Abstract:
:We considered the allocation of operating room (OR) time at facilities where the strategic decision had been made to increase the number of ORs. Allocation occurs in two stages: a long-term tactical stage followed by short-term operational stage. Tactical decisions, approximately 1 yr in advance, determine what specialized equipment and expertise will be needed. Tactical decisions are based on estimates of future OR workload for each subspecialty or surgeon. We show that groups of surgeons can be excluded from consideration at this tactical stage (e.g., surgeons who need intensive care beds or those with below average contribution margins per OR hour). Lower and upper limits are estimated for the future demand of OR time by the remaining surgeons. Thus, initial OR allocations can be accomplished with only partial information on future OR workload. Once the new ORs open, operational decision-making based on OR efficiency is used to fill the OR time and adjust staffing. Surgeons who were not allocated additional time at the tactical stage are provided increased OR time through operational adjustments based on their actual workload. In a case study from a tertiary hospital, future demand estimates were needed for only 15% of surgeons, illustrating the practicality of these methods for use in tactical OR allocation decisions.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Dexter F,Ledolter J,Wachtel REdoi
10.1213/01.ANE.0000149898.45044.3Dsubject
Has Abstractpub_date
2005-05-01 00:00:00pages
1425-32, table of contentsissue
5eissn
0003-2999issn
1526-7598pii
100/5/1425journal_volume
100pub_type
杂志文章abstract::After Fontan repair in children, we performed a prospective, open-label study to evaluate the effect of amrinone on pulmonary vascular resistance (PVRI). Eight patients who underwent the Fontan repair had baseline arterial pressure, left atrial pressure, central venous pressure, and cardiac output measured postoperati...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199602000-00004
更新日期:1996-02-01 00:00:00
abstract::The development of a technique for studying spinal dorsal horn electrophysiology in intact, awake, drug-free cats enables the study of spinal sites and mechanisms of action of anesthetic and analgesic agents in a system that more closely reflects normal physiology. Using this technique, we reevaluated the effect of ke...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1986-11-01 00:00:00
abstract:BACKGROUND:A decline in emergency surgical airway procedures in recent years has resulted in a decreased exposure to cricothyrotomy. Consequently, residents have very little experience or confidence in performing this intervention. In this study, we compared cricothyrotomy skills acquired on a simple inexpensive model ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181841efe
更新日期:2008-11-01 00:00:00
abstract:UNLABELLED:Hemorrhagic hypotension may aggravate the detrimental effects of head trauma on neurologic outcome. Our study examined whether using phenylephrine or large volumes of saline IV to increase mean arterial blood pressure (MAP) to 70, 80, or 90 mm Hg during the combination of head trauma and uncontrolled hemorrh...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199910000-00024
更新日期:1999-10-01 00:00:00
abstract:BACKGROUND:Platelet factor 4 (PF4) is released by activated platelets and has a strong affinity for heparin. Recombinant PF4 (rPF4) has been previously considered as an alternative to protamine for heparin reversal. However, it has been demonstrated that antibodies directed against the PF4/heparin moiety are important ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182662e1a
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:In this prospective, randomized, observer-blinded trial, we compared ultrasound-guided subparaneural popliteal sciatic nerve blocks performed either at or proximal to the neural bifurcation (B). We hypothesized that the total anesthesia-related time (sum of performance and onset times) would be decreased wit...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e31828a73be
更新日期:2013-05-01 00:00:00
abstract::This study was designed to compare the anesthetic properties of hypobaric bupivacaine with those of isobaric and hyperbaric solutions when administered in the supine position in an elderly population undergoing hip surgery using continuous spinal anesthesia. Plain bupivacaine (0.5%) was mixed with equal volumes of 10%...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199106000-00011
更新日期:1991-06-01 00:00:00
abstract::The sensitivity, specificity, and accuracy of the cobalt blue and ninhydrin sweat tests were compared with the sympathogalvanic response (SGR) in assessment of complete sympathetic blockade. Patients were randomly assigned to receive epidural administration of either preservative-free physiologic saline solution and 8...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1985-04-01 00:00:00
