Abstract：
:For select total knee arthroplasty (TKA) patients, we have established an alternative pathway to bypass the acute care surgical ward and directly admit patients from the post-anesthesia care unit to on-campus rehabilitation. We retrospectively examined whether this 'fast track' pathway decreased costs and improved patient outcomes. After reviewing records of consecutive primary unilateral TKA patients over a 15-month period, each patient admitted to rehabilitation was matched with a control admitted to the acute care ward. The primary outcome was estimated total hospitalization cost (length of stay in days multiplied by the average cost per day). Secondary outcomes were length of stay, in-hospital pain scores, opioid use, maximum ambulatory distance and 30-day readmission, morbidity, and mortality. Of the 262 TKA patients during the study period, 14 were admitted to rehabilitation and were matched to 14 patients admitted to acute care. Estimated total hospitalization cost [median (10th-90th percentiles)] was US$30,755 (US$23,066-38,444) for ward patients compared to US$17,620 (US$13,215-33,918) for rehabilitation patients (P = 0.006). This difference [mean (95% CI)] was US$10,143 (US$2174-18,112). There were no other differences. For facilities similar to ours, direct postoperative admission of select TKA patients to subacute rehabilitation may be less costly than acute care and may not negatively affect outcomes.
journal_name
J Anesthjournal_title
Journal of anesthesiaauthors
Tse BK,Walters TL,Howard SK,Kim TE,Memtsoudis SG,Sun EC,Kou A,Graham L,King R,Mariano ERdoi
10.1007/s00540-017-2372-9subject
Has Abstractpub_date
2017-10-01 00:00:00pages
785-788issue
5eissn
0913-8668issn
1438-8359pii
10.1007/s00540-017-2372-9journal_volume
31pub_type
杂志文章abstract：PURPOSE:We hypothesized that, after axillary block, positioning the patient in a lateral position with the injected side down and simultaneously in a 20° Trendelenburg position will increase the success rate and quality of the block. METHODS:Fifty patients with chronic renal failure (ASA 2-3) scheduled for arterioveno...
journal_title：Journal of anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00540-013-1766-6
更新日期：2014-08-01 00:00:00
abstract：PURPOSE:We investigated whether presynaptic facilitatory M1 and/or inhibitory M2 muscarinic receptors contributed to pancuronium- and cisatracurium-induced tetanic fade. METHODS:Phrenic nerve-diaphragm muscle preparations of rats were indirectly stimulated with tetanic frequency (75 +/- 3.3 Hz; mean +/- SD). Doses of ...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-009-0790-z
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Rocuronium (Rb) is ideal for continuous infusion but has a widely variable duration of action. We investigated the distribution of Rb infusion in a steady state of optimal muscle relaxation and the relationship between the measured and predicted blood Rb concentrations in laparoscopic surgery. METHODS:Seven...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-014-1879-6
更新日期：2015-02-01 00:00:00
abstract：PURPOSE:We aimed to introduce a simple, lightweight continuous positive airway pressure (CPAP)-delivery device for the nondependent lung during one-lung ventilation, to investigate how the type of three-way stopcocks, and the compliance and resistance of a test lung affect the relationship between the oxygen flow rate ...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-008-0681-8
更新日期：2009-01-01 00:00:00
abstract：:With the aim to optimize surgical safety, the World Health Organization (WHO) introduced the Surgical Safety Checklist (SSCL) in 2008. The SSCL has been piloted in many countries worldwide and shown to improve both safety attitudes within surgical teams and patient outcomes. In the study reported here we investigated ...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-013-1737-y
更新日期：2014-06-01 00:00:00
abstract：PURPOSE:The newly introduced erector spinae plane block (ESPB) has given anesthesiologists an alternative regional anesthetic technique for thoracic analgesia. Although ESPB and retrolaminar block (RLB) have similar puncture sites, no clinical study comparing ESPB and RLB has been reported. The aim of this study was to...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-020-02855-y
更新日期：2021-02-01 00:00:00
abstract：:Cardiopulmonary resuscitation (CPR) in the lateral position during noncardiac surgery has been described in only a few reports in the past. Here, we report a case of cardiac arrest in a 61-year-old man undergoing microvascular decompression surgery for trigeminal neuralgia in the left lateral decubitus position. Durin...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-010-0911-8
更新日期：2010-06-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to assess whether preanesthetic laboratory values can predict in-hospital mortality and morbidity in patients who have undergone burr hole craniostomy due to chronic subdural hematoma. METHODS:From January 2007 to February 2016, the records of 502 consecutive patients who under...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-016-2259-1
