scholarly journals Cannula complications using elastomeric infusers in Hospital in the Home

2020 ◽  
Vol 2 (3) ◽  
Author(s):  
Damian Ryan ◽  
Jennifer Miller ◽  
Joanne Campbell
Keyword(s):  
Patient Satisfaction ◽  
Patient Characteristics ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Patient Acceptance ◽  
Control Group ◽  
Complication Rates ◽  
Patient Satisfaction Scores ◽  
Home Service ◽  
Significant Difference

Abstract Objectives Comparison of the short peripheral cannula (SPC) complication rate of patients with cellulitis receiving IV cefazolin via an elastomeric infuser with those receiving twice-daily bolus treatment (control group) in the Hospital in the Home service. Methods A randomized controlled study using elastomeric infuser versus bolus delivery of IV cefazolin via an SPC of patients referred to the Hospital in the Home service in the Northern Illawarra for treatment of cellulitis. A total of 104 patients were enrolled during the time period of May 2018 to January 2019. Primary outcome measures were SPC complications including phlebitis with a secondary outcome of patient satisfaction. Results A total of 104 patients enrolled. After randomization there were 60 in the infuser group and 44 in the bolus group. Patient characteristics of age, gender, weight and mobility were similar for the two groups. There was no statistically significant difference between the groups for the endpoint of cannula complication rates. Patient satisfaction scores showed patient acceptance of both forms of treatment. Conclusions This study suggests that using elastomeric infusers to deliver cefazolin via a short peripheral IV catheter has similar complication rates to traditional bolus delivery. Patients surveyed showed high levels of satisfaction with both forms of antibiotic delivery.

scholarly journals Effect of Ketorolac on the Prevention of Postoperative Catheter-Related Bladder Discomfort in Patients Undergoing Robot-Assisted Laparoscopic Radical Prostatectomy: A Randomized, Double-Blinded, Placebo-Controlled Study

2019 ◽  
Vol 8 (6) ◽  
pp. 759
Author(s):  
Jun-Young Park ◽  
Jun Hyuk Hong ◽  
Jihion Yu ◽  
Doo-Hwan Kim ◽  
Gi-Ho Koh ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Radical Prostatectomy ◽  
Primary Outcome ◽  
Laparoscopic Radical Prostatectomy ◽  
Controlled Study ◽  
Control Group ◽  
Robot Assisted ◽  
Pain Scores ◽  
Patient Satisfaction Scores ◽  
Double Blinded

Urinary catheterization can cause catheter-related bladder discomfort (CRBD). Ketorolac is widely used for pain control. Therefore, we evaluated the effect of ketorolac on the prevention of CRBD in patients undergoing robot-assisted laparoscopic radical prostatectomy (RALP). All patients were randomly allocated to the ketorolac group or the control group. The primary outcome was CRBD above a moderate grade at 0 h postoperatively. CRBD above a moderate grade at 1, 2, and 6 h was also assessed. Postoperative pain, opioid requirement, ketorolac-related complications, patient satisfaction, and hospitalization duration were also assessed. The incidence of CRBD above a moderate grade at 0 h postoperatively was significantly lower in the ketorolac group (21.5% vs. 50.8%, p = 0.001) as were those at 1, 2, and 6 h. Pain scores at 0 and 1 h and opioid requirement over 24 h were significantly lower in the ketorolac group, while patient satisfaction scores were significantly higher in the ketorolac group. Ketorolac-related complications and hospitalization duration were not significantly different between the two groups. This study shows ketorolac can reduce postoperative CRBD above a moderate grade and increase patient satisfaction in patients undergoing RALP, suggesting it is a useful option to prevent postoperative CRBD.

Continuous Infusion of Lidocaine in Pediatric Colonoscopy: A Randomized Placebo-Controlled Study

2020 ◽  
Author(s):  
Chao Yuan ◽  
Chengli Wang ◽  
Jiayao Wu ◽  
Ningyang Gao ◽  
Kuiwei Li ◽  
...  
Keyword(s):  
Continuous Infusion ◽  
Recovery Time ◽  
Oxygen Desaturation ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Intravenous Lidocaine ◽  
Lidocaine Group ◽  
Significant Difference ◽  
Pediatric Colonoscopy

