Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

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116 Appendix 4 TABLE 66 contd Summary of adult clinical outcomes studies Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Cartwright et al., (1) Propofol, isoflurane, remifentanil (a) Response (a): (1) 9, (2) 7 min; NS Grade I 1997, 59 UK (n = 102) to verbal stimulation (b): (1) 13, (2) 14; NS Method of randomisation Multicentre RCT (2) Propofol, isoflurane, alfentanil not reported (n = 99) (b) Learning (c): (1) 206, (2) 210 min; NS memory Double-blind N 2O: none (d): Remifentanil better than (c) Discharge alfentanil; p < 0.05 (no data given) Premedication: none (d) Trieger (e): Remifentanil better than IPPV: vecuronium Dot Test alfentanil; p < 0.05 Procedures; mixed (e) DSST 30 min: (1) 33, (2) 38 Gender: 50% women (f) PONV 60 min: (1) 44, (2) 47 Age: 18–65 years 90 min: (1) 45, (2) 48 (f): (1) 25, (2) 27 patients; NS Cheng et al., (1) Propofol, propofol TIVA, (a) Open eyes (a): NS Grade I 1999, 60 Taiwan ketamine spontaneous ventilation (n = 30) (b) Obey (b): NS Method of randomisation RCT commands not reported (2) Thiopentone, fentanyl, atracurium, (c): NS isoflurane, IPPV (n = 30) (c) P-deletion Not blind test (d): (1) 7%, (2) 30%; p < 0.05 N 2O: none (d) PONV (e): (1) 7%, (2) 41%; p < 0.001 Premedication: atropine + prochlorperazine (e) Sore throat Procedures: gynaecological NB: group (a) laparoscopy not intubated Gender: women Age: 17–48 years Chittleborough et al., 1992, (1) Thiopentone, enflurane, N2O (a) Sit unaided (a): (1) 59.7, (2) 44.8 min; Grade I 61 (n = 20) p < 0.05 Australia (b) Discharge Method of randomisation (2) Propofol, enflurane, N2O (b): (1) 133.5, (2) 113.1 min; not reported RCT (n = 20) (c) P-deletion p < 0.05 test Blind Analgesia: fentanyl (d) Flashing (c, d): No differences Muscle relaxant: vecuronium lights (e): No differences N 2O: given (e) PONV Premedication: none Procedures: oral surgery Gender: 60% women Mean ± SD age: 21.4 ± 3.4 years continued
TABLE 66 contd Summary of adult clinical outcomes studies © Queen’s Printer and Controller of HMSO 2002. All rights reserved. <strong>Health</strong> <strong>Technology</strong> Assessment 2002; Vol. 6: No. 30 Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Chung et al., Remifentanil infusion (a) Time to (a) NS Grade I 2000, 62 UK extubation Propofol induction (b): (1) 6, (2) 6, (3) 7 min; Method of Multinational, (b) Respond p < 0.05 randomisation: multicentre trial, (1) Isoflurane (n = 285) to command computer-generated random 70 centres (c) NS random numbers over 14 countries (2) Enflurane (n = 285) (c) Aldrete (Glaxo sponsored) score (d) NS Not blind (3) Propofol TIVA (n = 284) (d) Time to (e) NS N 2O: none discharge from recovery Premedication: none (e) PONV Procedures: mixed Gender: 63% men Age: 18–78 years Collins et al., (1) Propofol TIVA, alfentanil (n = 15) (a) Nausea on (a): (1) 2, (2) 17 at 1 h Grade I 1996, 63 UK a VAS (p < 0.01); (1) 2, (2) 10 at 2 h (2) Propofol/isoflurane (n = 15) (p < 0.01) Method of RCT (b) Pain on a VAS randomisation N 2O: in group (b) only (b): (1) 48, (2) 45 at 1 h (NS); not reported (c) Drowsiness (1) 35, (2) 45 at 2 h (NS) Premedication: none on a VAS Blind (c): (1) 47, (2) 55 at 1 h (NS); Procedures: laparoscopic sterilisation (d) P-deletion (1) 27, (2) 30 at 2 h (NS) test Gender: women (d): (1) 158, (2) 164 (e) Time to preoperatively (NS); (1) 131, Age: 25–39 years opening eyes (2) 115 at 1 h (p < 0.01) (f) Time to give (e): (1) 9.3, (2) 8.4 min; NS date of birth (f): (1) 13.6, (2) 12.9; NS Dashfield et al., (1) Propofol, sevoflurane, N 2O (n = 20) (a) Open eyes (a): (1) 381, (2) 508 s Grade I 1998, 64 England (2) Sevoflurane, sevoflurane, N 2O (n = 20) (b) Com- (b): No differences Method of RCT puterised randomisation: N 2O: given coordination (c): No differences computer-generated test random numbers Premedication: none (d): (1) 0, (2) 0 (c) P-deletion Not blind Procedures: knee arthroscopy test No difference between groups Gender: 20% women (d) PONV at 90 min Mean ± SD age: 40 ± 10 years De Grood et al., (1) Propofol TIVA (n = 15) (a) Open eyes (1): (a) 7.9, (b) 8.6 min Grade I 1987, 65 The Netherlands (2) Etomidate TIVA (n = 15) (b) Answer (2): (a) 13.8, (b) 19.3 min Method of questions randomisation RCT (3) Propofol, N 2O, isoflurane (n = 15) (3): (a) 9.7, (b) 11.3 min not reported (4) Etomidate, N 2O, isoflurane (n = 15) (4): (a) 12.9, (b) 15.5 min Not blind (5) Thiopentone, N 2O, isoflurane (n = 15) (5): (a) 15.8, (b) 18.0 min N 2O: in groups 3–5 No significant differences Premedication: none Procedures: gynaecological laparoscopy continued 117
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Which anaesthetic agents are costef
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Which anaesthetic agents are costef
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NHS R&D HTA Programme The NHS R&D H
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Contents Appendix 6 Adult patient-b
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Background The aim of the project w
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• The incidence of PONV was low d
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2 Introduction dizziness or disorie
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4 Introduction a reduced incidence
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6 Introduction willingness to pay f
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8 Literature review included in the
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10 Literature review TABLE 1 Compar
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12 Literature review intermediate a
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18 Literature review Patient-based
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20 Literature review TABLE 5 contd
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22 Literature review No studies fol
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24 Literature review (30%) and meth
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26 Literature review • There are
