Effects of Total Intravenous Anesthesia with Propofol Versus Inhalational Anesthesia with Sevoflurane on Postoperative Quality of Life and Postoperative Delirium in Patients Undergoing Total Knee Arthroplasty: A Randomized, Controlled, Double-Blinded Clinical Trial

2020 ◽  
Author(s):  
Han Su ◽  
Yuxin Fang ◽  
Guanghong Xu ◽  
Xuesheng Liu
Keyword(s):  
Quality Of Life ◽  
Postoperative Delirium ◽  
Total Intravenous Anesthesia ◽  
Inhalational Anesthesia ◽  
Intravenous Anesthesia ◽  
Significant Difference ◽  
Total Knee ◽  
Anxiety Depression ◽  
Postoperative Quality

Abstract Background: The widespread use of total knee arthroplasty(TKA) to treat patients who suffer knee osteoarthritis(KOA) has led to a number of postoperative problems, including the recovery of postoperative quality of life and postoperative delirium(POD). Both problems could cause profound damages to patients and their families. This study assessed and compared the effects of total intravenous anesthesia with propofol versus inhalational anesthesia (sevoflurane) on postoperative quality of life and POD in patients who underwent TKA.Methods: One hundred and fifty patients American Society of Anesthesiologists(ASA) I-III were assessed for inclusion in this study, and randomly divided into inhalational anesthesia with sevoflurane group(group S), and total intravenous anesthesia with propofol group(group P). The primary outcome was postoperative quality of life and secondary outcome was POD.Results: The quality of life at the first month after surgery in group S was better than that in group P(P=0.02). However, there was no significant difference in quality of life between the two groups at 1 day before surgery, 1 day after surgery, 3 days after surgery, 7 days after surgery and 3 months after surgery. In group P, 19 patients (31.1%) had no anxiety/depression problems, 40 patients (65.6%) had moderate problems, and 2 patients (3.3%) had severe problems.In group S, 37 patients (60.6%) had no problems in anxiety/depression, 23 patients (37.7%) had moderate problems, and 1 patient had severe problems (1.7%). These two outcomes had significant differences (P=0.005) .The incidence of POD within 3 days after surgery was 24.6% (15/61) in group P and 36.1% (22/61) in group S. There was no significant difference in the incidence of POD between the two groups (P=0.17).Conclusions: Group S patients have a better quality of life at the first month after surgery in comparison with those in group P regarding anxiety/depression. However, there were no significant differences in the quality of lives between the two groups at 1 day before surgery, 1 day after surgery, 3 days after surgery, 7 days after surgery, and 3 months after surgery. There was also no significant difference in POD. Thus, we concluded that both anesthetic technologies could be extensively used for TKA.Trial registration: This trial was registered at the Chinese Clinical Trial Registry (ChiCRT-IOR-17012428). Date of Registration: 21 Aug. 2017.

The Effectiveness of Client-Centered Intervention With Telerehabilitation Method After Total Knee Arthroplasty

2021 ◽  
pp. 153944922110382
Author(s):  
Berkan Torpil ◽  
Özgür Kaya
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Intervention Program ◽  
Nottingham Health Profile ◽  
Performance Measure ◽  
Occupational Performance ◽  
Significant Difference ◽  
Total Knee

There is known to be a decrease in quality of life and perceived occupational performance and satisfaction following total knee arthroplasty (TKA). This study was planned to examine the effectiveness of a client-centered (CC) intervention with the telerehabilitation (TR) method on the quality of life, perceived occupational performance, and satisfaction after TKA. A total of 38 patients who had undergone TKA were randomly assigned to the CC and control groups. A 12-day intervention program was applied to the CC group. The Nottingham Health Profile (NHP) and Canadian Occupational Performance Measure (COPM) were applied before and after intervention. The 12-day intervention showed a strong effect on all parameters in the CC group ( p<.001). In the postintervention comparisons, a significant difference was found in favor of the CC group ( p < .001). CC interventions with the TR method can be used in post-TKA interventions.

scholarly journals Quality of life and functional outcome after single-radius and multi-radius total knee arthroplasty

