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

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142 Appendix 5 TABLE 67 contd Summary of paediatric clinical outcomes studies Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Lerman et al., (1) Halothane (n = 125) Time (min) to: (a): (1) 1.3, (2) 1.6; p < 0.001 Grade I 1996, 149 Canada and USA (2) Sevoflurane (n = 250) (a) induction (b): (1) 12.3, (2) 19.9; p < 0.001 No details of randomisation other than Multicentre RCT N 2O: given (b) responds (c): (1) 19.3, (2) 24.8; p < 0.001 1:2 ratio randomisation to commands Procedures: genitourinary, lower (d): (1) 63.8, (2) 71.9; NS No details on fall out abdominal, plastic, orthopaedic (c) Aldrete score > 8 (e): (1) 31.8, (2) 33.8; NS Patients receiving Age: 1–12 years sevoflurane had higher (d) tolerating (f): (1)
TABLE 67 contd Summary of paediatric 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 Naito et al., (1) Halothane (n = 15) Time (min) to: (a): (1) 3.3, (2) 3.2; NS Grade I 1991, 153 Japan (2) Sevoflurane (n = 15) (a) induction (b): (1) 9.5, (2) 4.3; p < 0.01 No details on RCT randomisation N 2O: given (b) emergence (c): (1) 137.4, (2) 90; p < 0.01 No record of time Procedures: pulsed-dye laser therapy (c) recovery (d): (1) 2, (2) 1;NS to discharge for port-wine stain on face or neck (d) vomiting (e): (1) 3, (2) 9; NS Age: 1–7 years (e) agitation Pandit et al., (1) N 2O (n = 30) (a) PACU stay No impact on PACU stay Grade I 1995, 154 USA or any measure of vomiting (2) No N 2O (n = 30) (b) Vomiting Limited outcome RCT measures measures Procedures: tonsillectomy/ adenoidectomy No details on randomisation Age: 4–12 years Piat et al., (1) Halothane (n = 17) Time (min) to: (a): (1) 6.1, (2) 5.6; NS Grade I 1994, 155 France (2) Sevoflurane (n = 17) (a) intubation (b): (1) 19.2, (2) 14.6; p < 0.01 No details on RCT randomisation N 2O: given (b) extubation (c): (1) 33.4, (2) 18.1; p < 0.001 No record of time Procedures: hernia, orchidopexy, (c) emergence (d): (1) 35.9, (2) 25.3; p < 0.01 to discharge hypospadias (d) Aldrete Age: 9 months to 9 years score > 8 Reimer et al., (1) Thiopentone/halothane + N 2O Time (min) to: (a): (1) 10, (2) 11, (3) 6; Grade I 1993, 156 Canada (n = 25) p < 0.0005 (a) extubation RCT (2) Propofol (n = 25) (b): (1) 32, (2) 26, (3) 14; (b) eye open p < 0.0001 (3) Propofol + N 2O (n = 25) (c) time (c): (1) 8, (2) 1, (3) 1; Procedures: strabismus surgery to vomit p < 0.0017 Age: 2–12 years (d) recovery (d): (1) 65, (2) 70, (3) 64; NS (e) hospital (e): (1) 155, (2) 148, (3) 140; discharge NS (f) vomiting (%) (f): (1) 48, (2) 28, (3) 42; NS Runcie et al., Comparison of induction methods Time (min) to: (a): (1) 21, (2) 20, (3) 17, Grade I 1993, 157 UK (4) 16; NS (1) Thiopentone, 0–5 years (n = 29) (a) eye opening RCT (b): (1) 15, (2) 21, (3) 5, (2) Thiopentone, 5–11 years (n = 21) (b) oral intake (4) 16; NS (3) Propofol, 0–5 years (n = 27) (c) discharge (c): (1) 95, (2) 117, (3) 88, (4) 86; p < 0.004 between (4) Propofol, 5–11 years (n = 26) (d) sedation groups 2 and 4 score Procedures: circumcision, hernia repair (d): (1) 13, (2) 14, (3) 12, No. of patients (4) 12; NS N 2O: given with isoflurane with: (e): (1) 1, (2) 3, (3) 4, (4) 2; NS (e) pain (f): (1) 0, (2) 0, (3) 0, (4) 0; NS (f) vomiting continued 143
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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
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agent used (see appendix 18). It wa
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Furthermore, anaesthetists operate
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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
Page 193: Struys M, Versichelen L, Thas O, He
Page 196 and 197: 182 Appendix 11
Page 205 and 206: 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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