Abstract
Anesthesiology’s journal-based CME program is open to all readers. Members of the American Society of Anesthesiologists participate at a preferred rate, but you need not be an ASA member or a journal subscriber to take part in this CME activity. Please complete the following steps:The American Society of Anesthesiologists is approved by the Accreditation Council for Continuing Medical Education (ACCME) to sponsor continuing medical education for physicians.The American Society of Anesthesiologists designates this continuing medical education program for a maximum of 1 hour of Category 1 credit toward the AMA’s Physician Recognition Award. Each physician should claim only those hours of credit actually spent in the activity.Purpose: The focus of the journal-based CME program, and the articles chosen for the program, is to educate readers on current developments in the science and clinical practice of the specialty of Anesthesiology.Target Audience: Physicians and other medical professionals whose medical specialty is the practice of anesthesia.Learning Objectives: After reading the articles related to this program the participants should be familiar with the current state of knowledge concerning anesthesia practice and factors that may contribute to anesthetic-related morbidity and mortality.Authors – Mark A. Warner, M.D.Grants or research support: NoneConsultantships or honoraria: NoneThe article authored by Dr. Warner was supported solely from institutional and/or departmental sources.Authors – M. Sesmu Arbous, M.D., Ph.D., Anneke E. E. Meursing, M.D., Ph.D., Jack W. van Kleef, M.D., Ph.D., Jaap J. de Lange, M.D., Ph.D., Huub H. A. J. M. Spoormans, M.D., Paul Touw, M.D., Ph.D., Frans M. Werner, M.D., Ph.D., and Diederick E. Grobbee, M.D., Ph.D.Grants or research support: Supported by the Dutch Association for Anesthesiology, Utrecht, The Netherlands; the Dutch National Organization for Quality Assurance in Health Care, The Hague, The Netherlands; and the Ministry of Health of The Netherlands, The Hague, The Netherlands.Consultantships or honoraria: NoneQuestion Writer – Peter L. Bailey, M.D. Dr. Bailey has no grants, research support, or consultant positions, nor does he receive any honoraria from outside sources, which may create conflicts of interest concerning this CME program.Based on the article by Arbous et al. entitled “Impact of anesthesia management characteristics on severe morbidity and mortality”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=102&issue=2&spage=257&part=fulltextand its accompanying editorial by Warner entitled “Perioperative mortality: Intraoperative anesthetic management matters”http://content.wkhealth.com/linkback/openurl/trusted?issn=0003-3022&volume=102&issue=2&spage=251&part=fulltextin the February issue of Anesthesiology, choose the one correct answer for each question:1. Which statement concerning a case-control study design is not true?A. It is useful in the study of rare events.B. It is more efficient than a full cohort study design.C. Control patients need to have the same factors as case patients.D. It allows the determination of absolute event rates.2. Which of the following preoperative factors in the study by Arbous et al. was found most likely to be associated with a decreased risk of perioperative morbidity and mortality?A. The documented performance of an anesthesia equipment check.B. Hospital admission of a patient the same day as surgery.C. Scheduling of surgery for a patient already in the hospital.D. Premedication of a patient in anticipation of surgery.3. Which of the following intraoperative management factors in the study by Arbous et al. was found most likely to be associated with a decreased risk of perioperative morbidity and mortality?A. Anesthesia care was administered by an anesthesia care team that included part-time nurse anesthetists.B. Anesthesia care that did not include the intraoperative exchange of one anesthesiologist by another.C. Anesthesia care was administered by an anesthesia care team supervised by an anesthesiologist who was physically present in the facility.D. Anesthesia care was administered by an anesthesia care team in communication with the supervising anesthesiologist by pager.4. Which of the following intraoperative management factors concerning the emergence phase of anesthesia in the study by Arbous et al. was found most likely to be associated with a decreased risk of perioperative morbidity and mortality?A. An anesthesiologist was providing care directly when the patient emerged from anesthesia.B. Two members of an anesthesia care team were present when the patient emerged from anesthesia.C. An anesthesiologist was providing care directly at the end of a general but not a regional anesthetic technique.D. Two members of an anesthesia care team were present when the patient emerged from a general but not a regional anesthetic.5. Which one of the following anesthesia factors in the study by Arbous et al. was not found to be associated with a decreased risk of perioperative morbidity and mortality?A. Avoiding the use of opioids intraoperatively.B. Reversal of neuromuscular blocking drugs at the end of anesthesia.C. Postoperative pain management included epidural local anesthetic administration.D. Postoperative pain management included intramuscular opioids administration.
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