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121. Bispectral index score and observer's assessment of awareness/sedation score may manifest divergence during onset of sedation: Study with midazolam and propofol. Full Text available with Trip Pro

Bispectral index score and observer's assessment of awareness/sedation score may manifest divergence during onset of sedation: Study with midazolam and propofol. Correlation between the clinical and electroencephalogram-based monitoring has been documented sporadically during the onset of sedation. Propofol and midazolam have been studied individually using the observer's assessment of awareness/sedation (OAA/S) score and Bispectral index score (BIS). The present study was designed to compare

2013 Indian journal of anaesthesia Controlled trial quality: uncertain

122. Two cases of medically-refractory spontaneous orthostatic headaches with normal cerebrospinal fluid pressures responding to epidural blood patching: Intracranial hypotension versus hypovolemia and the need for clinical awareness Full Text available with Trip Pro

Two cases of medically-refractory spontaneous orthostatic headaches with normal cerebrospinal fluid pressures responding to epidural blood patching: Intracranial hypotension versus hypovolemia and the need for clinical awareness The diagnosis of spontaneous intracranial hypotension or cerebrospinal fluid (CSF) hypovolemia syndrome requires a high index of suspicion and meticulous history taking, demonstration of low CSF pressure and/or neuroimaging features. A 31-year-old male, presented

2013 Annals of Indian Academy of Neurology

123. Cataract Surgery Planning in Amblyopic Patients – Which eye first? Awareness of the Potential for Post-operative Diplopia amongst Consultant Ophthalmic Surgeons in Wales Full Text available with Trip Pro

Cataract Surgery Planning in Amblyopic Patients – Which eye first? Awareness of the Potential for Post-operative Diplopia amongst Consultant Ophthalmic Surgeons in Wales To explore the views of consultant ophthalmic surgeons in Wales in the context of planning cataract surgery in patients with amblyopia. To compare prevailing views and preferences with recommendations in published literature.A cross-sectional survey was conducted in which all consultant ophthalmologists working in Wales were (...) was warranted.These results indicate that awareness of post-cataract surgery diplopia, and in particular fixation switch diplopia, is not widespread amongst consultant ophthalmic surgeons in Wales.

2013 The Ulster medical journal

124. A Multifaceted Initiative to Improve Clinician Awareness of Pain Management Disparities. (Abstract)

A Multifaceted Initiative to Improve Clinician Awareness of Pain Management Disparities. Patients belonging to some racial, ethnic, and socioeconomic groups are at risk of receiving suboptimal pain management. This study identifies health care provider attitudes, knowledge, and practices regarding the treatment of chronic pain in vulnerable patient populations and assesses whether a certified continuing medical education (CME) intervention can improve knowledge in this area. Survey responses

2013 American Journal of Medical Quality

125. A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK. Full Text available with Trip Pro

A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK. As part of the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland concerning accidental awareness during general anaesthesia, we issued a questionnaire to every consultant and staff and associate specialist anaesthetist in the UK. The survey was designed to ascertain (...) the number of new cases of accidental awareness that became known to them, for patients under their direct or supervised care, for a calendar year, and also to estimate how many cases they had experienced during their careers. The survey also asked about use of monitoring designed to measure the depth of anaesthesia. All local co-ordinators responsible for each of 329 hospitals (organised into 265 'centres') in the UK responded, as did 7125 anaesthetists (82%). There were 153 new cases of accidental

2013 Anaesthesia

126. A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK. Full Text available with Trip Pro

A national survey of anaesthetists (NAP5 Baseline) to estimate an annual incidence of accidental awareness during general anaesthesia in the UK. As part of the 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland concerning accidental awareness during general anaesthesia, we issued a questionnaire to every consultant and staff and associate specialist anaesthetist in the UK.The survey was designed to ascertain (...) the number of new cases of accidental awareness that became known to them, for patients under their direct or supervised care, for a calendar year, and also to estimate how many cases they had experienced during their careers. The survey also asked about use of monitoring designed to measure the depth of anaesthesia.All local co-ordinators responsible for each of 329 hospitals (organised into 265 'centres') in the UK responded, as did 7125 anaesthetists (82%). There were 153 new cases of accidental

2013 British Journal of Anaesthesia

127. Assessment of Intraoperative Awareness with Explicit Recall: A Comparison of 2 Methods. (Abstract)

Assessment of Intraoperative Awareness with Explicit Recall: A Comparison of 2 Methods. Superiority of the modified Brice interview over quality assurance techniques in detecting intraoperative awareness with explicit recall has not been demonstrated definitively.We studied a single patient cohort to compare the detection of definite awareness using a single modified Brice interview (postoperative day 28-30) versus quality assurance data (postoperative day 1).The incidence of awareness based (...) on the modified Brice interview was 19 per 18,847 or 0.1%. Fewer awareness cases (incidence 0.02%) were detected by the quality assurance approach (P < 0.0001).The modified Brice interview is the preferred modality for assessing intraoperative awareness with explicit recall.

