Introduction: Over 5 billion people in the world do not have access to safe, affordable surgical and anaesthesia care when needed. In order to improve health outcomes in patients with surgical conditions, both access to care and the quality of care need to be improved. A recent commission on high-quality health systems highlighted that poor-quality care is now a bigger barrier than non-utilisation of the health system for reducing mortality.
Aim: To carry out a systematic review to provide an evidence-based summary of hospital-based interventions associated with improved quality of surgical and anaesthesia care in sub-Saharan African countries (SSACs).
Methods And Analysis: Three search strings (1) surgery and anaesthesia, (2) quality improvement hospital-based interventions and (3) SSACs will be combined. The following databases EMBASE, Global Health, MEDLINE, CINAHL, Web of Science and Scopus will be searched. Further relevant studies will be identified from national and international health organisations and publications and reference lists of all selected full-text articles. The review will include all type of original articles in English published between 2008 and 2019. Article screening, data extraction and assessment of methodological quality will be done by two reviewers independently and any disputes will be resolved by a third reviewer or team consensus. Three types of outcomes will be collected including clinical, process and implementation outcomes. The primary outcome will be mortality. Secondary outcomes will include other clinical outcomes (major and minor complications), as well as process and implementation outcomes. Descriptive statistics and outcomes will be summarised and discussed. For the primary outcome, the methodological rigour will be assessed.
Ethics And Dissemination: The results will be published in a peer reviewed open access journal and presented at national and international conferences. As this is a review of secondary data no formal ethical approval is required.
Prospero Registration Number: CRD42019125570.
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http://dx.doi.org/10.1136/bmjopen-2019-036615 | DOI Listing |
Cureus
December 2024
Department of Biological Science and Nursing, Yokohama City University Graduate School of Medicine, Yokohama, JPN.
Purpose: Postoperative thirst is common and distressing to patients, as is pain and nausea. The causes of postoperative thirst are complex and include factors like preoperative fasting, perioperative fluid loss, and certain anesthesia medications. Effective care for postoperative thirst has been shown in post-anesthesia care units (PACUs), but many Japanese hospitals lack PACUs or do not address thirst in their PACUs.
View Article and Find Full Text PDFiScience
January 2025
Coma Science Group, GIGA-Consciousness, University of Liège, Liège, Belgium.
Post-comatose disorders of consciousness (DoC) represent persistent neurological conditions with limited therapeutic options and a poor prognosis. Recent works advocate for exploring the effects of psychedelics to enhance brain complexity in DoC and ameliorate their consciousness. We investigated sub-anesthetic concentration of the atypical psychedelic ketamine for treating post-comatose prolonged DoC through a double-blind, placebo-controlled, cross-over trial involving three adult patients.
View Article and Find Full Text PDFBMJ Oncol
August 2024
Medical Oncology, Tata Memorial Hospital, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, Maharashtra, India.
Objective: Older patients with cancer have traditionally been under-represented in global clinical trials. There are no data from India regarding this issue.
Methods And Analysis: This was a retrospective analysis done at our institute on interventional studies conducted between 2003 and 2023 in adult patients with malignancies.
Eur J Anaesthesiol
January 2025
From the North West School of Anaesthesia, UK (PG), Department of Anaesthesia, St John's Hospital, NHS Lothian, Livingston, Scotland (PAW, JLO, AFM), Faculty of Medicine, University of Bern, Bern, Switzerland (RG) and Department of Surgical Science, University of Turin, Turin, Italy (RG).
Background: Apnoeic oxygenation using high-flow nasal oxygen is becoming a commonly used technique in adult patients undergoing laryngotracheal surgery. Despite widespread adoption, there are no best practice guidelines governing its safe delivery.
Objective: To develop a checklist for use during laryngotracheal surgery to guide the safe delivery of apnoeic oxygenation using high-flow nasal oxygen.
Eur J Med Res
January 2025
Department of Otolaryngology, Affiliated Hospital of Hebei University, 212th Yuhua Road, Baoding, Hebei, China.
The patient's body temperature significantly fluctuates, affected by factors, including anesthesia. The ideal temperature monitoring method that is suitable for perioperative application is of great significance for identifying hypothermia and malignant hyperthermia early, as well as for guiding intraoperative temperature protection. This study aims to compare the cutaneous zero-heat-flux (ZHF) thermometer application in general anesthesia using the infrared tympanic measurement as a reference.
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