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

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128 Appendix 4 TABLE 66 contd Summary of adult clinical outcomes studies Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Nathanson et al., (1) Propofol, sevoflurane, N 2O (n = 21) (a) Open eyes (a): (1) 7.8, (2) 4.8 min; Grade II–1b 1995, 100 USA p < 0.05 (2) Propofol, desflurane, N 2O (n = 21) (b) Obey Controlled study command (b): (1) 10.2, (2) 6.4 min; NS N 2O: given (c) Orientation (c): (1) 11.2, (2) 9.3 min; NS Premedication: none (d) Sit unaided (d): (1) 90, (2) 107 min; NS Opioid: vecuronium, fentanyl (e) Walk (e): (1) 124, (2) 126 min; NS Procedures: laparoscopic sterilisation (f) Discharge (f): (1) 193, (2) 201 min; NS Nelskyla et al., (1) Sevoflurane (n = 22) (a) PONV (a): (1) 6%, (2) 1%; p < 0.01 Grade I 1999, 101 Finland (2) Propofol + alfentanil (n = 22) (b) Pain (b): (1) 21, (2) 19; NS Randomisation by RCT sequential coded N 2O: given (c) Time to (c): (1) 6.5, (2) 3.5 min; envelopes eyes open p < 0.05 Premedication: none Not blind (d) Time to (d): (1) 7.5, (2) 5.0 min; Procedures; evacuation orientation p < 0.05 Age: > 18 years; mean ± SD, (e) Time to (e): (1) 30, (2) 22 min; NS 28 ± 30 years fluids (f): (1) 149, (2) 166 min; NS (f) Time to discharge (g): (1) 86%, (2) 100%; NS (g) Patient satisfaction Nielsen et al., (1) Propofol TIVA, alfentanil (n = 28) (a) P-deletion Data only given for all tests Grade I 1991, 102 Denmark variant 2 h postoperatively (2) Thiopentone TIVA, alfentanil Method of randomisation RCT (n = 28) (b) Coordination (a–d): No differences not reported post-box N 2O: not given (e): No recollection of Blind (c) Coordination picture used; (1) 5, Premedication: none pegboard (2) 13; p < 0.05 Gender: women (d) Short-term memory Age: 18–60 years (e) Long-term memory Nightingale and Lewis, 1992, (1) Propofol TIVA, alfentanil, no N2O (a) Simple No significant difference Grade I 103 (n = 25) reaction time between groups for England any variable Method of randomisation (2) Propofol, isoflurane, N2O, alfentanil (b) Choice not reported RCT (n = 25) reaction time Not blind N2O: given in group 1 (c) CFFT Premedication: none (d) PONV Procedures: minor gynaecological Gender: women 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 O’Hara et al., (1) Thiopentone, sevoflurane, N 2O (a) Open eyes (a): (1) 9.7, (2) 11.9 min; NS Grade I 1996, 104 USA (n = 25) (b) Orientation (b): (1) 13.6, (2) 17 min; Method of randomisation RCT (2) Thiopentone, isoflurane, N 2O p = 0.02 not reported (n = 22) (c) Discharge (c): (1) 244, (2) 282 min; NS Not blind N 2O: given (d) PONV (%) (d): (1) 64%, (2) 54%; NS Premedication: none (e) DSST (e): No differences Procedures:“generally gynaecology” (graph data only) Gender: women Mean ± SD age: 34.3 ± 1.2 years Oikkonen, (1) Alfentanil, propofol, suxamethonium, (a) Open eyes/ (a–c): Data given on the Grade I 1994, 105 Finland alfentanil, propofol TIVA (n = 15) waken number of patients fulfilling the criteria at a number of Method of randomisation RCT (2) Alfentanil, propofol, suxamethonium, (b) Name, specified times. Group 1 not reported alfentanil, isoflurane (n = 15) date of birth better than group 2; p < 0.01 in all cases Not blind N 2O: not given (c) Obey command (d): NS Premedication: diazepam, glyco., alcuronium (d) P-deletion test Procedures: gynaecological laparoscopy Mean ± SD age: 38 ± 6 years Ong et al., (1) Fentanyl, propofol, propofol TIVA, (a) Open eyes (a): (1) 307, (2) 440 s; NS Grade I 2000, 106 Singapore no N2O (n = 40) (b) Orientation (b): (1) 346, (2) 427 s; NS Method of randomisation (2) Sevoflurane + N2O (n = 40) not reported RCT (c) PONV (c): (1) 0%, (2) 2.5%; NS N2O: given in group 2 Not blind Premedication: none Procedures: minor gynaecological Patil et al., 1999, 107 (1) Sevoflurane (n = 39: 4 women, (a) Time to (a): (1) 42.7, (2) 44.2 min; NS Grade I Mumbai 35 men) induction (b): (1) 0%, (2) 1%; NS Method of randomisation RCT (2) Thiopentone (n = 39: 7 women, (b) PONV not reported 32 men) (c): (1) 9.7, (2) 11.2 min; (c) Recovery p = 0028 Not blind N 2O: given in group A (d) Tandem (d): (1) 22, (2) 12; p < 0.05 Premedication: none walking test (able to walk Incidence of arrhythmias Procedures: laryngoscopy at 30 min) higher in group 2; p < 0.05 Age: > 18 years; mean ± SD 56 ± 57 years continued 129
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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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60 50 40 30 20 10 0 No. of patients
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a scale effect for scenario A, but
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The mean CVs for avoidance of PONV
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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
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
Page 181 and 182: TABLE 71 contd Quality of cost or e
Page 189 and 190: Abbott J, Abbott P. Psychological a
Page 191 and 192: 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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