Burnout, psychosomatic symptoms and job satisfaction among Dutch nurse anaesthetists: a survey.

BACKGROUND: To meet the increasing demand for healthcare providers, it is crucial to recruit and retain more nurse anaesthetists (NAs). The majority of NAs in the Netherlands are >45 years old, and retaining them in their jobs is very important. This study investigates the relationships among burnout, physical health and job satisfaction among Dutch NAs. METHODS: Two thousand NAs working in Dutch hospitals were invited to participate in this online questionnaire. We tested the relationships among burnout, psychosomatic symptoms, sickness absence, perceived general health and job satisfaction. RESULTS: Nine hundred and twenty-three questionnaires were completed and analysed (46% response rate). Burnout and psychosomatic symptoms were negatively associated with job satisfaction, and predicted 27% of job satisfaction. Perceived general health was positively and sickness absence was negatively related to job satisfaction. Older NAs had a higher incidence of burnout than their younger counterparts. CONCLUSIONS: The results confirmed the importance of a healthy psychosocial work environment for promoting job satisfaction. To prevent burnout, further research is necessary to determine the factors causing stress. These findings may also apply to anaesthesiologists who share many tasks and work in close cooperation with NAs.

Nanosecond switching of fiber Bragg gratings.

A FBG was written in a two-hole fiber with internal alloy electrodes. Nanosecond high current pulses cause metal expansion, increase birefringence and tune the gratings with a response time of 29 ns. This short length, low loss, all-spliced high-speed wavelength switching devices described here has potential use in Q-switching fiber laser.

[The role of non-invasive positive pressure ventilation in lung volume reduction surgery of pulmonary emphysema--a survey of German hospitals]. / Die Rolle der intermittierenden Selbstbeatmung bei Volumenreduktionschirurgie des Lungenemphysems.

BACKGROUND: Since the first publication by Cooper et. al. in 1994 of lung volume reduction surgery (LVRS) of emphysema a marked respiratory failure with hyperkapnia (PaCO2 > 55 Torr) has been regarded as an exclusion criterion for LVRS. PATIENTS AND METHOD: In a survey in German hospitals the question was asked whether non-invasive nasal ventilation (NIPPV) has a role in the management of LVRS. Of 12 hospitals 6 had experience with NIPPV and LVRS in a total of 19 patients with a mean FEV1 of 0.64 +/- 0.101. RESULTS: LVRS improved FEV1 by 0.20 +/- 0.181. Preoperative NIPPV was short (< 6 months) in 8 patients and resulted in improvement of physical condition and getting the patient used to NIPPV for better perioperative management. In 5 cases NIPPV was used on a long-term basis in order to allow the patient to be included in the LVRS program. In fact 7 of these 13 patients needed ventilation perioperatively, and 4 had to continue long-term NIPPV after surgery. In further 3 patients NIPPV was applied only perioperatively. One patient had to resume NIPPV after 15 months. Two patients started NIPPV 1 resp. 12 months after surgery. Two patients had bronchial cancer which was resected. Four patients died: 1 perioperatively after intubation, 2 after 3 resp. 13 months due to respiratory failure, 1 for cancer relapse after 20 months. CONCLUSION: NIPPV may be helpful in the planning and management of LVRS in patients with ventilatory failure with hypercarbia.

[Hard metal-induced lung changes. Hard metal asthma--interstitial hard metal pneumopathy]. / Hartmetallinduzierte Lungenveränderungen. Hartmetallasthma--interstitielle Hartmetallpneumopathie.

Hard metal pneumopathy and hard metal asthma are two separate forms of hard metal lung disease. Cobalt is the probable causal agent involved. Bronchial provocation with hard metal powder induces obstruction within 2 hours of the challenge. Suspected hard metal pneumopathy, however, should be confirmed or excluded by a period of non-exposure followed by re-exposure, since the long-term exposure in patients suffering from hard-metal pneumopathy leads to pulmonary fibrosis.

The neuromuscular blocking effect of Org 9426. A new intermediately-acting steroidal non-depolarising muscle relaxant in man.

Org 9426, a new steroidal non-depolarising muscle relaxant, which is stable in solution, was studied in 30 anaesthetised (thiopentone, fentanyl, nitrous oxide) male patients, ASA 1 or 2. A dose-response curve for Org 9426 was constructed and the ED90, mean (SD), was found to be 0.36 (0.031) mg/kg. The onset of action was 3.8 (1.8) minutes, the clinical duration 17.4 (3.2) minutes, the total duration of action 31.9 (6.2) minutes and the recovery time 9.96 (3.2) minutes. No signs of histamine release or cardiovascular effects were observed. Org 9426 thus has a faster onset of action than vecuronium bromide or atracurium dibesylate.

Domperidone in the treatment of postoperative vomiting: a double-blind multicenter study.

Domperidone was compared with placebo in a multicenter double-blind study of 116 patients (15 to 80 years) with postoperative vomiting. After vomiting had occurred, the patients received either domperidone 10 mg or placebo IV. Patients were then followed for at least 6 hours or until a 2nd injection of domperidone 10 mg from an open supply was needed. The period of time until an additional injection was registered and compared between the 2 treatment groups. Fifty-nine percent of the placebo patients needed a 2nd injection before the end of the 6-hour follow-up, compared with only 35% of the domperidone patients (p less than 0.05). When a 2nd injection was required, the time elapsed before it was needed was longer (p = 0.01) in the domperidone group (median 150 minutes) than in the placebo one (median 120 minutes). There were no significant side-effects.