What Is the Driving Performance of Ambulatory Surgical Patients after General Anesthesia?

2005 ◽  
Vol 103 (5) ◽  
pp. 951-956 ◽  
Author(s):  
Frances Chung ◽  
Leonid Kayumov ◽  
David R. Sinclair ◽  
Reginald Edward ◽  
Henry J. Moller ◽  
...  
Keyword(s):  
General Anesthesia ◽  
Arthroscopic Surgery ◽  
Subjective Assessment ◽  
Driving Performance ◽  
Driving Simulation ◽  
Surgical Patients ◽  
Control Group ◽  
Impaired Driving ◽  
Simulation Performance ◽  
Driving Skills

Background Ambulatory surgical patients are advised to refrain from driving for 24 h postoperatively. However, currently there is no strong evidence to show that driving skills and alertness have resumed in patients by 24 h after general anesthesia. The purpose of this study was to determine whether impaired driver alertness had been restored to normal by 2 and 24 h after general anesthesia in patients who underwent ambulatory surgery. Methods Twenty patients who underwent left knee arthroscopic surgery were studied. Their driving simulation performance, electroencephalographically verified parameters of sleepiness, subjective assessment of sleepiness, fatigue, alertness, and pain were measured preoperatively and 2 and 24 h postoperatively. The same measurements were performed in a matched control group of 20 healthy individuals. Results Preoperatively, patients had significantly higher attention lapses and lower alertness levels versus normal controls. Significantly impaired driving skills and alertness, including longer reaction time, higher occurrence of attention lapses, and microsleep intrusions, were found 2 h postoperatively versus preoperatively. No significantly differences were found in any driving performance parameters or electroencephalographically verified parameters 24 h postoperatively versus preoperatively. Conclusions Patients showed lower alertness levels and impaired driving skills preoperatively and 2 h postoperatively. Based on driving simulation performance and subjective assessments, patients are safe to drive 24 h after general anesthesia.

Driving Simulation and Cognitive Testing Can Improve Insight Into Impaired Driving Skills in Cirrhotic Patients With MHE

2011 ◽  
Vol 140 (5) ◽  
pp. S-952
Author(s):  
Jasmohan S. Bajaj ◽  
Arun J. Sanyal ◽  
Richard K. Sterling ◽  
Debulon E. Bell ◽  
Melanie B. White ◽  
...  
Keyword(s):  
Cognitive Testing ◽  
Driving Simulation ◽  
Impaired Driving ◽  
Driving Skills ◽  
Cirrhotic Patients ◽  
Insight Into

Maximal Pharmacologic Reduction of Postoperative Nausea and Vomiting in Patients Undergoing Aesthetic Breast Surgery Under General Anesthesia

2016 ◽  
Vol 33 (4) ◽  
pp. 189-192 ◽  
Author(s):  
Mauree NaShea Beard ◽  
Arup De
Keyword(s):  
General Anesthesia ◽  
Postoperative Nausea ◽  
Breast Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Multimodal Analgesia ◽  
Nausea And Vomiting ◽  
Surgical Patients ◽  
Control Group ◽  
Limited Data ◽  
Aesthetic Breast

Postoperative nausea and vomiting (PONV) is a major patient dissatisfier in aesthetic ambulatory surgical patients. Limited data exist demonstrating single surgeon reduction in PONV after utilizing modern pharmacologic techniques for analgesia and PONV chemoprophylaxis for patients who receive general anesthesia. In our study, multimodal analgesia included pregabalin, oxycontin, ketamine, and opioids; PONV chemoprophylaxis included transdermal scopolamine, diphenhydramine, dexamethasone, and ondansetron. A treatment arm of 36 patients undergoing aesthetic breast surgery was evaluated prospectively and compared with a retrospective control group of 47 patients who underwent similar procedures in the prior year. The aggressive screening for PONV risk factors preoperatively and preemptive treatment resulted in an overall reduction in PONV rate from 31.9% to 5.6%.

