ABSTRACT
BACKGROUND: To support patients discharged from the hospital after surgery, we launched an "Interdisciplinary Postoperative Support Program" in outpatient clinics for patients who were discharged within 1 month after thoracic esophagectomy and their families. We introduce our program and clarify the patient's physical and psychologic status by analyzing the questionnaire provided from this program. MATERIALS AND METHODS: From August 2014 to January 2015, we conducted the Interdisciplinary Postoperative Support Program every month. Thus, questionnaires regarding physical and psychologic symptoms as well as the meaningfulness of the program were obtained from 59 patients and prospectively analyzed. RESULTS: We obtained valid responses from 48 patients (81.4%). Frequent postoperative difficulties included dysphagia (50%) and decreased physical strength (39.5%). Oral intake decreased to half (55.3%) and one-fourth (25.5%) of that before esophagectomy. Frequent requests made by patients to medical staff included explanations of the postoperative symptoms (97.9%), further information on the treatments of esophageal cancer (93.8%), and the typical postoperative course experienced by other patients (76.6%). A higher percentage of positive comments were obtained regarding the management of symptoms (87.8%) and optimal access to the consultations (78.9%). The incidences of unscheduled outpatient visits were 4.1% and 14.0%, respectively, under conditions with and without this postoperative program (P = 0.03). CONCLUSION: We found that our program could provide appropriate information with higher levels of satisfaction after thoracic esophagectomy. Further investigations regarding longer periods of physical and psychologic symptoms, as well as the needs of patients and their families should be conducted to augment our program.
Subject(s)
Aftercare/methods , Ambulatory Care Facilities , Esophageal Neoplasms/psychology , Esophagectomy/rehabilitation , Program Evaluation , Thoracic Surgical Procedures/rehabilitation , Aged , Ambulatory Care Facilities/statistics & numerical data , Esophageal Neoplasms/surgery , Esophagectomy/methods , Female , Humans , Male , Middle Aged , Patient Care Team , Postoperative Period , Program Development , Prospective Studies , Surveys and Questionnaires , Thoracic Surgical Procedures/methodsABSTRACT
BACKGROUND: Seven patients were subjected to intraoperative wake-up tests during reconstruction surgery of the anterior crucial ligament (ACL) to measure the tension of the reconstructed ligament. METHODS: The patients were of 18 to 28 of age with ASA physical status 1. Anesthesia was maintained with nitrous oxide-sevoflurane-fentanyl or propofol-fentanyl under orotracheal intubation. RESULTS: Patients anesthetized with nitrous oxide-sevoflurane-fentanyl did not perform smoothly in the wake-up test because of restless or delayed emergence from anesthesia, and two of them experienced intraoperative awareness. On the other hand, all patients anesthetized with propofol-fentanyl performed smoothly, and no patient experienced intraoperative awareness. CONCLUSIONS: Propofol-fentanyl is better than nitrous oxide-sevoflurane-fentanyl as the method of anesthesia for wake-up tests of ACL reconstruction surgery.
