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Anaesthesia

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https://www.readbyqxmd.com/read/29105078/a-systematic-review-of-the-incidence-of-and-risk-factors-for-postoperative-atrial-fibrillation-following-general-surgery
#1
REVIEW
R Chebbout, E G Heywood, T M Drake, J R L Wild, J Lee, M Wilson, M J Lee
Atrial fibrillation is a common cardiac arrhythmia and can occur de novo following a surgical procedure. It is associated with increased inpatient and long-term mortality. There is limited evidence concerning new-onset atrial fibrillation following abdominal surgery. This study aimed to identify the prevalence of and risk factors for postoperative atrial fibrillation in the general surgical population. A systematic search of the Embase, MEDLINE and Cochrane (CENTRAL) databases was conducted. Studies were included in the review if they reported cases of new-onset atrial fibrillation within 30 days of the index operation...
November 4, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29098683/effect-of-sufentanil-on-bispectral-index-in-the-elderly
#2
T de Valence, N Elia, C Czarnetzki, L Dumont, M R Tramèr, C Lysakowski
We examined the impact of adding sufentanil during anaesthesia induction with propofol on bispectral index values in elderly patients (≥ 65 years). Patients were randomly assigned to receive a target-controlled sufentanil infusion (effect-site concentration of 0.3 ng.ml(-1) ) or matching placebo, followed by a target-controlled propofol induction (initial effect-site concentration of 0.5 μg.ml(-1) ; step-wise increase of 0.5 μg.ml(-1) ) until loss of consciousness defined as an Observer's Assessment of Alertness/Sedation score < 2...
November 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29094752/consequences-of-proceeding-with-surgery-after-resuscitation-from-intra-operative-anaphylaxis
#3
P H M Sadleir, R C Clarke, B Bozic, P R Platt
Intra-operative acute hypersensitivity reactions require a decision to be made regarding whether to proceed with or abandon the planned surgical procedure once the patient has stabilised. Using retrospective case controls, we examined all cases (223) of proven acute hypersensitivity reactions from 2005 to 2014 in Western Australia, in which the syndrome was recognised by the treating clinician before or during surgery, to determine whether recovery outcomes were adversely affected by proceeding with the planned procedure...
November 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29094751/evaluation-of-a-novel-waste-anaesthetic-gas-scavenger-device-for-use-during-recovery-from-anaesthesia
#4
R Tallent, J Corcoran, J Sebastian
Volatile anaesthetic agents are a potential occupational health hazard to theatre and recovery staff. Operating theatres and anaesthetic rooms are required to be equipped with scavenging systems, but recovery units often are not. We compared exhaled, spectrophotometric sevoflurane and desflurane concentrations 15 cm from the mouth ('patient breathing zone') and 91 cm laterally to the patient ('nurse work zone') in 120 patients after tracheal extubation who were consecutively allocated to either ISO-Gard mask oxygen/scavenging or standard oxygen mask, 0 min, 10 min and 20 min after arrival in the theatre recovery unit...
November 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29094750/when-rain-stops-play-a-duckworth-lewis-method-for-surgical-operating-list-productivity
#5
A Tavare, J J Pandit
No abstract text is available yet for this article.
November 2, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29090735/learning-from-the-law-a-review-of-21%C3%A2-years-of-litigation-for-pain-during-caesarean-section
#6
K McCombe, D G Bogod
The large majority of caesarean sections in the UK are now carried out under neuraxial anaesthesia. Although this technique is widely accepted as being the safest option in most circumstances, the use of regional anaesthesia increases the risk of patients experiencing intra-operative discomfort or pain. Pain during operative obstetric delivery is the commonest successful negligence claim relating to regional anaesthesia against obstetric anaesthetists in the UK. In the following article, using a database of over 360 cases spanning 21 years, we break down and examine the recurrent components of medicolegal claims concerning pain during caesarean section and consider how anaesthetists might avoid litigation...