2018 ◽  
Vol 26 (3) ◽  
pp. 230949901879241 ◽  
Author(s):  
Merrill Lee ◽  
Jerry Yongqiang Chen ◽  
Hao Ying ◽  
Pang Hee Nee ◽  
Darren Keng Jin Tay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Functional Outcome ◽  
Knee Arthroplasty ◽  
T Test ◽  
Significant Difference ◽  
Patient Groups ◽  
Total Knee ◽  
Single Radius

Purpose: The main objective of this study was to compare quality of life and functional outcome in patients who have undergone a single-radius (SR) or multi-radius (MR) total knee arthroplasty (TKA). The secondary objective was to observe changes in knee range of movement (ROM) and standardized knee scores (KSCs) in these patients. The hypothesis was that there would be no statistically significant difference between the two patient groups in quality of life and functional outcome. Methods: One hundred three SR TKAs were performed by a single surgeon between August 2008 and December 2012. A propensity score matching algorithm was used to select 103 MR TKAs performed during the same period. Preoperative and postoperative variables such as standardized knee and quality of life scores were captured prospectively and then analyzed via both the Student’s t-test and paired t-test to look for statistically significant differences between the SR and MR patient groups. Results: At 2 years postoperatively, there was no statistically significant difference between the SR and MR patient populations in knee extension, Oxford Knee Score, Knee Society Clinical Rating Scores, and the Physical Component Summary of the Short Form 36 Health Survey (SF-36). There was a statistically significant difference between the two patient groups in postoperative knee flexion in favor of the MR design ( p = 0.011). Conclusion: While an SR femoral implant design has several theoretical biomechanical advantages, postoperative standardized KSCs and quality of life scores in this single-surgeon series do not show a clear advantage of one design over the other. Level of evidence: III.

scholarly journals Influence of romifidine and detomidine on the induction of anesthesia and recovery from total intravenous anesthesia in horses

2014 ◽  
Vol 83 (3) ◽  
pp. 125-132
Author(s):  
V. J. F. Van Loon ◽  
T. J. Van den Brink ◽  
J. P. A. M. Van Loon ◽  
C. J. W. Scheffer ◽  
H. J. Bergman
Keyword(s):  
Computed Tomography ◽  
Total Intravenous Anesthesia ◽  
Intravenous Anesthesia ◽  
Significant Difference ◽  
Recovery From Anesthesia ◽  
To Receive

In the present study, the quality of the induction of and the recovery from anesthesia was compared in 146 horses undergoing total intravenous anesthesia with guaifenesin, ketamine and detomidine for computed tomography (CT), randomly assigned to receive either romifidine (n = 110) or detomidine (n = 36) during premedication. The induction of anesthesia was performed with a ketamine-midazolam combination. The anesthetic duration was short (mean +/- SD time: 23.5 +/- 8.8 minutes). No significant difference in induction score was observed. However, the recovery quality was significantly better in horses premedicated with romifidine.

Similar Healthcare Utilization and 1-Year Patient-Reported Outcomes between Cemented and Cementless Primary Total Knee Arthroplasty: A Propensity Score-Matched Analysis

2021 ◽  
Author(s):  
Michael P. Erossy ◽  
Ahmed K. Emara ◽  
Christopher A. Rothfusz ◽  
Alison K. Klika ◽  
Michael R. Bloomfield ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Total Knee Arthroplasty ◽  
Propensity Score ◽  
Healthcare Utilization ◽  
Knee Arthroplasty ◽  
Cementless Fixation ◽  
Significant Difference ◽  
Patient Reported ◽  
Total Knee

