Oral Oxycodone Offers Equivalent Analgesia to Intravenous Patient-Controlled Analgesia After Total Hip Replacement

Abstract

of Anaesthetists (NAP3) published prospective data on the number of central neuraxial blocks (CNBs) performed each year in the United Kingdom National Health Service (NHS) and the incidence of major complications. Various methods were used to disseminate the results (academic article published, full report sent to each UK NHS hospital anesthetic department, report able to be downloaded on the Royal College of Anaesthetists [RCoA] Web site, executive summary sent to NHS hospital chief executives, summary slide set sent to anesthetic departments or downloadable on RCoA Web site, and presentation of results at lectures). This current survey examines the effectiveness of this dissemination to departments of anesthesia, whether the results of NAP3 changed practice in CNBs, and anesthetists' attitudes about different methods of dissemination.The electronic survey was sent to a network of local reporters at 309 NHS hospitals 1 year after publication of the NAP3 report. The questionnaire included check-box responses and free-text comment. The survey explored and differentiated between personal and departmental practices.The survey was sent to 288 reporters who had responsibility for the 309 hospitals. A total of 217 responses were received for a response rate of 75.3%. A total of 214 respondents reported that they personally perform CNBs (96% adult perioperative, 51% obstetric, 14% pediatric perioperative, and 10% chronic pain management). With regard to dissemination of results, 99.5% of respondents had heard of NAP3, and 97.7% were aware of the results. The most common ways they knew of the results were reading the original article, departmental presentation, and reading the original report (51.2%, 49.3%, and 46.1%, respectively). The NAP3 results were reported in 174 (80.2%) of the respondents' hospitals. Overall, 82% of respondents thought that the results were disseminated satisfactorily, and 50.2% said dissemination could not be improved. Changes in departmental practice in their hospital were reported by about 50% of respondents, with the most frequent change being in the information provided to patients before CNB. These included development of an information leaflet for patients, changes in management of CNBs, nursing monitoring of CNBs, or investigation of potential complications. About 66% of respondents changed the information they personally offered to patients before the CNB; 16% to 25% also changed their management of CNB or their own investigations of complications. No change in overall use of CNB in their department was reported by 194 (89%) of respondents; 20 (9.2%) and 3 respondents (1.4%) reported a reduction or an increase in the number of CNBs performed, respectively. On a personal basis, 29 respondents (13.4%) had decreased and 3 (1.4%) had increased the use of CNBs; 185 (85.3%) had not changed their use of CNBs. When asked which has more effect in changing practice, learning points or recommendations, 70.5% considered both to be equally effective, 15.7% preferred recommendations, and 13.8% preferr...