Assuntos
Falso Aneurisma , Laparoscopia , Obesidade Mórbida , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/etiologia , Falso Aneurisma/cirurgia , Gastrectomia/efeitos adversos , Humanos , Obesidade Mórbida/cirurgia , Artéria Esplênica/diagnóstico por imagem , Artéria Esplênica/cirurgia , Resultado do TratamentoRESUMO
BACKGROUND: Opioid over-prescription following surgery is a significant public health issue in most developed countries. Multiple studies have been conducted in the USA demonstrating and investigating the issue; however, there is a lack of literature addressing this topic in the Australian setting. The aim of this study is to review prescribing practices at an Australian tertiary referral hospital on discharge in patients having undergone laparoscopic cholecystectomy (LC) or laparoscopic appendicetomy (LA). Additionally, to identify potential factors which influence medical officer prescribing practices. METHODS: A retrospective observational study on opioid prescribing practice on all patients who underwent LC or LA over a 12-month period at an Australian tertiary referral hospital. RESULTS: A total of 435 patients (223 LC, 214 LA) were prescribed a mean opioid dose on discharge of 25 oral morphine milli-equivalents (range 0-180 morphine milli-equivalents). Less opioids were prescribed following elective procedures (42% versus 10%, P < 0.001). There is a downward trend of opioid prescribing on discharge as the Junior Medical Officer clinical year progresses (P < 0.001). CONCLUSIONS: This study demonstrates a lower rate of opiate prescription on discharge for LC and LA in an Australian setting when compared to the US data. There is a wide diversity of prescribing demonstrated. This indicates the need for better training of opioid prescribers to reduce over-prescribing.
Assuntos
Analgésicos Opioides , Dor Pós-Operatória , Alta do Paciente , Padrões de Prática Médica , Assistência ao Convalescente , Analgésicos Opioides/uso terapêutico , Apendicectomia , Austrália/epidemiologia , Colecistectomia Laparoscópica , Prescrições de Medicamentos , Humanos , Laparoscopia , Dor Pós-Operatória/tratamento farmacológico , Dor Pós-Operatória/epidemiologiaRESUMO
The floatability of water on oil surface was studied. A numerical model was developed from the Young-Laplace equation on three interfaces (water/oil, water/air, and oil/air) to predict the theoretical equilibration conditions. The model was verified successfully with an oil/water system. The stability of the floating droplet depends on the combination of three interface tensions, oil density, and water droplet volume. For practical purposes, however, the equilibrium contact angle has to be greater than 5° so the water droplet can effectively float. This result has significant applications for biodegrading oil wastes.