Addition of sevoflurane to the formulary: Impact on a surgical daycare unit
Bibliographic record
Abstract
ABSTRACT Objectives: To determine the impact of sevoflurane on anesthetic-related patient outcomes an on anesthetic acquisition costs in a surgical daycare unit (SDU). Methods: A retrospective observational study comparing 50 historic controls from August 1995 – October 1995 (Phase 1) to 50 patients who received sevoflurane for dental or gynecologic procedures from August 1996 – October 1996 (Phase 2) in the SDU. From the health record, we obtained information on patient characteristics, procedure characteristics, anesthetic regimen characteristics, toxicities, ancillary drug, and time interval outcomes related to admission, recovery and duration of stay. From total SDU anesthetic expenditures we estimated the mean anesthetic expenditure per procedure in the SDU prior to and after introduction of sevoflurane. Results: There were no apparent differences in toxicities, ancillary drug use and time interval outcomes between the sevoflurane group and the control group with the exception of median time interval between recovery room admission and conscious-drowsy state for gynecology patients. Mean anesthetic costs per SDU procedure were $10.23 in Phase 1 and $12.30 in Phase 2. Conclusions: The use of sevoflurane in outpatient anesthesia did not permit quicker recovery or earlier discharge of patients undergoing dental or gynecologic procedures nor did it result in any cost advantage over other agents. Its role, therefore, appears limited to an inhalational alternative to propofol for induction anesthesia in the outpatient setting. RESUME Objectifs : Connaitre les effets du sevoflurane sur les resultats de l'anesthesie pour les patients ainsi que sur le cout des anesthesiques dans un service de chirurgie de jour (SCJ). Methodes : Etude retrospective par observation consistant a comparer, parmi des patients du SCJ, 50 patients temoins traites entre aout et octobre 1995 (Phase 1) a 50 patients ayant recu du sevoflurane pour une intervention dentaire ou gynecologique entre aout et octobre 1996 (Phase 2). Nous avons tire des dossiers de sante les renseignements suivants : caracteristiques des patients, de l'intervention et de l'anesthesique utilise, toxicites, medicament auxiliaire, periode ecoulee entre l'admission et le retablissement, duree du sejour. A partir des depenses totales du SCJ, nous avons estime le cout moyen de l'anesthesique par intervention avant et apres l'adoption du sevoflurane. Resultats : Nous n'avons constate aucune difference apparente entre les resultats relatifs aux toxicites, a l'utilisation de medicament auxiliaire et aux durees entre le groupe traite au sevoflurane et le groupe temoin, exception faite de la periode mediane ecoulee entre l'admission a la salle de reveil et l'atteinte de l'etat « conscient-somnolent » chez les patientes ayant subi une intervention gynecologique. Le cout moyen de l'anesthesique par intervention au SCJ s'est eleve a 10,23 $ en Phase 1 et a 12,30 $ en Phase 2. Conclusions : Par rapport aux autres agents anesthesiques, le sevoflurane utilise comme anesthesique en chirurgie externe n'a pas accelere le retablissement ou la liberation ni procure d'avantages sur le plan des couts. Son role semble donc limite a offrir une solution de rechange au propofol comme anesthesique inhale pour provoquer l'anesthesie en contexte de chirurgie externe.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".