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Hu CH, Chou WY. Improved Pittsburgh Sleep Quality Index scores on first postoperative night achieved by propofol anesthesia in patients undergoing ambulatory gynecologic surgery. World J Clin Cases 2022; 10:7256-7264. [PMID: 36157991 PMCID: PMC9353919 DOI: 10.12998/wjcc.v10.i21.7256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 04/07/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sleep disturbance on the first postoperative night commonly develops for patients after day surgeries. The choice of either total intravenous anesthesia by propofol or total inhalation anesthesia with sevoflurane has become an issue for preventing sleep disturbance.
AIM To compare sleep quality on the first postoperative night for female patients after total intravenous anesthesia by propofol and total inhalation anesthesia with sevoflurane.
METHODS We enrolled 61 American Society of Anesthesia (ASA) class I-II outpatients who underwent minor gynecologic surgeries by either propofol or sevoflurane anesthesia. Sleep quality of the very night was assessed by the Pittsburgh Sleep Quality Index (PSQI) on the next day, and PSQI scores were compared by the Wilcoxon signed-rank test and paired t-test pre-operatively and postoperatively.
RESULTS For the propofol group, the mean postoperative global PSQI score (3.3 ± 1.3) was lower than the mean preoperative global PSQI score (4.9 ± 2.3) (P < 0.001); for the sevoflurane group, the mean postoperative global PSQI score (6.5 ± 2.8) was higher than the mean preoperative global PSQI score (5.5 ± 3.2) (P = 0.02). Eighty percent of patients receiving propofol anesthesia subjectively reported improved sleep quality, but only 17% of patients receiving sevoflurane anesthesia reported improved sleep quality.
CONCLUSION Sleep quality assessed by the PSQI is better improved in ASA class I-II female patients receiving propofol anesthesia other than sevoflurane anesthesia for undergoing minor gynecologic surgeries.
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Affiliation(s)
- Chi-Hao Hu
- Department of Anesthesia, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - Wen-Ying Chou
- Department of Anesthesia, National Cheng Kung University Hospital, Tainan 704, Taiwan
- Institute of Clinical Pharmacy and Pharmaceutical Science, National Cheng Kung University, Tainan 704, Taiwan
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Misra U, Gilvarry E, Marshall J, Hall R, McLure H, Mayall R, El-Ghazali S, Redfern N, McGrady E, Gerada C. Substance use disorder in the anaesthetist: Guidelines from the Association of Anaesthetists: Guidelines from the Association of Anaesthetists. Anaesthesia 2022; 77:691-699. [PMID: 35445390 DOI: 10.1111/anae.15732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 03/22/2022] [Indexed: 12/25/2022]
Abstract
Anaesthetists have a higher incidence of substance use disorder when compared with other doctors. This might be due to the ease of access to intravenous opioids, propofol, midazolam, inhalational agents and other anaesthetic drugs. Alcohol use disorder continues to be the most common problem. Unfortunately, the first sign that something is amiss might be the anaesthetist's death from an accidental or deliberate overdose. While there are few accurate data, suicide is presumed to be the cause of death in approximately 6-10% of all anaesthetists. If we are to prevent this, substance use disorder must be recognised early, we should ensure the anaesthetist is supported by their department and hospital management and that the anaesthetist engages fully with treatment. Over 75% of anaesthetists return to full practice if they co-operate fully with the required treatment and supervision.