2013 Anesthesia and Analgesia Controlled trial quality: uncertain

128. Factors that impact on the use of mechanical ventilation weaning protocols in critically ill adults and children: a qualitative evidence-synthesis. Full Text available with Trip Pro

of mechanical ventilation, but there was significant heterogeneity in study findings. Growing awareness of the benefits of understanding the contextual factors impacting on effectiveness has encouraged the integration of qualitative evidence syntheses with effectiveness reviews, which has delivered important insights into the reasons underpinning (differential) effectiveness of healthcare interventions.1. To locate, appraise and synthesize qualitative evidence concerning the barriers and facilitators

2016 Cochrane

129. Second thoughts about palliative sedation

‘When I use a word,’ Humpty Dumpty said, ‘it means just what I choose it to mean—neither more nor less’. ‘The question is,’ said Alice, ‘whether you can make words mean so many different things’. (Carroll L 1872. Alice through the looking glass) Palliative sedation is a term used to describe the use of sedative drugs in dying patients to induce a state of decreased or absent awareness (unconsciousness) in order to relieve intolerable suffering from refractory symptoms. 1 , 2 Perhaps, for many of us

2017 Evidence-Based Nursing

130. Long-term clinical effectiveness of continuous positive airway pressure therapy versus non-invasive ventilation therapy in patients with obesity hypoventilation syndrome: a multicentre, open-label, randomised controlled trial. (Abstract)

through an electronic database, to receive treatment with either non-invasive ventilation or continuous positive airway pressure. Both investigators and patients were aware of the treatment allocation. The research team was not involved in deciding hospital treatment, duration of treatment in the hospital, and adjustment of medications, as well as adjudicating cardiovascular events or cause of mortality. Treating clinicians from the routine care team were not aware of the treatment allocation

2019 Lancet Controlled trial quality: predicted high

131. Tissue Adhesive for Wound Closure Reduces Immediate Postoperative Wound Dressing Changes After Primary TKA: A Randomized Controlled Study in Simultaneous Bilateral TKA Full Text available with Trip Pro

Tissue Adhesive for Wound Closure Reduces Immediate Postoperative Wound Dressing Changes After Primary TKA: A Randomized Controlled Study in Simultaneous Bilateral TKA Prolonged wound drainage after TKA is associated with increased risk of infection. To decrease wound drainage, tissue adhesive has been suggested as an adjunct to wound closure after TKA; however, no studies of which we are aware have investigated the effect of tissue adhesive in a modern fast-track TKA setting.The purpose

2019 EvidenceUpdates

132. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial. Full Text available with Trip Pro

herniorrhaphy, without previous exposure to general anaesthesia or risk factors for neurological injury. Patients were randomly assigned (1:1) by use of a web-based randomisation service to receive either awake-regional anaesthetic or sevoflurane-based general anaesthetic. Anaesthetists were aware of group allocation, but individuals administering the neurodevelopmental assessments were not. Parents were informed of their infants group allocation upon request, but were told to mask this information from

2019 Lancet Controlled trial quality: predicted high

133. Effect of Electroencephalography-Guided Anesthetic Administration on Postoperative Delirium Among Older Adults Undergoing Major Surgery: The ENGAGES Randomized Clinical Trial. Full Text available with Trip Pro

included anesthetic concentration, EEG suppression, and hypotension. Adverse events included undesirable intraoperative movement, intraoperative awareness with recall, postoperative nausea and vomiting, medical complications, and death.Of the 1232 randomized patients (median age, 69 years [range, 60 to 95]; 563 women [45.7%]), 1213 (98.5%) were assessed for the primary outcome. Delirium during postoperative days 1 to 5 occurred in 157 of 604 patients (26.0%) in the guided group and 140 of 609 patients (...) time with mean arterial pressure below 60 mm Hg (7 vs 7 minutes; difference, 0.0 [95% CI, -1.7 to 1.7]). Undesirable movement occurred in 137 patients (22.3%) in the guided and 95 (15.4%) in the usual care group. No patients reported intraoperative awareness. Postoperative nausea and vomiting was reported in 48 patients (7.8%) in the guided and 55 patients (8.9%) in the usual care group. Serious adverse events were reported in 124 patients (20.2%) in the guided and 130 (21.0%) in the usual care