Abstract Background: To investigate the effect of intravenous lidocaine on perioperative propofol and sufentanil dosage, pulse oxygen saturation, postoperative pain score and recovery time during pediatric colonoscopy.Methods: We designed a randomized placebo-controlled study and enrolled 80 children aged from 3 to 10 years old who were received colonoscopy. After titration of propofol to achieve unconsciousness, patients were given intravenous lidocaine (1.5 mg kg-1 then 2 mg kg-1 h-1) or the same volume of saline. Sedation was standardized and combined propofol with sufentanil. The primary outcome variables were intraoperative propofol and sufentanil requirements and number of oxygen desaturation episodes. Secondary outcome variables were recovery time after colonoscopy and post-colonoscopy pain.Results: Lidocaine infusion resulted in a significant reduction in propofol requirements: mean (SD) 44.3 (9.9) vs 74.5 (12.0) mg, respectively; P<0.001) and sufentanil requirements: mean (SD) 1.5 (0.3) vs 2.6 (0.6) ug respectively; p<0.001). The number of subjects who experienced oxygen desaturation below 95% in the lidocaine group was also significantly less than that in the control group: 2 vs 8 (P=0.04). The mean (SD) recovery time was significantly shorter in lidocaine group: 19.2 (2.6) vs 13.3 (2.6) min respectively; p<0.001). There were no significant difference regarding post-colonoscopy pain.Conclusions: Continuous infusion of lidocaine resulted in reduction of propofol and sufentanil dose, recovery time and risk of hypoxemia during pediatric colonoscopy.Trial Registration: Chinese Clinical Trials Registry, ChiCTR2000028927, 8 January, 2020, prospectively registered.

scholarly journals Impact of telephone monitoring on cancer patients undergoing esophagectomy and gastrectomy

2021 ◽  
Vol 55 ◽  
Author(s):  
Daniele da Silva Salgado Oliveira ◽  
Ulysses Ribeiro Junior ◽  
Natalia de Araújo Sartório ◽  
André Roncon Dias ◽  
Flávio Roberto Takeda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Cancer Patients ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
Emergency Center ◽  
Significant Difference ◽  
Telephone Monitoring

ABSTRACT Objective: To evaluate telephone monitoring for symptoms, quality of life, distress, admissions to the emergency center and the satisfaction of cancer patients undergoing esophagectomy and gastrectomy. Method: Randomized controlled study in two groups, carried out at the Cancer Institute of the State of Sao Paulo; the intervention group received telephone monitoring for four moments after the surgery, while the control group received only institutional care. Results: Of the 81 patients evaluated, the domain most affected by quality of life was social relationships domain. Distress had no significant difference between groups and moments. In both groups, admissions to the emergency center were similar (p=0.539). Pain was the most reported symptom in telephone monitoring. There was statistical significance regarding patient satisfaction with monitoring (p=0.002). Conclusion: Telephone monitoring provided greater patient satisfaction in the intervention group, demonstrating the real impact of this process on the care of cancer patients.

scholarly journals Web-Based Education Prior to Outpatient Orthopaedic Surgery Enhances Early Patient Satisfaction Scores: A Prospective Randomized Controlled Study

2018 ◽  
Vol 6 (1) ◽  
pp. 232596711775141 ◽  
Author(s):  
Carola F. van Eck ◽  
Aneet Toor ◽  
Michael B. Banffy ◽  
Ralph A. Gambardella
Keyword(s):  
Patient Satisfaction ◽  
Orthopaedic Surgery ◽  
Emotional Health ◽  
Controlled Study ◽  
Control Group ◽  
Study Group ◽  
Web Based ◽  
Randomized Controlled ◽  
Patient Satisfaction Scores ◽  
Web Based Education

Background: A good patient-surgeon relationship relies on adequate preoperative education and counseling. Several multimedia resources, such as web-based education tools, have become available to enhance aspects of perioperative care. Purpose/Hypothesis: The purpose of this study was to evaluate the effect of an interactive web-based education tool on perioperative patient satisfaction scores after outpatient orthopaedic surgery. It was hypothesized that web-based education prior to outpatient orthopaedic surgery enhances patient satisfaction scores. Study Design: Randomized controlled trial; Level of evidence, 1. Methods: All patients undergoing knee arthroscopy with meniscectomy, chondroplasty, or anterior cruciate ligament reconstruction or shoulder arthroscopy with rotator cuff repair were eligible for inclusion and were randomized to the study or control group. The control group received routine education by the surgeon, whereas the study group received additional web-based education. At the first postoperative visit, all patients completed the OAS CAHPS (Outpatient and Ambulatory Surgery Consumer Assessment of Healthcare Providers and Systems) survey. Differences in patient satisfaction scores between the study and control groups were determined with an independent t test. Results: A total of 177 patients were included (104 [59%] males; mean age, 42 ± 14 years); 87 (49%) patients were randomized to receive additional web-based education. Total patient satisfaction score was significantly higher in the study group (97 ± 5) as compared with the control group (94 ± 8; P = .019), specifically for the OAS CAHPS core measure “recovery” (92 ± 13 vs 82 ± 23; P = .001). Age, sex, race, workers’ compensation status, education level, overall health, emotional health, procedure type and complexity, and addition of a video did not influence patient satisfaction scores. Conclusion: Supplemental web-based patient education prior to outpatient orthopaedic surgery enhances patient satisfaction scores.

