Abstract:
BACKGROUND:Tardiness from scheduled start times is a common source of frustration for both operating room (OR) personnel and patients. Factors that influence tardiness were quantified in a companion paper and have been used to develop interventions that have the potential for reducing tardiness. METHODS:Data from two surgical suites were used to compare the effectiveness of several interventions to reduce tardiness, including i) moving cases to different ORs on the afternoon of surgery, ii) recalculating the OR schedule when it is published to correct for average lateness in first cases of the day, iii) recalculating the OR schedule when it is published to correct for average service-specific case duration bias, and iv) scheduling a gap (time buffer) before the cases of a "to follow" surgeon if the day is expected to end early. These last three interventions involve creation of a modified schedule with revised start times that are more accurate for both patient and "to follow" surgeon. The surgeon performing the first case of the day would not be affected. RESULTS:Moving cases to different ORs when a room was running late produced a 50%-70% reduction in the tardiness for those cases that were moved. However, overall tardiness in each suite was reduced by only 6%-9%, because few cases were moved. Scheduling a gap between surgeons if the day was expected to end early reduced tardiness by more than 50% for those cases that were preceded by gaps. However, overall tardiness in each suite was reduced by only 4%-8%, because few gaps could be scheduled. In contrast, correcting for the combination of lateness in first cases of the day and service-specific case duration bias reduced overall tardiness in each suite by 30%-35%. CONCLUSIONS:Interventions which involve small numbers of cases have little potential to reduce overall tardiness. Generating a modified or auxiliary OR schedule that compensates for known causes of tardiness can significantly reduce patient and "to follow" surgeon waiting times. Modifying the OR schedule to create revised start times for patients and "to follow" surgeons involves interventions that are simple to perform. The official schedule is not changed and case sequencing is not altered. Results do not depend on changing surgeon, anesthesia provider, or nursing behavior.
journal_name
Anesth Analgjournal_title
Anesthesia and analgesiaauthors
Wachtel RE,Dexter Fdoi
10.1213/ane.0b013e31819f9fd2subject
Has Abstractpub_date
2009-06-01 00:00:00pages
1902-9issue
6eissn
0003-2999issn
1526-7598pii
108/6/1902journal_volume
108pub_type
杂志文章abstract:BACKGROUND:When temporary arterial occlusion of the parent artery is difficult for anatomical reasons, or when inadvertent aneurysmal rupture occurs during surgical dissection, adenosine administration can be used to produce flow arrest and brief, profound systemic hypotension that can facilitate intracranial aneurysm ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e3182a6d31b
更新日期:2013-11-01 00:00:00
abstract::A randomized double-blind study was conducted in 50 orthopedic patients to determine the effect of epinephrine and phenylephrine on the anesthetic properties of intrathecally administered tetracaine. Two doses of each vasoconstrictor agent were studied: 0.2 mg of epinephrine, 0.3 mg of epinephrine, 1 mg of phenylephri...
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:1984-02-01 00:00:00
abstract:BACKGROUND:The status of neuropathic pain alters the responsiveness to formalin injection in rats. However, the mechanism by which this alteration occurs is unknown. METHODS:We used immunocytochemistry to examine the expression of brain-derived neurotrophic factor (BDNF) and calcitonin gene-related peptide (CGRP) in t...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000258762.22607.15
更新日期:2007-04-01 00:00:00
abstract:UNLABELLED:Postoperative pain is a common reason for the delayed discharge and unanticipated hospital admission of out-patients. In this study, we examined the pattern of pain in ambulatory surgical patients and determined those factors that predict postoperative pain. Ten thousand eight consecutive ambulatory surgical...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199710000-00017
更新日期:1997-10-01 00:00:00
abstract:BACKGROUND:There have been numerous studies published on the ProSeal laryngeal mask airway (PLMA). However, few have investigated its utility in a large practice setting. We sought to gather comprehensive data about the characteristics, efficacy, and safety of its use by a representative group of anesthesiologists work...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318189ac84
更新日期:2008-12-01 00:00:00
abstract:UNLABELLED:Natural killer (NK) cells can lyse certain tumor cells as well as virally infected cells without prior sensitization. Animal studies have shown that general anesthesia (GA) alone or GA followed by surgery decreases both basal NK cytotoxicity and enhancement of NK activity by interferon (IFN). The purpose of ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199710000-00037
