Abstract：
:Human error poses significant risk for hospitalized patients causing an estimated 100,000 to 400,000 deaths in the USA annually. Medication errors contribute, with error occurring in 5.3% of medication administrations during surgery. In this study 70.3% of medication errors were deemed preventable. Given the paucity of randomized controlled studies, we undertook a rigorous review of the literature to identify recommendations supported by expert opinions. An extensive literature search pertaining to medication error, medication safety, operating room, and anaesthesia was performed. The National Guidelines Clearinghouse was searched for any anaesthesia or operating room medication safety guidelines.A total of 74 articles were included. Recommendations were tabulated and assigned points based on a scale revised from a prior study. A total of 138 unique recommendations were identified, with point tallies ranging from 4 to 190. An in-person focus meeting occurred, where the 138 recommendations were reviewed, combined and condensed. A modified Delphi process was used to eliminate items found to be unimportant or those unable to be quantified (e.g. "minimize fatigue"). A total of 35 specific recommendations remained. Adverse events as a result of medication errors occur frequently in the operative setting. There are few rigorous studies to direct medication safety strategies, but this should not lead us to do nothing. The overwhelming consensus regarding best practices should be accepted, and the recommendations implemented. Our list of recommended strategies can hopefully be used to assess local vulnerabilities and institute system solutions.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Wahr JA,Abernathy JH 3rd,Lazarra EH,Keebler JR,Wall MH,Lynch I,Wolfe R,Cooper RLdoi
10.1093/bja/aew379subject
Has Abstractpub_date
2017-01-01 00:00:00pages
32-43issue
1eissn
0007-0912issn
1471-6771pii
S0007-0912(17)30113-7journal_volume
118pub_type
杂志文章,评审abstract：:Dose-duration relationships for vecuronium were determined and the duration of action produced by vecuronium 0.3 mg kg-1 shown to equal that of pancuronium 0.1 mg kg-1. Using these doses, the neuromuscular blocking properties and cardiovascular effects of the two drugs were compared. With large dose administration of ...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/61.2.180
更新日期：1988-08-01 00:00:00
abstract：:We have studied the effect of analgesia on maternal temperature (oral and tympanic membrane) progression in 53 women during normal spontaneous labour. Three groups were studied: two received extradural analgesia with a continuous infusion of 0.25% bupivacaine with or without the addition of fentanyl; the third group r...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/67.5.565
更新日期：1991-11-01 00:00:00
abstract：BACKGROUND:Multiple cognitive and psychiatric disorders are associated with an increased tonic inhibitory conductance that is generated by α5 subunit-containing γ-aminobutyric acid type A (α5 GABAA) receptors. Negative allosteric modulators that inhibit α5 GABAA receptors (α5-NAMs) are being developed as treatments for...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2020.11.032
更新日期：2020-12-30 00:00:00
abstract：:In 105 patients undergoing day-case surgery recovery of consciousness was significantly faster after enfluane compared with halothane anaesthesia. There was no difference in postoperative morbidity between the two anaesthetic groups. ...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/51.12.1143
更新日期：1979-12-01 00:00:00
abstract：BACKGROUND:Parecoxib, a cyclo oxygenase-2 inhibiting non-steroidal anti-inflammatory drug, has been widely used for postoperative analgesia. Our aim was to quantify the benefit of a single dose after coronary artery bypass grafting. METHODS:The investigation was carried out as a randomized double blind placebo control...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/aei298
更新日期：2006-02-01 00:00:00
abstract：:Animal studies suggest that alpha 2 agonists inhibit the chemoreceptor response to hypoxia. We have examined the effect of oral clonidine on the ventilatory response to sustained, isocapnic hypoxia (SpO2 79.7% (SD 1.1%) for 20 min) in eight male subjects. The hypoxic ventilatory response was measured before and after ...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/76.2.214
更新日期：1996-02-01 00:00:00
abstract：:We have compared bispectral index (BIS), 95% spectral edge frequency (SEF) and approximate entropy (ApEn) in 37 patients during induction and recovery from a short general anaesthetic. Heart rate variability (HRV) was also compared during induction only. These indices were noted at the start of induction, when a syrin...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/82.5.666
更新日期：1999-05-01 00:00:00
