scholarly journals Methadone or Butorphanol as Pre-Anaesthetic Agents Combined with Romifidine in Horses Undergoing Elective Surgery: Qualitative Assessment of Sedation and Induction

Animals ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 2572
Author(s):  
Sara Nannarone ◽  
Giacomo Giannettoni ◽  
Chiara Laurenza ◽  
Andrea Giontella ◽  
Giulia Moretti
Keyword(s):  
General Anaesthesia ◽  
Intravenous Injection ◽  
Patient Population ◽  
Elective Surgery ◽  
Physiological Parameters ◽  
Qualitative Assessment ◽  
Anaesthetic Agents ◽  
Analgesic Potency

While butorphanol is the most commonly used opioid in horses, methadone is not licensed in most countries. Our aim was to compare the effects of both drugs, combined with romifidine, regarding the quality of sedation and induction in horses undergoing elective surgery. Results indicate the suitability of both methadone and butorphanol in this patient population. Animals were scored 10 min after intravenous injection of sedatives. Despite lower overall sedation (OS) score in horses receiving methadone (p = 0.002), the quality and time of induction and intubation remained unchanged. None of the horses had the lowest OS score (no sedation), nor the highest score for ataxia (horse falling). Methadone induced a tendency for minor noise reaction yet minor head lowering scores, the latter being probably the most influencing parameter when scoring OS. Measured physiological parameters decreased in both groups, with greater bradycardia recorded after methadone (p = 0.017), including a higher incidence of atrioventricular blocks that resolved during general anaesthesia. The quality of induction was good–excellent in most of the animals. While comparisons between the degree of antinociception were beyond the scope of this study, analgesic potency might influence the choice when considering opioids as pre-anaesthetic drugs in combination with romifidine before surgery in equines.

scholarly journals Comparison of quality of induction of anaesthesia between intramuscularly administered ketamine, intravenously administered ketamine and intravenously administered propofol in xylazine premedicated cats

2007 ◽  
Vol 78 (4) ◽  
Author(s):  
T.B. Dzikiti ◽  
S. Chanaiwa ◽  
P. Mponda ◽  
C. Sigauke
Keyword(s):  
General Anesthesia ◽  
Induction Period ◽  
General Anaesthesia ◽  
Heart Rates ◽  
Anaesthetic Agents ◽  
Induction Of Anaesthesia

The quality of induction of general anesthesia produced by ketamine and propofol, 2 of the most commonly used anaesthetic agents in cats, was assessed. Eighteen cats admitted for elective procedures were randomly assigned to 3 groups and then premedicated with xylazine 0.75 mg/kg intramuscularly before anaesthesia was induced with ketamine 15 mg/kg intramuscularly (KetIM group), ketamine 10 mg/kg intravenously (KetIV group) or propofol 4 mg/kg intravenously (PropIV group). Quality of induction of general anaesthesia was determined by scoring ease of intubation, degree of struggling, and vocalisation during the induction period. The quality of induction of anaesthesia of intramuscularly administered ketamine was inferior to that of intravenously administered ketamine, while intravenously administered propofol showed little difference in quality of induction from ketamine administered by both the intramuscular and intravenous routes. There were no significant differences between groups in the ease of intubation scores, while vocalisation and struggling were more common in cats that received ketamine intramuscularly than in those that received intravenously administered ketamine or propofol for induction of anaesthesia. Laryngospasms occurred in 2 cats that received propofol. The heart rates and respiratory rates decreased after xylazine premedication and either remained the same or decreased further after induction for all 3 groups, but remained within normal acceptable limits. This study indicates that the 3 regimens are associated with acceptable induction characteristics, but administration of ketamine intravenously is superior to its administration intramuscularly and laryngeal desensitisation is recommended to avoid laryngospasms.

scholarly journals ASSESSMENT OF CHANGES OF SKIN MOISTURE IN PATIENTS SUBJECT TO GENERAL ANESTHESIA WITH NEUROLOGICAL DISEASES IN AN INTERVIEW

