Factors driving the difference in quality of recovery scores between scheduled and unscheduled Caesarean delivery patients

2022 ◽  
Author(s):  
Cyrus Bhiladvala ◽  
Robert ffrench-O’Carroll ◽  
Yeganeh Dadkhah ◽  
Susan Bright ◽  
Anthony Chau ◽  
...  
Keyword(s):  
Caesarean Delivery ◽  
Quality Of Recovery ◽  
The Difference

Comparative study of hemodynamic effects, quality of extubation and emergence - agitation response of the patients with dexmedetomidine versus lignocaine during and following the endotracheal extubation

2021 ◽  
Vol 19 (3) ◽  
pp. 91-95
Author(s):  
Manasi Panat ◽  
Keyword(s):  
Comparative Study ◽  
Stress Responses ◽  
Tracheal Extubation ◽  
Emergence Agitation ◽  
Quality Of Recovery ◽  
Group 12 ◽  
The Difference ◽  
Group D ◽  
Endotracheal Extubation

Background: Endotracheal extubation is the translaryngeal removal of a tube from the trachea via the nose or mouth. It is associated with hemodynamic changes because of reflex sympathetic discharge caused by epipharyngeal and laryngopharyngeal stimulation. Various drugs and techniques have been tried to attenuate the airway and stress responses during tracheal extubation. In present study, we have compared the effects of dexmedetomidine and intravenous lignocaine on the hemodynamic and recovery profiles during endotracheal extubation. Material and Methods: Present study was prospective randomised comparative study, conducted in patients from age group of 18-45 years, ASA grade I/II, scheduled for elective abdominal surgeries. The patients were categorised into two different groups using the sealed envelope method as Group D and group L. Results: In present study, patients were divided in following 2 groups with 50 patients in each group as group D (Dexmedetomidine) and group L (Lignocaine). Age, gender, mean BMI were comparable in both groups and difference was not significant statistically. The difference between mean heart rate, systolic BP, diastolic BP and mean arterial BP during extubation, after extubation at 1, 3, 5, 10, 15, 20, 25, 30 minutes in dexmedetomidine group and lignocaine group was statistically significant. In Dexmedetomidine group, 12% of the patients had no cough during extubation, 72% of the patients had smooth extubation with minimal cough while in Lignocaine group, 22% of the patients had smooth extubation with minimal cough, 74 % of the patients had moderate cough during extubation. Statistical analysis of the Emergence agitation score shows better results in group D. Conclusion: Administration of Dexmedetomidine before tracheal extubation was more effective in maintaining the hemodynamic stability, facilitated smooth tracheal extubation and had a better quality of recovery as compared to Lignocaine.

scholarly journals Development and evaluation of an obstetric quality-of-recovery score (ObsQoR-11) after elective Caesarean delivery

2019 ◽  
Vol 122 (1) ◽  
pp. 69-78 ◽  
Author(s):  
S. Ciechanowicz ◽  
T. Setty ◽  
E. Robson ◽  
C. Sathasivam ◽  
M. Chazapis ◽  
...  
Keyword(s):  
Caesarean Delivery ◽  
Quality Of Recovery ◽  
Recovery Score ◽  
Elective Caesarean Delivery

Evaluation of the Obstetric Quality-of-Recovery score (ObsQoR-11) following non-elective caesarean delivery

2019 ◽  
Vol 39 ◽  
pp. 51-59 ◽  
Author(s):  
S. Ciechanowicz ◽  
R. Howle ◽  
C. Heppolette ◽  
B. Nakhjavani ◽  
B. Carvalho ◽  
...  
Keyword(s):  
Caesarean Delivery ◽  
Quality Of Recovery ◽  
Recovery Score ◽  
Elective Caesarean Delivery

scholarly journals Multimodal Analgesic Regimen for Spine Surgery

2020 ◽  
Vol 132 (5) ◽  
pp. 992-1002 ◽  
Author(s):  
Kamal Maheshwari ◽  
Rafi Avitsian ◽  
Daniel I. Sessler ◽  
Natalya Makarova ◽  
Marianne Tanios ◽  
...  
Keyword(s):  
Placebo Group ◽  
Spine Surgery ◽  
Group Versus ◽  
Opioid Consumption ◽  
Verbal Response ◽  
Quality Of Recovery ◽  
Pain Scores ◽  
Analgesic Regimen ◽  
The Difference

