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 first cases to calculate the difference of the time a patient entered the operating room (OR) vs the scheduled entry time. Median and inter-quartile range were used to evaluate changes in distribution parameters. A statistical process-control methodology was used to compare the differences in performance between the pre- and post-intervention phases. RESULTS:Post-intervention first cases entered the OR on average within 4 min [95% confidence interval (CI): 4-5 min] of the scheduled start time, as opposed to within 8 min (95% CI: 8-8 min) in the pre-intervention period. The median delay decreased from 5 min (95% CI: 5-5 min) to 2 min (95% CI: 2-2 min). The inter-quartile range of the difference between the scheduled start time and the first case in room time decreased from 13 min (95% CI: 13-13 min) to 10 min (95% CI: 9-10 min). CONCLUSIONS:The reduction in inter-quartile range demonstrates that improvement in on-time starts resulted from the process being in better control. The start time of preoperative preparatory activities did not move earlier, which means that OR and preoperative staff do not need to arrive at work earlier. Improvements resulting from the process being in control were sustained.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Tiwari V,Ehrenfeld JM,Sandberg WSdoi
10.1016/j.bja.2018.05.043subject
Has Abstractpub_date
2018-11-01 00:00:00pages
1148-1155issue
5eissn
0007-0912issn
1471-6771pii
S0007-0912(18)30434-3journal_volume
121pub_type
杂志文章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：:As the physiology of deliberate hypotension has been unravelled, and as each new pharmacological agent has become available which either depresses or blocks peripheral vascular tone, depresses myocardial performance, or interferes with the conducting tissues within the myocardium, its possible incorporation into the a...
journal_title：British journal of anaesthesia
pub_type： 历史文章,杂志文章
doi：10.1093/bja/47.7.745
更新日期：1975-07-01 00:00:00
abstract：:The protein binding of four non-depolarizing neuromuscular blocking drugs-tubocurarine, fazadinium, pancuronium and Org NC45-was measured, in serum from normal patients and from patients with cirrhosis of the liver, by an ultracentrifugation method. The fraction bound to serum protein in normal patients was 56% for tu...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/54.5.513
更新日期：1982-05-01 00:00:00
abstract：:Thiopentone 4 mg/kg, Althesin 0.055 ml/kg and ketamine 2 mg/kg were compared in 157 children undergoing minor otolaryngological surgery, mostly adenotonsillectomy. Premedication was with pethidine and atropine and anaesthesia was maintained with nitrous oxide in oxygen and halothane. Tracheal intubation was facilitate...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/49.4.363
更新日期：1977-04-01 00:00:00
abstract：BACKGROUND:Movement responses are an important indicator of noxious perception in the unconscious state. To allow for a continual monitoring of the responsiveness to noxious stimuli during general anaesthesia, surrogate parameters are needed. Here we compare the performance of the bispectral index (BIS) and the RIII th...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aep357
更新日期：2010-02-01 00:00:00
abstract：:A genetic disorder of the calcium releasing ryanodine receptor has recently been postulated in malignant hyperthermia (MH) and ryanodine-induced contractures differ between subjects who are malignant hyperthermia susceptible (MHS) and non-susceptible (MHN). We tested 39 patients from 26 families for MH, using the proc...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/71.2.242
更新日期：1993-08-01 00:00:00
abstract：BACKGROUND:This study focuses on a recently developed robotic nerve block system and its impact on learning regional anaesthesia skills. We compared success rates, learning curves, performance times, and inter-subject performance variability of robot-assisted vs manual ultrasound (US)-guided nerve block needle guidance...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/aet440
更新日期：2014-06-01 00:00:00
abstract：:We describe a case of a 9-yr-old child with sickle cell disease complicated by abdominal vaso-occlusive crisis and priapism. Both complications were successfully treated with a combination of epidural local anesthetics and morphine. ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/87.6.935
更新日期：2001-12-01 00:00:00
abstract：:Patients are at risk for several types of lung injury in the perioperative period including atelectasis, pneumonia, pneumothorax, acute lung injury, and acute respiratory distress syndrome. Anaesthetic management can cause, exacerbate, or ameliorate these injuries. This review examines the effects of perioperative mec...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,评审
doi：10.1093/bja/aeq299
更新日期：2010-12-01 00:00:00
