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  • Ovid Technologies (Wolters Kluwer Health)  (7)
  • 1
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 11, No. 19 ( 2022-10-04)
    Abstract: Methohexital and propofol can both be used as sedation for direct current cardioversion (DCCV). However, there are limited data comparing these medications in this setting. We hypothesized that patients receiving methohexital for elective DCCV would be sedated more quickly, recover from sedation faster, and experience less adverse effects. Methods and Results This was a prospective, blinded randomized controlled trial conducted at a single academic medical center. Eligible participants were randomly assigned to receive either methohexital (0.5 mg/kg) or propofol (0.8 mg/kg) as a bolus for elective DCCV. The times from bolus of the medication to achieving a Ramsay Sedation Scale score of 5 to 6, first shock, eyes opening on command, and when the patient could state their age and name were obtained. The need for additional medication dosing, airway intervention, vital signs, and medication side effects were also recorded. Seventy patients who were randomized to receive methohexital (n=37) or propofol (n=33) were included for analysis. The average doses of methohexital and propofol were 0.51 mg/kg and 0.84 mg/kg, respectively. There were no significant differences between methohexital and propofol in the time from end of injection to loss of conscious (1.4±1.8 versus 1.1±0.5 minutes; P =0.33) or the time to first shock (1.7±1.9 versus 1.4±0.5 minutes; P =0.31). Time intervals were significantly lower for methohexital compared with propofol in the time to eyes opening on command (5.1±2.5 versus 7.8±3.7 minutes; P =0.0005) as well as at the time to the ability to answer simple questions of age and name (6.0±2.6 versus 8.6±4.0 minutes; P =0.001). The methohexital group experienced less hypotension (8.1% versus 42.4%; P 〈 0.001) and less hypoxemia (0.0% versus 15.2%; P =0.005), had lower need for jaw thrust/chin lift (16.2% versus 42.4%; P =0.015), and had less pain on injection compared with propofol using the visual analog scale (7.2±9.7 versus 22.4±28.1; P =0.003). Conclusions In this model of fixed bolus dosing, methohexital was associated with faster recovery, more stable hemodynamics, and less hypoxemia after elective DCCV compared with propofol. It can be considered as a preferred agent for sedation for DCCV. Registration URL: https://www.clinicaltrials.gov/ct ; Unique identifier: NCT04187196.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2653953-6
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  • 2
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Anesthesia & Analgesia Vol. 130, No. 1 ( 2020-01), p. 2-13
    In: Anesthesia & Analgesia, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. 1 ( 2020-01), p. 2-13
    Abstract: Atrial fibrillation (AF) is the most common arrhythmia in the perioperative period. Previously considered a benign and self-limited entity, recent data suggest that perioperative AF is associated with considerable morbidity and mortality and may predict long-term AF and stroke risk in some patients. Despite known risk factors, AF remains largely unpredictable, especially after noncardiac surgery. As a consequence, strategies to minimize perioperative risk are mostly supportive and include avoiding potential arrhythmogenic triggers and proactively treating patient- and surgery-related factors that might precipitate AF. In addition to managing AF itself, clinicians must also address the hemodynamic perturbations that result from AF to prevent end-organ dysfunction. This review will discuss current evidence with respect to causes, risk factors, and outcomes of patients with AF, and address current controversies in the perioperative setting.
    Type of Medium: Online Resource
    ISSN: 0003-2999
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 80032-6
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  • 3
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Anesthesiology Vol. 131, No. 4 ( 2019-10-01), p. 896-897
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. 4 ( 2019-10-01), p. 896-897
    Type of Medium: Online Resource
    ISSN: 0003-3022
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 269-0
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  • 4
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Anesthesiology ( 2019-01), p. 1-
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), ( 2019-01), p. 1-
    Type of Medium: Online Resource
    ISSN: 0003-3022
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 269-0
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Anesthesiology Vol. 128, No. 6 ( 2018-06-01), p. 1240-1240
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 128, No. 6 ( 2018-06-01), p. 1240-1240
    Type of Medium: Online Resource
    ISSN: 0003-3022
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 269-0
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  • 6
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Journal of Patient Safety Vol. 15, No. 1 ( 2019-3), p. 18-23
    In: Journal of Patient Safety, Ovid Technologies (Wolters Kluwer Health), Vol. 15, No. 1 ( 2019-3), p. 18-23
    Abstract: Checklists are tools that are developed to complete tasks by drawing on specific and relevant knowledge and supporting communication at critical times. If checklists were designed specifically for patient use, they could promote patient engagement, potentially leading to improved quality of care. Physicians of all specialties, nurses, patients, patient advocates, and administrators can take an active role in checklist development and dissemination. Methods Our method to investigate concepts in developing a customizable patient checklist included a literature search concerning existing checklists and resources currently available to patients. Literature containing expert opinion regarding checklists, professional organization statements, and patients and providers were consulted. Results A template for designing a patient checklist was developed incorporating methods from previous literature and resources regarding checklists. This template includes a development, drafting, and validation phase. Sample content for inclusion in potential checklists for patients with diabetes and patients undergoing anesthesia was devised. Conclusions Developed by physicians with input from patients and other involved health-care providers such as nurses, this relatively novel concept of a patient’s checklist creates a role for the patient to ensure their own safety. With increasing attention to high-quality and cost-effective health care, patient satisfaction surveys will be assessed to rate overall health care. Further development of checklists will need to be guided by specific medical conditions and acceptance by patients and providers. Providers can use these checklists as a method to gauge a patient’s understanding of an intervention, solidify the patient-doctor relationship, and improve patient safety.
    Type of Medium: Online Resource
    ISSN: 1549-8425 , 1549-8417
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2185392-7
    detail.hit.zdb_id: 2394324-5
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  • 7
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Anesthesiology Vol. 130, No. 4 ( 2019-04-01), p. 615-616
    In: Anesthesiology, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. 4 ( 2019-04-01), p. 615-616
    Type of Medium: Online Resource
    ISSN: 0003-3022
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 269-0
    Location Call Number Limitation Availability
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