Publications (3)8.47 Total impact
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ABSTRACT: Anesthesiology is technically complex, caring for sicker patients with growing production pressure on clinicians. Wellbeing and a balanced lifestyle to prevent clinician burnout and improve patient safety have been increasingly recognized. This study assesses burnout and coping strategies in anesthesiologists in a metropolitan area of the Northeastern US. An anonymous online questionnaire including the Maslach Burnout Inventory and assessment of coping strategies was distributed via email to Boston area anesthesiologists. Correlations between burnout, demographic variables, and coping strategies were examined. Of 57 respondents to the survey, moderate to high degrees of burnout were found (61.4% emotional exhaustion, 31.6% depersonalization, 64.9% low personal achievement) and associated with avoidant and emotion-focused coping behaviors. Significant relationships existed between burnout and demographics including age, number of years in practice, perceived workload, and academic versus private practice. Burnout by anesthesiologists in this study is mainly characterized by emotional exhaustion and low personal achievement. An association with severe workload, young age, and moderate number of years in practice (5-15 years) was found. Positive coping strategies which involved planning and reassessment of stressors as a source of personal growth were utilized by older, more experienced and less burned out anesthesiologists.Middle East journal of anaesthesiology 02/2012; 21(4):529-34.
Article: Reply from the authors.BJA British Journal of Anaesthesia 10/2011; 107(4):638-9. · 4.24 Impact Factor
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ABSTRACT: Paracetamol is the most commonly prescribed analgesic for the treatment of acute pain. The efficacy and safety of i.v. formulations of paracetamol is unclear. We performed a systematic search (multiple databases, bibliographies, any language, to May 2010) for single-dose, randomized, controlled clinical trials of propacetamol or i.v. paracetamol for acute postoperative pain in adults or children. Thirty-six studies involving 3896 patients were included. For the primary outcome, 37% of patients (240/367) receiving propacetamol or i.v. paracetamol experienced at least 50% pain relief over 4 h compared with 16% (68/527) receiving placebo (number needed to treat=4.0; 95% confidence interval, 3.5-4.8). The proportion of patients in propacetamol or i.v. paracetamol groups experiencing at least 50% pain relief diminished over 6 h. Patients receiving propacetamol or paracetamol required 30% less opioid over 4 h and 16% less opioid over 6 h than those receiving placebo. However, this did not translate to a reduction in opioid-induced adverse events (AEs). Similar comparisons between propacetamol or i.v. paracetamol and active comparators were either not statistically significant, not clinically significant, or both. AEs occurred at similar rates with propacetamol or i.v. paracetamol and placebo. However, pain on infusion occurred more frequently in those receiving propacetamol compared with placebo (23% vs 1%). A single dose of either propacetamol or i.v. paracetamol provides around 4 h of effective analgesia for about 37% of patients with acute postoperative pain. Both formulations are associated with few AEs, although patients receiving propacetamol have a higher incidence of pain on infusion.BJA British Journal of Anaesthesia 06/2011; 106(6):764-75. · 4.24 Impact Factor