AbstractCementless fixation for total knee arthroplasty (TKA) has gained traction with the advent of newer fixation technologies. This study assessed (1) healthcare utilization (length of stay (LOS), nonhome discharge, 90-day readmission, and 1-year reoperation); (2) 1-year mortality; and (3) 1-year joint-specific and global health-related patient-reported outcome measures (PROMs) among patients who received cementless versus cemented TKA. Patients who underwent cementless and cemented TKA at a single institution (July 2015–August 2018) were prospectively enrolled. A total of 424 cementless and 5,274 cemented TKAs were included. The cementless cohort was propensity score-matched to a group cemented TKAs (1:3-cementless: n = 424; cemented: n = 1,272). Within the matched cohorts, 76.9% (n = 326) cementless and 75.9% (n = 966) cementless TKAs completed 1-year PROMs. Healthcare utilization measures, mortality and the median 1-year change in knee injury and osteoarthritis outcome score (KOOS)-pain, KOOS-physical function short form (PS), KOOS-knee related quality of life (KRQOL), Veteran Rand (VR)-12 mental composite (MCS), and physical composite (PCS) scores were compared. The minimal clinically important difference (MCID) for PROMs was calculated. Cementless TKA exhibited similar rates of median LOS (p = 0.109), nonhome discharge disposition (p = 0.056), all-cause 90-day readmission (p = 0.226), 1-year reoperation (p = 0.597), and 1-year mortality (p = 0.861) when compared with cemented TKA. There was no significant difference in the median 1-year improvement in KOOS-pain (p = 0.370), KOOS-PS (p = 0.417), KOOS-KRQOL (p = 0.101), VR-12-PCS (p = 0.269), and VR-12-MCS (p = 0.191) between the cementless and cemented TKA cohorts. Rates of attaining MCID were similar in both cohorts for assessed PROMs (p > 0.05, each) except KOOS-KRQOL (cementless: n = 313 (96.0%) vs. cemented: n = 895 [92.7%]; p = 0.036). Cementless TKA provides similar healthcare-utilization, mortality, and 1-year PROM improvement versus cemented TKA. Cementless fixation in TKA may provide value through higher MCID improvement in quality of life. Future episode-of-care cost-analyses and longer-term survivorship investigations are warranted.

P1212PREDICTORS OF QUALITY OF LIFE IN PERITONEAL DIALYSIS: A SINGLE-CENTER EXPERIENCE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Carolina Figueiredo ◽  
Pedro Maia ◽  
Teresa Mendes ◽  
Helena Pinto ◽  
Alice Lança ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Clinical Decision Making ◽  
Health State ◽  
Important Indicator ◽  
Number Of Patients ◽  
Significant Difference ◽  
Anxiety Depression ◽  
Residual Diuresis

Abstract Background and Aims Quality of life (QoL) is an important indicator of quality of healthcare. Measuring QoL and its correlates for peritoneal dialysis (PD) patients is very important for intervention and clinical decision-making. Being a technique performed by the patients themselves, their perspective of health related QoL is extremely important. The EuroQol questionnaire evaluates 5 QoL dimensions (mobility, self-care, usual activities, pain/ discomfort and anxiety/ depression) and includes a visual analogue scale (VAS) rated 0-100% that provides a quantitative measure of the patients’ perception of their overall health. Method Data from 69 patients on peritoneal dialysis at our center were collected using EQ-5D-5L EuroQol questionnaire. Health state index (HSI) scores were calculated from individual health profiles using the Spanish value set (maximum score 1). Additional clinical and laboratory data was collected from the patient’s medical files. Results Mean age of the population studied was 55,2 ± 14,0 years, and 66,7% (n=46) were male. Most patients were on PD &gt; 1 year (62,3%, n=43) and performing automated peritoneal dialysis (APD) (52,2%, n=36). Mean HSI was 0,88 ± 0,15 and mean VAS score was 75,1 ± 18,7. Patients with weekly Kt/V ≥ 1,7 scored on average 0,09 points higher on the HSI (p=0,070) and 13,34 points higher in VAS (p=0,019), compared to patients with weekly Kt/V &lt; 1,7. Patients on PD &gt; 1 year scored on average 0,09 points lower on the HSI (p=0,017), mainly due to higher levels of anxiety/depression, and 11,9 points lower in VAS (p=0,005) than those &lt; 1 year. Age did not significantly influence QoL, even when comparing patients &gt; 70 years with those &lt; 70 years old (HSI 73.0 ± 15.5 vs 75.4 ± 19.3, p=0.710 / VAS 0.82 ± 0.3 vs 0.89 ± 0.1, p=0.175). Likewise, when comparing continuous ambulatory peritoneal dialysis (CAPD) to APD, there was no significant difference in the scores of QoL. Gender, diabetes mellitus, arterial hypertension, cancer and infectious events related to PD in the last year did not influence QoL. Residual diuresis as an isolated factor did not significantly influence QoL scores. However, as it is a fundamental contributor to Kt/V, it may be indirectly associated with better QoL. A more detailed analysis was not possible as the number of patients with Kt/V ≥ 1.7 and no residual diuresis was, as expected, very low (n=4). Conclusion Perceived QoL in the elderly when compared to younger patients in PD was not inferior in our study, showing this option should be discussed individually with each patient. Our results revealed time in PD negatively influences patients’ perception of their own health, which may be due to patient’s burden and exhaustion, and eventually lead to technique related complications. Kt/V ≥ 1,7 was related to better QoL, either because higher dialysis adequacy leads to better QoL, or because patients who feel better have less tendency to neglect the technique. Finally, we also found type of PD (CAPD vs APD) to have no significant influence on QoL, reinforcing the idea that it should be discussed and adapted to each individual patient.