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29090733/international-consensus-statement-on-the-management-of-hypotension-with-vasopressors-during-caesarean-section-under-spinal-anaesthesia
#7
LETTER
S M Kinsella, B Carvalho, R A Dyer, R Fernando, N McDonnell, F J Mercier, A Palanisamy, A T H Sia, M Van de Velde, A Vercueil
No abstract text is available yet for this article.
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29090732/management-of-hypotension-with-vasopressors-at-caesarean-section-under-spinal-anaesthesia-have-we-found-the-holy-grail-of-obstetric-anaesthesia
#8
EDITORIAL
J P Campbell, G M Stocks
No abstract text is available yet for this article.
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29090731/human-cadavers-preserved-using-thiel-s-method-for-the-teaching-of-fibreoptically-guided-intubation-of-the-trachea-a-laboratory-investigation
#9
C J László, Z Szűcs, Á Nemeskéri, G Baksa, A Szuák, M Varga, E Tassonyi
We assessed the suitability of human cadavers preserved using Thiel's method for teaching flexible fibreoptic tracheal intubation. Thirty-one anaesthetists unacquainted with this technique received didactic teaching followed by handling of the fibrescope on the Oxford teaching box. They then carried out fibreoptic intubations in two cadavers to establish a baseline sample of their intubation skills. Thereafter, we randomly assigned the trainees to two groups to practice fibreoptic intubation either on two distinct cadavers or on two airway manikins...
November 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29086911/maternal-cardiac-output-response-to-colloid-preload-and-vasopressor-therapy-during-spinal-anaesthesia-for-caesarean-section-in-patients-with-severe-pre-eclampsia-a-randomised-controlled-trial
#10
R A Dyer, A Daniels, A Vorster, A Emmanuel, M J Arcache, S Schulein, A R Reed, C J Lombard, M F James, D van Dyk
We examined the haemodynamic effects of colloid preload, and phenylephrine and ephedrine administered for spinal hypotension, during caesarean section in 42 women with severe early onset pre-eclampsia. Twenty patients with pre-delivery spinal hypotension were randomly allocated to receive an initial dose of either 50 μg phenylephrine or 7.5 mg ephedrine; the primary outcome was percentage change in cardiac index. After a 300-ml colloid preload, mean (SD) cardiac index increased from 4.9 (1.1) to 5.6 (1.2) l...
October 31, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29057452/is-unconsciousness-simply-the-reverse-of-consciousness
#11
EDITORIAL
F Engbers
No abstract text is available yet for this article.
October 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29052225/peripheral-nerve-block-in-ankle-fracture-surgery-a-qualitative-study-of-patients-experiences
#12
M J Henningsen, R Sort, A M Møller, S F Herling
Peripheral nerve blocks are popular as a mode of anaesthesia for limb surgery and their beneficial effects are well documented in elective surgery. However, concerns have been raised about potential rebound pain outweighing the benefits in acute ankle fracture surgery. Furthermore, pain scores and morphine consumption do not provide a full picture, as pain is subjective. To evaluate the clinical usefulness of peripheral nerve blocks, we explored patients' expectations and experiences by means of semi-structured interviews analysed with systematic text condensation...
October 19, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29044483/hyperbaric-vs-isobaric-bupivacaine-for-spinal-anaesthesia-for-elective-caesarean-section-a-cochrane-systematic-review
#13
REVIEW
B L Sng, N L R Han, W L Leong, R Sultana, F J Siddiqui, P N Assam, E S Chan, K H Tan, A T Sia
Both isobaric and hyperbaric bupivacaine have been used for spinal anaesthesia for elective caesarean section, but it is not clear if one is better than the other. The primary objective of this systematic review was to determine the effectiveness and safety of hyperbaric bupivacaine compared with isobaric bupivacaine administered during spinal anaesthesia for elective caesarean section. We included 10 studies with 614 subjects in the analysis. There was no evidence of differences either in the risk of conversion to general anaesthesia, with a relative risk (95%CI) of 0...