scholarly journals Behavioral and Cardiovascular Responses to Frustration During Simulated Driving Tasks in Young Adults With and Without Attention Disorder Symptoms

2011 ◽  
Vol 16 (6) ◽  
pp. 478-490 ◽  
Author(s):  
Michele L. Oliver ◽  
Joel T. Nigg ◽  
Nicholas D. Cassavaugh ◽  
Richard W. Backs
Keyword(s):  
Young Adults ◽  
Negative Emotions ◽  
Cardiovascular Responses ◽  
Driving Performance ◽  
Self Report ◽  
Control Group ◽  
Adhd Symptoms ◽  
Sinus Arrhythmia ◽  
Simulated Driving ◽  
Driving Skills

Objective: The present study examined the role of negative emotions on driving performance in relation to ADHD, by comparing young adults scoring high on measures of ADHD ( n = 20) with a control group ( n = 22). Method: The authors used cardiorespiratory physiological measures, simulated driving behavior, and self-report to examine how participants with high and low ADHD symptoms responded to frustration and to determine how frustration affected simulated driving performance. Results: Groups did not differ in operational driving skills, but participants with high ADHD symptoms reported more frustration and exhibited more impairment at the tactical level of driving performance than the controls. There was significant suppression of respiratory sinus arrhythmia from resting baseline during tasks, but it did not differ between groups during driving. Conclusion: This article proposes that remedial driver training for ADHD populations should focus more on the control of negative emotions rather than on attention or fundamental driving skills. (J. of Att. Dis. 2012; 16(6) 478-490)

scholarly journals Driving Simulation Can Improve Insight into Impaired Driving Skills in Cirrhosis

2011 ◽  
Vol 57 (2) ◽  
pp. 554-560 ◽  
Author(s):  
Jasmohan S. Bajaj ◽  
Leroy R. Thacker ◽  
Douglas M. Heuman ◽  
Douglas P. Gibson ◽  
Richard K. Sterling ◽  
...  
Keyword(s):  
Driving Simulation ◽  
Impaired Driving ◽  
Driving Skills ◽  
Insight Into

scholarly journals Bi-caudate ratio as a MRI marker of white matter atrophy in multiple sclerosis and ischemic leukocencephalopathy

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Dena Serag ◽  
Eman Ragab
Keyword(s):  
Multiple Sclerosis ◽  
White Matter ◽  
Surrogate Marker ◽  
Normal Subjects ◽  
Subjective Assessment ◽  
Linear Measurement ◽  
Control Group ◽  
Imaging Science ◽  
The Difference ◽  
Sensitivity Specificity

Abstract Background Brain atrophy measurement is now a cornerstone in basic neuro-imaging science. While assessment of white matter atrophy by visual inspection is subjective, volumetric approaches are time-consuming and not often feasible. Bi-caudate ratio represents a linear surrogate parameter of brain volume that can be derived from standard imaging sequences. This study highlights the value of the bi-caudate ratio (BCR) as a MRI marker of white matter atrophy in patients with multiple sclerosis and ischemic leukoencephalopathy and set a cut-off value to differentiate between patients with white matter atrophy and normal subjects. Results A total of 115 patients (54 males and 61 females) diagnosed with white matter leukoencephalopathy (MS in 51 patients and ischemic leukoencephalopathy in 64 patients) were included. Another group of 60 subjects with a normal white matter signal was recruited as a control group. BCR for the patient group ranged from 0.13 to 0.27 (mean (± SD) = 0.16 ± 0.02), while for the control group, it ranged from 0.05 mm to 0.13 (mean (± SD) = 0.09 ± 0.01). The difference between the two groups was statistically significant (P value < 0.001). A cut-off value of 0.13 was used to differentiate between the BCR in both patients and control groups with sensitivity, specificity, and accuracy of 99.2%, 100%, and 99%, respectively. The difference in BCR for patients diagnosed with MS and ischemic leukoencephalopathy was also statistically significant (P value < 0.001). Conclusion The bi-caudate ratio represents a linear measurement of subcortical atrophy that can be useful as a surrogate marker of global supra-tentorial white matter atrophy instead of the usually performed visual and therefore subjective assessment. It is an easily obtained measure that can be performed without complex time-consuming volumetric studies. Our findings also revealed that the BCR is higher in patients with ischemic leukoencephalopathy than in patients with MS.