abstract：:Metoclopramide has been used for almost 40 yr to prevent postoperative nausea and vomiting (PONV). We have reviewed the efficacy and safety of metoclopramide for the prevention of PONV. A systematic search (MEDLINE, EMBASE, manufacturers' databases, hand searching, bibliographies, all languages, up to June 1998) was p...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析
doi：10.1093/bja/83.5.761
更新日期：1999-11-01 00:00:00
abstract：:Seventeen patients received morphine 0.2 mgkg-1 in a 10% dextrose solution i.m. (n = 5), extradurally (n = 6) and intrathecally (n = 6) for pain after operation. Morphine was measured in plasma by radioimmunoassay. Plasma immunoreactive morphine concentration was significantly less after intrathecal administration aft...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/53.9.911
更新日期：1981-09-01 00:00:00
abstract：BACKGROUND:Growing evidences indicate that inhalational anaesthetics can enhance the growth and malignant potential of tumour cells and may affect tumour recurrence after surgery. Tumour stem cells play a vital role in tumour recurrence. This study investigates the effect of sevoflurane on glioma stem cells (GSCs) in v...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aeu402
更新日期：2015-05-01 00:00:00
abstract：:Interest in the use of psychosocial interventions to help older adults manage pain is growing. In this article, we review this approach. The first section reviews the conceptual background for psychosocial interventions with a special emphasis on the biopsychosocial model of pain. The second section highlights three p...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aet129
更新日期：2013-07-01 00:00:00
abstract：:Following a paravertebral surgical incision, mature, female rats under ether anaesthesia were exposed to either 3% nitrous oxide, continuously for 48 h, or 50% nitrous oxide, 4 h each day for 7 days. For each exposure group, a similar number of rats was exposed to atmospheres containing no nitrous oxide. Wound healing...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/57.6.621
更新日期：1985-06-01 00:00:00
abstract：:The study of rare families with inherited pain insensitivity can identify new human-validated analgesic drug targets. Here, a 66-yr-old female presented with nil requirement for postoperative analgesia after a normally painful orthopaedic hand surgery (trapeziectomy). Further investigations revealed a lifelong history...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2019.02.019
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Early tracheostomy may decrease the duration of mechanical ventilation, sedation exposure, and intensive care stay, possibly resulting in improved clinical outcomes, but the evidence is conflicting. METHODS:Systematic review and meta-analysis of randomized trials in patients allocated to tracheostomy within...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,meta分析,评审
doi：10.1093/bja/aeu440
更新日期：2015-03-01 00:00:00
abstract：:The sedation of 50 children aged 6 months to 9 years who had undergone open heart surgery was studied. During artificial ventilation a midazolam infusion was used in conjunction with the administration of morphine (and tubocurarine). Sedation for patients breathing spontaneously with positive airway pressure was conti...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/58.10.1104
更新日期：1986-10-01 00:00:00
abstract：:We describe an obstetric patient who presented for removal of a retained placenta. After insertion of the spinal anaesthetic, she developed a severe headache, and a subarachnoid haemorrhage was diagnosed. We discuss the differential diagnosis of the headache, the occurrence of intracranial haemorrhages after dural pun...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/86.3.442
更新日期：2001-03-01 00:00:00
abstract：:We present a new pattern of nerve stimulation--double burst stimulation (DBS)--to detect residual neuromuscular block manually. The DBS consists of two short lasting, 50-Hz tetanic stimuli or bursts separated by a 750-ms interval. The response to this pattern of stimulation is two single separated muscle contractions ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/62.3.274
更新日期：1989-03-01 00:00:00
abstract：:We have studied the complications associated with three techniques used to maintain extradural analgesia in labour: midwife top-up doses of 0.25% bupivacaine 10 ml, continuous infusion of 0.125% bupivacaine 10 ml h-1 and patient-controlled extradural analgesia (PCEA) with self-administered 3-ml bolus doses of 0.25% bu...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/73.5.619
更新日期：1994-11-01 00:00:00
