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- Jaensson, Maria, 1967-, et al.
(författare)
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Evaluation of postoperative recovery in day surgery patients using a mobile phone application : a multicentre randomized trial
- 2017
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Ingår i: British Journal of Anaesthesia. - : Oxford University Press. - 0007-0912 .- 1471-6771. ; 119:5, s. 1030-1038
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Tidskriftsartikel (refereegranskat)abstract
- Background: Many patients undergoing anaesthesia and surgery experience postoperative complications. Our aim was to investigate whether a systematic follow-up smartphone-based assessment, using recovery assessment by phone points (RAPP) compared with standard care, had a positive effect on day surgery patients' postoperative recovery. We also investigated whether there were differences in women and men's recovery and recovery scores.Methods: The study was a single-blind, multicentre randomized controlled trial. A total of 997 patients were randomly allocated to either RAPP or standard care. The Swedish web version of a quality of recovery (SwQoR) questionnaire was used to evaluate the patients' postoperative recovery, either on paper or using an application (RAPP) on postoperative days seven and 14.Results: On postoperative day seven the RAPP group reported significantly better values in seven out of 24 items of the SwQoR: sleeping difficulties; not having a general feeling of wellbeing; having difficulty feeling relaxed/comfortable; and dizziness; headache; pain in the surgical wound; and a swollen surgical wound compared with the control group, implying a good postoperative recovery. Both men and women in the RAPP group reported significantly better values (and, hence good postoperative recovery) compared with the control group in the items sleeping difficulties; not having a general feeling of wellbeing and pain in the surgical wound.Conclusions: Measurement of patient-reported outcomes using a smartphone-based application was associated with decreased discomfort from several postoperative symptoms. Systematic e-assessment can thereby increase patients' quality of recovery and identify key areas for improvement in perioperative care.
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- Jaensson, Maria, 1967-, et al.
(författare)
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Gender differences in risk factors for airway symptoms following tracheal intubation
- 2012
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Ingår i: Acta Anaesthesiologica Scandinavica. - Hoboken, USA : Wiley-Blackwell. - 0001-5172 .- 1399-6576. ; 56:10, s. 1306-1313
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Tidskriftsartikel (refereegranskat)abstract
- Background: A common complaint after endotracheal intubation is sore throat and hoarseness. The aim of this study was to describe gender differences and independent risk factors in the development of post-operative sore throat and hoarseness after endotracheal intubation in adults.Methods: This prospective cross-sectional observational study was conducted at a university hospital in Sweden. A total of 495 patients were included (203 men and 292 women) and enrolled from a total of eight different surgical departments. Outcome variables were post-operative sore throat and hoarseness evaluated post-operatively in the post-anaesthesia care unit. A total of 31 variables were recorded which described the intubation process, intraoperative factors as well as the extubation process. Bivariate and multivariate analyses were performed.Results: The overall incidence of post-operative sore throat was 35% and hoarseness 59%. The results show different predictors for men and women in the development of airway symptoms. The main risk factor for developing sore throat in men was intubation by personnel with Conclusion: Post-operative sore throat and hoarseness result from several factors, and the cause of these symptoms are multifactorial and differs by gender. Identification of these factors pre-operatively may increase awareness among anaesthesia personnel and possibly reduce the incidence of these minor but distressing symptoms.
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- Jaensson, Maria, 1967-, et al.
(författare)
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Gender differences in sore throat and hoarseness following endotracheal tube or laryngeal mask airway : a prospective study
- 2014
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Ingår i: BMC Anesthesiology. - : BioMed Central. - 1471-2253 .- 1471-2253. ; 14:56
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Tidskriftsartikel (refereegranskat)abstract
- Background and objective. Postoperative sore throat and hoarseness are common minor complications following airway manipulation. This study was primarily done to determine gender differences in the incidence of these symptoms and the location of POST after laryngeal mask airway (LMA) and endotracheal tube (ETT).Methods. A total of 112 men and 185 women were included during a four month period. All patients were evaluated postoperatively and after 24 hours about the occurrence of sore throat, its location and hoarseness. If the patients had any symptom, they were followed-up at 48, 72 and 96 hours until the symptoms resolved. Results. There was no significant gender difference in postoperative sore throat (POST) and postoperative hoarseness (PH) when analyzing both airway devices together. The incidence of sore throat and hoarseness were higher postoperatively after an ETT than an LMA (32% vs. 19%, p= 0.012) and 57% vs. 33% (p< 0.001) respectively. Significantly more women than men had POST after an LMA (26% vs. 6%, p=0.004). No significant gender difference was found in either POST or PH after an ETT or in the incidence of PH after an LMA. More patients located their pain below the larynx after an ETT vs. an LMA (24% vs. 4%). Pain above the larynx was more common after an LMA than an ETT (52 % vs. 37 %).Conclusions. In a clinical setting where women are intubated with a smaller size ETT than men, there were no significant differences in POST or PH between genders. Additionally, more women than men have POST when an LMA is used. Awareness of POST and PH may help streamline patients in whom the best airway device could be used during anesthesia and surgery.
