An 8-h infusion of remifentanil did not affect NK cell activity in normal volunteers. This result differs from previous findings of morphine-induced NK cell activity suppression and fentanyl-induced NK cell activity enhancement in normal volunteers.

Background: Postoperative patients are sleep deprived. Opioids, commonly administered for postoperative pain control, are often mistakenly considered inducers of naturally occurring sleep. This study describes the effect of the opioid remifentanil on nocturnal sleep in healthy volunteers. In addition, this study tests the hypothesis that opioid-induced sleep disturbance is caused by a circadian pacemaker disturbance, reflected by suppressed nocturnal plasma concentration of melatonin.Methods: Polysomnography was performed in 10 volunteers from 11:00 PM to 7:00 AM for four nights at 6-day intervals. On two nights, remifentanil (0.01-0.04 g ⅐ kg ؊1 ⅐ min ؊1 ) was

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Background: Less than 10% of ischemic stroke patients receive tissue plasminogen activator. Low treatment rates have been associated with delay in hospital presentation and reluctance to treat. Studies have found that a combination of community and professional education increase thrombolytic therapy from 2.2% to 11.3% with the data suggesting that professional education made the most impact. An Acute Stroke Nurse Response educational program was piloted as a means of providing specialized treatment education for nurses in North Carolina. Project goals: A. Increase the number of nurses across the state experienced to provide acute stroke assessment and treatment. B. Determine the best educational approach: on-line vs. class room vs. both. C. Develop a mock code stroke training module. D. Provide guidance in developing individualized models of stroke care protocols. Measurable objectives: A. Gauge interest in the program. B. Assess pre and post-test knowledge measuring effectiveness of modules. C. Assess nurse preference for teaching method. D. Evaluate the methodology of the mock code stroke module. Methods: The educational program covered stroke topics through on-line modules and a one day lecture series to meet the needs of the working nurse. The program consisted of 10 specialized stroke training modules: Module 1: Introduction to Stroke Module 2: Emergency Management Module 3: Acute Stroke Treatment Module 4: Management of ICH Module 5: Stroke Prevention Module 6: Nursing Care of the Stroke Patient Lecture 7: Neurological Assessment Lecture 8: Stroke Imaging Lecture 9: Quality Improvement/Joint Commission Primary Certification Lecture 10: Mock Stroke Code 6 weeks were allowed to complete the on-line modules prior to the day lecture series. Pre and post-test exams were administered to assess baseline knowledge and knowledge gained. Results: 42 nurses showed interest in the program. 12 nurses completed the pilot program. 10 were from NC, originating throughout the state and 2 from SC. Two participants were NP’s, 2 ED nurses, 3 staff nurses and 5 stroke coordinators. Participants had a mean pre-test score of 53.2, which increased significantly (p<0.001) to a mean post-test score of 77.8 (absolute mean improvement of 24.6%). The improvement in the scores ranged from 11.1 to 44.5% with one participant experiencing a decrease in test scores by 5.6%. Program feedback was positive, with strengths identified as “convenient and informative”. All participants requested the program continue as originally developed with on-line modules and the one day lecture series. Conclusions: There was a significant educational benefit from this program, as demonstrated by participant responses to the pilot program.