abstract:UNLABELLED:In this study, we evaluated the reliability of a newly developed method for pain assessment, which is based on perceptual matching by Pain Matcher, Cefar Medical AB, Lund, Sweden, during minor gynecological surgery. In addition, the responsiveness to two different anesthetic methods-electro-acupuncture or a ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200207000-00027
更新日期:2002-07-01 00:00:00
abstract:UNLABELLED:The transient hyperemic response (THR) in the middle cerebral artery (MCA) after the release of brief compression of the ipsilateral common carotid artery has been used to study cerebral autoregulation. We conducted the present study to evaluate the reliability of THR to detect changes in cerebral autoregula...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199810000-00018
更新日期:1998-10-01 00:00:00
abstract:BACKGROUND:In this study, we compared the effect of light sedation with remifentanil versus propofol on intracranial (ICP) and cerebral perfusion pressure (CPP) of patients undergoing stereotactic brain tumor biopsy under regional anesthesia. METHODS:This was a prospective, open-label, randomized, and controlled study...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e3181a3ea3a
更新日期:2009-07-01 00:00:00
abstract::The decrease of cardiac index observed during portal triad clamping (PTC) with and without pneumoperitoneum has been studied only with right heart catheterization. To better understand this decrease of cardiac index, we investigated the balance between the adequacy of preload and the ability of the heart to pump again...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000144592.20499.12
更新日期:2005-03-01 00:00:00
abstract::Although convective warming therapy is effective in preventing hypothermia in anesthetized patients, little is known concerning the potential risks of its use. Hence, this balanced cross-over study was designed to determine if the use of convective warming therapy increased the risk of wound contamination. For 4 h, ei...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199301000-00009
更新日期:1993-01-01 00:00:00
abstract::We hypothesized that intrathecal fentanyl infusion would provide excellent analgesia, require lower doses than necessary for the epidural or intravenous route of administration, and reduce the incidence and/or severity of side effects. Accordingly, we studied 12 patients during 48 h after thoracotomy (three pneumonect...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199311000-00011
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Pulse wave analysis (PWA) allows cardiac output (CO) measurement after calibration by transpulmonary thermodilution. A PWA system that does not require previous calibration, the FloTrac/Vigileo (FTV), has been recently developed. We compared determinations of CO made with the FTV to simultaneous measurements...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181a491b8
更新日期:2009-07-01 00:00:00
abstract::Apnea and airway obstruction are common during monitored anesthesia care (MAC). Because their early detection is essential, we sought to measure the efficacy of capnography as an indicator of apnea during MAC at a variety of oxygen flow rates compared with thoracic impedance. Anesthesia care providers using standard A...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ANE.0000131964.67524.E7
更新日期:2004-08-01 00:00:00
abstract::We studied 49 patients of ASA physical status I to determine cerebral anesthetic concentration on awakening calculated with end-tidal anesthetic concentration, when the end-tidal concentration decreased spontaneously. We also attempted to explain the difference in the average of the bracketing alveolar anesthetic conc...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199311000-00024
更新日期:1993-11-01 00:00:00
abstract:UNLABELLED:Patients receiving effective thoracic epidural analgesia for postthoracotomy pain may still complain of severe ipsilateral shoulder pain. The etiology of this pain is unclear. In this randomized, double-blinded, placebo-controlled study, we investigated the effect of phrenic nerve infiltration with lidocaine...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200108000-00004
更新日期:2001-08-01 00:00:00
abstract:UNLABELLED:Apparently large plasma volumes derived by indocyanine green (PV-ICG) have been determined in the initial period after induction of anesthesia. We tested the hypothesis that possible overestimation of PV-ICG occurs shortly after anesthetic induction. Anesthesia was induced in 13 patients with fentanyl bolus ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000084361.12884.d1
