Abstract:
BACKGROUND:There are three basic types of decision aids to facilitate operating room (OR) management decision-making on the day of surgery. Decision makers can rely on passive status displays (e.g., big screens or whiteboards), active status displays (e.g., text pager notification), and/or command displays (e.g., text recommendations about what to do). METHODS:Anesthesiologists, OR nurses, and housekeepers were given nine simulated scenarios (vignettes) involving multiple ORs to study their decision-making. Participants were randomized to one of four groups, all with an updated paper OR schedule: with/without command display and with/without passive status display. RESULTS:Participants making decisions without command displays performed no better than random chance in terms of increasing the predictability of work hours, reducing over-utilized OR time, and increasing OR efficiency. Status displays had no effect on these end-points, whereas command displays improved the quality of decisions. In the scenarios for which the command displays provided recommendations that adversely affected safety, participants appropriately ignored advice. CONCLUSIONS:Anesthesia providers and nursing staff made decisions that increased clinical work per unit time in each OR, even when doing so resulted in an increase in over-utilized OR time, higher staffing costs, unpredictable work hours, and/or mandatory overtime. Organizational culture and socialization during clinical training may be a cause. Command displays showed promise in mitigating this tendency. Additional investigations are in our companion paper.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Dexter F,Willemsen-Dunlap A,Lee JDdoi
10.1213/01.ane.0000268539.85847.c9subject
Has Abstractpub_date
2007-08-01 00:00:00pages
419-29issue
2eissn
0003-2999issn
1526-7598pii
105/2/419journal_volume
105pub_type
杂志文章abstract::Three-centimetre linear incisions were made in 90 young male Lew/f Mai rats by scalpel through skin to the investing fascia of the left flank. The skin was undermined sharply for a distance of 0.5 cm along both sides of the entire length of the incision. The wound site was closed per primam with Michel clips and left ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197809000-00003
更新日期:1978-09-01 00:00:00
abstract:UNLABELLED:To determine whether the "second gas effect" is valid, we determined the pharmacokinetics of 0.2% enflurane with or without 80% N2) (n = 7 each) under controlled constant volume ventilation in 14 young healthy male patients before their operations. The alveolar (end-tidal) concentration (FA) and inspired con...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199901000-00035
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:Short-term case cancellation causes frustration for anesthesiologists, surgeons, and patients and leads to suboptimal use of operating room (OR) resources. In many facilities, >10% of all cases are cancelled on the day of surgery, thereby causing major problems for OR management and anesthesia departments. T...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,多中心研究
doi:10.1213/ANE.0b013e318222be4d
更新日期:2011-09-01 00:00:00
abstract::The protective effect of a nonionic surface-active polyol agent (Pluronic F-68) against bolus injection and constant-rate IV infusion of air was studied in 21 dogs anesthetized with pentobarbital. Aortic, pulmonary artery and right ventricular pressures, cardiac output, end-tidal CO2 concentration, wasted ventilation,...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197511000-00030
更新日期:1975-11-01 00:00:00
abstract:BACKGROUND:We have recently shown that levetiracetam, administered systemically, exerts an antihyperalgesic effect in a rat inflammatory pain model. In this study, we examined whether levetiracetam has local peripheral antihyperalgesic/anti-edematous effects in the same model of localized inflammation and whether opioi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31826c7fc2
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Perioperative opioid use is associated with poor survival in patients with esophageal squamous cell carcinoma. The most common histological type of esophageal cancer in western countries is adenocarcinoma. The objective of this study was to evaluate the association between intraoperative opioid consumption a...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000003428
更新日期:2018-07-01 00:00:00
abstract:OBJECTIVE:In this study we sought to identify differences in risk factors and outcome of critically ill patients with Candida albicans and non-albicans candidemia. METHODS:Nonimmunosuppressed, nonneutropenic patients with candidemia diagnosed after intensive care unit (ICU) admission were included in a prospective obs...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e3181607262
