scholarly journals The Association Between Intraoperative Objective Neuromuscular Monitoring and Rocuronium Consumption During Laparoscopic Abdominal Surgery: A Single-Center Retrospective Analysis

Cureus ◽  
2021 ◽  
Author(s):  
Kenichi Takahoko ◽  
Hajime Iwasaki ◽  
Yosuke Inaba ◽  
Takashi Matsuno ◽  
Risako Matsuno ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Retrospective Analysis ◽  
Neuromuscular Monitoring ◽  
Single Center

scholarly journals The Association Between Intraoperative Objective Neuromuscular Monitoring and Rocuronium Consumption During Laparoscopic Abdominal Surgery: A Single-Center Retrospective Analysis

2021 ◽  
Author(s):  
Kenichi Takahoko ◽  
Hajime Iwasaki ◽  
Sarah Kyuragi Luthe ◽  
Takashi Matsuno ◽  
Risako Matsuno ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Multiple Linear Regression Model ◽  
Neuromuscular Monitoring ◽  
University Hospital ◽  
Clinical Settings ◽  
Single Center ◽  
Individual Factor ◽  
Male Sex ◽  
Medical University ◽  
Interaction Test

Abstract Background: Rocuronium consumption with or without intraoperative objective neuromuscular monitoring in clinical settings of unrestricted use of sugammadex and neuromuscular monitoring has not been reported. The aim of the study was to investigate the association between the use of intraoperative objective neuromuscular monitoring and rocuronium consumption in patients undergoing laparoscopic abdominal surgery.Methods: Data were collected by reviewing electronic medical records of patients who received laparoscopic abdominal surgery under general anesthesia with rocuronium and reversal with sugammadex at Asahikawa Medical University Hospital between May 2017 and April 2018. Multiple linear regression model was developed to compare the amount of rocuronium consumption per weight per hour (mg/kg/h) between the group in which intraoperative objective neuromuscular monitoring was used (NM+ group) and the group in which intraoperative neuromuscular monitoring was not used (NM- group). Additionally, we performed an interaction test with reference to the results of the subgroup analysis.Results: A total of 429 patients were evaluated, with 371 patients (86%) included in NM+ group and 58 patients (14%) in NM- group. In the NM+ group, 94% of the patients received additional rocuronium after reappearance of TOF response while 6% of the patients received additional rocuronium before reappearance of TOF in order to maintain post-tetanic count. Log-transformed rocuronium consumption between NM+ group and NM- group was not significantly different (back-transformed β-coefficients [95%CI]: 1.054 [0.946–1.174]; P=0.34). Male sex and body mass index (BMI) were independent factors associated with 15% (0.854 [0.789–0.925]; P<0.001) and 3% (for every 1 kg/m2 increase in BMI) (0.970 [0.962­–0.979]; P<0.001) decrease in intraoperative rocuronium consumption, respectively. A significant interaction was detected between the use of neuromuscular monitoring and age≥65 (β: 0.843 [0.759–0.936]; P=0.001).Conclusions: This single center retrospective study demonstrated that although the use of intraoperative objective neuromuscular monitoring was not an individual factor influencing intraoperative rocuronium consumption, the use of intraoperative neuromuscular monitoring reduced rocuronium consumption by approximately 15% during laparoscopic abdominal surgery in elderly patients.

A Retrospective Analysis of Oral Mucosa Pathologies: A Single-Center Trial

2018 ◽  
Vol 1 (34) ◽  
pp. 11-17
Author(s):  
hilal erinanç ◽  
özgül topal
Keyword(s):  
Retrospective Analysis ◽  
Oral Mucosa ◽  
Single Center

Description of the role of pharmacist independent double checks during cognitive order verification of outpatient parenteral anti-cancer therapy

2021 ◽  
pp. 107815522199431
Author(s):  
Jennifer P Booth ◽  
Julie M Kennerly-Shah ◽  
Amber D Hartman
Keyword(s):  
Cancer Therapy ◽  
Medication Error ◽  
Retrospective Analysis ◽  
Error Reporting ◽  
Single Center ◽  
Medication Error Reporting ◽  
Anti Cancer ◽  
Secondary Endpoints ◽  
Type Frequency

Introduction To describe pharmacist interventions as a result of an independent double check during cognitive order verification of outpatient parenteral anti-cancer therapy. Methods A single-center, retrospective analysis of all individual orders for outpatient, parenteral anti-cancer agents within a hematology/oncology infusion center during a 30 day period was conducted. The primary endpoint was error identification rates during first and second verification. Secondary endpoints included the type, frequency, and severity of errors identified during second verification using a modified National Coordinating Council for Medication Error Reporting and Prevention Index. Results A total of 1970 anti-cancer parenteral orders were screened, from which 1645 received an independent double check and were included. The number of errors identified during first and second verification were 30 (1.8%) and 10 (0.6%) respectively; second verification resulted in a 33.3% increase in corrected errors. The 10 errors identified during second verification included: four rate transcriptions to optimize pump interoperability, three rate and/or volume modifications, two dosage adjustments, and one treatment deferral due to toxicity. The severity was classified as Category A for four (40%), Category C for three (30%), and Category D for three (30%) errors. This correlated to a low capacity for harm for seven (70%) and a serious capacity for three (30%) errors. Conclusions Second verification of outpatient, parenteral anti-cancer medication orders resulted in a 33.3% increase in corrected errors. Three errors detected during second verification were determined to have a serious capacity for harm, supporting the value of independent double checks during pharmacist cognitive order verification.

Pulmonary Fungal Diseases in Immunocompetent Hosts: A Single-Center Retrospective Analysis of 35 Subjects

2016 ◽  
Vol 181 (7-8) ◽  
pp. 513-521 ◽  
Author(s):  
XiaoPei Yan ◽  
Feng Zong ◽  
Hui Kong ◽  
YanLi Wang ◽  
XinYun Zhao ◽  
...  
Keyword(s):  
Retrospective Analysis ◽  
Fungal Diseases ◽  
Single Center
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