更新日期:2003-11-01 00:00:00
abstract::The efficacy of leg skin warming in preventing hypothermia and shivering was evaluated in two separate prospective, randomized trials in patients undergoing abdominal surgery. In the first trial, 22 patients were randomized to receive no hypothermia prevention (control group) or active warming with an electric warming...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199311000-00021
更新日期:1993-11-01 00:00:00
abstract:UNLABELLED:In this study, we tested the validity of the bispectral index (BIS) monitor during conscious and deep sedation of children by comparing it with the University of Michigan Sedation Scale (UMSS), a validated observational pediatric sedation scale. Eighty-six children <12 yr of age were enrolled in this observa...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/01.ane.0000067402.02136.a2
更新日期:2003-07-01 00:00:00
abstract::The advantages of laparoscopic over open surgery have been documented in nonblinded settings. Our prospective, double-blind setting evaluated pain scores 72 h after surgery by comparing patients who underwent laparoscopic myomectomy or with laparotomy. Forty women referred for conservative myomectomy were included in ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/01.ane.0000204321.85599.0d
更新日期:2006-05-01 00:00:00
abstract:UNLABELLED:The adenosine triphosphate (ATP)-sensitive potassium channels (K(+)-ATP channels) are activated by decreases in intracellular ATP and help to match blood flow to tissue needs. Such metabolism-flow coupling occurs predominantly in the smallest arterioles measuring 50 microm or less in diameter. Previous studi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200007000-00015
更新日期:2000-07-01 00:00:00
abstract:UNLABELLED:Spinal anesthesia is commonly used in former preterm infants (FPI). In these patients, hypotension induced by spinal anesthesia may impair cerebral blood flow. We measured cerebral blood flow velocity (CBFV) by transcranial Doppler ultrasound to assess the effect of hypotension induced by spinal anesthesia o...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000108962.37210.69
更新日期:2004-05-01 00:00:00
abstract:BACKGROUND:We determined the sensitivity of motor responses evoked by stimulating catheters in determining catheter-nerve contact using ultrasonography as reference. METHODS:Femoral nerves were contacted using stimulating catheters under ultrasonography scanning in 25 patients. The output current was increased from it...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31822c9887
更新日期:2011-11-01 00:00:00
abstract:BACKGROUND:A single preoperative dose of 600 mg gabapentin, combined with multimodal analgesia, has previously been shown to reduce postcesarean pain and improve maternal satisfaction but was associated with increased maternal sedation. We hypothesized that a lower dose of gabapentin may be effective with less sedation...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e31826ac3b9
更新日期:2012-12-01 00:00:00
abstract:UNLABELLED:The optimal dose and timing of 5-HT(3) antagonist administration for prophylaxis against postoperative nausea and vomiting (PONV) remains controversial. Although 5-HT(3) antagonists seem to be most effective when administered near the end of surgery, there are no data on the comparative efficacy or costs ass...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-200006000-00017
更新日期:2000-06-01 00:00:00
abstract:BACKGROUND:The ability to identify the correct vertebral level through examination is an important skill for clinicians who are performing nerve blocks without fluoroscopy. The conventional palpation method, which identifies the most prominent cervical spinous process as the seventh cervical (C7) spinous process is unr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3182110f9f
更新日期:2011-05-01 00:00:00
abstract:UNLABELLED:We compared the effectiveness of ondansetron, dimenhydrinate, and placebo for the prevention of postoperative vomiting in children after adenotonsillectomy. In a randomized, placebo-controlled, double-blind study, 74 children, 2-10 yr of age scheduled for adenotonsillectomy as outpatients were given a single...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199803000-00008
更新日期:1998-03-01 00:00:00
abstract:BACKGROUND:Current respiratory monitoring technologies such as pulse oximetry and capnography have been insufficient to identify early signs of respiratory compromise in nonintubated patients. Pulse oximetry, when used appropriately, will alert the caregiver to an episode of dangerous hypoxemia. However, desaturation l...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000001395
更新日期:2017-01-01 00:00:00