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

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146 Appendix 5 TABLE 67 contd Summary of paediatric clinical outcomes studies Study Investigations and subjects Outcome Results Conclusions and measures grade of evidence Walker et al., (1) Halothane (n = 26) Time (min) to: (a): (1) 2.85, (2) 3.34; NS Grade I 1997, 164 Australia (2) Sevoflurane (n = 24) (a) induction (b): (1) 33.06, (2) 21.36; No statistics reported RCT p < 0.01 for vomiting N 2O: given (b) emergence (c): (1) 35, (2) 22.1; p < 0.01 Length of stay Procedures: lower abdominal, (c) Aldrete not reported genitourinary score > 8 (d): Higher in group 2 Age: 2–13 years (d) Pain (e): (1) 38.5, (2) 54.2; NS discomfort scale (f): (1) 19.2, (2) 16.7; NS % Patients with: (g): (1) 4, (2) 2; NS (e) emergence excitement (f) vomiting in hospital (g) vomiting postdischarge Weir et al., (1) Halothane induction (n = 39) (a) Discharge (a): (1) 119, (2) 109; NS Grade I 1993, 165 USA (2) Halothane vs propofol (n = 39) (b) Nausea and (b): (1) 27, (2) 17; p < 0.05 No details on RCT vomiting randomisation Maintenance (c): (1) 25, (2) 16; p < 0.05 (c) Vomiting N 2O: given alone (d): (1) 2.8, (2) 1.5; p < 0.05 Procedures: strabismus surgery (d) Total vomit Age: 3–12 years Welborn et al., (1) Sevoflurane/sevoflurane (n = 20) Time (min) to: (a): (1) 11, (2) 11, (3) 10, Grade I 1996, 166 USA (4) 5.6; p < 0.0001 (faster (2) Halothane/sevoflurane (n = 20) (a) emergence recovery in group 4) No emergence RCT excitement with (3) Halothane/halothane (n = 20) (b) recovery (b): (1) 17, (2) 19, (3) 21, sevoflurane (4) 11; p < 0.0001 (faster (4) Halothane/desflurane (n = 20) (c) discharge recovery in group 4) N 2O: given Patients with: (c): (1) 134, (2) 129, (3) 117, (4) 137; NS Procedures: myringotomy and (d) pain tube insertion (d): (1) 19, (2) 19, (3) 19, (e) vomiting (4) 19; NS Age: 1–7 years (f) excitement (e): (1) 6, (2) 9, (3) 4, (4) 4; NS DSU, day surgery unit; PACU, postanaesthesia care unit (f): (1) 1, (2) 3, (3) 5, (4) 4; p < 0.008 (increased incidence in group 4)
TABLE 68 Summary of adult patient-based outcomes studies © Queen’s Printer and Controller of HMSO 2002. All rights reserved. Appendix 6 Health Technology Assessment 2002; Vol. 6: No. 30 Adult patient-based outcomes studies Study Investigations Outcome Results Conclusions and Reviewers’ comments and subjects measures grade of evidence Baker et al., 150 patients SF-36, a generic Preoperative overall health This study used a Used a generic quality of 1995, 167 UK undergoing quality of life was similar to that of the validated questionnaire life instrument to assess varicose vein questionnaire general population.There to assess quality of life the impact of varicose vein Survey day surgery with eight was increased pain and surgery. 41% of respondents domains reduced role function at did not complete all three 1-month postoperatively. questionnaires (pre- Social function and health operative, 1 month, perception were not 6 months) improved at 6-months postoperatively Biemans et al., Comparison Verbal Rating TAPP (laparoscopic Number of patients Grade IV survey. Unclear 1998, 168 The of patient Score of post- correction) mean time in TAPP group with on type of questions asked Netherlands satisfaction after operative pain 80 (50–120); two patients postoperative nausea laparoscopic and and nausea could not be discharged was greater than in the Number of ambulatory Survey conventional on same day (TAPP); all Griffith group. Less surgical procedures is day-case inguinal patients discharged on postoperative pain increasing; laparoscopic hernia repair same day for Griffith’s after the laparoscopic hernia repair as well as procedure.All patients technique the conventional Griffith were satisfied with pre- method can be performed operative information. as a day procedure TAPP group experienced less pain (p < 0.05) but more nausea (p < 0.05). Convalescence in TAPP group shorter than in Griffith group (p < 0.05) Black and 373 patients Postoperative 50% response rate. Questionnaire Puts concerns about Sanderson, undergoing day symptoms, Outcome and satisfaction developed for a anaesthesia into context 1993, 169 UK surgery in four complications, related to sex, age, type of national comparative of overall process of hospitals in health and procedure. Dissatisfaction database day surgery Survey 1990 functional status, with: parking (30%), general satis- occupied on ward (15%), faction, satis- level of privacy (15%), faction with information (15%), afterspecific aspects effects of anaesthetic of care (13%), pain control (12%) continued 147
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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
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practice, such as the use of midazo
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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
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Page 126 and 127: 112 Appendix 3 Quality assessment o
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Page 179 and 180: TABLE 71 Quality of cost or economi
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Page 191 and 192: Hall JE, Stewart JIM, Harmer M. Sin
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Page 196 and 197: 182 Appendix 11
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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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