更新日期:1997-10-01 00:00:00
abstract::Outpatients undergoing minor diagnostic and therapeutic procedures associated with intermittent discomfort are frequently given bolus injections of intravenous opioid analgesics. In a group of 80 healthy women undergoing vaginal ovum pickup procedures, we evaluated patient-controlled administration of alfentanil using...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1213/00000539-199207000-00008
更新日期:1992-07-01 00:00:00
abstract:BACKGROUND:The cellular mechanisms underlying the sedative effect of general anesthetics are not completely understood. Accumulating evidence indicates that the ventrolateral preoptic area (VLPO) of the hypothalamus plays a critical role. The VLPO contains 2 major types of neurons, the noradrenalin-inhibited GABAergic ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ANE.0b013e318297366e
更新日期:2013-08-01 00:00:00
abstract:BACKGROUND:Lidocaine can alleviate acute as well as chronic neuropathic pain at very low plasma concentrations in humans and laboratory animals. The mechanism(s) underlying lidocaine's analgesic effect when administered systemically is poorly understood but clearly not related to interruption of peripheral nerve conduc...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e31818e0d34
更新日期:2009-01-01 00:00:00
abstract::We studied the effect of intravenous (IV) thiamylal or ketamine on the increases in serum myoglobin, creatine kinase (CK), and potassium induced by succinylcholine under halothane anesthesia. Ninety patients were divided into three groups. In Group O, succinylcholine (1.0 mg/kg) was administered after an the inhaled i...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00000539-199511000-00021
更新日期:1995-11-01 00:00:00
abstract:BACKGROUND:The combination of propofol-remifentanil for procedural deep sedation in spontaneously breathing patients is characterized by the frequent incidence of side effects, especially respiratory depression. These side effects may be due to either the drug combination or the drug delivery technique. Target-controll...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e318198f6dc
更新日期:2009-03-01 00:00:00
abstract::Stellate ganglion block (SGB) is an established procedure for the diagnosis and treatment of chronic pain. SGB results in an acute sympathetic denervation of a part of the left ventricular (LV) wall innervated by the blocked ganglion, which may impair regional contractility. The resulting imbalance of myocardial contr...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199412000-00010
更新日期:1994-12-01 00:00:00
abstract::Preoperative anxiety may increase gastric fluid acidity and volume. To pursue this possibility we evaluated the relationship between peroral premedication, preoperative anxiety, and gastric content in 246 consecutive patients presenting for elective gynecologic surgery. All patients fasted overnight and received eithe...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1213/00000539-199207000-00017
更新日期:1992-07-01 00:00:00
abstract::Transesophageal Doppler (TED) monitoring provides continuous, noninvasive monitoring of cardiac output by measurement of aortic flow velocities. Because of the effects on aortic flow dynamics resulting from atherosclerosis, aortic cross-clamping, and wide variations in arterial blood pressure, the validity of TED moni...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199112000-00006
更新日期:1991-12-01 00:00:00
abstract:UNLABELLED:Takayasu's arteritis is a rare, chronic progressive panendarteritis involving the aorta and its main branches. Anesthesia for patients with Takayasu's arteritis is complicated by their severe uncontrolled hypertension, end-organ dysfunction resulting from hypertension, stenosis of major blood vessels affecti...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-200107000-00014
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Halothane and desflurane have been shown to attenuate neuronal injury; however, the effects of these anesthetics on mitochondria are unclear. We investigated whether halothane and desflurane affect the function of mitochondria after cerebral ischemia in rats. METHODS:Forty male Wistar rats were randomly div...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/ane.0b013e318164f2a5
更新日期:2008-04-01 00:00:00
abstract::The potency of conventional inhaled anesthetics increases with increasing age: the 50% effective dose (minimum alveolar anesthetic concentration [MAC]) for anesthesia in the neonatal animal or human exceeds MAC in the young adult by approximately 30% to 60%. We tested whether this relationship also applies to the alka...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1097/00000539-199704000-00028
更新日期:1997-04-01 00:00:00
abstract::Attempted pulmonary artery catheterization via the left internal jugular vein resulted in a misdiagnosis of pulmonary hypertension before transesophageal echocardiography revealed the catheter positioned in the ascending aorta. Inadvertent aortic cannulation through an unusual type of partial anomalous pulmonary venou...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ane.0000296459.51820.64