scholarly journals Donepezil for mild cognitive impairment in Parkinson’s disease

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Kyoungwon Baik ◽  
Seon Myeong Kim ◽  
Jin Ho Jung ◽  
Yang Hyun Lee ◽  
Seok Jong Chung ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Treatment Group ◽  
Outcome Measures ◽  
Rating Scale ◽  
Secondary Outcome ◽  
Control Group ◽  
Significant Difference

AbstractWe investigated the efficacy of donepezil for mild cognitive impairment in Parkinson’s disease (PD-MCI). This was a prospective, non-randomized, open-label, two-arm study. Eighty PD-MCI patients were assigned to either a treatment or control group. The treatment group received donepezil for 48 weeks. The primary outcome measures were the Korean version of Mini-Mental State Exam and Montreal Cognitive Assessment scores. Secondary outcome measures were the Clinical Dementia Rating, Unified Parkinson’s Disease Rating Scale part III, Clinical Global Impression scores. Progression of dementia was assessed at 48-week. Comprehensive neuropsychological tests and electroencephalography (EEG) were performed at baseline and after 48 weeks. The spectral power ratio of the theta to beta2 band (TB2R) in the electroencephalogram was analyzed. There was no significant difference in the primary and secondary outcome measures between the two groups. However, the treatment group showed a significant decrease in TB2R at bilateral frontotemporoparietal channels compared to the control group. Although we could not demonstrate improvements in the cognitive functions, donepezil treatment had a modulatory effect on the EEG in PD-MCI patients. EEG might be a sensitive biomarker for detecting changes in PD-MCI after donepezil treatment.

scholarly journals Effect of pelvic laparoscopic implantation of neuroprosthesis in spinal cord injured subjects: a 1-year prospective randomized controlled study

Spinal Cord ◽  
2021 ◽  
Author(s):  
Helge Kasch ◽  
Uffe Schou Løve ◽  
Anette Bach Jønsson ◽  
Kaare Eg Severinsen ◽  
Marc Possover ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Outcome Measures ◽  
Outcome Measure ◽  
Secondary Outcome ◽  
Controlled Study ◽  
Control Group ◽  
Walking Ability ◽  
Data Set ◽  
Cord Injury

Abstract Study design 1-year prospective RCT. Objective Examine the effect of implantable pulse generator and low-frequency stimulation of the pelvic nerves using laparoscopic implantation of neuroprosthesis (LION) compared with neuromuscular electrical stimulation (NMES) in SCI. Methods Inclusion criteria: traumatic spinal cord injury (SCI), age 18–55 years, neurological level-of-injury Th4–L1, time-since-injury >1 year, and AIS-grades A–B. Participants were randomized to (A) LION procedure or (B) control group receiving NMES. Primary outcome measure: Walking Index for Spinal Cord Injury (WISCI-II), which is a SCI specific outcome measure assessing ability to ambulate. Secondary outcome measures: Spinal Cord Independence Measure III (SCIM III), Patient Global Impression of Change (PGIC), Penn Spasm Frequency Scale (PSFS), severity of spasticity measured by Numeric Rating Scale (NRS-11); International Spinal Cord Injury data sets-Quality of Life Basic Data Set (QoLBDS), and Brief Pain Inventory (BPI). Results Seventeen SCI individuals, AIS grade A, neurological level ranging from Th4–L1, were randomized to the study. One individual was excluded prior to intervention. Eight participants (7 males) with a mean age (SD) of 35.5 (12.4) years were allocated to the LION procedure, 8 participants (7 males) with age of 38.8 (15.1) years were allocated to NMES. Significantly, 5 LION group participants gained 1 point on the WISCI II scale, (p < 0.013; Fisher´s exact test). WISCI II scale score did not change in controls. No significant changes were observed in the secondary outcome measures. Conclusion The LION procedure is a promising new treatment for individuals with SCI with significant one-year improvement in walking ability.

