Document Detail


Patient outcomes comparing CRNA-administered peripheral nerve blocks and general anesthetics: a retrospective chart review in a US Army same-day surgery center.
MedLine Citation:
PMID:  20572408     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We compared outcomes between patients receiving general anesthesia (GA) vs regional block (RB) in a military same-day surgery unit (SDSU), where Certified Registered Nurse Anesthetists (CRNAs) delivered all RBs and GA. All patient charts from 2003 through 2006 were reviewed. Patients were included if they were 18 years or older, had an ASA physical status I or II, and underwent a shoulder or knee arthroscopy that used either RB or GA. Overall, 342 patients met inclusion criteria: 161 GA and 181 RB. With GA, mean anesthesia time was shorter (109.6 vs 135.5 minutes, P < .001), but recovery times were longer (56.7 vs 36.4 minutes, P < .001). SDSU times were nearly identical (GA vs RB, 71.5 vs 72.8 minutes), resulting in a total hospital time that was not significantly different (352.7 vs 347.5). The GA group received more morphine equivalents of narcotic in the operating room (22.9 vs 15.1 mg, P < .001) yet still had higher pain scores postoperatively than the RB group (1.1 vs 0.3, P < .001). The GA group received a significantly greater number of antiemetic doses intraoperatively (0.58 vs 0.04, P < .001) but still had a higher, although nonsignificant, rate of emesis (15.5% vs 10.0%). Patients receiving RB had less pain and received less analgesia without any increase in postoperative nausea and vomiting, hospital time, or anesthesia-related complications.
Authors:
Young J Yauger; Jay A Bryngelson; Kaon Donohue; Lori A Lawhorn; Brian M Pitcher; Bruce A Schoneboom; Dorraine D Watts
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Publication Detail:
Type:  Comparative Study; Evaluation Studies; Journal Article    
Journal Detail:
Title:  AANA journal     Volume:  78     ISSN:  0094-6354     ISO Abbreviation:  AANA J     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0431420     Medline TA:  AANA J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  215-20     Citation Subset:  N    
Affiliation:
Walter Reed Army Medical Center, Washington, DC, USA. jyauger1@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Ambulatory Surgical Procedures / adverse effects
Anesthesia Recovery Period
Anesthesia, General* / methods,  nursing
Clinical Nursing Research
Hospitals, Military
Humans
Incidence
Length of Stay / statistics & numerical data
Logistic Models
Maryland / epidemiology
Nerve Block* / methods,  nursing
Nurse Anesthetists / organization & administration*
Outcome Assessment (Health Care)
Pain, Postoperative / epidemiology,  etiology,  prevention & control
Peripheral Nerves
Postoperative Nausea and Vomiting / epidemiology,  etiology,  prevention & control
Retrospective Studies
Severity of Illness Index
Statistics, Nonparametric
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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