abstract：BACKGROUND:There has been a renewed interest in nitric oxide donor drugs, such as nitroglycerin, delivered by the inhalational route for treatment of pulmonary arterial hypertension (PAH). We investigated the acute effects of inhaled nitroglycerin on pulmonary and systemic haemodynamics in children with PAH associated ...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/ael112
更新日期：2006-08-01 00:00:00
abstract：:A new method has been developed to measure end-tidal carbon dioxide partial pressure (PECO2) during high frequency jet ventilation (HFJV). A digital flow controller incorporated in a computerized high frequency jet ventilator was used to deliver either a single deep breath or a series of three deep breaths. On user re...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/63.7.47
更新日期：1989-01-01 00:00:00
abstract：:Simple methods are described for computing the variables derived from the Siggaard-Andersen nomogram, where the in vitro buffer line is either established by direct measurement or calculated from measurements of pH, Pco2 and haemoglobin. Calculations are performed using the equation of the pH-log Pco2 buffer line, the...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/47.4.500
更新日期：1975-04-01 00:00:00
abstract：:The use of di-isopropyl phenol (Diprivan) for induction of anaesthesia was assessed in doses ranging from 1 to 3 mg kg-1. With less than 1.75mg kg-1 not all patients were anaesthetized; 2.0 mg kg-1 appeared to be a satisfactory induction dose. Involuntary muscle movement, cough and hiccup at induction were rare with a...
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/53.11.1197
更新日期：1981-11-01 00:00:00
abstract：:Since 1972, 367 patients with chronic low-back pain have been treated by electrical stimulation (e.s.). Patients with herniated disc lesions and spondylitis and allied conditions were included. Following e.s. 75-100% pain relief was obtained by 53% of the patients 50% pain relief by 27% and there was no improvement in...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/49.6.629
更新日期：1977-06-01 00:00:00
abstract：:Intra-oral masses in neonates can seriously compromise the airway, potentially causing hypoxia and death if not recognized and managed appropriately. We report a case in which an intra-oral mass was diagnosed on antenatal ultrasound scan. Preparation for delivery involved a multidisciplinary team approach, with a stra...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/83.6.951
更新日期：1999-12-01 00:00:00
abstract：BACKGROUND:Preoperative anaemia affects one third of patients undergoing cardiac surgery and is associated with increased mortality and morbidity. Although it is recommended that perioperative teams should identify and treat patients with preoperative anaemia before surgery, introducing new treatment protocols can be c...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,多中心研究
doi：10.1016/j.bja.2019.11.023
更新日期：2020-03-01 00:00:00
abstract：:We have studied the effects of bilateral ilioinguinal nerve block and wound infiltration with 0.5% bupivacaine on postoperative pain and analgesic requirements in 62 patients undergoing Caesarean section under general anaesthesia. A control group received no local anaesthetic supplementation. Both ilioinguinal block a...
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/72.2.229
更新日期：1994-02-01 00:00:00
abstract：:Single dose-response curves were determined for suxamethonium in neonates, infants and children during thiopentone-fentanyl-nitrous oxide anaesthesia. During onset of neuromuscular block, suxamethonium produced an increase in muscle tone which was greatest in neonates and infants. The dose-response curves for the thre...
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/62.6.655
更新日期：1989-06-01 00:00:00
abstract：:Temazepam elixir 30 mg by mouth was compared with i.v. Diazemuls titrated to a maximum dose of 20 mg in a double-blind study of 50 patients undergoing elective minor oral surgery. The treatments produced a similar reduction in anxiety score and similar degrees of patient relaxation and co-operation. The diazepam group...
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/60.1.18
更新日期：1988-01-01 00:00:00
abstract：:We describe the management of a patient with Eisenmenger's syndrome presenting for laparoscopic cholecystectomy. Of prime concern was maintenance of systemic vascular resistance and this was achieved using infusion of noradrenaline started before induction of anaesthesia and continued after operation. Avoidance of oth...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/79.6.810
更新日期：1997-12-01 00:00:00
abstract：:Serum concentrations of the cytokine, interleukin-6 (IL-6), increase after surgical trauma. IL-6 mediates the synthesis of acute phase proteins and stimulates secretion of pituitary hormones. We have examined the time course of circulating IL-6, and cortisol and growth hormone responses in patients undergoing hysterec...
