: one-group quasi-experimental pretest/post-test design. Anxiety Inventory) Spielberger, Y-1 (state) Wilcoxon signed ranks test.

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2 one-group quasi-experimental pretest/post-test design - - STAI Y (State-Trait Anxiety Inventory) Spielberger Y (state) & ) ) / Wilcoxon signed ranks test Spearmans rank order correlation Kruskal Wallis test Mann Whitney test p<005 STAI [min-max] 76 (56 20 ) 40 [191] STAI (57 [23-80]) (51 [217] p = ) 77% 64% 75% 40% (60 [23-80] vs 57 [301] p = 0080) (515 [227] vs 42 [210] p = 0058) (p = 0939 p = 0199) (p = 0803 p = 0224) (37%) (22%) (17%) (11%) (615 [427] p = 0002) 1) Kathol DK AORN J 1984 Jul;40(1)131 2) Leske JS AORN J 1996 Sep;64(3) ) Leske JS Appl Nurs Res 1995 Nov;8(4)1693 4)Tselebis A et al Ann Gen Psychiatry 2010 Apr 14;

3 бп % 55% ( ) бп (95%) 4 (2%) 45% (135%) (58%) 45% (55%) 3 ESA 4 1 Skinner CM Rangasami J Preoperative use of herbal medicines a patient survey Br J Anaesth 2002; Heller J Gabbay JS Ghadjar K et al Top0 List of herbal and supplemental medicines used by cosmetic patients what the plastic surgeon needs to know Plast Reconstr Surg 2006; Kaye A D Baluch A et al Pharmacology of herbals and their impact in anesthesia Curr Opin Anaesthesiol 2007; 20(4) De Hert S et al Preoperative evaluation of the adult patient undergoing non-cardiac surgery guidelines from the European Society of Anaesthesiology Eur J Anaesthesiol 2011;

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5 THN % 461% 37% 618% (p<0005) 2 563% 188% 117% 133% 3 36/128 (281%) 47/128 (367%) 45/128 (352%) 4 379% 10% (<0005) 5 966% 952% 6 906% 939% 7 91% 46% 1 Soar J Monsieurs K Balance J et al European Council Guidelines for Resuscitation 2010 Section 9 Principales of education in resuscitation 2 Cummins R Chamberlain D Hazinski M et al Recommended guidelines for reviewing reporting and conducting research on in hospital resuscitation the in hopsitan Utstein Style Resuscitation 1997 ;

6 BUDGET IMPACT OF USING SUGAMMADEX FOR THE ROUTINE REVERSAL OF NEUROMUSCULAR BLOCKADE IN A GREEK HEALTH CARE SETTING Insinga RP 1 Konstantopoulou T 2 Athanasakis K 3 Argyris G 2 1 Merck & Co Inc Upper Gwynedd PA USA 2 MSD Greece Alimos Greece 3 National School of Public Health Department of Health Economics Athens Greece Objective To model the annual impact on hospital costs following the introduction of sugammadex for routine reversal of neuromuscular blockade Methods An economic model reflecting resource use and costs associated with neuromuscular block and its reversal and residual blockade was constructed for a typical Greek hospital Clinical trial data were used to estimate time savings relating to shortened reversal in the operating room (OR) for sugammadex compared to neostigmine and no reversal Costs of OR time were derived from labor costs for different types of OR staff Resource use associated with residual blockade sequelae (aspiration hypoxemia muscle weakness upper airway obstruction) was estimated from the literature Annual procedures utilization of neuromuscular blocking and reversal agents and uptake of sugammadex within a typical Greek hospital were estimated Unit costs were based on public data sources or published literature Results If all OR staff modeled (with average staff attendance across all procedures of 24 anesthetists 35 surgeons and 37 nurses) can realize time savings with shortened reversal use of sugammadex is estimated to save a typical Greek hospital using sugammadex in 7130 procedures annually per year This corresponds to an increase in drug costs of which is more than fully offset by a decrease in costs of OR staff and clinical sequelae of residual blockade (82680 ) In a worst case scenario if only one second degree anesthetist one second degree surgeon and one nurse in attendance realize time savings annual costs would be increased ( ) Results were sensitive to OR staff costs and time savings Conclusion Sugammadex for routine reversal of neuromuscular blockade can potentially lead to cost savings in the Greek healthcare setting The degree to which costs may be saved depends upon which OR staff can realize time savings with shortened reversal 299

7 IA ( 219/22-07) To (BLS/AED 2007 BLS/AED / 2 67 / Soar J Monsieursb K Ballancec J et al European Resuscitation Council Guidelines for Resuscitation 2010 Section 9 Principles of education in resuscitation Resuscitation 2010 ; Chamberlain D Hazinski M Education in resuscitation Resuscitation 2003;

8 A i i i ii i i i (i) (ii) /3 195 (344%) 360 (291%) 624% 376% 628% (829%) (28%) (25%) (244%) 133% 6% 27% 292% 211% (68%) (09%) 933% 195% 26% 651% бп 301

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