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

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122 Appendix 4 TABLE 66 contd Summary of adult clinical outcomes studies Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Haley et al., (1) Thiopentone, alfentanil, N 2O (n = 20) (a) Respond (a): (1) 2.8, (2) 4.7, Grade I 1988, 80 Canada to command (3) 8.1 min (2) Thiopentone, fentanyl, N 2O (n = 20) Method of randomisation RCT (b) Orientation (b): (1) 5.6, (2) 7.7, not reported (3) Thiopentone, enflurane, N 2O (n = 19) (3) 10.8 min Not blind N 2O: given No difference between groups PONV not measured Premedication: none Procedures: minor gynaecological surgery Age: 18–60 years Hough and Sweeney, 1998, (1) Propofol, isoflurane, N2O (n = 80) PONV only No vomiting Grade I 81 measured England (2) Propofol, desflurane, N2O (n = 76) Nausea only Method of randomisation not reported RCT N2O: given Desflurane 14/76 Not blind Premedication: none Isoflurane 4/80 Fentanyl: to all patients p < 0.05 Procedures: knee arthroscopy Gender: 33% women Age: 16–70 years Hovorka et al., (1) Isoflurane, N 2O, O 2 (n = 50) (a) PONV (a): (1) 54%, (2) 48%, Grade II–1a 1989, 82 Finland (3) 52%; NS (2) Enflurane, N 2O, O 2 (n = 50) Pseudo-randomisation RCT by date of birth (3) Isoflurane, air, O 2 (n = 50) Single blind Premedication: oxycodone Procedures: gynaecological laparoscopy Gender: women Mean age: 33 years Huma, 1990, 83 Kenya (1) Propofol, halothane, N2O (n = 20) (a) Eye opening No difference between groups Grade I (2) Thiopentone, halothane, N2O (b) PONV Method of randomisation RCT (n = 20) not reported N 2O: given Not blind Premedication: none Procedures: not reported Age: 16–65 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 Jakobsson et al., Fentanyl: 1–2 µg/kg (a) Time in (a): NS Grade I 1997, 84 Sweden recovery room (1) Propofol induction/TIVA (n = 20) (b): NS Method of randomisation RCT (b) Time to not reported (2) Propofol induction, desflurane discharge (c): NS maintenance (n = 20) Not blind (c) PONV (d): NS N 2O/O 2:given in 66% (d) Pain Premedication: 5 mg midazolam Procedures: arthroscopy Gender: 50% women Mean ± SD age: 34 ± 13 years Kashtan et al., (1) Propofol TIVA (n = 30) (a) Open eyes (a): (1) 6.4, (2) 13.9 min; Grade I 1990, 85 Canada p < 0.02 (2) Thiopentone TIVA (n = 30) (b) Obey Method of randomisation RCT command (b): (1) 7.6, (2) 15.4 min; not reported N 2O: not given p < 0.03 (c) Orientation Blind Premedication: none (c): (1) 22.7, (2) 36.2 min; (d) Walk p < 0.01 Procedures: not reported (e) P-deletion (d): (1) 45, (2) 41;NS Gender: 85% women test (e): No differences Mean ± SD age: 36.7 ± 9 years (f) Trieger Dot Test (f): Bilateral: (1) 2.5, (2) 2.7; postoperatively, (1) 6.0, (g) PONV (2) 10.3; p < 0.05 (g): No differences Killian et al., (1) Propofol TIVA (n = 33: 25 women, (a) Time to (a): (1) 8.4, (2) 8.7 min; NS Grade I 1992, 86 Canada 8 men) eye open (b): (1) 13, (2) 13; NS Randomisation by tables RCT (2) Thiopentone/isoflurane (n = 30: (b) Aldrete 24 women, 6 men) score (c): (1) 14.9, (2) 15.4 min; NS Not blind N 2O: given (c) Time to (d): (1) 112, (2) 142 min; 12/75 patients excluded: orientation p < 0.01 prior to statistical analysis Premedication: none (d) Time to (e): (1) 71, (2) 101 min; Procedures: gynaecology, orthopaedic, bathroom p < 0.01 other day surgery (e) Time to (f): (1) 34, (2) 163 min; p < 0.02 Age: 18–65 years fluids (g): (1) –2, (2) –3; NS (f) Time to discharge (h): (1) 1.36%, (2) 1.52%; NS (g) P-deletion (i): (1) 1.36%, (2) 1.52%; NS test (j): (1) 4.55, (2) 3.97; p < 0.01 (h) Nausea (i) Vomiting (j) Overall recovery continued 123
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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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TABLE 49 The occurrence of any PONV
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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
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Page 124 and 125: 110 Appendix 2 TABLE 65 contd Summa
Page 126 and 127: 112 Appendix 3 Quality assessment o
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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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