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Anaesthesia

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https://www.readbyqxmd.com/read/29349776/effect-of-palpable-vs-impalpable-cricothyroid-membranes-in-a-simulated-emergency-front-of-neck-access-scenario
#1
C F Pairaudeau, C Mendonca, C Hillermann, I Qazi, P A Baker, R E Hodgson, S Radhakrishna
The Difficult Airway Society 2015 guidelines recommend and describe in detail a surgical cricothyroidotomy technique for the can't intubate, can't oxygenate (CICO) scenario, but this can be technically challenging for anaesthetists with no surgical training. Following a structured training session, 104 anaesthetists took part individually in a simulated can't intubate, can't oxygenate event using simulation and airway models to evaluate how well they could perform these front-of-neck access techniques. Main outcomes measures were: ability to correctly perform the technical steps; procedural time; and success rate...
January 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29349775/the-association-between-borderline-pre-operative-anaemia-in-women-and-outcomes-after-cardiac-surgery-a-cohort-study
#2
G Blaudszun, K E Munting, A Butchart, C Gerrard, A A Klein
Anaemia is common before cardiac surgery and is associated with increased morbidity and mortality. The World Health Organization (WHO) definition of anaemia is lower for women than for men by 10 g.l-1 , potentially putting women at a disadvantage compared with men with regard to pre-operative optimisation. Our hypothesis was that women with borderline anaemia (defined by us as haemoglobin concentration 120-129 g.l-1 ) would have a higher rate of red cell transfusion, morbidity and mortality than non-anaemic women (haemoglobin ≥ 130 g...
January 19, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29345325/a-new-retrograde-transillumination-technique-for-videolaryngoscopic-tracheal-intubation
#3
P Biro, E Fried, M Schlaepfer, M S Kristensen
This single-centre, prospective trial was designed to assess the efficacy of a new retrograde transillumination device called the 'Infrared Red Intubation System' (IRRIS) to aid videolaryngoscopic tracheal intubation. We included 40 adult patients, who were undergoing elective urological surgery under general anaesthesia. We assessed the ability to differentiate the transilluminated glottis from other structures and found a median (IQR [range]) larynx recognition time of 8 (5-14 [3-28]) s. The difference in laryngeal visibility on the screen between the deactivated vs...
January 18, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29330854/combined-spinal-epidural-vs-spinal-anaesthesia-for-caesarean-section-meta-analysis-and-trial-sequential-analysis
#4
REVIEW
M Klimek, R Rossaint, M van de Velde, M Heesen
Combined spinal-epidural and single-shot spinal anaesthesia are both used for caesarean section. It has been claimed in individual trials that combined spinal-epidural is associated with higher sensory spread and greater cardiovascular stability. We set out to gather all available evidence. We performed: a systematic literature search to identify randomised controlled trials comparing combined spinal-epidural with spinal anaesthesia for caesarean section: conventional meta-analysis; trial-sequential analysis; and assessment of trial quality using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29330853/transnasal-humidified-rapid-insufflation-ventilatory-exchange-thrive-vs-facemask-breathing-pre-oxygenation-for-rapid-sequence-induction-in-adults-a-prospective-randomised-non-blinded-clinical-trial
#5
Å Lodenius, J Piehl, A Östlund, J Ullman, M Jonsson Fagerlund
Transnasal humidified rapid-insufflation ventilatory exchange (THRIVE) can prolong apnoea time in adults. Therefore, THRIVE used for pre-oxygenation in rapid sequence induction of anaesthesia could extend safe apnoea time during prolonged laryngoscopy and intubation. In this randomised controlled trial, we compared the lowest peripheral oxygen saturation (SpO2 ) during intubation when pre-oxygenating with either traditional facemask or THRIVE. Eighty adult patients, undergoing rapid sequence induction of anaesthesia for emergency surgery, were randomly allocated to pre-oxygenation with 100% oxygen with facemask or with THRIVE...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29330843/clinical-guideline-and-recommendations-on-pre-operative-exercise-training-in-patients-awaiting-major-non-cardiac-surgery
#6
LETTER
G A Tew, R Ayyash, J Durrand, G R Danjoux
Despite calls for the routine implementation of pre-operative exercise programmes to optimise patient fitness before elective major surgery, there is no practical guidance for providing safe and effective exercise in this specific context. The following clinical guideline was developed following a review of the evidence on the effects of pre-operative exercise interventions. We developed a series of best-practice and, where possible, evidence-based statements to advise on patient care with respect to exercise training in the peri-operative period...
January 13, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327465/has-analgesia-changed-for-lung-resection-surgery
#7
EDITORIAL
H L Short, K Kamalanathan
No abstract text is available yet for this article.
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327462/propensity-score-matched-outcomes-after-thoracic-epidural-or-paravertebral-analgesia-for-thoracotomy
#8
W J Blackshaw, A Bhawnani, S H Pennefather, O Al-Rawi, S Agarwal, M Shaw
It is not known which regional analgesic technique is most effective or safest after open lung resection. We retrospectively examined outcomes in 828 patients who received thoracic epidural analgesia and 791 patients who received paravertebral block after lung resection between 2008 and 2012. We analysed outcomes for 648 patients, 324 who had each analgesic technique, matched by propensity scores generated with peri-operative data. There were 22 out of 324 (7%) postoperative respiratory complications after thoracic epidural and 23 out of 324 (7%) after paravertebral block, p = 0...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29327341/combined-thoracic-paravertebral-and-pectoral-nerve-blocks-for-breast-surgery-under-sedation-a-prospective-observational-case-series
#9
A Pawa, J Wight, D N Onwochei, R Vargulescu, I Reed, L Chrisman, E Pushpanathan, A Kothari, K El-Boghdadly
Avoidance of general anaesthesia for breast surgery may be because of clinical reasons or patient choice. There is emerging evidence that the use of regional anaesthesia and the avoidance of volatile anaesthetics and opioid analgesia may have beneficial effects on oncological outcomes. We conducted a prospective observational case series of 16 breast cancer surgeries performed under thoracic paravertebral plus pectoral nerve block with propofol sedation to demonstrate feasibility of technique, patient acceptability and surgeon satisfaction...