October 17, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29034449/nitrous-oxide-based-vs-nitrous-oxide-free-general-anaesthesia-and-accidental-awareness-in-surgical-patients-an-abridged-cochrane-systematic-review
#14
REVIEW
J Hounsome, J Greenhalgh, O J Schofield-Robinson, S R Lewis, T M Cook, A F Smith
Accidental awareness during general anaesthesia can arise from a failure to deliver sufficient anaesthetic agent, or from a patient's resistance to an expected sufficient dose of such an agent. Awareness is 'explicit' if the patient is subsequently able to recall the event. We conducted a systematic review into the effect of nitrous oxide used as part of a general anaesthetic on the risk of accidental awareness in people over the age of five years undergoing general anaesthesia for surgery. We included 15 randomised controlled trials, 14 of which, representing a total of 3439 participants, were included in our primary analysis of the frequency of accidental awareness events...
October 16, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28990161/real-time-ultrasound-guided-axillary-vein-cannulation-in-children-a-randomised-controlled-trial
#15
E-H Kim, J-H Lee, I-K Song, H-S Kim, Y-E Jang, S-N Choi, J-T Kim
The axillary vein is a good site for ultrasound-guided central venous cannulation in terms of infection rate, patient comfort and its anatomical relationship with the clavicle and lungs. We compared real-time ultrasound-guided axillary vein cannulation with conventional infraclavicular landmark-guided subclavian vein cannulation in children. A total of 132 paediatric patients were randomly allocated to either ultrasound-guided axillary vein (axillary group) or landmark-guided subclavian vein (landmark group)...
October 9, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28986931/can-point-of-care-ultrasound-predict-spinal-hypotension-during-caesarean-section-a-prospective-observational-study
#16
L Zieleskiewicz, A Noel, G Duclos, M Haddam, A Delmas, C Bechis, A Loundou, J Blanc, A Mignon, L Bouvet, S Einav, A Bourgoin, M Leone
Spinal anaesthesia for elective caesarean section is associated with maternal hypotension, secondary to alteration of sympathetic tone and hypovolemia, in up to 70% of cases. Measurement of the subaortic variation in the velocity time integral (VTI) after passive leg raising allows prediction of fluid responsiveness. Our objective, in this prospective single-centre observational study, was to assess the ability of change in VTI after 45° passive leg raising to predict hypotension after spinal anaesthesia. Ultrasound measurements were performed just before elective caesarean section...
October 7, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28983903/dynamic-ultrasound-guided-short-axis-needle-tip-navigation-technique-vs-landmark-technique-for-difficult-saphenous-vein-access-in-children-a-randomised-study
#17
S Hanada, M T Van Winkle, S Subramani, K Ueda
Dynamic ultrasound-guided short-axis needle tip navigation is a novel technique for vascular access. After venipuncture, the needle and catheter are further advanced within the vessel lumen under real-time ultrasound guidance with constant visualisation of the needle tip in the short-axis view. This can minimise the risk of transfixing the cannulated vessel. We compared two techniques for non-visible saphenous vein cannulation under general anaesthesia in children weighing ≥ 3 kg and less than four years of age: dynamic ultrasound-guided short-axis needle tip navigation technique (ultrasound group) vs...
October 6, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28983910/-your-lack-of-planning-does-not-constitute-my-emergency-caring-for-obstetric-patients-with-mental-illness
#18
EDITORIAL
K McCombe
No abstract text is available yet for this article.
October 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28983904/pre-operative-variables-including-fitness-associated-with-complications-after-oesophagectomy
#19
R C F Sinclair, A W Phillips, M Navidi, S M Griffin, C P Snowden
Oesophagectomy is a technically-demanding operation associated with a high level of morbidity. We analysed the association of pre-operative variables, including those from cardiopulmonary exercise testing, with complications (logistic regression) and survival and length of stay (Cox regression) after scheduled transthoracic oesophagectomy in 273 adults, in isolation and on multivariate testing (maximum Akaike information criterion). On multivariate analysis, any postoperative complication was associated with ventilatory equivalents for carbon dioxide, odds ratio (95%CI) 1...
October 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28975605/whose-fault-are-wrong-predictions-the-clinician-the-patient-or-the-pigeon
#20
EDITORIAL
J B Carlisle
No abstract text is available yet for this article.
October 4, 2017: Anaesthesia
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