scholarly journals Influence of design of dentist’s chairs on body posture for dentists with different working experience

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
F. Huppert ◽  
W. Betz ◽  
C. Maurer-Grubinger ◽  
F. Holzgreve ◽  
L. Fraeulin ◽  
...  
Keyword(s):  
Work Experience ◽  
Dental Treatment ◽  
Subjective Assessment ◽  
Body Posture ◽  
Control Group ◽  
Sitting Position ◽  
Ergonomic Design ◽  
Sitting Posture ◽  
Working Posture ◽  
Working Postures

Abstract Background Musculoskeletal disorders (MSD) are a common health problem among dentists. Dental treatment is mainly performed in a sitting position. The aim of the study was to quantify the effect of different ergonomic chairs on the sitting position. In addition, it was tested if the sitting position of experienced workers is different from a non-dental group. Methods A total of 59 (28 m/31f) subjects, divided into two dentist groups according to their work experience (students and dentists (9 m/11f) < 10 years, dentists (9 m/10f) ≥ 10 years) and a control group (10 m/10f) were measured. A three-dimensional back scanner captured the bare back of all subjects sitting on six dentist’s chairs of different design. Initially, inter-group comparisons per chair, firstly in the habitual and secondly in the working postures, were carried out. Furthermore, inter-chair comparison was conducted for the habitual as well as for the working postures of all subjects and for each group. Finally, a comparison between the habitual sitting posture and the working posture for each respective chair (intra-chair comparison) was conducted (for all subjects and for each group). In addition, a subjective assessment of each chair was made. For the statistical analysis, non-parametric tests were conducted and the level of significance was set at 5%. Results When comparing the three subject groups, all chairs caused a more pronounced spinal kyphosis in experienced dentists. In both conditions (habitual and working postures), a symmetrical sitting position was assumed on each chair. The inter-chair comparisons showed no differences regarding the ergonomic design of the chairs. The significances found in the inter-chair comparisons were all within the measurementerror and could, therefore, be classified as clinically irrelevant. The intra-chair comparison (habitual sitting position vs. working sitting position) illustrated position-related changes in the sagittal, but not in the transverse, plane. These changes were only position-related (forward leaned working posture) and were not influenced by the ergonomic sitting design of the respective chair. There are no differences between the groups in the subjective assessment of each chair. Conclusions Regardless of the group or the dental experience, the ergonomic design of the dentist’s chair had only a marginal influence on the upper body posture in both the habitual and working sitting postures. Consequently, the focus of the dentist’s chair, in order to minimize MSD, should concentrate on adopting a symmetrical sitting posture rather than on its ergonomic design.

scholarly journals The effect of opioid-free anesthesia on the quality of recovery after gynecological laparoscopy: study protocol for a prospective randomized controlled trial

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae Yen Song ◽  
Hoon Choi ◽  
Minsuk Chae ◽  
Jemin Ko ◽  
Young Eun Moon
Keyword(s):  
General Anesthesia ◽  
Assessment Tool ◽  
Controlled Trial ◽  
Perioperative Period ◽  
Postoperative Outcomes ◽  
Control Group ◽  
Quality Of Recovery ◽  
Gynecological Laparoscopy ◽  
Prospective Randomized Controlled Trial

Abstract Background Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods The participants (n = 78) will be allocated to one of the two groups; the study group will receive bolus and infusion of dexmedetomidine and lidocaine, and the control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in the two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, and opioid-related side effects will be assessed. Additionally, an ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during the study period. Discussion This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA. Trial registration ClinicalTrials.gov NCT04409964. Registered on 28 May 2020

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