Corrigendum to “Reduced Pain and Opioid Use in the Early Postoperative Period in Patients Undergoing a Frontotemporal Craniotomy under Regional vs General Anesthesia” [World Neurosurgery 150 (June/2021) e31-e37]

Bojaxhi, Elird; Louie, Christopher; ReFaey, Karim; Gruenbaum, Shaun E.; Leone, Bruce J.; Bechtel, Perry; Barbosa, Maria P.; Chaichana, Kaisorn L.; Quiñones‐Hinojosa, Alfredo

doi:10.1016/j.wneu.2022.04.027

Cited by 2 publications

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“…The lesser occipital and auriculotemporal nerves were blocked ipsilateral to the surgical side only. To address discomfort seen with dissection of the temporalis muscle off the temporal bone, 7 we performed an ipsilateral deep temporal nerve block under direct ultrasound guidance. Approximately 20 ml of 0.5% ropivacaine with 1:200 000 of epinephrine was injected in total.…”

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…The evolution of neuro-oncological surgery has led to progressively reduced surgical morbidity and enhanced patient recovery as new technologies and protocols are implemented. 1 , 2 , 3 , 4 , 5 , 6 , 7 In fact, updated neuroanesthesia protocols, improved neuromonitoring and neuronavigation, and implementation of new surgical adjuncts have resulted in a reduced length of stay (LOS) and, in some cases, same-day discharge. 8 , 9 , 10 , 11 , 12 Reduced LOS lowers exposure to potential nosocomial infections and thromboembolic complications, alleviates the psychological impact of brain tumor surgery, and is associated with higher patient satisfaction.…”

Section: Introductionmentioning

confidence: 99%

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Awake Craniotomy Program Implementation

Moniz-Garcia,

Bojaxhi,

Borah

et al. 2024

JAMA Netw Open

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ImportanceImplementing multidisciplinary teams for treatment of complex brain tumors needing awake craniotomies is associated with significant costs. To date, there is a paucity of analysis on the cost utility of introducing advanced multidisciplinary standardized teams to enable awake craniotomies.ObjectiveTo assess the cost utility of introducing a standardized program of awake craniotomies.Design, Setting, and ParticipantsA retrospective economic evaluation was conducted at Mayo Clinic Florida. All patients with single, unilateral lesions who underwent elective awake craniotomies between January 2016 and December 2021 were considered eligible for inclusion. The economic perspective of the health care institution and a time horizon of 1 year were considered. Data were analyzed from October 2022 to May 2023.ExposureTreatment with an awake craniotomy before standardization (2016-2018) compared with treatment with awake craniotomy after standardization (2018-2021).Main Outcomes and MeasuresPatient demographics, perioperative, and postoperative outcomes, including length of stay, intensive care (ICU) admission, extent of resection, readmission rates, and 1-year mortality were compared between patients undergoing surgery before and after standardization. Direct medical costs were estimated from Medicare reimbursement rates for all billed procedures. A cost-utility analysis was performed considering differences in direct medical costs and in 1-year mortality within the periods before and after standardization of procedures. Uncertainty was explored in probability sensitivity analysis.ResultsA total of 164 patients (mean [SD] age, 49.9 [15.7] years; 98 [60%] male patients) were included in the study. Of those, 56 underwent surgery before and 108 after implementation of procedure standardization. Procedure standardization was associated with reductions in length of stay from a mean (SD) of 3.34 (1.79) to 2.46 (1.61) days (difference, 0.88 days; 95% CI, 0.33-1.42 days; P = .002), length of stay in ICU from a mean (SD) of 1.32 (0.69) to 0.99 (0.90) nights (difference, 0.33 nights; 95% CI, 0.06-0.60 nights; P = .02), 30-day readmission rate from 14% (8 patients) in the prestandardization cohort to 5% (5 patients) (difference, 9%; 95% CI, 19.6%-0.3%; P = .03), while extent of resection and intraoperative complication rates were similar between both cohorts. The standardized protocol was associated with mean (SD) savings of $7088.80 ($12 389.50) and decreases in 1-year mortality (dominant intervention). This protocol was found to be cost saving in 75.5% of all simulations in probability sensitivity analysis.Conclusions and RelevanceIn this economic evaluation of standardization of awake craniotomy, there was a generalized reduction in length of stay, ICU admission time, and direct medical costs with implementation of an optimized protocol. This was achieved without compromising patient outcomes and with similar extent of resection, complication rates, and reduced readmission rates.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Awake Craniotomy Program Implementation

Moniz-Garcia,

Bojaxhi,

Borah

et al. 2024

JAMA Netw Open

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The effect of spaced learning on the learning outcome and retention of nurse anesthesia students: a randomized-controlled study

Khalafi,

Fallah,

Sharif-Nia

2024

BMC Med Educ

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Background Poor learning and retention are common problems of students, which may be alleviated by optimization of widely used educational methods such as lectures. This study aimed to investigate the effect of spaced learning on the learning outcome and retention of nurse anesthesia students. Methods This was a randomized controlled study with a pre-and post-test design on 64 nurse anesthesia students who were divided into two groups of spaced lecture (n = 32) and conventional lecture (n = 32). The spaced lectures included three 30-minute training sessions with 10-minute intervals while the conventional sessions including 90 min of continuous training. Students’ knowledge was measured using one valid and reliable questionnaire developed by the research team. All students in both groups took a pre-test, and their level of knowledge acquisition was evaluated immediately after the training. Their level of knowledge retention was tested two and four weeks after the lecture. Results There was no significant difference between the two groups regarding demographic characteristics (p > 0.05). In the pre-test, the mean score of knowledge in the intervention group was lower than that in the control group, there was no significant difference (p = 0.177). But after the intervention, the mean scores of learning outcome and retention in the intervention group were significantly higher than those in the control group (p < 0.001, eta = 0.576). Also, the results showed that learning outcome and retention across the three academic semesters in the two groups are significantly different, and students with a higher academic semester obtained a significantly higher mean score of knowledge and retention (p < 0.001, eta = 0.604). Conclusion Spaced learning improves nurse anesthesia students’ knowledge and retention more than conventional method. Future studies focusing on spaced learning should specifically examine the impact of duration and number of intervals, as well as the time gap between training and measurement of learning retention.

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Corrigendum to “Reduced Pain and Opioid Use in the Early Postoperative Period in Patients Undergoing a Frontotemporal Craniotomy under Regional vs General Anesthesia” [World Neurosurgery 150 (June/2021) e31-e37]

Cited by 2 publications

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Awake Craniotomy Program Implementation

Awake Craniotomy Program Implementation

The effect of spaced learning on the learning outcome and retention of nurse anesthesia students: a randomized-controlled study

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