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Anxiety and depression are debilitating, costly psychological disorders that account for $133 billion in direct medical expenses per year in the United States. Finding alternative means of treatment to reduce the personal and financial burden for patients with these disorders, while maintaining patient safety, is vital for overall patient wellness. The purposes of this study were 2-fold: (1) to determine if pure eucalyptol (1,8-cineole) produces anxiolytic and/or antidepressant effects using rat models for anxiety and behavioral despair and (2) to determine the effects of eucalyptol at the benzodiazepine site on the y-aminobutyric acid (GABA) A receptor in the rat central nervous system. Fifty-five male Sprague-Dawley rats were randomly assigned to 1 of 5 groups: vehicle (dimethyl sulfoxide), eucalyptol, midazolam, flumazenil plus eucalyptol, and midazolam plus eucalyptol. Behavioral analyses were conducted on the elevated plus-maze and in the forced swim test. Data were analyzed using a 2-tailed multivariate analysis of variance and a least significant difference post hoc test. Data from the maze suggested eucalyptol may produce anxiolytic effects by acting at the benzodiazepine site on the GABAA receptor while not affecting psychomotor activity. However, no effects on behavioral despair were demonstrated in the Forced Swim test. [ABSTRACT FROM AUTHOR]

The "handoff" phase of patient care is frequently associated with the genesis of adverse events. Patient handoffs in anesthesia care remain poorly studied. By reviewing archived video of anesthesia handoffs taking place in a simulated environment, we aimed to identify latent conditions and their impact on the quality and nature of handoffs occurring during surgical anesthesia care. Four trained coders assessed 58 handoffs occurring in 58 different simulated cases, for the presence or absence of 4 latent conditions: distractions, production pressure, noninteractive communication, and inappropriately timed handoff. Latent hazards frequently jeopardized handoff quality. Distractions and interruptions were conditions observed in 82% of cases; independently these did not appear to degrade handoff quality. The latent condition noninteractive communication was the greatest predictor of poor handoff scores (P < .001). Handoffs were often good or excellent with 0, 1, or 2 latent conditions present, but with 3 or more latent conditions, the quality invariably degraded. When handoff scores were high, the handoffs were always interactive. This is the first study to relate specific latent conditions to handoff quality, providing a foundation for future research, as well as for the education and training of anesthesia providers. [ABSTRACT FROM AUTHOR]

The primary purpose of this investigation was to evaluate postprocedure cognitive function associated with 3 distinct standard sedation regimens used for endoscopic procedures. A secondary aim was to identify complications requiring provider interventions. Subjects scheduled for colonoscopies were approached for enrollment the day of their procedure. A convenience sample of 96 subjects was randomly assigned. Cognitive function was recorded on the day of surgery using the Mini-Mental State Examination (MMSE) and 24 and 48 hours postoperatively using the Telephone Interview of Cognitive Status (TICS). The propofol plus fentanyl group had a mean TICS score of 34.53 at 24 hours compared with 34.96 at 48 hours (P = .017). The midazolam plus fentanyl group had a mean TICS score of 34.76 at 24 hours compared with 36.26 at 48 hours (P = .004). The propofol-alone group had a mean TICS score of 35.09 at 24 hours compared with 35.98 at 48 hours (P = .924). The results of this investigation indicate that the sedation regimen of propofol alone has the least impact on postprocedure cognitive function. Additionally, the number of jaw lift interventions was significantly higher in both groups who received fentanyl. [ABSTRACT FROM AUTHOR]

This retrospective study examined whether practice in computer-based tests (CBTs) in student registered nurse anesthetists improved scores on the National Certification Examination (NCE). A group of students with extensive practice in CBTs was compared with a group of students whose tests were administered primarily on paper. Groups were matched on age, grade point average (GPA), and gender (n = 73 each). Higher GPA was associated with higher NCE scores overall. Adjusted for GPA (with analysis of covariance), the mean NCE proficiency score (Φ) in the CBT group was 2.68 (95% confidence interval, 2.54-2. 82), which was higher than the mean score in the paper-based group of 2.36 (95% confidence interval, 2.22-2.50), with an effect size of 0.52. When subgroups were examined, CBT practice improved NCE scores only in those students with graduate GPA less than or equal to 3.50, with an effect size of 1.1. It was concluded that, controlling for GPA, student registered nurse anesthetists at a university with greater exposure to CBTs had higher scores on the NCE than a comparison group with less practice in CBTs. This difference was significant only in students with GPA of 3.50 or less, consistent with a beneficial effect of practice in CBTs. [ABSTRACT FROM AUTHOR]