suite. PARTICIPANTS: Surgeons, anaesthesia providers, nurses and support staff. EXPOSURE: ORs were randomised to receive, or not receive, real-time feedback on safety checklist compliance and efficiency metrics via display boards and text messages, followed by a …

The Accuracy Of Nitrous Oxide Passive Dosimeters As Compared With An Infra-Red Spectrographic Reference Method, Susan Allen

Community & Environmental Health Theses & Dissertations

Nitrous oxide is a gas often used in dental, surgical and veterinary operations as an anesthetic agent. Employees stationed in proximity of fugitive gas emissions may potentially suffer adverse health effects from chronic exposure to this agent. Passive dosimeters can be worn in the breathing zone of potentially affected personnel during exposure periods, then later analyzed to quantify nitrous oxide exposure. This study sought to establish the accuracy of several commercially available passive monitoring devices for nitrous oxide by comparison against an infra-red spectrophotometric reference method.

A Comparison Of Four Muscle Relaxant Techniques And Their Incidence Of Postoperative Myalgia In Ambulatory Patients, William James Garske Jr.

Community & Environmental Health Theses & Dissertations

Postoperative myalgia was measured 24 and 72 hours following the administration of four different anesthetic regimens to 36 patients undergoing outpatient or 23-hour admission procedures. Each patient, ASA class I or II, was to undergo procedures of limited duration, 30 to 90 minutes, and surgical stimulation, including procedures such as knee arthroscopy, hernia repair, and breast biopsy. Anesthesia was induced with propofol 1.5 mg/kg, fentanyl 50 mcg, and maintained with O₂ , N₂O, and isoflurane. Group I (n=20), the control, received no muscle relaxant and was maintained with mask ventilation. Group II (n=5) received succinylcholine 1.5 mg/kg …

The Degree Of Exposure To Anesthetic Nitrous Oxide Waste Gas In The Operating Room During Various Surgical Procedures, Kathryn Ann Longworth

Community & Environmental Health Theses & Dissertations

Halsey (1991) summarized the underlying reasons for continuing concern about the problem of waste anesthetic gases. Careful and systematic monitoring studies indicate that individual trends in anesthetic pollution levels are not as low as was confidently predicted 10 years ago, when scavenging devices became commonplace. Second, there are now clear legal requirements for assessment of the situation. It is estimated that each year more than 200,000 health professionals are occupationally at risk of illness as a consequence of chronic exposure to low doses of waste anesthetic gases (Rogers, 1986).

These contaminants are suspected pf being ~eratogenic, carcinogenic, mutagenic, and embryo-lethal. …

A History Of Anesthesia, H. R. Mattern

Henry Ford Hospital Medical Journal

No abstract provided.

Narcotic Drugs In The Postanesthetic Recovery Room, John W. Ditzler, Paul R. Dumke, Beverly Collier

Henry Ford Hospital Medical Journal

No abstract provided.

Physiological Trespass In Anesthesia, John W. Ditzler

Henry Ford Hospital Medical Journal

No abstract provided.

Newer Agents For The Anesthesiologist, Paul R. Dumke

Henry Ford Hospital Medical Journal

No abstract provided.