abstract：BACKGROUND:The relationship between end-tidal sevoflurane concentration, bispectral index (BIS) and the EEG bispectrum in children appears to be age dependent. The aim of this study was to quantify the BIS values at 1 MAC (minimum alveolar concentration) for desflurane and halothane, and explore the relationship with a...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/ael034
更新日期：2006-04-01 00:00:00
abstract：BACKGROUND:Several medications have proved to be useful in preventing postoperative nausea and vomiting (PONV). However, routine antiemetic prophylaxis is not cost-effective. We evaluated the accuracy and discriminating power of an artificial neural network (ANN) to predict PONV. METHODS:We analysed data from 1086 in-...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/ael282
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:We describe a practical method of training anaesthetists in the technique of awake fibreoptic intubation. This is performed on a training course using the delegates as subjects. METHODS:The first 15 subjects underwent cardiovascular monitoring during airway fibreoptic endoscopy performed by other course mem...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aef226
更新日期：2002-10-01 00:00:00
abstract：BACKGROUND:Supraglottic airways (SGAs) have an established role in airway management of difficult airways in both adults and children. However, there are limited data regarding the use of SGAs for primary airway management in children. The aim of this study is to assess the success rates and adverse events related to t...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aet411
更新日期：2014-04-01 00:00:00
abstract：BACKGROUND:Lower thoracic epidural anaesthesia and analgesia (EDA) has gained increasing importance in perioperative pain therapy. The loss-of-resistance technique used to identify the epidural space is thought to rely on the penetration of the ligamentum flavum. Investigations at the cervical and lumbar regions have d...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aei133
更新日期：2005-06-01 00:00:00
abstract：BACKGROUND:We explored whether a previously successful initiative to improve first-case on-time starts succeeded because (i) preoperative steps started earlier (but the process did not necessarily improve) or (ii) the process was brought into better control. METHODS:We analysed 35 months of data comprising 28 882 firs...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1016/j.bja.2018.05.043
更新日期：2018-11-01 00:00:00
abstract：:Using in vivo microdialysis, we have investigated the effects of propofol on acetylcholine (ACh) release from various regions of the rat brain. Propofol 25 and 50 mg kg-1 i.p. decreased basal ACh release from the frontal cortex by 70% and 85%, respectively. Propofol 25 and 50 mg kg-1 i.p. decreased basal ACh release f...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/80.5.644
更新日期：1998-05-01 00:00:00
abstract：BACKGROUND:Priming during anaesthesia has been hard to replicate and the conditions under which it occurs remain poorly understood. We replicated and extended a recent study to determine whether intraoperative priming during propofol and nitrous oxide anaesthesia is a reliable phenomenon, whether it occurs due to aware...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1093/bja/aeh289
更新日期：2005-01-01 00:00:00
abstract：:The physical and pharmacological properties of the structural isomers isoflurane and enflurane differ from each other and from those of other potent inhaled anaesthetics. The minimum alveolar concentration (MAC) for isoflurane (1.15%) is one-and-one-half times that for halothane (0.75%) and two-thirds that for enflura...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：
更新日期：1984-01-01 00:00:00
abstract：:This study tests the hypothesis that naloxone, but not its quarternary salt, naloxone methiodide (which does not enter the central nervous system), improves recovery from myocardial stunning in conscious dogs. Twenty dogs were chronically instrumented for measurement of heart rate, left atrial, aortic and left ventric...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/86.4.545
更新日期：2001-04-01 00:00:00
abstract：:Lung function and clinical evidence of muscle weakness were assessed in 12 ASA I patients who received vecuronium 0.01 mg kg-1 pretreatment as a part of their anaesthetic management, before and 3 min after pretreatment. Most patients demonstrated ptosis and diplopia, while five of the 12 were unable to raise the head ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/69.3.318
更新日期：1992-09-01 00:00:00
abstract：:The use of atracurium during major abdominal surgery was assessed in 20 infants with hepatic dysfunction caused by biliary atresia. An initial dose of 0.6 mg kg-1 provided excellent intubating conditions in all patients. Subsequent neuromuscular blockade was monitored with a peripheral nerve stimulator and incremental...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/58.11.1214
更新日期：1986-11-01 00:00:00
