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

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120 Appendix 4 TABLE 66 contd Summary of adult clinical outcomes studies Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Fletcher et al., (1) Thiopentone, desflurane, N 2O (a) Open eyes (a, b, c): Only graph data Grade I 1991, 73 USA (n = 20) given. Group 4 fastest; (b) Obey p < 0.05. Group 1 faster Method of RCT (2) Thiopentone, isoflurane, N 2O command than groups 2 and 3; p < 0.05. randomisation (n = 20) Group 2 slowest not reported (c) Orientation (3) Thiopentone, desflurane, no N 2O (d): Group 2 best at 30 min. Blind (n = 20) (d) Sedation Groups 2 and 3 best at (subjective 60 min. No other differences (4) Desflurane, desflurane, no N 2O 4-point scale) (n = 20) (e, f, g): No differences (e) Choice N 2O: given in groups 1 and 2 routine time Premedication: none (f) CFFT Procedures: mixed (g) PONV Gender: not reported Mean ± SD age: 40.7 ± 1.3 years Fredman et al., (1) Propofol TIVA (n = 50) (a) Open eyes (a): (1) 9, (2) 9, (3) 10 min; NS Grade I 1995, 74 USA (2) Propofol, sevoflurane (n = 48) (b) Obey (b): (1) 11, (2) 12, (3) 12 min; Method of RCT command NS randomisation (3) Sevoflurane, sevoflurane (n = 48) not reported (c): (1) 13, (2) 13, (3) 15 min; N 2O: given (c) Orientation NS Blind Premedication: none (d): (1) 108, (2) 107, (d) Sit unaided (3) 116 min; NS Fentanyl (e) Walk (e): (1) 146, (2) 156, Vecuronium (3) 165 min; NS (f) Discharge Procedures: gynaecology, ENT (f): (1) 183, (2) 184, (g) PONV (3) 207 min; NS Gender: 78% women (h) DSST (g1): (1) 27%, (2) 30%, (3) 56%; Mean ± SD age: 36 ± 12 years NS (g2): (1) 10%, (2) 18%, (3) 33%; p < 0.05 (h): No differences Green Gand Jonsson, 1993, (1) Propofol, isoflurane + N2O (n = 32) (a) Open eyes (a): (1) 9.7, (2) 11.3, Grade II–1a 75 (3) 11.0 min; p < 0.05 Sweden (2) Propofol TIVA for 25 min, then (b) Orientation Not clear whether isoflurane + N2O (n = 31) (b): (1) 11.0, (2) 13.4, randomisation was Controlled study (c) Maddox (3) 13.1 min; p < 0.05 carried out (3) Propofol TIVA + N2O (n = 32) Wing (c): No differences N2O: given (d) Choice reaction time (d): No differences Premedication: none (e) P-deletion (e): No differences Procedures: arthroscopy, laparoscopy test Gender: 79% women (f) PONV (f): Group 1 significantly more (data not given) Mean ± SD age: 36 ± 8.7 years continued
TABLE 66 contd Summary of adult clinical outcomes studies © Queen’s Printer and Controller of HMSO 2002. All rights reserved. Health Technology Assessment 2002; Vol. 6: No. 30 Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Gunawardene and (1) Propofol TIVA, no N 2O (n = 30) (a) PONV only No significant difference Grade I White, 1988, 76 England (2) Propofol TIVA + N 2O (n = 30) Method of randomisation not reported RCT (3) Propofol induction, enflurane + N 2O (n = 30) Blind N 2O: given in groups 2 and 3 Premedication: 12 patients received temazepam Procedures: gynaecology Age: 22–67 years Gupta et al., (1) Thiopentone, isoflurane (n = 16) (a) Simple Raw data not supplied, Grade I 1992, 77 Sweden reaction time only graphs (2) Propofol, isoflurane (n = 14) Method of randomisation RCT (b) Choice (a–e):Thiopentone not reported N 2O: not given reaction time significantly more than propofol at 30 min; p < 0.05 Not blind Premedication: none (c) Perception accuracy test No other differences Procedures: arthroscopy (d) DSST Gender: 23% women (e) Clinical Age: 17–49 years recovery (subjective, scale 1–5) (f) PONV Gupta et al., (1) Propofol TIVA (n = 25) (a) P-deletion (a): (1) 24, (2) 33; p < 0.05 Grade I 1995, 78 Sweden test (controls 32) (2) Propofol, isoflurane (n = 25) Method of randomisation RCT (b) Trieger (b): (1) 11.6, (2) 7.5; p < 0.01 not reported N 2O: given Dot Test (controls (1) 3.5, (2) 3.3) Blind assessment Premedication: none (c) Steward (c): No difference of recovery score Analgesia: alfentanil (d): No difference Also examined Mood (d) Time to Adjective Checklist Procedures: knee arthroscopy open eyes (e): (1) 4%, (2) 15% preoperatively and at 2 and 24 h postoperatively Gender: 44% women (e) PONV (f): No difference Age: 15–45 years (f) Time to discharge Gupta et al., (1) Propofol, desflurane, N 2O (n = 25) (a) Open eyes (a): (1) 255, (2) 327 s; Grade I 1996, 79 Sweden p < 0.05 (2) Propofol, isoflurane, N 2O (n = 25) (b) Orientation Method of randomisation RCT (b): (1) 301, (2) 362 s; not reported N 2O: given (c) Finger p < 0.05 tapping Blind Premedication: none (c): No difference (d) Perceptive Alfentanil accuracy (d): No difference (graph data only) Procedures: arthroscopy (e) PONV (e): (1) 5%, (2) 3%; NS Gender; 30% women Mean ± SD age: 30.6 ± 8.9 years continued 121
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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
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500 400 300 200 100 0 -100 -200 -30
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Recruitment to the CESA RCT The stu
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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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Page 183 and 184: TABLE 71 contd Quality of cost or e
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TABLE 71 contd Quality of cost or e
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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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