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AN OBSERVATIONAL STUDY ASSESSING THE IMPACT OF NOISE-REDUCTION HEADPHONES ON SEDATION REQUIREMENTS AND PATIENT SAFETY DURING PRIMARY LOWER LIMB ARTHROPLASTY
ESRA Academy. Nash A. Sep 8, 2016; 138537; 0404 Topic: Safety of Regional Anaesthesia - Complications - General Aspects
Andrew Nash
Andrew Nash

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Abstract
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Background and Aims:

Propofol sedation is the commonest adjunct to regional anaesthesia for primary lower limb arthroplasty. ASA guidance dictates that safe sedation practice should aim for a score of 3 on the Ramsay sedation scale, or moderate (Conscious) sedation. This is essential to avoid the cardiorespiratory morbidity and potential airway interventions that are associated with deeper levels of sedation

Methods:

This observational study, as part of a service and quality improvement initiative assessed the impact of noise-reduction headphones on patient experience and satisfaction, as well as propofol sedation in the form of target-controlled infusions (TCI) in 112 patients undergoing primary lower limb arthroplasty. Data was collected in the form of questionnaires and was checked where required against the anaesthetic record. Quantitative data subsequently underwent statistical analysis by an independent statistician using Mann-Whitney U test

Results:

Our data revealed a statistically significant difference between the Headphone (HP) group and Non-Headphone (NHP) groups in relation to both total propofol used (8ml less in HP; median 20.5ml; p<0.001) and maximum TCI concentrations (0.7 ug/ml HP vs 1.10ug/ml NHP; p = 0.001)

Conclusions:

We therefore propose that the Noise Reduction Headphones significantly reduce sedation requirement in patients undergoing lower limb primary arthroplasty using a regional anaesthetic technique. Such an intervention provides a number of potential advantages. These might include enhanced clinical safety through lower sedation levels; an improved patient recovery profile and a reduction in both patient stress and anxiety and finally financial benefits through a reduction in the resources utilised

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