更新日期：2016-12-01 00:00:00
abstract：:We report a case of hyperglycemic shock associated with hepatic portal venous gas. A 79-year-old woman with post-stroke depression developed severe tachycardiac atrial fibrillation and hypotension due to hypovolemia caused by severe hyperglycemia, as well as showing disseminated intravascular coagulation (DIC). Contin...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-007-0586-y
更新日期：2008-01-01 00:00:00
abstract：PURPOSE:"Juci", one of the traditional acupuncture techniques, means contralateral acupuncture; i.e., implanting a needle into an acupoint to treat a given disease or disorder, but on the side of the body opposite to the diseased side. The aim of this study was: (1) to assess acupuncture effects on formalin-induced noc...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-006-0443-4
更新日期：2007-01-01 00:00:00
abstract：:The purpose of this study was to determine the mortality rate in 527 critically ill patients with multiple organ failure (MOF), treated in our ICU between August, 1986 and January, 1992, and to compare it with the results obtained in a group of patients studied who had been treated between October, 1978 and July, 1986...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/BF02514648
更新日期：1994-09-01 00:00:00
abstract：:Cardiac effects of sevoflurane (SE) with or without nitrous oxide were examined in the canine blood-perfused papillary muscle and sinoatrial node preparations. Although SE depressed developed tension (DT), mean arterial pressure (MAP) and heart rate of the donor dog (DHR) dose dependently, sinoatrial rate (SAR) was no...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s0054090030145
更新日期：1989-09-01 00:00:00
abstract：:Airway management in patients of faciomaxillary injury is of great concern to the anesthesiologist. Bag and mask ventilation and orotracheal intubation may be difficult with these patients. Recently, a middle aged, obese female presented in the emergency department after sustaining a blast injury, with laceration of t...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-010-1091-2
更新日期：2011-04-01 00:00:00
abstract：:The excretion of trifluoroacetic acid (TFAA) in bile, saliva and gastric juice of two groups of guinea pigs with bile fistulae was measured by ion-chromatography during inhalation of halothane (0.25% and 1.0%) for two hours and after inhalation of halothane. In another two groups without bile fistulae, excretion of TF...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s0054080020133
更新日期：1988-09-01 00:00:00
abstract：:A needle guide kit will be able to improve visibility on ultrasonic images. We examined the degree of stability using a SIVA guide. The SIVA guide is a needle guide kit in which the angle is not restricted, allowing the puncture to be made at any angle. We punctured the Blue Phantom™ with a high-frequency linear probe...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-015-2021-0
更新日期：2015-10-01 00:00:00
abstract：PURPOSE:Remifentanil has been available in Japan for 3 years. The use of this new opioid is considered a useful adjuvant to general anesthesia. Knowing the exact cost-effectiveness of remifentanil should lead to improved anesthetic outcomes with a reasonable cost. METHODS:This single-blinded, prospective, randomized s...
journal_title：Journal of anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00540-010-1006-2
更新日期：2010-12-01 00:00:00
abstract：PURPOSE:Intravenous infusion of lidocaine attenuates the stress response to surgery. We aimed to evaluate the effects of perioperative lidocaine on the hemodynamic and hormonal responses for cesarean delivery. METHODS:After the gaining of ethical approval, 90 patients scheduled for elective cesarean delivery were rand...
journal_title：Journal of anesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00540-009-0738-3
更新日期：2009-01-01 00:00:00
abstract：:Familial dysautonomia is an inherited disorder characterized by autonomic and sensory nervous system neuropathy resulting in extremely labile blood pressure (severe hypertension followed by hypotension). As more patients with familial dysautonomia reach adulthood due to improved medical treatment, perioperative encoun...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-009-0795-7
更新日期：2009-01-01 00:00:00
abstract：:In a case with malignant hyperthermia (MH), membrane fluidity of erythrocytes was studied by electron spin resonance (ESR)-spin labeling technique. The measurement was made with samples obtained during and after pyrexic crisis until full recovery. The results indicated that membrane fluidity increased during pyrexic c...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s0054070010088
更新日期：1987-03-01 00:00:00
abstract：PURPOSE:The effects of midazolam-thiopental coinduction on recovery were investigated and compared with thiopental induction. METHODS:Fifty patients, ASA 1 or 2, undergoing minor orthopedic surgery, were randomly divided into coinduction and thiopental groups. During preoxygenation, the patients received midazolam 0.1...