2019 JAMA Controlled trial quality: predicted high

134. End-tidal Control software for use with Aisys closed circuit anaesthesia systems for automated gas control during general anaesthesia

and the Royal College of Anaesthetists reported 153 cases of accidental awareness during general anaesthesia (including people anaesthetised by inhalational anaesthesia as well as other techniques) in the UK in 2011, representing a risk of 1 in 15,414 general anaesthesia procedures (Pandit et al. 2013). Automating the process of monitoring and adjusting gas concentrations shortens anaesthetic induction and results in steadier arterial and brain anaesthetic concentrations, stabilising the level (...) manually by continually altering the fraction of inspired gases, fresh gas flow and vaporiser settings to ensure optimal anaesthesia delivery (T ay et al. 2013) while minimising anaesthetic waste. This approach can be automated using the GE Healthcare Aisys Carestation or Aisys CS 2 . NICE is aware of the following devices that appear to fulfil a similar function to the GE Healthcare End-tidal Control automated gas control option on Aisys anaesthesia delivery systems: Zeus IE anaesthesia system

2014 National Institute for Health and Clinical Excellence - Advice

135. Nitrous oxide-based versus nitrous oxide-free general anaesthesia and accidental awareness during general anaesthesia in surgical patients [Cochrane Protocol]

Nitrous oxide-based versus nitrous oxide-free general anaesthesia and accidental awareness during general anaesthesia in surgical patients [Cochrane Protocol] Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr

2015 PROSPERO

136. Acute pain management: scientific evidence (3rd Edition)

assessment as the basis for annual reappointment of state physicians. Yet, aware that an evidence-informed approach to patient care has recently at times inappropriately been used as a rationale for restricting the range of therapeutic options available to patients, the authors of the third edition counsel that ‘while knowledge of current best evidence is important, it plays only a part in the management of acute pain for any individual patient and more than evidence is needed if such treatment

2015 National Health and Medical Research Council

137. Standards for Conscious Sedation in the Provision of Dental Care

It is to be read in conjunction with Safe Sedation Practice for Healthcare Procedures published by the Academy of Medical Royal Colleges in October 2013 5 and Sedation in Children And Young People published by the National Institute for Health and Care Excellence (NICE) in December 2010. 6 There are differences in laws, regulations, ethical guidance and governance between different countries in the UK and Ireland; this report describes best practice but it is incumbent on individuals to be aware of the laws (...) the principles set out in the GDC’s Standards for the Dental Team. 11 Consent is a complex process, and different laws and regulations apply at different ages in different countries in the UK. Practitioners must be aware of the laws that apply in their own country. Preparation for sedation Consent for treatment11 Written information for adult and child patients, those with parental responsibility, carers and escorts must be supplied. This is to be used in conjunction with the clinical pre-operative

2015 Royal College of Anaesthetists

138. Anaesthetic Agents in Pregnant Women Undergoing Non-Obstetric Surgical or Endoscopic Procedures

that the anaesthesia team is aware when a surgical patient is pregnant, inform patients of the potential risks of anaesthesia, and for all members of the clinical team to provide comprehensive case management. 3,4,11,12 PREPARED BY: Canadian Agency for Drugs and Technologies in Health Tel: 1-866-898-8439 www.cadth.ca Anaesthetic Agents in Pregnant Women Undergoing Surgical or Endoscopic Procedures 9 REFERENCES 1. Reitman E, Flood P. Anaesthetic considerations for non-obstetric surgery during pregnancy. Br J

2015 Canadian Agency for Drugs and Technologies in Health - Rapid Review

140. Prevention of intraoperative awareness with explicit recall in an unselected surgical population: a randomized comparative effectiveness trial. Full Text available with Trip Pro

Prevention of intraoperative awareness with explicit recall in an unselected surgical population: a randomized comparative effectiveness trial. Intraoperative awareness with explicit recall occurs in approximately 0.15% of all surgical cases. Efficacy trials based on the Bispectral Index® (BIS) monitor (Covidien, Boulder, CO) and anesthetic concentrations have focused on high-risk patients, but there are no effectiveness data applicable to an unselected surgical population.We conducted (...) a randomized controlled trial of unselected surgical patients at three hospitals of a tertiary academic medical center. Surgical cases were randomized to alerting algorithms based on either BIS values or anesthetic concentrations. The primary outcome was the incidence of definite intraoperative awareness; prespecified secondary outcomes included postanesthetic recovery variables.The study was terminated because of futility. At interim analysis the incidence of definite awareness was 0.12% (11/9,376) (95

2012 Anesthesiology Controlled trial quality: predicted high

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