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

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136 Appendix 4 TABLE 66 contd Summary of adult clinical outcomes studies Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Tarazi and Philip, Induction: fentanyl, ketorolac, propofol, (a) Open eyes (a): (1) 5, (2) 5 min Grade I 1998, 130 USA vecuronium, suxamethonium (b) Obey (b): (1) 6, (2) 6 min Method of randomisation RCT (1) Induction: fentanyl, ketorolac, command not reported propofol, vecuronium, suxamethonium, (c): (1) 64, (2) 75 min sevoflurane + N 2O (n = 30) (c) Sit unaided Not blind (d): (1) 83, (2) 93 min (2) Induction: fentanyl, ketorolac, (d) Walk propofol, vecuronium, suxamethonium, unaided (e): (1) 136, (2) 151 min desflurane + N 2O (n = 30) (e) Street-fit (f): NS N 2O: given (f) DSST (g): NS Premedication: none (g) PONV No differences significant Procedures: laparoscopic tubal ligation Mean ± SD age: 35 ± 4 years Tracey et al., (1) Thiopentone, N 2O, halothane (n = 25) (a) PONV NS Grade I 1982, 131 England (2) Thiopentone, N 2O, enflurane (n = 25) Method of randomisation RCT not reported (3) Thiopentone, N 2O, isoflurane (n = 25) Not blind N 2O: given Premedication: none Procedures: D&C, laparoscopy Valanne, 1992, 132 Finland (1) Propofol TIVA, N2O (n = 25) (a) Orientation (a): (1) 11.0, (2) 16.5 min; p < 0.01 Grade I (2) Propofol, isoflurane, N2O (n = 25) (b) Straight line walking (No. (b): (1) 25, (2) 14; p < 0.01 Method of randomisation RCT N2O: given of patients) not reported (c): (1) 25%, (2) 15%; p < 0.001 Premedication: none (c) PONV Not blind (d): No differences Procedures: oral surgery (d) Perceptual speed test (no data given) Gender: 25% women Mean ± SD age: 29 ± 7.2 years (variant of P-deletion test) 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 van Hemelrijck et al., 1991, (1) Propofol TIVA + N2O (n = 23) (a) Open eyes (a): (1) 7.3, (2) 5.1, (3) 5.9, Grade I 133 (4) 4.5 min; p < 0.05 (group 1 USA (2) Propofol, desflurane, N2O (n = 23) (b) Obey command against groups 2, 3 and 4) Method of randomisation not reported RCT (3) Desflurane, desflurane, N2O (n = 23) (b): (1) 8.3, (2) 6.4, (3) 7.0, (c) Orientation (4) 5.1 min; p < 0.05 (group 1 Not blind (4) Desflurane, desflurane, no N2O against groups 2, 3 and 4) (n = 23) (d) Sit unaided N2O: give in groups 1–3 (e) Discharge (c): (1) 10.2, (2) 8.3, (3) 9.0, (4) 6.7 min; p < 0.05 (group 1 against groups 2, 3 and 4) Premedication: none (f) DSST (d): (1) 89, (2) 101, (3) 94, Procedures: gynaecologic laparoscopy (g) PONV (4) 89 min; NS Mean ± SD age: 31 ±6 years (e): (1) 199, (2) 204, (3) 196, (4) 215 min; NS (f): No significant differences (data not given) (g): Group 1 significantly less than other three groups, which were equal (data not given) Wandel et al., 1995, (1) Propofol TIVA + N2O (n = 25) (a) Open eyes (a): (1) 9.8, (2) 6.6 min; Grade I 134 p < 0.01 Germany (2) Propofol, sevoflurane + N2O (n = 25) (b) Obey command (b): (1) 12.6, (2) 7.2 min; Method of randomisation not reported RCT p < 0.01 N2O: given (c) Orientation (c): (1) 14.6, (2) 8.6 min; Not blind Premedication: none (d) DSST p < 0.01 Analgesia: fentanyl, vecuronium (d): Group 1 worse at 15 and 30 min only; p < 0.01 Procedures: not reported (graph data only) Gender: 60% men Mean ± SD age: 36.2 ± 14 years Werner and (1) Methohexitone, isoflurane, N 2O (a) VAS of (a): (1) 4.4, (2) 4.9; NS Grade I Newhouse, (n = 25) memory 1993, 135 USA (subjective, by (b): (1) 7, (2) 6 min; NS Method of randomisation (2) Propofol TIVA, N 2O (n = 25) recovery staff) not reported RCT (c): (1) 9, (2) 8 min; NS N 2O: given (b) Open eyes Blind (d): (1) 14, (2) 13 min; NS Premedication: none (c) Orientation (e): (1) 38, (2) 33 min; NS Analgesia: alfentanil (d) Sit unaided (f): (1) 16%, (2) 1%; p < 0.05 Procedures; dental day surgery (e) Walk Gender: not reported (f) PONV Age: not reported continued 137
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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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1.80 The new variable cost and tota
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100 90 80 70 60 50 40 30 20 10 0 Su
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The structure and content of this d
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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
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
Page 193: Struys M, Versichelen L, Thas O, He
Page 196 and 197: 182 Appendix 11
Page 198 and 199: 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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