更新日期:2008-02-01 00:00:00
abstract:BACKGROUND:Botulinum neurotoxin type A (BoNT/A) has been used as an analgesic for myofascial pain syndromes, migraine, and other types of headaches. Although an antinociceptive effect of central or peripheral administration of BoNT/A is suggested, the effect at the spinal level is still unclear. In this study, we evalu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3181ffa1d7
更新日期:2011-01-01 00:00:00
abstract:BACKGROUND:Severe exacerbation of chronic neuropathic pain often requires morphine in patients already treated with drugs such as tricyclic antidepressants, carbamazepine and gabapentin. However, it is unclear if a combination of these drugs intensifies the effects of morphine on the respiratory system and, if so, whet...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31817e6e53
更新日期:2008-10-01 00:00:00
abstract:UNLABELLED:We tested the hypothesis that an insulin infusion would effectively treat bupivacaine-induced cardiac depression in dogs. In 24 mongrel dogs anesthetized with pentobarbital (5 mgkg(-1)h(-1), IV), 0.5% bupivacaine was administrated at a rate of 0.5 mgkg(-1)min(-1) until the mixed venous oxygen saturation decr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200011000-00010
更新日期:2000-11-01 00:00:00
abstract:UNLABELLED:In the present study, we investigated the effect of remifentanil on cerebral blood flow velocity (CBFV). We investigated 20 patients (ASA physical status III) scheduled for elective coronary artery bypass graft surgery. Anesthesia was induced with remifentanil 5 microg/kg IV (Group 1, n = 10) or 2 microg/kg ...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199809000-00013
更新日期:1998-09-01 00:00:00
abstract::The direct effect of protamine sulfate upon myocardial inotropism was studied using an isolated canine heart muscle preparation. Isometric force (F) was decreased to 87.6 +/- 1.2% of control values by a concentration of 50 x 10(-3) g/L protamine, which is approximately equal to the estimated serum concentration of pro...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1980-02-01 00:00:00
abstract:BACKGROUND:Increasing evidence suggests that patients with eating disorders are more likely to develop chronic pain. A misaligned diet has been reported to disrupt the sleep-awake rhythms. Combined with our previous investigation on circadian pain, we aimed to investigate the role of misaligned diet in the pain sensiti...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002727
更新日期:2018-07-01 00:00:00
abstract::Descriptive statistics are specific methods basically used to calculate, describe, and summarize collected research data in a logical, meaningful, and efficient way. Descriptive statistics are reported numerically in the manuscript text and/or in its tables, or graphically in its figures. This basic statistical tutori...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0000000000002471
更新日期:2017-11-01 00:00:00
abstract:BACKGROUND:Nicotine has an antinociceptive effect in animal models. The analgesic effect in humans has been examined, but studies have had mixed results. A proposed etiology is variability in chronic nicotine exposure because of differences in tobacco smoking rates and second-hand smoke exposure. In this study, we exam...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e3181bd1612
更新日期:2009-12-01 00:00:00
abstract::Mitral valve replacement is frequently complicated by a low cardiac output syndrome and elevated pulmonary arterial pressures. In the present study, we used dobutamine to increase cardiac index and measured the pulmonary hemodynamic effects in 10 patients with increased pulmonary vascular tone following mitral valve r...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-04-01 00:00:00
abstract:UNLABELLED:IV volume is often administered to patients in an intensive care unit (ICU) to improve cardiovascular function. We investigated the relationship between stroke volume (SV) and left ventricular (LV) size by using transesophageal echocardiography (TEE) in a population of 20 ICU patients and 21 postoperative ca...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200002000-00021
更新日期:2000-02-01 00:00:00
abstract:UNLABELLED:We designed this study to determine the minimum dose of dexamethasone for preventing nausea and vomiting associated with the use of morphine by patient-controlled analgesia (PCA). Two hundred forty female patients were randomly assigned to receive dexamethasone 2, 4, 8, or 12 mg IV immediately before inducti...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ane.0000105875.05357.a0