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Affiliation(s)
- U Misra
- South Tyneside and Sunderland NHS Foundation Trust, Sunderland, UK
| | - E Gilvarry
- Addictions Services at Cumbria, Northumberland Tyne and Wear NHS FT, Newcastle upon Tyne, UK
| | - J Marshall
- South London and Maudsley NHS Foundation Trust, London, UK
| | - R Hall
- Royal Papworth Hospital NHS Trust, Cambridge, UK
| | - H McLure
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | | | - S El-Ghazali
- Department of Anaesthesia, London North West Hospital Trust, London, UK
| | - N Redfern
- Department of Anaesthesia, Newcastle upon Tyne NHS Foundation Trust, Newcastle, UK
| | | | - C Gerada
- NHS Practitioner Health, London, UK
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van der Wal RAB, Wallage J, Scheffer G, Prins JB, Bijleveld E. Personality in anaesthesiologists, a systematic review of the literature. Eur J Anaesthesiol 2022; 39:378-387. [PMID: 35232934 DOI: 10.1097/eja.0000000000001650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND As a central part of their job, anaesthesiologists often have to perform demanding tasks under high-stakes conditions. Yet, some anaesthesiologists seem better able to deal with the demands of the profession than others. OBJECTIVES This review aims to answer the following questions. What are the necessary or desirable qualities of an anaesthesiologist? Which personality traits or characteristics have been found in anaesthesiologists? How does personality relate to job performance and work stress among anaesthesiologists? DESIGN Systematic review of studies that examined anaesthesiologists' personality or personality characteristics. We performed our synthesis in terms of the five-factor model of personality. DATA SOURCES The search was conducted in the PubMed, EMBASE and Web of Science databases. Literature was included until December 2020. ELIGIBILITY CRITERIA We included qualitative and quantitative studies that examined anaesthesiologists' personality; also, we included studies that focused on anaesthesiologists' stress, performance or mental health but only if these topics were examined from the perspective of personality. RESULTS We included 6 qualitative and 25 quantitative articles. Synthesis of the qualitative articles revealed two classes of desirable technical and nontechnical personality characteristics. Synthesis of the quantitative articles suggested that anaesthesiologists do not essentially differ from other medical specialists. Moreover, our synthesis revealed several personality traits that predict good performance, low stress and good mental health among anaesthesiologists: lower Neuroticism, higher Extraversion, higher Openness and higher Conscientiousness. CONCLUSION Those personality traits that predict performance, stress or mental health in anaesthesiologists, also predict performance, stress or mental health in other high demand/high stakes environments (both medical and nonmedical). The ideal anaesthesiologist would be lower on Neuroticism, higher on Extraversion and higher on Conscientiousness.
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Affiliation(s)
- Raymond A B van der Wal
- From the Department of Anaesthesiology, Pain and Palliative Medicine, Radboud University Medical Center, Nijmegen (RABvdW, GJS), Department of Intensive Care, Amsterdam Medical Center, Amsterdam (JW), Department of Medical Psychology, Radboud University Medical Center, Nijmegen (JBP) and Behavioural Science Institute, Radboud University, Nijmegen, the Netherlands (EB)
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Wong RXY, Farrell M, Degenhardt L, Memedovic S, Harvey SB, Petrie K. Substance use among vocational trainees in Australia: differences between medical specialties. Intern Med J 2022. [PMID: 35257451 DOI: 10.1111/imj.15729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 02/06/2022] [Accepted: 02/25/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND There have been few large-scale nationally representative studies on the prevalence of substance use among doctors. Additionally, the association of different medical specialties with the use of different substances requires further research. AIMS This study aimed to investigate how the use of alcohol, tobacco and illicit drugs varied between junior doctors enrolled in different specialty training programmes. METHODS A secondary analysis was conducted on a national survey of 12,252 Australian doctors. The population of interest was junior doctors currently enrolled in a specialty training programme, termed Vocational Trainees (VTs) (n=1890, 15.4% overall sample). Self-report prevalence of current alcohol, tobacco and illicit drug use were assessed, and hazardous alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT). Logistic regression was used to examine the association between specialty and substance use, adjusting for demographic characteristics when required. RESULTS One in six VTs reported hazardous levels of alcohol use (n=268, 17.3%). After adjusting for confounders, the association between the prevalence of alcohol use and the specialties of emergency medicine/ICU (OR=2.15, 95% CI:1.40-3.32, p<0.001), anaesthetics (OR=2.53, 95% CI:1.35-4.76, p=0.004) and obstetrics/gynaecology (OR=1.89, 95% CI:1.19-3.02, p=0.007) remained significant. No significant associations were found between tobacco use/illicit drug use/hazardous alcohol use and medical specialty. CONCLUSIONS While rates of substance use and hazardous alcohol use in VTs are similar, if not lower, to the general population, it poses a concern that there are higher rates of alcohol use in certain medical specialties. This article is protected by copyright. All rights reserved.