2019 ◽  
Vol 72 (7) ◽  
pp. 1288-1294
Author(s):  
Jolanta Piskorz ◽  
Gustaw Wójcik ◽  
Włodzimierz Bulikowski ◽  
Dorota Kozak-Putowska
Keyword(s):  
General Anaesthesia ◽  
Mild Hypothermia ◽  
Elective Surgery ◽  
Neurological Diseases ◽  
Circulatory System ◽  
Perioperative Period ◽  
Hydration Status ◽  
Control Group ◽  
Anaesthetic Agents ◽  
Skin Moisture

Introduction: General anaesthesia is carried out using anaesthetic agents that among others depress the circulatory system and CNS. Central and peripheral thermoregulation occurs, which is due to mild hypothermia as well as changes in skin moisture. An important element of therapy in the perioperative period is adequate intravenous fluid therapy, which affects the final effects of treatment. The aim: Evaluation of skin moisture as a result of changes in central and peripheral thermoregulation during general anaesthesia and evaluation of the hydration status of patients. Material and methods: The study included 180 patients undergoing general anaesthesia for elective surgery, aged 20-85 years of age. Before general anaesthesia, patients were evaluated for ASA-related risk of anaesthesia (ASA 1 - healthy patients, ASA 2 and 3 - patients with neurological and circulatory disorders). Patients were divided into 2 groups, the study group (90 people) were patients who were given no intravenous fluids before the surgery and the control group (90 patients) were those receiving doses of 500 ml crystalline intravenously one hour before anaesthesia. The research was carried out at the Operational Block of the Provincial Hospital in Tarnobrzeg, from November 2013 to November 2014. Skin moisture was measured using a CM 825 Corneometer: before general anaesthesia, after induction for anaesthesia, 15 min after surgical incision of the skin and after awakening the patient. Results: Both in the test and control groups, statistically significant differences were found in subsequent skin moisture measurements. Pairwise comparisons indicate statistically significant differences between each pair of measurements. In both groups of patients, there is a clear decrease in skin moisture after induction of anaesthesia compared to the measurement performed before general anaesthesia. The skin moisture values are reduced in subsequent measurements, however the difference is much lower. Conclusions: 1 Measurement of skin moisture can be used as one of the parameters to assess perioperative stress and changes in body temperature during general anaesthesia, which indirectly determines the functioning of the hypothalamus. 2 By measuring the skin moisture it is possible to indirectly assess the hydration status of patients as well as the decrease of the metabolism during general anaesthesia. 3 The decrease in skin moisture during general anaesthesia is the effect of changes in central and peripheral thermoregulation.

scholarly journals A prospective clinical audit on quality of anaesthesia and accidental awareness in patients undergoing elective surgery under general anaesthesia

2021 ◽  
Vol 4 (3) ◽  
pp. 128-133
Author(s):  
Dr. PR Chauhan ◽  
Dr. HK Mahajan ◽  
Dr. Abhinav Gupta ◽  
Dr. Shalu Singh ◽  
Dr. Lokesh ◽  
...  
Keyword(s):  
General Anaesthesia ◽  
Clinical Audit ◽  
Elective Surgery

Qualitative assessment of equipment failure cause finding and removal

2018 ◽  
pp. 116-126
Author(s):  
E. A. Vakulin ◽  
A. I. Zayats ◽  
V. A. Beklemeshev ◽  
V. A. Ivashkevich ◽  
V. A. Khazhiev ◽  
...  
Keyword(s):  
Production Condition ◽  
Real Life ◽  
Open Pit Mine ◽  
Qualitative Assessment ◽  
Open Pit ◽  
Quality Level ◽  
Equipment Failure ◽  
Operation Conditions ◽  
Failure Investigation