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- Jaensson, Maria, 1967-, et al.
(författare)
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Risk factors for development of postoperative sore throat and hoarseness after endotracheal intubation in women : a secondary analysis
- 2012
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Ingår i: AANA: American Association of Nurse Anesthetists. - West Sussex, United Kingdom : American Association of Nurse Anesthesiology. - 0094-6354 .- 2162-5239. ; 80:4, s. S67-S73
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Tidskriftsartikel (refereegranskat)abstract
- Postoperative sore throat and hoarseness are common and disturbing complications following endotracheal intubation, and women are more frequently affected by these symptoms. This study explores risk factors associated with postoperative sore throat and hoarseness in women following intubation.In this prospective cross-sectional study, 97 patients undergoing elective ear, nose, and throat surgery or plastic surgery were included. Eight different variables were analyzed to detect possible associations for the development of postoperative sore throat or hoarseness. For data analysis, the f} test and the odds ratio were used.Three variables were found to be significant risk factors for postoperative sore throat: age greater than 60 years (P = .01), the use of a throat pack (P = .04), and endotracheal tube No. 7.0 (size 7 mm; P = .02). The only risk factor found to be significantly associated with developing hoarseness was an endotracheal cuff pressure below 20 centimeters of water (P = .04). Larger studies are needed to confirm these risk factors.
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- Jaensson, Maria, 1967-, et al.
(författare)
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Secondary analysis of risk factors for development of postoperative sore throat and hoarseness after endotracheal intubation in women
- 2012
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Konferensbidrag (refereegranskat)abstract
- Introduction with Hypothesis: Postoperative sore throat (POST) and postoperative hoarseness (PH) are common but disturbing complications following endotracheal intubation. Previously recognized risk factors for POST are: female gender, the size of endotracheal tube, grade of difficulty in intubation, duration of surgery (1, 2) and increased cuff pressure. There is inconsistency in the literature as to the age group that is at greatest risk for developing POST (1). Risk factors associated with PH are endotracheal tube size (3) and non-optimal intubation conditions . Therefore, identification of risk factors associated with POST and PH would add to our knowledge of predictors of poor outcome in our patients.Methods: This was a secondary analysis of prospective, cross-sectional data collected from patients previously enrolled in a randomized controlled trial (n=100 women). Eight different variables were analyzed in order to detect possible association between endotracheal intubation and the development of POST or PH. At the Post-Anaesthesia Care Unit, the patients rated their POST on a four-point scale (0=none, 1= mild, 2=moderate, 3=severe). The data was dichotomized, to sore throat (grade 1-3 on the four-grade scale) and no sore throat (grade 0 on the same scale). PH was assessed on a binary scale. The independent variables were analyzed against the dependent variables using the Chi-Square test, and the odds ratio (OR) and confidence interval (CI) were calculated for each significant variable. Results: Three patients were excluded. Thus, a total of 97 women completed the study.Three variables were found to be significant risk factors for the development of POST: age >60 yrs n=14/22 (63%) vs. 18-60: n=24/75 (32%) (P = 0.008), endotracheal tube size 7.0 i.e n=25/49 (51 %) vs. ETT 6.0: n= 13/48 (27 %) (P = 0.016) and the use of throat pack i.e n= 9/14 (64 %) vs. no throat pack: n=29/ 83 (35%) (P = 0.037). The corresponding odds ratio (OR) for these three risk factors were: age 3.71 (95% CI 1.4-10.1), ETT 2.80 (95% CI 1.2-6.6) and throat pack 3.35 (95% CI 1.0-10.9) respectively. 20 cm i.e n= 17/29 (59 %) vs. > 20 cmH2O: 24/67 (36%) (P= 0.038). The OR was 2.5 (95 % CI 1.0-6.1) if the cuff pressure was < 20 cm H2O compared to if the cuff pressure was > 20 cm H2O. Discussion and Conclusion: Patient-reported outcome measures research is based on the knowledge that we, as nurse anesthetists, get some insight into how the patient perceives different situations. Therefore, it is important to increase our knowledge of the patients at risk and the conditions under which this risk increases. In conclusion, we found that women over 60 years, a larger size on the endotracheal tube or the use of a throat pack are at an increased risk for developing postoperative sore throat. A lower cuff pressure was the only factor that contributed towards postoperative hoarseness.
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