January 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29322504/a-randomised-controlled-trial-comparing-needle-movements-during-combined-spinal-epidural-anaesthesia-with-and-without-ultrasound-assistance
#10
A Chin, B Crooke, L Heywood, R Brijball, A M Pelecanos, W Abeypala
Ultrasound assistance for neuraxial techniques may improve technical performance; however, it is unclear which populations benefit most. Our study aimed to investigate the efficacy of neuraxial ultrasound in women having caesarean section with combined spinal-epidural anaesthesia, and to identify factors associated with improved technical performance. Two-hundred and eighteen women were randomly allocated to ultrasound-assisted or control groups. All the women had a pre-procedure ultrasound, but only women in the ultrasound group had this information conveyed to the anaesthetist...
January 10, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29322502/systematic-review-of-benefits-or-harms-of-routine-anaesthetist-inserted-throat-packs-in-adults-practice-recommendations-for-inserting-and-counting-throat-packs-an-evidence-based-consensus-statement-by-the-difficult-airway-society-das-the-british-association
#11
REVIEW
V Athanassoglou, A Patel, B McGuire, A Higgs, M S Dover, P A Brennan, A Banerjee, B Bingham, J J Pandit
Throat packs are commonly inserted by anaesthetists after induction of anaesthesia for dental, maxillofacial, nasal or upper airway surgery. However, the evidence supporting this practice as routine is unclear, especially in the light of accidentally retained throat packs which constitute 'Never Events' as defined by NHS England. On behalf of three relevant national organisations, we therefore conducted a systematic review and literature search to assess the evidence base for benefit, and also the extent and severity of complications associated with throat pack use...
January 10, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29322492/have-we-reached-the-end-for-throat-packs-inserted-by-anaesthetists
#12
EDITORIAL
C R Bailey, R Nouraie, J M Huitink
No abstract text is available yet for this article.
January 10, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29315473/a-before-and-after-observational-study-of-a-protocol-for-use-of-the-c-mac-videolaryngoscope-with-a-frova-introducer-in-pre-hospital-rapid-sequence-intubation
#13
S Ångerman, H Kirves, J Nurmi
Results using videolaryngoscopy in pre-hospital rapid sequence intubation are mixed. A bougie is not commonly used with videolaryngoscopy. We hypothesised that using videolaryngoscopy and a bougie as core elements of a standardised protocol that includes a drugs and a laryngoscopy algorithm would result in a high first-pass tracheal intubation success rate. We employed videolaryngoscopy (C-MAC) combined with a bougie (Frova intubating introducer) in an anaesthetist-staffed helicopter emergency medical service...
January 8, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29315471/big-data-big-problems-causation-confounders-and-cohorts
#14
S W Choi, G T C Wong
No abstract text is available yet for this article.
January 8, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29315467/a-systematic-review-of-outcomes-in-postoperative-pain-studies-in-paediatric-and-adolescent-patients-towards-development-of-a-core-outcome-set
#15
REVIEW
A Ross, J Young, R Hedin, G Aran, A Demand, A Stafford, J Worley, M Moore, M Vassar
Systematic reviews of postoperative pain in children have called into question the consistency of outcomes measured by clinical triallists as well as the measurement instruments used for assessment. Core outcome set methodology may be a solution to improve standardisation. This study provides an evidence-based foundation for the development of a core outcome set for paediatric postoperative pain studies. We searched ClinicalTrials.gov to identify relevant postoperative pain studies in children. The search yielded 300 registered trials...
January 8, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29292500/prospective-clinical-trial-registration-not-sufficient-but-always-necessary
#16
EDITORIAL
S M Smith, R H Dworkin
No abstract text is available yet for this article.
January 2, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29292508/journal-response-prospective-clinical-trial-registration-desirable-but-not-necessary
#17
EDITORIAL
J J Pandit, A A Klein
No abstract text is available yet for this article.
January 1, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29292498/adherence-to-guidance-on-registration-of-randomised-controlled-trials-published-in-anaesthesia
#18
K El-Boghdadly, M D Wiles, S Atton, C R Bailey
The International Committee of Medical Journal Editors recommends the prospective registration of interventional clinical trials. We aimed to assess the compliance with these guidelines for manuscripts submitted to and published by a single anaesthetic journal. We examined the rates of prospective trial registration, the incidence of discrepancies in primary outcome measure(s) and sample sizes, and the citation metrics of all randomised controlled trials published in Anaesthesia over a 3-year period (2014-2016)...
January 1, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29280475/the-comparative-efficacy-and-safety-of-sugammadex-and-neostigmine-in-reversing-neuromuscular-blockade-in-adults-a-cochrane-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#19
REVIEW
A-M Hristovska, P Duch, M Allingstrup, A Afshari
We compared the efficacy and safety of sugammadex and neostigmine in reversing neuromuscular blockade in adults. Our outcomes were: recovery time from second twitch to train-of-four ratio > 0.9; recovery time from post-tetanic count 1-5 to train-of-four ratio > 0.9; and risk of composite adverse and serious adverse events. We searched for randomised clinical trials irrespective of publication status and date, blinding status, outcomes reported or language. We included 41 studies with 4206 participants...
December 27, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29280144/working-out-wrong-side-blocks
#20
EDITORIAL
I K Moppett, S T Shorrock
No abstract text is available yet for this article.
December 27, 2017: Anaesthesia
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