更新日期:2004-04-01 00:00:00
abstract::The swallowing reflex is depressed by anesthetics. During recovery from anesthesia the rapid return of laryngeal and upper airway reflexes is important to protect the lower airway from aspiration. This study measures the recovery of the swallowing reflex after propofol anesthesia. Fifteen patients undergoing a colonos...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199411000-00007
更新日期:1994-11-01 00:00:00
abstract::Enhancement of a vecuronium neuromuscular blockade by prior administration of succinylcholine has been attributed to both pharmacokinetic and pharmacodynamic mechanisms. This study was performed to elucidate the mechanism of this interaction using decamethonium as the agonist drug. In five healthy patients undergoing ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199303000-00033
更新日期:1993-03-01 00:00:00
abstract:UNLABELLED:We tested the hypothesis that electro-acupuncture at the Zusanli, Yanglingquan, and Kunlun acupuncture points on the legs decreases anesthetic requirement. Fourteen young, healthy volunteers were anesthetized with desflurane on two separate days. Needle electrodes were positioned at the three acupuncture poi...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-200207000-00017
更新日期:2002-07-01 00:00:00
abstract::To test the relative effects on serum creatinine (CRE), blood urea nitrogen (BUN), and urine output of small-dose dopamine and fenoldopam in patients undergoing liver transplantation, we randomized 43 patients to 1 of 2 continuous infusions over 48 h, starting with anesthesia induction: fenoldopam, 0.1 microg . kg(-1)...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/01.ANE.0000136420.01393.81
更新日期:2004-12-01 00:00:00
abstract:UNLABELLED:This study was designed to determine if, and to what extent, antithrombin III (AT) levels affect the response of the activated clotting time (ACT) to heparin in concentrations used during cardiac surgery, and to characterize the relationship between AT levels and markers of activation of coagulation during c...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199709000-00005
更新日期:1997-09-01 00:00:00
abstract:BACKGROUND:Previous studies have demonstrated that Homer 1b/c, a postsynaptic molecular scaffolding protein that binds and clusters metabotropic glutamate receptors at neuronal synapses, has an important role in the metabotropic glutamate receptor signaling process. In the current study, we investigated the possible in...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e31822c0b98
更新日期:2011-12-01 00:00:00
abstract:UNLABELLED:The purpose of our study was to investigate the effects of sodium nitroprusside-induced hypotension on splanchnic perfusion and hepatocellular integrity. Thirty patients undergoing radical prostatectomy were allocated randomly to a sodium nitroprusside (SNP) or control group (control). Regional pco2 was meas...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验,收录出版
doi:10.1097/00000539-199912000-00008
更新日期:1999-12-01 00:00:00
abstract::This study was undertaken to compare the antinociceptive and behavioral effects of intrathecally administered opiates, alpha-2-adrenergic agonists, and local anesthetics injected by lumbar puncture in the mouse and rat. Antinociception was determined by observing the response to a clamp applied to the tail (Haffner te...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1988-07-01 00:00:00
abstract::Epidural analgesia, often using opioids intraoperatively and postoperatively, is widely accepted as a valuable modality for perioperative pain management. In this review I present data from meta-analyses and recently published trials that evaluate the perioperative use of opioids administered epidurally or parenterall...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/01.ane.0000179686.73009.2b
更新日期:2005-11-01 00:00:00
abstract::The present investigation explored the possibility that the commonly observed hypotension that occurs during induction of anesthesia with propofol might be related to its ability to produce venodilation. Thirty-six ASA I and II patients who received no premedication were studied. The first 20 patients were divided int...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199206000-00017
更新日期:1992-06-01 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::Previous studies have shown that the anesthetic potency of organic compounds increases as a given halogen is replaced with successively larger halogens. These studies often are limited in the accuracy of determination of potency, rarely correlate potency with physical properties, and usually fail to include ether comp...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1989-05-01 00:00:00