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/72.3.272
更新日期：1994-03-01 00:00:00
abstract：:The effect on intervillous blood flow of lumbar extradural analgesia for Caesarean section was studied in nine healthy women using xenon-133. Extradural anaesthesia was performed with lignocaine 1 1/2% 16--20 ml with adrenaline 5 microgram ml-1. Impairment of placental blood flow during the block was observed in seven...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/50.3.275
更新日期：1978-03-01 00:00:00
abstract：:One hundred and forty male rats received a cryoinjury to a segment of the exposed sciatic nerve. A variety of temperatures and freeze patterns was used and the recovery of function was monitored. Where obvious nerve freezing occurred, the cryoinjury caused complete loss of function in the limb. The return of motor act...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/53.11.1121
更新日期：1981-11-01 00:00:00
abstract：:We prospectively studied spontaneous recovery from cisatracurium-induced neuromuscular block in 18 patients scheduled for cardiac surgery, and its suitability for fast-track cardiac surgery. Neuromuscular block was induced by an i.v. bolus (range 0.15-0.3 mg kg(-1)) and maintained by a continuous infusion (range 1.1-3...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/86.1.130
更新日期：2001-01-01 00:00:00
abstract：:Midazolam is often used for paediatric premedication. We have compared two methods of administering midazolam intranasally in 44 surgical day-case children allocated randomly to receive midazolam 0.2 mg kg-1 as drops or midazolam 0.1 mg kg-1 from an intranasal spray device. Behaviour was recorded on a four-point scale...
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/81.6.865
更新日期：1998-12-01 00:00:00
abstract：:The isolated rat hepatocyte model has been used to assess the hepatotoxicity of a number of i.v. anaesthetic induction agents. Ketamine, Althesin and CCI 12923 (minaxolone) all inhibited gluconeogenesis and urea formation from alanine. There was also a decrease in the cell ATP concentration, and a dose-related increas...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/51.8.733
更新日期：1979-08-01 00:00:00
abstract：:We have assessed the role of the cell-cell adhesion molecule, E-cadherin, in the pathogenesis of multiorgan failure in 24 intensive care patients with sepsis and varying degrees of organ dysfunction, compared with 21 healthy subjects. Plasma soluble E-cadherin (sE-cadherin) was measured by enzyme immunoassay. The medi...
journal_title：British journal of anaesthesia
pub_type： 杂志文章
doi：10.1093/bja/76.5.629
更新日期：1996-05-01 00:00:00
abstract：BACKGROUND:Magnesium is a calcium and an NMDA-receptor antagonist and can modify important mechanisms of nociception. We evaluated the co-analgesic effect of magnesium in the postoperative setting after on-pump cardiac surgery. METHODS:Forty patients randomly received either magnesium gluconate as an i.v. bolus of 0.2...
journal_title：British journal of anaesthesia
pub_type： 杂志文章,随机对照试验
doi：10.1093/bja/ael037
更新日期：2006-04-01 00:00:00
abstract：:Thirty mothers undergoing elective Caesarean section received thiopentone 3.5 mg kg-1 and 30 received etomidate 0.3 mg kg-1 for induction of anaesthesia. Subsequent management of anaesthesia was identical in both groups. Maternal to fetal base excess differences and the degree of biochemical correlation between mother...
journal_title：British journal of anaesthesia
pub_type： 临床试验,杂志文章
doi：10.1093/bja/51.2.135
更新日期：1979-02-01 00:00:00
abstract：:We have studied the tone of the lower oesophageal sphincter (LOS) in 40 adults undergoing routine body surface surgery and allocated randomly to receive anaesthesia either by face mask and Guedel airway or by laryngeal mask airway. In the laryngeal mask group there was a mean (SEM) decrease in barrier pressure (LOS mi...
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/69.4.346
更新日期：1992-10-01 00:00:00