Abstract Background Various multimodal analgesic approaches have been proposed for spine surgery. The authors evaluated the effect of using a combination of four nonopioid analgesics versus placebo on Quality of Recovery, postoperative opioid consumption, and pain scores. Methods Adults having multilevel spine surgery who were at high risk for postoperative pain were double-blind randomized to placebos or the combination of single preoperative oral doses of acetaminophen 1,000 mg and gabapentin 600 mg, an infusion of ketamine 5 µg/kg/min throughout surgery, and an infusion of lidocaine 1.5 mg/kg/h intraoperatively and during the initial hour of recovery. Postoperative analgesia included acetaminophen, gabapentin, and opioids. The primary outcome was the Quality of Recovery 15-questionnaire (0 to 150 points, with 15% considered to be a clinically important difference) assessed on the third postoperative day. Secondary outcomes were opioid use in morphine equivalents (with 20% considered to be a clinically important change) and verbal-response pain scores (0 to 10, with a 1-point change considered important) over the initial postoperative 48 h. Results The trial was stopped early for futility per a priori guidelines. The average duration ± SD of surgery was 5.4 ± 2.1 h. The mean ± SD Quality of Recovery score was 109 ± 25 in the pathway patients (n = 150) versus 109 ± 23 in the placebo group (n = 149); estimated difference in means was 0 (95% CI, –6 to 6, P = 0.920). Pain management within the initial 48 postoperative hours was not superior in analgesic pathway group: 48-h opioid consumption median (Q1, Q3) was 72 (48, 113) mg in the analgesic pathway group and 75 (50, 152) mg in the placebo group, with the difference in medians being –9 (97.5% CI, –23 to 5, P = 0.175) mg. Mean 48-h pain scores were 4.8 ± 1.8 in the analgesic pathway group versus 5.2 ± 1.9 in the placebo group, with the difference in means being –0.4 (97.5% CI; –0.8, 0.1, P = 0.094). Conclusions An analgesic pathway based on preoperative acetaminophen and gabapentin, combined with intraoperative infusions of lidocaine and ketamine, did not improve recovery in patients who had multilevel spine surgery. Editor’s Perspective What We Already Know about This Topic What This Article Tells Us That Is New

scholarly journals Validation of an obstetric quality-of-recovery scoring tool (ObsQoR-11) after emergency Caesarean delivery

2018 ◽  
Vol 121 (2) ◽  
pp. e19-e20
Author(s):  
R. Howle ◽  
S. Ciechanowicz ◽  
C. Heppolette ◽  
B. Nakhjavani ◽  
P. Sultan
Keyword(s):  
Caesarean Delivery ◽  
Quality Of Recovery ◽  
Emergency Caesarean ◽  
Scoring Tool

Letter to the Editor: The Continuing Challenge of Evaluating RSD Impairment and Disability

1998 ◽  
Vol 3 (5) ◽  
pp. 8-10
Author(s):  
Robert L. Knobler ◽  
Charles N. Brooks ◽  
Leon H. Ensalada ◽  
James B. Talmage ◽  
Christopher R. Brigham
Keyword(s):  
Disability Evaluation ◽  
Body Part ◽  
Loss Of Function ◽  
Regulatory Requirements ◽  
Major Cardiac Event ◽  
Clinical Scenarios ◽  
Impairment Score ◽  
Occupational Activities ◽  
The Difference

Abstract The author of the two-part article about evaluating reflex sympathetic dystrophy (RSD) responds to criticisms that a percentage impairment score may not adequately reflect the disability of an individual with RSD. The author highlights the importance of recognizing the difference between impairment and disability in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides): impairment is the loss, loss of use, or derangement of any body part, system, or function; disability is a decrease in or the loss or absence of the capacity to meet personal, social, or occupational demands or to meet statutory or regulatory requirements because of an impairment. The disparity between impairment and disability can be encountered in diverse clinical scenarios. For example, a person's ability to resume occupational activities following a major cardiac event depends on medical, social, and psychological factors, but nonmedical factors appear to present the greatest impediment and many persons do not resume work despite significant improvements in functional capacity. A key requirement according to the AMA Guides is objective documentation, and the author agrees that when physicians consider the disability evaluation of people, more issues than those relating to the percentage loss of function should be considered. More study of the relationships among impairment, disability, and quality of life in patients with RSD are required.

COMBINATORIAL POLYNOMIALLY COMPUTABLE CHARACTERISTICS OF SUBSTITUTIONS AND THEIR PROPERTIES

2020 ◽  
Vol 7 (2) ◽  
pp. 34-41
Author(s):  
VLADIMIR NIKONOV ◽  
◽  
ANTON ZOBOV ◽  
Keyword(s):  
Mathematical Expectation ◽  
Point Of View ◽  
Small Range ◽  
Computational Point ◽  
Wide Range ◽  
Bijective Function ◽  
The Difference ◽  
Element Base ◽  
Selection Of

The construction and selection of a suitable bijective function, that is, substitution, is now becoming an important applied task, particularly for building block encryption systems. Many articles have suggested using different approaches to determining the quality of substitution, but most of them are highly computationally complex. The solution of this problem will significantly expand the range of methods for constructing and analyzing scheme in information protection systems. The purpose of research is to find easily measurable characteristics of substitutions, allowing to evaluate their quality, and also measures of the proximity of a particular substitutions to a random one, or its distance from it. For this purpose, several characteristics were proposed in this work: difference and polynomial, and their mathematical expectation was found, as well as variance for the difference characteristic. This allows us to make a conclusion about its quality by comparing the result of calculating the characteristic for a particular substitution with the calculated mathematical expectation. From a computational point of view, the thesises of the article are of exceptional interest due to the simplicity of the algorithm for quantifying the quality of bijective function substitutions. By its nature, the operation of calculating the difference characteristic carries out a simple summation of integer terms in a fixed and small range. Such an operation, both in the modern and in the prospective element base, is embedded in the logic of a wide range of functional elements, especially when implementing computational actions in the optical range, or on other carriers related to the field of nanotechnology.

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