scholarly journals Quality of Life Is Impaired in Anemic MDS Patients, and May Still Remain Poor Even When Hemoglobin Improves

Blood ◽  
2021 ◽  
Vol 138 (Supplement 1) ◽  
pp. 3698-3698
Author(s):  
Yael Haring ◽  
Nitzan Cohen Sagy ◽  
Shaimaa Taha ◽  
Albert Kolomansky ◽  
Howard S. Oster ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Severe Anemia ◽  
Advisory Committees ◽  
Sharp Drop ◽  
Lower Quadrant ◽  
Vas Score ◽  
Significant Difference ◽  
Anxiety Depression

Abstract Background: Quality of life (QoL) is impaired in MDS. Aims: 1) To study QoL for various levels of anemia in MDS patients at diagnosis, 2) Compare with non-MDS controls. 3) Compare at MDS diagnosis to 1 year later. Methods: Patients in The Israel MDS registry fill out the EQ-5D QoL questionnaire. The evaluated parameters are: mobility, self-care, daily activities, pain/discomfort and anxiety/depression, each scored 0(normal), 1(mild/moderate), or 2(poor). They also evaluate their general health using a visual analogue scale (VAS), scoring from 0 (poor) to 100(excellent). Anemia was classified as none/normal (Hb≥12.5 g/dl), mild (10≤Hb&lt;12.5), moderate (9≤Hb&lt;10), severe (8≤Hb&lt;9) or very severe (Hb&lt;8). To assess QoL dynamics, MDS patients repeat this every 6 months . For controls, we used VAS to assess QoL of patients admitted to the Department of Medicine. Results: In total, 126 MDS patients participated: 19, 40, 17, 21 and 29, from normal to very severe anemia, respectively. Fig.1 shows mean QoL of the 5-parameters for all patients (A), and for each individual (B), as well as the mean VAS score for all patients (C) and for each individual (D). Anemic MDS patients show a wide QoL variability (patients with the same Hb behave differently, Fig.1, B, D). Also, note the drop in QoL from moderate to severe anemia (below 9 g/dl, p=0.06, for 5-parameter; p=0.01, for VAS). In the non-MDS controls (n=141), there was impaired QoL in anemic patients as compared to those without anemia (VAS, Figure 2; p=0.02). However, there was no significant difference in QoL among patients with various degrees of anemia. Follow-up QoL data (1 year) were available for 61 MDS patients (Figure 3). 27 (44%) increased Hb. 32 (52%) decreased, and 2 (3%), had no change. Of the 32 who decreased Hb, average QoL deteriorated by -11.88 [95%CI: -17.96, -5.79]; 24 patients (75%, Figure 3, left-lower quadrant) had decreased VAS score; some still had improved QoL (16%), or stayed the same (9%). Of the 27 who increased Hb, average VAS still reduced by -6.48 [-14.08, 1.12]. The minority increased QoL (26%), or stayed the same (19%). Most (56%) still deteriorated in QoL (right-lower). The QoL results using the 5 parameters was consistent. Conclusions: In this preliminary study: 1) Poor QoL in anemic MDS is variable and not linear, suggesting that other factors, in addition to Hb, affect QoL. 2) The sharp drop in QoL with Hb&lt;9 g/dl (Figure 1, A and C from blue to pink), might lead to a therapeutic paradigm shift, with transfusion recommendations for patients with Hb&lt;9. 3) QoL in anemic MDS patients might differ from non-MDS. 4) Anemia treatment and Hb rise are not necessarily associated with improved QoL. Larger studies will help determine QoL in MDS and other anemias and when and how to treat. Figure 1 Figure 1. Disclosures Mittelman: Janssen · Roche · Novartis · Takeda · Medison / Amgen · Neopharm / Celgene / BMS · Abbvie · Gilead: Research Funding; Novartis · Takeda · Fibrogen · Celgene / BMS · Onconova · Geron: Other: Clini; Onconova · Novartis · Takeda · Silence: Membership on an entity's Board of Directors or advisory committees; MDS HUB: Consultancy; Celgene / BMS · Novartis: Speakers Bureau.

