Central vascular catheters versus peripherally inserted central catheters in nurse anesthesia. A perspective within the Greek health system.

PURPOSE: We present a study comparing the insertion of central vascular catheter (CVC) and peripherally inserted central catheter (PICC) by an anesthesia nurse at 2 Greek University Hospitals. METHODS: Eighty patients, aged 20-80 years, were enrolled in the study. Patients were divided into 2 groups. In group A (41 patients), a CVC was inserted in the internal jugular vein. In group B (39 patients), a pressure-injectable PICC was inserted in the basilica vein. RESULTS: Correlations between the methods applied, the patients' characteristics, the procedures' characteristics and the overall satisfaction scores for each procedure were examined. The final results show that the patients of group B (PICC method) were more satisfied with the procedure than the patients of group A (CVC method), at the statistical significance level of a=0.01. Also, according to the results of the analysis, the PICC method offers significantly more comfort and relative satisfaction than the CVC method, at the statistical significance level of a=0.01. The satisfaction scores of "physicians" were statistically more significant, at a=0.01, for the patients of group A (classic CVCs) mainly because of the insufficient flow rate of the PICCs when compared with the CVCs and especially if one considers the fact that the physicians did not have any experience with the PICC method at all. CONCLUSIONS: PICCs under ultrasound guidance constitute the solution of choice for patients and they definitely surpass the CVCs focusing mainly on the improvement of the quality of life and the satisfaction of patients.

A randomized double-blind trial of anesthesia provided for colonoscopy by university-degreed anesthesia nurses in Greece: safety and efficacy.

There are numerous studies in the literature of anesthesia administered during colonoscopy including various methods, drugs, and monitoring systems; however, none of them has studied whether a university-degreed nurse anesthesia provider (known as a certified registered nurse anesthetist in the United States) is skillful enough to provide safe anesthesia in patients undergoing endoscopic procedures. The aim of our study was to determine whether anesthesia provided by a university-degreed nurse anesthesia provider during an endoscopic procedure is comparable in terms of safety and efficacy with routine sedation practice. This randomized, double-blind study included 100 adult patients who underwent colonoscopy conducted in the Evgenidion University Hospital during a single year. Subjects were divided into 2 groups: the first group received the usual scheme of intravenous sedation with midazolam and fentanyl administered by a member of the endoscopic team that was blind to Bispectral Index (BIS) values recordings (Group 0). The second group received intravenous bolus injection of propofol bolus by a university-degreed anesthesia registered nurse based on the BIS values (Group 1). The average of the mean BIS values of Group 0 was 85.07 (SD = 8.01) and for Group 1 was 76.1 (SD = 10.88; p = .04). The parameters of "patient memory during procedure" and the satisfaction scores (as self-assessed by the patients as well as 2 gastroenterologists) were also significantly different between the patients of the 2 groups (p = .000). Comparison between the 2 groups showed that the sedation offered by a university-degreed nurse anesthesia provider was absolutely safe and effective, offering particular comfort to the patient during the intervention and contributing significantly to its successful results.