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Deral Tanil

Bio: Deral Tanil is an academic researcher. The author has contributed to research in topics: Anesthesia Recovery Period. The author has an hindex of 1, co-authored 1 publications receiving 361 citations.

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Journal ArticleDOI
TL;DR: A patient-rated quality of recovery score is developed by constructing a 61-item questionnaire that asked individuals to rate the importance of certain aspects of recovery after anesthesia.
Abstract: A variety of methods have been used to quantify aspects of recovery after anesthesia.Most are narrowly focused, are not patient-rated, and have not been validated. We therefore set out to develop a patient-rated quality of recovery score. We constructed a 61-item questionnaire that asked individuals

390 citations


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Journal ArticleDOI
TL;DR: The anaesthetist has an important role in facilitating early postoperative recovery by provision of minimally-invasive anaesthesia and pain relief, and by collaborating with surgeons, surgical nurses, and physiotherapists to reduce risk and pain.

1,276 citations

Journal ArticleDOI
TL;DR: Intraoperative oesophageal Doppler guided fluid management was associated with a 1.5-day median reduction in postoperative hospital stay and patients recovered gut function significantly faster and suffered significantly less gastrointestinal and overall morbidity.
Abstract: Background Occult hypovolaemia is a key factor in the aetiology of postoperative morbidity and may not be detected by routine heart rate and arterial pressure measurements. Intraoperative gut hypoperfusion during major surgery is associated with increased morbidity and postoperative hospital stay. We assessed whether using intraoperative oesophageal Doppler guided fluid management to minimize hypovolaemia would reduce postoperative hospital stay and the time before return of gut function after colorectal surgery. Methods This single centre, blinded, prospective controlled trial randomized 128 consecutive consenting patients undergoing colorectal resection to oesophageal Doppler guided or central venous pressure (CVP)-based (conventional) intraoperative fluid management. The intervention group patients followed a dynamic oesophageal Doppler guided fluid protocol whereas control patients were managed using routine cardiovascular monitoring aiming for a CVP between 12 and 15 mm Hg. Results The median postoperative stay in the Doppler guided fluid group was 10 vs 11.5 days in the control group P Conclusions Intraoperative oesophageal Doppler guided fluid management was associated with a 1.5-day median reduction in postoperative hospital stay. Patients recovered gut function significantly faster and suffered significantly less gastrointestinal and overall morbidity.

588 citations

Journal ArticleDOI
TL;DR: The QoR-15 provides a valid, extensive, and yet efficient evaluation of postoperativeQoR, and is suitable for clinical and research evaluation of quality of recovery after anesthesia.
Abstract: BACKGROUND Quality of recovery (QoR) after anesthesia is an important measure of the early postoperative health status of patients The aim was to develop a short-form postoperative QoR score, and test its validity, reliability, responsiveness, and clinical acceptability and feasibility METHODS Based on extensive clinical and research experience with the 40-item QoR-40, the strongest psychometrically performing items from each of the five dimensions of the QoR-40 were selected to create a short-form version, the QoR-15 This was then evaluated in 127 adult patients after general anesthesia and surgery RESULTS There was good convergent validity between the QoR-15 and a global QoR visual analog scale (r = 068, P < 00005) Construct validity was supported by a negative correlation with duration of surgery (r = -049, P < 00005), time spent in the postanesthesia care unit (r = -041, P < 00005), and duration of hospital stay (r = -053, P < 00005) There was also excellent internal consistency (085), split-half reliability (078), and test-retest reliability (ri = 099), all P < 00005 Responsiveness was excellent with an effect size of 135 and a standardized response mean of 104 The mean ± SD time to complete the QoR-15 was 24 ± 08 min CONCLUSIONS The QoR-15 provides a valid, extensive, and yet efficient evaluation of postoperative QoR

447 citations

Journal ArticleDOI
TL;DR: In this article, the authors compared the use of nitrous oxide-free and N2O-based anesthesia in patients undergoing major surgery and found that the latter significantly decreased the incidence of complications after major surgery, while the latter increased the inspired oxygen concentration.
Abstract: BACKGROUND: Nitrous oxide is widely used in anesthesia, often administered at an inspired concentration around 70%. Although nitrous oxide interferes with vitamin B12, folate metabolism, and deoxyribonucleic acid synthesis and prevents the use of high inspired oxygen concentrations, the consequences of these effects are unclear. METHODS: Patients having major surgery expected to last at least 2 h were randomly assigned to nitrous oxide-free (80% oxygen, 20% nitrogen) or nitrous oxide-based (70% N2O, 30% oxygen) anesthesia. Patients and observers were blind to group identity. The primary endpoint was duration of hospital stay. Secondary endpoints included duration of intensive care stay and postoperative complications; the latter included severe nausea and vomiting, and the following major complications: pneumonia, pneumothorax, pulmonary embolism, wound infection, myocardial infarction, venous thromboembolism, stroke, awareness, and death within 30 days of surgery. RESULTS: Of 3,187 eligible patients, 2,050 consenting patients were recruited. Patients in the nitrous oxide-free group had significantly lower rates of major complications (odds ratio, 0.71; 95% confidence interval, 0.56-0.89; P = 0.003) and severe nausea and vomiting (odds ratio, 0.40; 95% confidence interval, 0.31-0.51; P < 0.001), but median duration of hospital stay did not differ substantially between groups (7.0 vs. 7.1 days; P = 0.06). Among patients admitted to the intensive care unit postoperatively, those in the nitrous oxide-free group were more likely to be discharged from the unit on any given day than those in the nitrous oxide group (hazard ratio, 1.35; 95% confidence interval, 1.05-1.73; P = 0.02). CONCLUSIONS: Avoidance of nitrous oxide and the concomitant increase in inspired oxygen concentration decreases the incidence of complications after major surgery, but does not significantly affect the duration of hospital stay. The routine use of nitrous oxide in patients undergoing major surgery should be questioned.

390 citations

Journal ArticleDOI
TL;DR: Adjunctive use of an intraoperative Dex infusion decreased fentanyl use, antiemetic therapy, and the length of stay in the PACU, but it failed to facilitate late recovery or improve the patients’ overall quality of recovery.
Abstract: BACKGROUND:Dexmedetomidine (Dex), an α2 agonist, has well-known anesthetic and analgesic-sparing effects. We designed this prospective, randomized, double-blind, and placebo-controlled dose-ranging study to evaluate the effect of Dex on both early and late recovery after laparoscopic bariatric surge

298 citations