Investigation of failures is one of the critical activities of mining and haulage equipment operability assurance in mining. Maintaining failure investigation at the required quality level, it is possible to identify provisions, rules and procedures that should be revised or changed, operation conditions that should be improved, additional personnel training, if required, etc. Investigation of failures in mines is under responsibility of machine men and electricians of maintenance and operation services. In reality, factory management and setup for production condition weak concernment of these workers in quality investigation aimed at finding of sources of equipment failures. This article describes real-life results achieved in development and use of maintenance service operation, technology and management monitoring. The requirements are substantiated for quality improvement in failure cause finding and removal in mining and haulage equipment at Chernogorsky open pit mine, SUEK-Khakassia. Causes of the present quality of failure investigation by machine men of Chernogorsky Repair and Engineering Works and Chernogorsky open pit mine are revealed. The proposed recommended practices will improve quality of mining and haulage equipment failure investigation.

Automated Insulin Delivery Systems: Today, Tomorrow and User Requirements

2021 ◽  
pp. 193229682110299
Author(s):  
Marga Giménez ◽  
Ignacio Conget ◽  
Nick Oliver
Keyword(s):  
Lived Experience ◽  
Diabetes Management ◽  
Real Life ◽  
Insulin Delivery ◽  
Qualitative Assessment ◽  
Management Tool ◽  
Diabetes Distress ◽  
Glycemic Targets

Automated insulin delivery (AID) is the most recent advance in type 1 diabetes (T1D) management. It has the potential to achieve glycemic targets without disabling hypoglycemia, to improve quality of life and reduce diabetes distress and burden associated with self-management. Several AID systems are currently licensed for use by people with T1D in Europe, United States, and the rest of the world. Despite AID becoming a reality in routine clinical practice over the last few years, the commercially hybrid AID and other systems, are still far from a fully optimized automated diabetes management tool. Implementation of AID systems requires education and support of healthcare professionals taking care of people with T1D, as well as users and their families. There is much to do to increase usability, portability, convenience and to reduce the burden associated with the use of the systems. Co-design, involvement of people with lived experience of T1D and robust qualitative assessment is critical to improving the real-world use of AID systems, especially for those who may have greater need. In addition to this, information regarding the psychosocial impact of the use of AID systems in real life is needed. The first commercially available AID systems are not the end of the development journey but are the first step in learning how to optimally automate insulin delivery in a way that is equitably accessible and effective for people living with T1D.

scholarly journals Supranational Assessment of the Quality of Probiotics: Collaborative Initiative between Independent Accredited Testing Laboratories

2021 ◽  
Vol 9 (7) ◽  
pp. 1456
Author(s):  
Jean-Pol Warzée ◽  
Marina Elli ◽  
Abdoulaye Fall ◽  
Daniela Cattivelli ◽  
Jean-Yves François
Keyword(s):  
Daily Basis ◽  
Qualitative Assessment ◽  
Close Collaboration ◽  
Quality Label ◽  
Accredited Laboratories ◽  
Quantitative Analyses ◽  
Quality Of Food ◽  
The Eu

Recent acquisitions about the role of the microbiota in the functioning of the human body make it possible to envisage an increasing use of beneficial microbes, and more particularly of probiotics as well as their metabolites, as nutritional supplements. National and EU authorities are engaged in assuring the safety and quality of food supplements and in defining rules to assess and communicate their efficacy on human health. The quality of probiotics, intended as strains’ identification, viability, and stability over time, is a crucial factor of credibility with consumers and health professionals. Analytical technologies for the quality control of probiotics must also be adapted to new preparations, such as those including new multistrains complex combinations. Accredited laboratories face this relevant challenge on a daily basis. Through its close collaboration with the laboratory commissioned to produce the specifications for its ESLP quality label (identification and quantitative analyses) together with its scientific committee, the ESLP has been focusing on this issue for 10 years. Recently, as part of the internationalization of the ESLP quality label, a new and unique initiative in Europe for the evaluation of the quality of probiotic preparations has been carried out. The collaboration between two accredited laboratories in Belgium and in Italy represented a concrete example of supranational collaboration in the assessment of the quality of probiotic preparations. Results show that both laboratories are in line as expected in terms of performance. Common approaches to the qualitative assessment of probiotic preparations, especially for complex and composite recipes, in terms of number of strains and included substances, should be encouraged and promoted all over the EU.

