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

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244 Appendix 26 TABLE 104 Occurrence of PONV by awareness on recovery from anaesthetic in the adult study statistically significant trend. Nevertheless, visually there is the suggestion that the risk of PONV declines with increasing anaesthetic experience. This observation was tested by including the actual number of previous anaesthetics, rather than a grouped variable, into a logistic regression (see chapter 5). Duration of anaesthesia Table 107 shows that the risk of PONV depends on the duration of anaesthesia. A similar pattern was found for one or more episodes of vomiting (linear trend, p < 0.02) No. of patients Alert Agitated/ Drowsy Total distressed Total 618 (100%) 68 (100%) 367 (100%) 1053 (100%) Nausea or vomiting – no 534 (86.4%) 39 (57.4%) 274 (74.7%) 847 (80.4%) Nausea or vomiting – yes 84 (6.5%) 29 (42.6%) 93 (25.3%) 206 (19.6%) χ 2 : p < 0.001 TABLE 105 Occurrence of PONV by ASA grade in the adult study TABLE 106 Occurrence of PONV by tertile group of previous number of occasions on which anaesthesia received for the adult study No. of patients 0 or 1 previous 2 or 3 previous 4 or more previous Total occasions occasions occasions Total 352 (100%) 389 (100%) 320 (100%) 1061 (100%) Nausea or vomiting – no 275 (78.1%) 313 (80.5%) 266 (83.1%) 854 (80.5%) Nausea or vomiting – yes 77 (21.9%) 76 (19.5%) 54 (16.9%) 207 (19.5%) χ 2 : p > 0.1 (linear trend) No. of patients ASA category ASA ASA ASA Total not known category 1 category 2 category 3 Total 15 (100%) 720 (100%) 308 (100%) 11 (100%) 1054 (100%) Nausea or vomiting – no 13 (86.7%) 560 (77.8%) 263 (85.4%) 11 (100%) 847 (80.4%) Nausea or vomiting – yes 2 (13.3%) 160 (22.2%) 45 (14.6%) 0 (0%) 207 (19.6%) χ 2 : p < 0.02 Anaesthetic regimen Tables 108 and 109 display how some of the variables associated with the occurrence of PONV are distributed among the anaesthetic regimens; gender is not displayed, as random allocation was within single gender groups. Such differences as occur are small. These data indicate that the marked increase in occurrence of PONV among patients receiving sevoflurane/sevoflurane may represent a real effect (i.e. the effect is due neither to chance nor confounding).
TABLE 107 Occurrence of PONV by duration of anaesthesia in the adult study © Queen’s Printer and Controller of HMSO 2002. All rights reserved. Health Technology Assessment 2002; Vol. 6: No. 30 No. of patients Duration Duration Duration Total < 15 min 15 to < 24 min > 24 min Total 341 (100%) 356 (100%) 353 (100%) 1050 (100%) Nausea or vomiting – no 310 (90.9%) 281 (78.9%) 256 (72.5%) 847 (80.7%) Nausea or vomiting – yes 31 (9.1%) 75 (21.1%) 97 (27.5%) 203 (19.3%) χ 2 : p < 0.001 (linear trend) TABLE 108 Degree of orientation category by randomisation groups in the adult study No. of patients Propofol/ Propofol/ Propofol/ Sevoflurane/ Total propofol isoflurane sevoflurane sevoflurane Total 264 (100%) 268 (100%) 277 (100%) 246 (100%) 1055 (100%) Alert 158 (59.8%) 159 (59.3%) 163 (58.8%) 140 (56.9%) 620 (58.8%) Agitated and distressed 15 (5.7%) 21 (7.8%) 13 (4.7%) 19 (7.7%) 68 (6.4%) Drowsy 91 (34.5%) 88 (32.8%) 101 (36.5%) 87 (35.4%) 367 (34.8%) TABLE 109 Duration of anaesthesia by anaesthetic regimen and gender in the adult study No. of patients Propofol/propofol Propofol/isoflurane Propofol/sevoflurane Sevoflurane/sevoflurane Median Mean Minimum, Median Mean Minimum, Median Mean Minimum, Median Mean Minimum, dur- dur- maximum dur- dur- maximum dur- dur- maximum dur- dur- maximum ation ation duration ation ation duration ation ation duration ation ation duration Men 40 42 16, 89 35 36 11,86 36 40 13, 102 38 39 14, 79 Women 34 36 11, 108 33 36 11, 109 33 36 11,93 36 38 12, 116 245
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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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1. Royal College of Surgeons of Eng
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60. Cheng KI, Chu KS, Fang YR, Su K
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112. Raeder J, Gupta A, Pedersen FM
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162. Viitanen H, Baer G, Annila P.
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220. Rosenberg KM, Bridge P, Brown
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The range of databases interrogated
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24. preferen$.mp. [mp=title, abstra
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110 Appendix 2 TABLE 65 contd Summa
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112 Appendix 3 Quality assessment o
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TABLE 69 Summary of paediatric pati
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TABLE 69 contd Summary of paediatri
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TABLE 70 Characteristics of cost or
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TABLE 71 Quality of cost or economi
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TABLE 71 contd Quality of cost or e
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Abbott J, Abbott P. Psychological a
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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
Page 207 and 208: anaesthetics in day surgery, using
Page 209: © Queen’s Printer and Controller
Page 213 and 214: Background The empirical study quan
Page 215 and 216: Satisfaction with care Nearly all (
Page 217 and 218: TABLE 76 Reason given for preferenc
Page 219 and 220: TABLE 79 Comparisons with previous
Page 221 and 222: TABLE 80 Reason given for preferenc
Page 223 and 224: TABLE 81 Reason given for willingne
Page 225 and 226: Background Variable costs account f
Page 227 and 228: TABLE 85 Unit costs for the purchas
Page 229 and 230: Background The empirical study requ
Page 231 and 232: Ethical approval This was covered b
Page 233 and 234: 20 15 10 5 0 -5 -10 -15 True weight
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Page 238 and 239: 224 Appendix 19 • patients aged o
Page 241 and 242: All staff unit costs were for the y
Page 243: Background Fixed costs account for
Page 246 and 247: 232 Appendix 22 March, Tuesday 15 A
Page 248 and 249: 234 Appendix 23 TABLE 96 Reasons fo
Page 251 and 252: Patients were coded using the OPCS
Page 253 and 254: Q03.4 punch biopsy of cervix Q03.5
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Page 262 and 263: 248 Appendix 27 TABLE 113 Frequency
Page 265 and 266: This section displays the associati
Page 267 and 268: The adverse events observed in the
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