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28 National survey of anaesthetic p
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36 Economic evaluation methods (inc
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38 Economic evaluation methods The
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40 Economic evaluation methods Tabl
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42 Economic evaluation methods simi
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44 Economic evaluation methods Prob
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Recruitment to the CESA RCT The stu
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Clinical outcome data PONV by anaes
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The findings from the logistic regr
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TABLE 29 The length of stay and pri
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140 120 100 80 60 40 20 0 No. of pa
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250 200 150 100 50 0 No. of patient
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TABLE 37 Deterministic sensitivity
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20 15 10 5 0 -5 Difference in varia
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Patient admitted for day surgery an
Page 79 and 80: 500 400 300 200 100 0 -100 -200 -30
Page 81 and 82: Recruitment to the CESA RCT The stu
Page 83 and 84: TABLE 49 The occurrence of any PONV
Page 85 and 86: 60 50 40 30 20 10 0 No. of patients
Page 87 and 88: a scale effect for scenario A, but
Page 89 and 90: The mean CVs for avoidance of PONV
Page 91 and 92: 1.80 The new variable cost and tota
Page 93 and 94: 100 90 80 70 60 50 40 30 20 10 0 Su
Page 95 and 96: The structure and content of this d
Page 97 and 98: nurses to have an in-depth knowledg
Page 99 and 100: agent used (see appendix 18). It wa
Page 101 and 102: Furthermore, anaesthetists operate
Page 103 and 104: The CESA project was designed to as
Page 105: practice, such as the use of midazo
Page 109 and 110: 1. Royal College of Surgeons of Eng
Page 111 and 112: 60. Cheng KI, Chu KS, Fang YR, Su K
Page 113 and 114: 112. Raeder J, Gupta A, Pedersen FM
Page 115 and 116: 162. Viitanen H, Baer G, Annila P.
Page 117 and 118: 220. Rosenberg KM, Bridge P, Brown
Page 119 and 120: The range of databases interrogated
Page 121: 24. preferen$.mp. [mp=title, abstra
Page 124 and 125: 110 Appendix 2 TABLE 65 contd Summa
Page 126 and 127: 112 Appendix 3 Quality assessment o
Page 173 and 174: TABLE 69 Summary of paediatric pati
Page 175 and 176: TABLE 69 contd Summary of paediatri
Page 177 and 178: TABLE 70 Characteristics of cost or
Page 179 and 180: TABLE 71 Quality of cost or economi
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TABLE 71 contd Quality of cost or e
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Abbott J, Abbott P. Psychological a
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Hall JE, Stewart JIM, Harmer M. Sin
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Struys M, Versichelen L, Thas O, He
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182 Appendix 11
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184 Appendix 11
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186 Appendix 11
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188 Appendix 11
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The aim of this study was to develo
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anaesthetics in day surgery, using
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© Queen’s Printer and Controller
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Background The empirical study quan
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Satisfaction with care Nearly all (
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TABLE 76 Reason given for preferenc
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TABLE 79 Comparisons with previous
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TABLE 80 Reason given for preferenc
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TABLE 81 Reason given for willingne
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Background Variable costs account f
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TABLE 85 Unit costs for the purchas
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Background The empirical study requ
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Ethical approval This was covered b
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20 15 10 5 0 -5 -10 -15 True weight
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15 10 5 0 -5 -10 True weight - Dion
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224 Appendix 19 • patients aged o
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All staff unit costs were for the y
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Background Fixed costs account for
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232 Appendix 22 March, Tuesday 15 A
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234 Appendix 23 TABLE 96 Reasons fo
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Patients were coded using the OPCS
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Q03.4 punch biopsy of cervix Q03.5
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This section displays the associati
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given in Table 103 confirm the age
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TABLE 107 Occurrence of PONV by dur
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248 Appendix 27 TABLE 113 Frequency
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This section displays the associati
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The adverse events observed in the
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262 Health Technology Assessment Pr
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264 Health Technology Assessment Pr
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