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Affiliation(s)
| | - Michael Farrell
- National Drug and Alcohol Research Centre (NDARC), University of Sydney, Sydney, Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre (NDARC), University of Sydney, Sydney, Australia
| | - Sonja Memedovic
- National Drug and Alcohol Research Centre (NDARC), University of Sydney, Sydney, Australia
| | - Samuel B Harvey
- Black Dog Institute, University of New South Wales, Randwick, Australia
| | - Katherine Petrie
- Black Dog Institute, University of New South Wales, Randwick, Australia.,School of Psychiatry, University of New South Wales, Sydney, Australia
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Foli KJ, Forster A, Bostic LA, Zhang Z, Zhang L, Stone L. Nurse Anesthetists: Current Perceptions and Practices Related to Substance Use. JOURNAL OF NURSING REGULATION 2022. [DOI: 10.1016/s2155-8256(22)00008-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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DeFord S, Bonom J, Durbin T. A review of literature on substance abuse among anaesthesia providers. J Res Nurs 2019; 24:587-600. [PMID: 34394581 DOI: 10.1177/1744987119827353] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Research has demonstrated that anaesthesia providers are susceptible to substance abuse. Several preventive measures are being implemented in certified registered nurse anaesthetist programmes to educate future providers about substance abuse. Given the continued prevalence and impact of the problem, more research is needed about the prevalence of substance abuse among student registered nurse anaesthetists and the implementation of preventive strategies in the educational setting. Aims The purpose of this narrative literature review was to examine the state of the science related to substance abuse among US certified anaesthesia providers. This literature review covered abuse of alcohol, tobacco, recreational drugs, opioids and anaesthetic agents. Methods This narrative review was conducted using the following search terms: anaesthesia, student, wellness, stress, substance abuse, satisfaction, personality, depression, nurse, nurse anaesthetist, propofol, isoflurane and fentanyl. References were identified using PubMed, CINAHL, Google Scholar, and the American Society of Anesthesiologists and American Association of Nurse Anesthetists websites. A total of 36 articles were identified as relevant to this literature review based on content and country of publication. This literature review was limited to articles published in the past 15 years. With one exception, our search was limited to manuscripts from the US. Results The literature underscored that various risk factors contribute to substance abuse. Board-certified anaesthesia providers fall prey to substance abuse due to ease of access, the high stress associated with administering anaesthesia, and the propensity to become addicted to opioids and other anaesthetics. A gap in the science exists about the prevalence of substance abuse among student registered nurse anaesthetists and the effectiveness of preventive strategies in the educational setting. Conclusions Anaesthesia providers are at high risk of abusing substances. To create a safer environment, future research should explore the prevalence of substance abuse among student registered nurse anaesthetists and emphasise the integration of effective preventive strategies in the educational setting.
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Wolter DK. Abhängigkeitspotenzial und andere Risiken von Opioidanalgetika im Alter. SUCHT-ZEITSCHRIFT FUR WISSENSCHAFT UND PRAXIS 2017. [DOI: 10.1024/0939-5911/a000475] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Zusammenfassung. Zielsetzung: Übersicht über Suchtpotenzial und andere Risiken von Opioidanalgetika im höheren Lebensalter. Methodik: Narrativ review. Literaturrecherche in PubMed (Suchbegriffe: opioid analgesics UND abuse; opioid analgesics UND dependence; opioid analgesics UND addiction; opioid analgesics UND adverse effects; jeweils UND elderly) sowie aktuellen einschlägigen Standardwerken; Auswahl nach altersmedizinischer Relevanz und Aktualität. Ergebnisse: Die Verordnung von Opioidanalgetika (OA) hat in den letzten 25 Jahren massiv zugenommen, die weitaus meisten Verordnungen entfallen auf alte Menschen und Menschen mit chronischen Nicht-Tumorschmerzen (CNTS). Die diagnostischen Kriterien für die Opiatabhängigkeit in ICD-10 und DSM-5 sind für die OA-Behandlung von CNTS ungeeignet. Bei langfristiger OA-Behandlung bei CNTS kann eine spezifische Form von Abhängigkeit entstehen, die nicht mit der illegalen Opiat-(Heroin-)Sucht gleichzusetzen ist. Vorbestehende Suchterkrankungen und andere psychische Störungen sind die wesentlichsten Risikofaktoren. Weitere Nebenwirkungen sind zu beachten. Schmerztherapie bei Suchtkranken stellt eine besondere Herausforderung dar. Schlussfolgerungen: Die Anwendung von OA bei CNTS verlangt eine sorgfältige Indikationsstellung. Die besondere Form der Abhängigkeit von OA ist nicht ausreichend erforscht und wird zu wenig beachtet.