scholarly journals A preliminary study of bowel rest strategy in the management of Clostridioides difficile infection

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hiroshi Sugimoto ◽  
Ayaka Yoshihara ◽  
Takao Yamamoto ◽  
Keisuke Sugimoto
Keyword(s):  
Secondary Outcome ◽  
Control Group ◽  
Matched Cohort ◽  
Full Cohort ◽  
Clostridioides Difficile ◽  
Significant Difference ◽  
All Cause Mortality ◽  
Clostridioides Difficile Infection ◽  
Bowel Rest ◽  
Preliminary Study

AbstractClostridioides difficile infection (CDI) is an important nosocomial infection and is the leading cause of infectious diarrhea in hospitalized patients. We aimed to assess the effect of bowel rest on the management of CDI. A single-center retrospective cohort study was conducted. The primary outcome was the composite of the all-cause mortality and CDI recurrence within 30 days. The main secondary outcome was switching from metronidazole to vancomycin. Of the 91 patients with CDI enrolled as the full cohort, 63 patients (69%) and 28 patients (31%) constituted the control group and the bowel rest group, respectively. After one-to-one propensity score matching, a total of 46 patients were included as the matched cohort. In the full cohort, the composite outcome occurred in 19.0% and 14.3% of the patients in the control and the bowel rest group, respectively (p = 0.768). In the matched cohort, it was 17.4% in each group. Although there was no statistically significant difference, the trend of switching was lower in the bowel rest group. The bowel rest may not affect the all-cause mortality and CDI recurrence within 30 days. However, in those prescribed bowel rest, switching from metronidazole to vancomycin may reduce.

Abstract WP341: Difference in Acute Ischemic Post Thrombolytic Stroke Outcomes in Pre Comprehensive and Post Comprehensive Status: Single Center Experience

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Vishal B Jani ◽  
Achint Patel ◽  
Jillian Schurr ◽  
Erin Shell ◽  
Julie Bey ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Secondary Outcome ◽  
Rank Test ◽  
Stroke Severity ◽  
Complication Rates ◽  
Single Center ◽  
Stroke Treatment ◽  
Significant Difference ◽  
Multivariable Regression ◽  
Iv Tpa

Background: In last decade there is a significant change in stroke care especialy with newer data for ischemic stroke treatment there is a movement to obtain comprehensive stroke center certification (CSCC) to provide enhanced complex care for stroke. This study aims to assess the single center quality matrix assessment pre and post CSC status Methods: We reviewed single center cohort of IV tPA (tissue plasminogen activator) in-between year 2010 to 2014 at sparrow health system in mid Michigan region. This cohort was dichotomized in pre CSCC and post CSCC era. Stroke quality matrics data was collected for these patients. Severity of stroke was categorized in mild-moderate vs moderate-severe based on NIH stroke scale (NIHSS) scale. Primary out come for this study was any complication, which is composite end point of in-hospital mortality, and hemorrhage and secondary outcome was hospital stay. Chi square, student’s t test and wilcoxon sum rank test was used to compare both groups. Multivariable regression models were utilized to calculate odd ratios after adjusting with stroke severity. Results: Cohort of IV tPA was identified in-between year 2010 to 2014 (332 hospitalizations off which 241 were pre CSCC and 91 were Post CSCC ). In- hospital complication was lower after receiving CSCC (9.89% vs. 21.99%; p:0.011). In multivariable regression analysis the trend for in hospital complication persisted [Adjusted Odds ratio (OR):0.43–95%confidence-Interval(CI):0.20-0.93–p:0.032] but there was no significant difference in hospital stay (Median days 5 vs. 5; P:673) Conclusion: There is a clear and persistent trend of low in-hospital complication rates after acquiring CSCC quality matrics.

scholarly journals Effect of Tourniquet Use in Ankle Arthroscopic Surgery on Postoperative Recovery: A Prospective Non- Randomized Controlled Study