scholarly journals Postoperative Nausea and Vomiting and Postoperative Pain in Patients Undergoing Elective Laparoscopy; Comparison of Total Intravenous Anesthesia versus Inhalational Anesthesia; A Randomized Clinical Trial

2020 ◽  
Author(s):  
Ali Ahmadzadeh Amiri ◽  
Kasra Karvandian ◽  
Mojgan Rahimi ◽  
Mohammad Ashouri ◽  
Amir Ahmadzadeh Amiri
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Postoperative Recovery ◽  
Nausea And Vomiting ◽  
Total Intravenous Anesthesia ◽  
Inhalational Anesthesia ◽  
Intravenous Anesthesia ◽  
Significant Difference

Background: Two major complications of surgeries are postoperative nausea and vomiting (PONV) and also postoperative pain (POP). Several studies have compared total intravenous anesthesia (TIVA) with inhalational anesthesia regarding these two complications. Some results have shown a better postoperative recovery conditions, but other contradictory results can also be found. This study was performed to evaluate and compare the effect of inhalational and intravenous anesthesia in patients undergoing elective laparoscopic surgery, on the incidence and the severity of PONV and POP. Methods: This study was performed as a single-blinded prospective clinical trial. All patients aged 18-65, with ASA class I and II who underwent elective laparoscopy were included. Patients were divided into two groups of intravenous anesthesia and inhalational anesthesia. The incidence and the severity of PONV and POP were examined in 5 separated times after the surgery. The use of a rescue antiemetic and analgesic medication were also evaluated. Results: Overall, 67 patients received inhalational anesthesia and 55 patients received intravenous anesthesia. It was revealed that 47.8% of the patients in the inhalation group and 18.2% of the patients in the intravenous group developed PONV (P<0.001). The severity of PONV was significantly lower in the TIVA group (P<0.001), however, no statistically significant difference was found regarding the severity of abdominal pain (P=0.62). Conclusion: The incidence of PONV and the need for administration of an antiemetic rescue drug are significantly lower in the TIVA group.

scholarly journals Level of anxiety, depression, self-esteem and quality of life among the women with vaginitis

2018 ◽  
Vol 7 (8) ◽  
pp. 3009
Author(s):  
Gulsum Uysal ◽  
Sefa Arlıer ◽  
Fulya Cagli ◽  
Hatice Akkaya ◽  
Murat Soyak ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Body Image ◽  
Self Esteem ◽  
Careful Examination ◽  
Control Group ◽  
Body Image Scale ◽  
Significant Difference ◽  
Quality Of Life Scale ◽  
Anxiety Depression

Background: Present aim is to evaluate anxiety, depression, quality of life and self-esteem in patients with vaginitis (not only specific to candidasis) and also to determine factors affecting vaginitis such as demographic, cultural and psychological causes.Methods: Each patient completed a self-administered questionnaire (Rosenberg’ Self-Esteem Scale, Short-Form 36, Quality of Life Scale, Beck Anxiety Inventory, and Beck Depression Inventory, Body Image Scale) and underwent a careful examination of the vulva and vagina. The cross-sectional study was carried out with two groups. The first group consisted of 107 women between the ages 18 and 45 years and had no physical disease but reccurrent vulvovaginitis (≥4 in a year).  The comparison control group consisted of 94 healthy (no vaginitis symptoms in 12 months) age matched volunteer participants.Results: Women with vaginitis had significantly higher anxiety and depression scores. There was no statistically significant difference in body image scale. Regarding type of marriage, arranged type was statistically significantly higher in vaginitis group while flirting type was statistically higher in control group. University school degree and income was statistically significantly lower in vaginitis group. Living residence as rent and vaginal douch was statistically significantly higher in vaginitis group.Conclusions: A better detailed history should be taken into consideration for personal stress sources and treatment support should be provided for patients with vaginitis. Not only gynecologists but also a multidisciplinary team should take part in the treatment and follow up of the patients to cope with recurrency even in non-specific vaginitis.

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