scholarly journals Qualitative assessment of YouTube videos as a source of patient information for cochlear implant surgery

2021 ◽  
pp. 1-4
Author(s):  
C Thomas ◽  
J Westwood ◽  
G F Butt
Keyword(s):  
Cochlear Implant ◽  
Cochlear Implants ◽  
Qualitative Assessment ◽  
Supplementary Information ◽  
Implant Surgery ◽  
Critical Elements ◽  
Positive Elements ◽  
Cochlear Implant Surgery ◽  
Youtube Videos

Abstract Background YouTube is increasingly used as a source of healthcare information. This study evaluated the quality of videos on YouTube about cochlear implants. Methods YouTube was searched using the phrase ‘cochlear implant’. The first 60 results were screened by two independent reviewers. A modified Discern tool was used to evaluate the quality of each video. Results Forty-seven videos were analysed. The mean overall Discern score was 2.0 out of 5.0. Videos scored higher for describing positive elements such as the benefits of a cochlear implant (mean score of 3.4) and scored lower for negative elements such as the risks of cochlear implant surgery (mean score of 1.3). Conclusion The quality of information regarding cochlear implant surgery on YouTube is highly variable. These results demonstrated a bias towards the positive attributes of cochlear implants, with little mention of the risks or uncertainty involved. Although videos may be useful as supplementary information, critical elements required to make an informed decision are lacking. This is of particular importance when patients are considering surgery.

scholarly journals The effectiveness of different patient referral systems to shorten waiting times for elective surgeries: systematic review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dimuthu Rathnayake ◽  
Mike Clarke
Keyword(s):  
Primary Care ◽  
Health Systems ◽  
Elective Surgery ◽  
Waiting Times ◽  
Surgical Care ◽  
High Income ◽  
Surgical Patients ◽  
Timely Access ◽  
Referral Systems

Abstract Background Long waiting times for elective surgery are common to many publicly funded health systems. Inefficiencies in referral systems in high-income countries are more pronounced than lower and middle-income countries. Primary care practitioners play a major role in determining which patients are referred to surgeon and might represent an opportunity to improve this situation. With conventional methods of referrals, surgery clinics are often overcrowded with non-surgical referrals and surgical patients experience longer waiting times as a consequence. Improving the quality of referral communications should lead to more timely access and better cost-effectiveness for elective surgical care. This review summarises the research evidence for effective interventions within the scope of primary-care referral methods in the surgical care pathway that might shorten waiting time for elective surgeries. Methods We searched PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library databases in December-2019 to January-2020, for articles published after 2013. Eligibility criteria included major elective surgery lists of adult patients, excluding cancer related surgeries. Both randomised and non-randomised controlled studies were eligible. The quality of evidence was assessed using ROBINS-I, AMSTAR 2 and CASP, as appropriate to the study method used. The review presentation was limited to a narrative synthesis because of heterogeneity. The PROSPERO registration number is CRD42019158455. Results The electronic search yielded 7543 records. Finally, nine articles were considered as eligible after deduplication and full article screening. The eligible research varied widely in design, scope, reported outcomes and overall quality, with one randomised trial, two quasi-experimental studies, two longitudinal follow up studies, three systematic reviews and one observational study. All the six original articles were based on referral methods in high-income countries. The included research showed that patient triage and prioritisation at the referral stage improved timely access and increased the number of consultations of surgical patients in clinics. Conclusions The available studies included a variety of interventions and were of medium to high quality researches. Managing patient referrals with proper triaging and prioritisation using structured referral formats is likely to be effective in health systems to shorten the waiting times for elective surgeries, specifically in high-income countries.

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