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Period Prevalence of Ketamine-Propofol Admixture "Ketofol" in the Operating Room among Anesthesia Providers at an Academic Medical Center.

Olson AN, Rao WR, Marienau ME, Smischney NJ - Med. Sci. Monit. (2015)

Bottom Line: The period prevalence of "ketofol" was greater for sedation than induction.There was a significant reduction in barriers following education, with oral presentations being more effective than electronic only.Period prevalence was increasing following education; however, allowing more time may have shown a significant practice change.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.

ABSTRACT

Background: The primary aim of this study was to determine the period prevalence of the single-syringe ketamine-propofol admixture used for sedation and induction among anesthesia providers during a 5-year period before and after educational sessions addressing barriers to its use. Secondary aims were to determine barriers to its use and address the most prevalent concerns through educational sessions.

Material and methods: Surveys were administered to certified and student registered nurse anesthetists, anesthesia residents, and anesthesiologists at Mayo Clinic Rochester, MN before and after educational sessions addressing common barriers. Identified barriers were addressed by oral and/or electronic presentations with identical content.

Results: Pre-education period prevalence for sedation was 110 (43%) and 64 (25%) for induction. Identified barriers were uncertainty of benefit in 62 respondents (23%), mixed controlled substance disposal in 48 (18%), regulatory/institutional policies in 20 (7%), and compatibility in 9 (3%). Post-education period prevalence for sedation was 102 (44%), and induction 63 (27%). No concerns were noted in 72% of the post-education group verses 42% in the pre-education group (p<0.01). No concerns were reported in 51% of the electronic only education group verses 64% in the oral education group (p<0.01).

Conclusions: The period prevalence of "ketofol" was greater for sedation than induction. The period prevalence following education showed a slight increase in both sedation and induction use. There was a significant reduction in barriers following education, with oral presentations being more effective than electronic only. Period prevalence was increasing following education; however, allowing more time may have shown a significant practice change.

No MeSH data available.


Related in: MedlinePlus

Reasons for not administering single-syringe ketamine-propofol admixture for sedation and induction by years of experience among anesthesia providers.
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f3-medscimonit-21-1737: Reasons for not administering single-syringe ketamine-propofol admixture for sedation and induction by years of experience among anesthesia providers.

Mentions: Of the 57 anesthesia providers with 0–5 years of experience who indicated they had not used the combination as an induction agent, the primary reason listed was “satisfied with current practice of giving only one”, 26 (46%). The next most common reason was lack of experience and/or knowledge, 24 (42%). Of the 58 anesthesia providers with greater than 5 years of experience who had not used the combination as an induction agent, 37 (64%) indicated they were satisfied with current practice of giving only 1 at a time. The next most common reason 17 (29%) was lack of experience and/or knowledge, and 4 (7%) indicated it was too time consuming (Figure 3).


Period Prevalence of Ketamine-Propofol Admixture "Ketofol" in the Operating Room among Anesthesia Providers at an Academic Medical Center.

Olson AN, Rao WR, Marienau ME, Smischney NJ - Med. Sci. Monit. (2015)

Reasons for not administering single-syringe ketamine-propofol admixture for sedation and induction by years of experience among anesthesia providers.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4482185&req=5

f3-medscimonit-21-1737: Reasons for not administering single-syringe ketamine-propofol admixture for sedation and induction by years of experience among anesthesia providers.
Mentions: Of the 57 anesthesia providers with 0–5 years of experience who indicated they had not used the combination as an induction agent, the primary reason listed was “satisfied with current practice of giving only one”, 26 (46%). The next most common reason was lack of experience and/or knowledge, 24 (42%). Of the 58 anesthesia providers with greater than 5 years of experience who had not used the combination as an induction agent, 37 (64%) indicated they were satisfied with current practice of giving only 1 at a time. The next most common reason 17 (29%) was lack of experience and/or knowledge, and 4 (7%) indicated it was too time consuming (Figure 3).

Bottom Line: The period prevalence of "ketofol" was greater for sedation than induction.There was a significant reduction in barriers following education, with oral presentations being more effective than electronic only.Period prevalence was increasing following education; however, allowing more time may have shown a significant practice change.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA.

ABSTRACT

Background: The primary aim of this study was to determine the period prevalence of the single-syringe ketamine-propofol admixture used for sedation and induction among anesthesia providers during a 5-year period before and after educational sessions addressing barriers to its use. Secondary aims were to determine barriers to its use and address the most prevalent concerns through educational sessions.

Material and methods: Surveys were administered to certified and student registered nurse anesthetists, anesthesia residents, and anesthesiologists at Mayo Clinic Rochester, MN before and after educational sessions addressing common barriers. Identified barriers were addressed by oral and/or electronic presentations with identical content.

Results: Pre-education period prevalence for sedation was 110 (43%) and 64 (25%) for induction. Identified barriers were uncertainty of benefit in 62 respondents (23%), mixed controlled substance disposal in 48 (18%), regulatory/institutional policies in 20 (7%), and compatibility in 9 (3%). Post-education period prevalence for sedation was 102 (44%), and induction 63 (27%). No concerns were noted in 72% of the post-education group verses 42% in the pre-education group (p<0.01). No concerns were reported in 51% of the electronic only education group verses 64% in the oral education group (p<0.01).

Conclusions: The period prevalence of "ketofol" was greater for sedation than induction. The period prevalence following education showed a slight increase in both sedation and induction use. There was a significant reduction in barriers following education, with oral presentations being more effective than electronic only. Period prevalence was increasing following education; however, allowing more time may have shown a significant practice change.

No MeSH data available.


Related in: MedlinePlus