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At least 361 records · Page 20Linked to original sources
PubMed2006

Pacemaker-driven tachycardia induced by electrocardiograph monitoring in the recovery room.

Monitoring devices are known to induce tachycardia in minute-ventilation rate-responsive pacemakers. This is because some monitoring devices measure the same parameter as do the pacemakers (change in thoracic impedance). Hence, the biological signal to the pacemaker is increased and is misconstrued as increased minute ventilation causing tachycardia which resolves when the monitoring device is removed. Whilst this could occur for all minute-volume rate responsive pacemakers, most reported interactions have been with the Telectronics META series. We present a case of an interaction between a Telectronics Tempo DR pacemaker (St. Jude Medical) and an Agilent Patient Care System (Philips). Failure to recognise the true nature and cause of such tachycardias may lead to mismanagement of the patient, including the inappropriate use of cardio-active medications.

Aged↗
PubMed2006

Systematic review on the recurrence of postoperative nausea and vomiting after a first episode in the recovery room - implications for the treatment of PONV and related clinical trials.

BACKGROUND: Despite the presence of a plethora of publications on the prevention of postoperative nausea and vomiting (PONV) only little is known how to treat established symptoms. Besides the high effort of performing these efficacy trials (much more patients must give their consent than are actually included in a study) and ethical concerns, little is known about the rate of re-occurring PONV/vomiting after placebo. As a consequence investigators will have difficulties defining a clinically relevant effect for the new treatment which is crucial for any planning. A quantitative systematic review was performed in order to provide more reliable estimates of the incidence of re-occurring PONV/vomiting after placebo and to help investigators defining a clinically relevant treatment effect. METHODS: A systematic search of the literature was performed using an extended search strategy of a previous review. Data on the recurrence of PONV (any nausea or emetic symptom) and vomiting (retching or vomiting) was extracted from published reports treating PONV with placebo and unpublished results from two observational trials where no treatment was given. A nonlinear random effects model was used to calculate estimates of the recurrence of symptoms and their 95%-confidence intervals (95%-CI). RESULTS: A total of 29 trials (including the unpublished data) were eligible for the calculations. Depending on the length of observation after administering placebo or no treatment the recurrence rate of PONV was between 65% (95%-CI: 53%...75%) and 84% (95%-CI: 73%...91%) and that of vomiting was between 65% (95%-CI: 44%...81%) and 78% (95%-CI: 59%...90%). CONCLUSION: Almost all trials showed a considerable and consistently high rate of recurrence of emetic symptoms after placebo highlighting the need for a consequent antiemetic treatment. Future (placebo) controlled efficacy trials may use the presented empirical estimates for defining clinically relevant effects and for statistical power considerations.

Journal Article↗
PubMed1990

Comparison of non-invasive respiratory and arterial blood gas analysis. A recovery room study on acute respiratory depression.

The effect on invasive and non-invasive oxygen, carbon dioxide and haemoglobin saturation measures of two repeated doses of alfentanil 0.5 microgram/kg were tested in 16 patients scheduled for elective cataract surgery under periocular anaesthesia. Alfentanil caused an acute respiratory depression, which was demonstrated as increased levels of arterial and end-tidal carbon dioxide and concomitant decrease in arterial and end-tidal oxygen levels as well as decreased arterial blood saturation and pulse oximeter readings. There was a good correlation between the non-invasive respiratory parameters and blood gas levels, as well as between pulse oximetry numbers and oxygen saturation of arterial blood. Therefore, hypoventilation and concurrent hypoxaemia can be predicted by monitoring end-tidal CO2.

Aged↗
PubMed1980

A new look at pharmacy services in the operating suite and recovery room.

Drug control and charging traditionally have been delegated to overburdened physicians and nursing personnel in operating rooms, anesthesiology, and immediate postoperative patient care areas. Better drug control (e.g., charging, intravenous admixture preparation, and narcotic record keeping) in these areas is needed, and a 24-hour satellite pharmacy system is proposed. Revenue production and expense incurred were projected by analyzing drug usage. Responsive drug dispensing and control were evaluated by a 10-day pilot study during which the pharmacy provided the entire drug needs of the patient while in the operating suite. Economic analyses revealed significant "lost charges" by the automatic replacement system currently in use. Revenue was maintained while providing clearly labeled drugs in a ready-to-use form. Problems with drug inventory and narcotic control were lessened for the nursing and physician staffs during the pilot study. It was concluded that drug distribution and control via a decentralized pharmacy satellite located in the operating room area is a financially viable solution resulting in better patient care.

Accounts Payable and Receivable↗
PubMed2004

Treatment of pain after spinal surgery in the recovery room by single dose lornoxicam: a randomized, double blind, placebo-controlled trial.

BACKGROUND: Lornoxicam has been used in microsurgical lumbar discectomy. However, there is no data about controlling pain after open discectomy or laminectomy. OBJECTIVE: To compare the efficacy of a single dose of 16 mg of lornoxicam for the treatment of pain after disectomy or laminectomy with placebo in the PACU. STUDY DESIGN: Randomized, double blind, placebo-controlled trial. MATERIAL AND METHOD: Fifty-six patients who underwent discectomy or laminectomy were randomly allocated to receive 16 mg lornoxicam (Group L), or placebo (Group P) at the beginning of wound closure. Pain scores at rest (using a verbal numeric rating scale: VNRS 0-10), time to first analgesia requirement, morphine consumption during the first 2 hr after surgery and adverse effects were all recorded. The outcomes were assessed on admission to the PACU (T0), then at 1 (T1) and 2 (T2) hr after surgery. RESULTS: Baseline data were comparable between the two groups. The proportion of patients with VNRS > 5 at T0 in both groups were not significantly different (44.4% in group P vs 50.0% in group L, CI of difference: - 32.4%, 21.3%, p = 0.68). The mean VNRS scores, at T0 and T1 were > 5 and at T2 was < 5 in both groups. There was no difference between the two groups. The morphine consumption in both groups was not different (9.0 mg vs 9.3 mg) as well as the time to first analgesia requirement (35 min vs 40 min). Patients in the two groups had no significant difference in the symptoms or degree of nausea/vomiting. The number of patients with excessive sedation and the proportion of patients needing oxygen during transportation to the ward were not different. CONCLUSION: Lornoxicam 16 mg given intravenously before wound closure provides inadequate pain relief immediately after disectomy or laminectomy in the PACU. However, adequate pain relief was demonstrated at 2 hr after surgery, which was similar to the placebo.

Adolescent↗