This prospective study was performed to determine whether anesthesia clinicians (i.e., both anesthesiologists and nurse anesthetists) can identify operating room alarms by their distinctive sounds and to identify factors related to alarm recognition accuracy. Nineteen alarms from 15 commonly used devices were recorded. These sounds were played, in a quiet room, to 44 anesthesia clinicians. The clinicians were asked to choose from a list the device that produced the alarm. After this recognition test, the clinicians rated the importance of each alarm and the frequency with which they heard it in the clinical situation. Clinicians correctly identified the alarm source 34% of the time. The recognition rate was higher for alarms rated as heard more frequently; however, alarms that were rated as more important were less likely to be correctly identified. Complexity of the sound did not influence accuracy of recognition. Most errors were attributed to similarities in sound or function, or both, among alarms. We conclude that anesthetists cannot reliably identify current operating room alarms by their distinctive sounds.
The efficacy of intraoperatively administered ketorolac for the prophylactic treatment of pain in the postanesthesia care unit (PACU) was examined in a prospective, double-blinded study. Thirty patients undergoing general anesthesia for orthopedic or lower abdominal surgery were randomized into two groups. Both groups received equivalent doses of opioids intraoperatively. Upon surgical closure, one group received intramuscular (IM) ketorolac 60 mg (2 mL) and the other group received normal saline 2 mL, IM. The saline control group more frequently required opioid-analgesic supplementation in the PACU than did the ketorolac group (P < 0.05). Time to first-required opioid dose in the PACU was 22 +/- 8 versus 76 +/- 11 min for the control group and ketorolac group, respectively (P < 0.001). The ketorolac group reported significantly lower pain scores 1 hr after PACU admission (P < 0.01). Time to PACU discharge was not different between groups. Intraoperatively administered ketorolac is an effective adjunct in the management of postoperative pain.
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