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

TABLE 68 contd Summary of adult patient-based outcomes studies
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Health Technology Assessment 2002; Vol. 6: No. 30
Study Investigations Outcome Results Conclusions and Reviewers’ comments
and subjects measures grade of evidence
Larsen et al., (1) Propofol PAT Significant difference Found that PAT has the Part II is grade I; Part 1 is
1992, 89 Sweden induction, (p < 0.05) in psychomotor following features: (1) experimenting with PAT
propofol + O2 recovery of PAT between shallow learning curve;
Two-part study: maintenance propofol group and (2) consistent and If the PAT is validated and
I, experiment (15 patients) control group; no reproducible; (3) reliable, it has shown that
on outcome significant difference in phenomenon of ‘arousal’ psychomotor recovery
measures; II, (2) Propofol psychomotor recovery on has not been noticed; following isoflurane
RCT induction, PAT between isoflurane (4) simple and easy to anaesthesia is quicker than
isoflurane 5–2% and control; change in use. Found, using this that following propofol
maintenance choice reaction time – PAT, that psychomotor infusion. Further studies are
(15 patients) difference between recovery following required to evaluate the
isoflurane (p < 0.05) and isoflurane anaesthesia precise difference between
(3) Control propofol (p < 0.01) groups is quicker than that PAT-60 and PAT-200
group: 15 compared with control following propofol
unanaesthetised
volunteers
in PAT-60 infusion
Law, 1997, 185
(1) Assess Telephone Nursing care: excellent Patients on hold Grade IV
UK usefulness of survey 76.3%; satisfactory 23.6%. were happy with new
preoperative Advice leaflets: excellent day-surgery service; Patient satisfaction was
Descriptive assessment No real 57.8%, satisfactory 42.1%. allocation of difficult to measure;
study (telephone outcome Doctor waiting times preoperative questions on patient
survey audit) (2) Identify measures of 5–180 min; 50% waited assessment time satisfaction were closed
written and quality of life 30 min; mean waiting time should be realistic questions with a rating of
verbal advice measures used 56.97 min (median 30 min). poor, fair, etc. Sample size
26.3% (10) said they would was small
(3) Identify Rating: poor, fair, prefer a longer stay
usefulness of satisfactory, in hospital
counselling
criteria
excellent
(4) Assess
patient satisfaction
45 patients
approached,
38 participated
(84.4%)
Leith et al., Questionnaire Questions only 97.8% used NSAIDs; most Pain problems are a Grade IV
1994, 19
survey looking using diclofenac; 61.7% cause for concern in
England and at: using ketorolac, about 70% of units. Questionnaire survey
Wales administered either The authors believe
(1) use of i.m. or i.v. that droperidol should Looking at practices in
Descriptive analgesics not be used in day different day-surgery units
survey postoperatively 90.8% supplied patients surgery. Prophylactic
with analgesic drugs to anti-emetic drugs were
(2) use of take home. 53.9% gave given in 53.9% of units
prophylactic prophylactic anti-emetic
anti-emetics drugs: metoclopramide
46.1%; ondansetron 9.2%;
231 units; droperiodol 28.4%;
147 replied prochlorperazine 17.7%.
(64%) Pain was considered a
problem in 69.5%; 44%
felt nausea was a problem
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