更新日期:2008-01-01 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::In view of the overall experience regarding regional anesthetic techniques to control postoperative pain in infants and children, it is feasible that a similar efficacy and safety profile can be obtained when using such techniques after major orthopedic procedures such as anterior or posterior spinal fusion. I reviewe...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/01.ane.0000107938.80562.75
更新日期:2004-04-01 00:00:00
abstract::Transesophageal echocardiography (TEE) is increasingly used intraoperatively as a monitor of ventricular function and volume. Despite its increasing use, whether data from TEE monitoring can be interpreted accurately on-line in real-time is unknown. We studied the performance of five community-based, full-time cardiac...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章
doi:10.1097/00000539-199606000-00006
更新日期:1996-06-01 00:00:00
abstract::Endocardial motion and surface/volume changes during the cardiac cycle are echocardiographic methods for regional (analysis of wall motion) and global (fractional area change, stroke volume, and ejection fraction) evaluation of cardiac function. These conventional methods can be subjective, and/or time consuming and, ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,评审
doi:10.1213/ane.0b013e31818a6c4c
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:In this randomized study, we compared intrathecal (i.t.) morphine with or without clonidine and i.v. postoperative patient-controlled analgesia (PCA) morphine for analgesia after radical retropubic prostatectomy. METHODS:Fifty patients were randomly divided into three groups. They were allocated to receive ...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ane.0b013e3181a30182
更新日期:2009-06-01 00:00:00
abstract::We evaluated the effects of adding clonidine for continuous peripheral nerve infusions. Sixty patients undergoing total knee arthroplasty under combined single-injection sciatic block and continuous femoral infusion were randomly allocated to three groups: block induction with 0.75% ropivacaine followed by 0.2% ropiva...
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.0000143952.75985.8F
更新日期:2005-03-01 00:00:00
abstract::Lidocaine decreases the minimum alveolar concentration (MAC) of inhaled anesthetics and has been used clinically to reduce the requirements for other anesthetic drugs. In this study we examined the effects of lidocaine on isoflurane MAC in cats. Six cats were studied. In Experiment 1, the MAC of isoflurane was determi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/01.ANE.0000139350.88158.38
更新日期:2005-01-01 00:00:00
abstract::Practicing anesthesiologists are at high risk of hepatitis B infection, but the risk for anesthesia residents has not been assessed. Anesthesia residents at seven universities were surveyed to study the epidemiology of hepatitis B in these trainees. Hepatitis B virus markers in serum were measured and data from questi...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:
更新日期:1985-07-01 00:00:00
abstract::In a randomized, double-blind, placebo-controlled trial, we evaluated the use of preoperative local anesthesia with regard to postoperative pain. Before surgery in 66 patients scheduled for cholecystectomy, the abdominal wall along the proposed line of incision was infiltrated with 70 mL of 0.25% ropivacaine, 70 mL of...
journal_title:Anesthesia and analgesia
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1213/00000539-199402000-00003
更新日期:1994-02-01 00:00:00
abstract::Lidocaine catabolism under N2O anesthesia was evaluated in 5 dogs given a lidocaine infusion of 2 mg/kg/min for 20 minutes. Comparison of results with those of a prior similar study with halothane to be significantly faster in the animals given N2O. The extraction ratio for lidocaine, which did not vary with its arter...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-197605000-00007
更新日期:1976-05-01 00:00:00
abstract:BACKGROUND:In this study, we hypothesized that leg positioning and distal tourniquet application, when compared with neutral positioning of the leg, alters the efficacy of sciatic nerve block performed by the double-stimulation technique. METHODS:Ninety randomized, consecutive, ASA physical status I to III patients un...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章,随机对照试验
doi:10.1213/ANE.0b013e31822f8b99
更新日期:2011-12-01 00:00:00
abstract::We examined the effect of halothane and isoflurane on contraction in the vascular smooth muscle of rat thoracic aorta simultaneously with the cytosolic Ca2+ levels ([Ca2+]i). Isolated spiral strips of rat thoracic aorta were suspended for isometric tension recordings in physiologic salt solution. The [Ca2+]i was measu...
journal_title:Anesthesia and analgesia
pub_type: 杂志文章
doi:10.1213/00000539-199406000-00006
更新日期:1994-06-01 00:00:00