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Affiliation(s)
- Dirk K. Wolter
- Psykiatrien i Region Syddanmark, Gerontopsykiatrisk Afdeling, Aabenraa, Denmark
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Samuelson ST, Bryson EO. The impaired anesthesiologist: what you should know about substance abuse. Can J Anaesth 2016; 64:219-235. [DOI: 10.1007/s12630-016-0780-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 10/21/2016] [Accepted: 11/16/2016] [Indexed: 12/20/2022] Open
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Non-opioid anesthetic drug abuse among anesthesia care providers: a narrative review. Can J Anaesth 2016; 64:169-184. [PMID: 27470230 DOI: 10.1007/s12630-016-0698-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 03/19/2016] [Accepted: 07/05/2016] [Indexed: 10/21/2022] Open
Abstract
PURPOSE The objective of this narrative review is to provide an overview of the problem of non-opioid anesthetic drug abuse among anesthesia care providers (ACPs) and to describe current approaches to screening, therapy, and rehabilitation of ACPs suffering from non-opioid anesthetic drug abuse. SOURCE We first performed a search of all literature available on PubMed prior to April 11, 2016. The search was limited to articles published in Spanish and English, and the following key words were used: anesthesiology, anesthesia personnel, AND substance-related disorders. We also searched Ovid MEDLINE® databases from 1946-April 11, 2016 using the following search terms: anesthesiology OR anesthesia, OR nurse anesthetist OR anesthesia care provider OR perioperative nursing AND substance-related disorders. PRINCIPAL FINDINGS Despite an increased awareness of drug abuse among ACPs and improvements in preventive measures, the problem of non-opioid anesthetic drug abuse remains significant. While opioids are the most commonly abused anesthesia medications among ACPs, the abuse of non-opioid anesthetics is a significant cause of morbidity, mortality, and professional demise. CONCLUSION Early detection, effective therapy, and long-term follow-up help ACPs cope more effectively with the problem and, when possible, resume their professional activities. There is insufficient evidence to determine the ability of ACPs to return safely to anesthesia practice after rehabilitation, though awareness of the issue and ongoing treatment are necessary to minimize patient risk from potentially related clinical errors.
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Breath alcohol of anesthesiologists using alcohol hand gel and the “five moments for hand hygiene” in routine practice. Can J Anaesth 2016; 63:938-44. [DOI: 10.1007/s12630-016-0666-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 03/12/2016] [Accepted: 04/22/2016] [Indexed: 10/21/2022] Open
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Shiraishi Zapata CJ. Anesthesiologists and Substance Use Disorders: An Important Issue for All Members of the Health Team. Anesth Analg 2015; 120:1174. [PMID: 25899281 DOI: 10.1213/ane.0000000000000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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12
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Fry RA, Fry LE, Castanelli DJ. A Retrospective Survey of Substance Abuse in Anaesthetists in Australia and New Zealand from 2004 to 2013. Anaesth Intensive Care 2015; 43:111-7. [DOI: 10.1177/0310057x1504300117] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A questionnaire on substance abuse was distributed electronically to the heads of 185 Australian and New Zealand College of Anaesthetists accredited anaesthesia departments in Australia and New Zealand. The response rate was 57%. From January 2004 to December 2013, 61 cases of substance abuse were identified, giving an estimated incidence of 1.2 cases per 1000 anaesthetist years. Of 44 detailed reports completed, the majority were aged between 30 and 49 years, were male and of specialist grade. However, when corrected for gender and grade, the estimated overall incidence was higher in females and twice as high for trainees compared with specialists. When compared with prior surveys, the pattern of substance abuse in Australia and New Zealand appears to have changed significantly, with a notable increase in propofol and alcohol abuse and a decrease in reported cases of opioid abuse. Common presenting features of abuse included intoxication and witnessed abuse. Seventy percent of cases had more than one comorbid condition, most frequently either mental health or family problems. Only 32% of abusers had made a long-term recovery within the specialty. Death was the eventual outcome in 18% overall, with a particularly high mortality associated with propofol abuse (45%). Trainee suicide from all causes was reported at three times the rate of specialists. The findings indicate that substance abuse remains a significant problem in Australia and New Zealand and is associated with a significant mortality rate.
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Affiliation(s)
- R. A. Fry
- Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand
| | - L. E. Fry
- Monash Medical School, Monash University, Melbourne, Victoria
| | - D. J. Castanelli
- Department of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Victoria
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Fry R, Prager S, Shrivastava P. Treatment concerns for anaesthetists with substance abuse disorder. Australas Psychiatry 2014; 22:592-3. [PMID: 25414456 DOI: 10.1177/1039856214543080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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14
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Correspondence. Anaesth Intensive Care 2014. [DOI: 10.1177/0310057x1404200518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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15
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Return to Work for Healthcare Professionals with Substance Use Disorders: Clinical, Legal, and Ethical Challenges. PSYCHOLOGICAL INJURY & LAW 2013. [DOI: 10.1007/s12207-013-9166-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Moon YE. Treating and preventing relapse of drug abuse by healthcare providers. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2013. [DOI: 10.5124/jkma.2013.56.9.778] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Young Eun Moon
- Department of Anesthesiology and Pain Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
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