2020 ◽  
Author(s):  
Tingting Huang ◽  
Haixiao Liu ◽  
Yuezheng Hu ◽  
Xinxian Xu
Keyword(s):  
Functional Outcome ◽  
Ischemia Reperfusion Injury ◽  
Ischemia Reperfusion ◽  
Arthroscopic Surgery ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Control Group ◽  
Complication Rates ◽  
Randomized Controlled ◽  
The Mean

Abstract The aim of this prospective non- randomized controlled study was to explore the effect of tourniquet use on joint swelling, pain, functional outcome, and tourniquet- related ischemia- reperfusion injury (IRI) during ankle arthroscopic surgery.52 patients who received ankle arthroscopy were allocated to had the procedure done with the tourniquet inflated (the Control group, n= 27) or without the tourniquet inflated (the NT group, n= 25). The main outcome measures were: (1) The amount of swelling of the ankle; (2) Pain as measured by a visual analog scale (VAS); (3) The levels of MDA, IMA,TOS, TAS and OSI at 10 min before incision (T1)，after the completion of surgery (T2), and 30 min after tourniquet deflation (T3); (4) The functional outcome as measured by American Orthopaedic Foot and Ankle Society (AOFAS) ankle hindfoot score; (5) The rate of complication. All patients were reviewed at a mean follow- up of 14.2 months (range, 12- 19 months). The mean circumferences of the ankle in the NT group were significantly lower than those in the Control group on postoperative day 2 and 5 (p<0.05). The mean level of VAS in the Control group was significantly higher on postoperative day 2 (p<0.05). The outcomes of AOFAS ankle hindfoot score were comparable between groups postoperatively (p>0.05). The levels of MDA, IMA, TOS and OSI were all significantly lower in the NT group compared at T2 and T3 (p<0.05), and the level of TAS was significantly lower in the NT group at T3 (p<0.05). The complication rates of two groups were comparable (p>0.05).With the use of tourniquet during ankle arthroscopic surgery, there was increased joint swelling and pain postoperatively, and a trend toward increased levels of MDA, IMA, TOS, TAS and OSI intraoperatively. Thus, we do not recommend using a tourniquet in this type of procedure.

scholarly journals Intravesical dexmedetomidine instillation reduces postoperative catheter-related bladder discomfort in male patients under general anesthesia: a randomized controlled study

2020 ◽  
Author(s):  
Hong Chen ◽  
Bin Wang ◽  
Qin Li ◽  
Juan Zhou ◽  
Rui Li ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Patient Satisfaction ◽  
General Anesthesia ◽  
Normal Saline ◽  
Rating Scale ◽  
Intravesical Instillation ◽  
Controlled Study ◽  
Control Group ◽  
Post Operation ◽  
Male Patients

Abstract Background: The catheter-related bladder discomfort (CRBD) of male patients is a common clinical problem, albeit lacking effective solutions. The present study aimed to investigate whether intravesical dexmedetomidine instillation alleviates the postoperative urinary discomfort in male patients with catheter under general anesthesia.Methods: This single-blinded, prospective, randomized study included a total of 167 male patients American Society of Anesthesiologists (ASA) physical status I-II scheduled for surgery under general anesthesia were allocated to two groups: 84 in the dexmedetomidine group and 83 in the control group. Dexmedetomidine group patients received intravesical instillation of the drug 0.5 μg/kg and normal saline 20 mL, while the control group received intravesical instillation of 20 mL normal saline. The catheter was clamped for 30 min after intravesical instillation for all patients. CRBD scores and urethra pain numerical rating scale (NRS) scores were measured at admittance to post-anesthesia care unit (PACU) (T0), intravesical instillation (T1), 30 min (T2), 60 min (T3), 2 h (T4) after intravesical instillation, discharged from PACU (T5), and 6 h (T6) and 24 h (T7) after the operation. Patient satisfaction at discharge from PACU and 24 h post-operation were compared between the two groups. Results: CRBD scores and urethra pain NRS scores after 30 min of intravesical dexmedetomidine instillation to 24 h post-operation were significantly lower than the control group (p<0.001), and patient satisfaction was higher at discharge from PACU and 24 h post-operation (p<0.001). No differences were detected in Steward score out of PACU (p=0.213) and from the time of the end of operation to fully awake (p=0.417).Conclusion: Intravesical dexmedetomidine instillation reduces postoperative urinary discomfort and urethra pain and improves satisfaction in male patients under general anesthesia.Clinical Trial Registration: Chinese Clinical Trial Registry (No. ChiCTR1800016429), date of registration 1st June 2018

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