Elizabeth Szokol

Elizabeth Landry’s research works | NorthShore University HealthSystem, IL and other places

Publications (8)

Citations

… [3] Murphy et al. evaluated 149 patients in the PACU at admission and up to 1 h, based on the presence of 16 symptoms (general weakness, 5-s head lift; 5-s hand grip; 5-s eye opening; 5-s tongue protrusion; ability to hold tongue depressor; blurry vision; double vision; ability to track objects; facial numbness; ability to smile; ability to swallow; ability to smile; ability to speak; ability to cough; and ability to breathe deeply) and eleven objective signs (5-s head lift; 5-s hand grip; 5-s eye opening; 5-s tongue protrusion; tongue depressor test; ability to smile; swallow; speak; cough; object tracking and ability to breathe deeply) at TOF < 0.9 and TOF >0.9. [29] An increased incidence and severity of symptoms were noted at all-time points in the patients with TOF < 0.9 (P < 0.001). The median TOF was 0.75 (0.33-0.87) in the TOF <0.9 group and 1.01 (0.90-1.28) in the TOF >0.9 group, respectively. …

… 12 A number of small studies have shown that a single dose of dexamethasone was associated with a modest increase in blood glucose concentrations and that it could suppress plasma cortisol concentrations for up to 24 h when used in noncardiac surgery. [13][14][15] There is growing concern about harm from hyperglycaemia induced by dexamethasone, particularly in patients with diabetes mellitus. 16,17 Given that up to 50% of surgical patients may receive intra-operative dexamethasone as part of their anaesthesia care, 18 it is important to determine whether this may induce excessive hyperglycaemia. …

… In addition, the reliability of qualitative TOF may be questionable in comparison to acceleromyography with residual paralysis (TOF <0.9) noted in acceleromyography group (14.5%) versus qualitative TOF group (50.0%) (P < 0.0001) in a cohort of 155 patients after GA with rocuronium as the relaxant. [25] In our study, 5-s sustained head lift failed to show significant correlation with TOF and DBS whereas tongue depressor test, absent diplopia and ability to cough were good indicators of recovery as they correlated with TOF ratio of approximately 0.80-0.90 and DBS ratio of 0.89-0.96. ...

… The use of neuromuscular monitoring methods such as “train of four” (TOF) to avoid residual block is important to prevent postoperative complications. Sugammadex, which is used to restore aminosteroid muscle relaxants, is faster and safer than conventional agents, but it should be noted that it increases costs [21]. …

Murphy GS, Szokol JW, Avram MJ, Greenberg SB, Marymont JH, Vender JS, Gray J, Landry E, Gupta DK. Intraoperative acceleromyography monitoring reduces symptoms of muscle weakness and improves quality of recovery in the early postoperative period

… When consent is obtained on the same day as surgery, the vast majority of patients do understand the intent of the clinical anesthesia trials and recognize that participation is voluntary and that consent may be withdrawn at any time without consequence. 16,17 Patients are capable of digesting consent form documents and making informed decisions about research participation in thirty minutes or less. 16,18 Similarly, most patients feel that the perioperative setting offers adequate privacy for consent discussions. …

… Laparoscopic surgeries under low abdominal pressure are associated with a lower incidence of postoperative pain and referred pain in the shoulder, 24 hours after surgery [22]. In addition, monitoring of neuromuscular relaxation prevents residual blockage upon awakening, which may cause adverse respiratory events, such as hypoxia, upper airway obstruction, and a prolonged stay in the PACU, that may decrease patient-perceived quality of recovery [15,23,24]. …

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