journal_title：Journal of anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s005400170044
更新日期：2001-01-01 00:00:00
abstract：:We encountered three cases of lung disorders caused by drowning in the recent large tsunami that struck following the Great East Japan Earthquake. All three were females, and two of them were old elderly. All segments of both lungs were involved in all the three patients, necessitating ICU admission and endotracheal i...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-011-1273-6
更新日期：2012-04-01 00:00:00
abstract：PURPOSE:To identify whether the presence of preoperative depression in patients with diabetes mellitus is a risk factor for postoperative cognitive dysfunction after coronary artery bypass graft (CABG) surgery. METHODS:Data from 90 patients with diabetes mellitus undergoing elective CABG were analyzed. Hemodynamic dat...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-010-1072-5
更新日期：2011-02-01 00:00:00
abstract：:The pharmacokinetics and pharmacodynamics of vecuronium bromide were studied in patients under general anesthesia of enflurane and nitrous oxide in oxygen. Eighteen patients were randomly divided into two groups which received either 0.05 mg.kg(-1) (low dose group) or 0.20 mg.kg(-1) (high dose group) of vecuronium int...
journal_title：Journal of anesthesia
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1007/s0054020060028
更新日期：1992-01-01 00:00:00
abstract：PURPOSE:Bone metastasis is one of the major causes of cancer-related pain, and not all bone cancer pain can be effectively treated. Recently, a mouse model of bone cancer pain was introduced. To test the analgesic effects of nonsteroidal antiinflammatory drugs on bone cancer pain, the authors examined the effects of or...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-005-0323-3
更新日期：2005-01-01 00:00:00
abstract：:Within the airway management field, simulation has been used as a tool of training for over 40 years. Simulation training offers a chance of active involvement for the trainees. It can effectively enhance and upgrade the knowledge and skills of the trainees in airway management, and subsequently decrease medical error...
journal_title：Journal of anesthesia
pub_type： 杂志文章,评审
doi：10.1007/s00540-015-2116-7
更新日期：2016-04-01 00:00:00
abstract：PURPOSE:We investigated the mechanism by which inhibition of carbonic anhydrase (CA) increases organ blood flow. METHODS:Regional blood flow (rBF) in white rabbits anesthetized with ketamine/urethane was measured in the kidney, liver, stomach wall, and abdominal muscle by means of laser blood flow probes. Data obtaine...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/BF02480036
更新日期：1997-09-01 00:00:00
abstract：PURPOSE:Several reports indicate that a neutrophil elastase inhibitor, sivelestat, may have prophylactic efficacy against a systemic inflammatory response after cardiovascular surgery with cardiopulmonary bypass (CPB). We evaluated the clinical pulmonary and cardiac effects of sivelestat. METHODS:We performed a retros...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-008-0645-z
更新日期：2008-01-01 00:00:00
abstract：:Isolated adrenocorticotropic hormone (ACTH) deficiency is an extremely rare disease in which ACTH-producing cells of the pituitary gland are selectively damaged. The resulting decline in ACTH production and secretion results in chronic secondary adrenocortical insufficiency. The patient in this case did not present wi...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-011-1118-3
更新日期：2011-06-01 00:00:00
abstract：PURPOSE:The general public's perceptions of anesthesia and the risks associated with it may be skewed. The outpatient preoperative appointment with an anesthesiologist allows for patient education regarding different anesthetic options and counseling regarding anxiety related to anesthesia and surgery. This study inves...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/s00540-018-02608-y
更新日期：2019-04-01 00:00:00
abstract：:In this study induction of anesthesia using the single-breath technique with either enflurane or sevoflurane in oxygen was compared. Each group consisted of 16 unpremedicated volunteers who breathed approximately 1.7 minimum alveolar concentration (MAC) equivalents of either vapor. There were no significant difference...
journal_title：Journal of anesthesia
pub_type： 杂志文章
doi：10.1007/BF02514709
更新日期：1994-06-01 00:00:00
