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Anaesthesia

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https://www.readbyqxmd.com/read/30184254/volume-of-ropivacaine-0-2-and-common-peroneal-nerve-block-duration-a-randomised-double-blind-cohort-trial-in-healthy-volunteers
#1
C B Christiansen, M H Madsen, C Rothe, A M Andreasen, L H Lundstrøm, K H W Lange
The volume-duration relationship using low concentrations of ropivacaine for peripheral nerve blocks is unknown, even though low concentrations of ropivacaine are increasingly used clinically. We investigated the effect of ropivacaine 0.2% on common peroneal nerve block duration. With ethical committee approval, 60 consenting, healthy volunteers were randomly allocated to receive one of five volumes of ropivacaine 0.2% (2.5, 5.0, 10, 15 or 20 ml) administered by ultrasound-guided, catheter-based injection (at 10 ml...
September 5, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30184242/characteristics-of-children-aged-2-17-years-undergoing-anaesthesia-in-danish-hospitals-2005-2015-a-national-observational-study
#2
C Strøm, L H Lundstrøm, A Afshari, N Lohse
Provision of paediatric anaesthesia requires careful consideration of the child's cognitive state, unique body composition and physiology. In an observational cohort study, we describe the population characteristics and conduct of anaesthesia in children aged 2-17 years from 1 January 2005 to 31 December 2015. Children were identified from the Danish Anaesthesia Database. We recorded the following variables: age; sex; comorbidities; indications for anaesthesia; practice of anaesthesia; and complications. Results are presented for two age groups: 2-5 and 6-17 years...
September 5, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30168596/echocardiographic-determination-of-resting-haemodynamics-and-optimal-positioning-in-term-pregnant-women
#3
A T Dennis, A Buckley, T Mahendrayogam, J M Castro, L Leeton
Optimal positioning for anaesthesia in pregnant women involves balancing the need for ideal tracheal intubation conditions (achieved by the head elevated ramped position), with the prevention of reduced cardiac output from aortocaval compression (achieved by left lateral pelvic tilt). No studies have examined the effect on cardiac output of left lateral pelvic tilt in the ramped position. We studied non-labouring, non-anaesthetised healthy term pregnant women who underwent baseline (left lateral decubitus) cardiac assessment using transthoracic echocardiography...
August 31, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30152035/a-foundation-programme-educational-placement-in-peri-operative-medicine-for-older-people-mixed-methods-evaluation
#4
A Rogerson, J S L Partridge, J K Dhesi
We established an innovative Foundation placement in peri-operative medicine for older patients in response to the need for training in 'whole patient' medicine and the challenge of fewer Foundation doctors in acute surgical roles. The placement and underpinning curriculum were co-designed with junior doctors and other clinical stakeholders. This resulted in a modular design offering acute and community experience and dedicated quality improvement project time. To evaluate the placement we used a mixed methods study based on Kirkpatrick's model of workplace learning...
August 27, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30151989/the-association-of-time-of-emergency-surgery-day-evening-or-night-with-postoperative-30-day-hospital-mortality
#5
M J Tessler, L Charland, N N Wang, J A Correa
It is unclear whether the time of day for emergency surgery is associated with postoperative mortality. We assessed this association in 9319 patients who had emergency surgery as their first surgery at the Jewish General Hospital, Montreal, QC, Canada from April 2010 to March 2015. Of the 7362 (80%) patients with complete data, 168 (2.3%) died within 30 postoperative days. There was no significant association of time of day with postoperative mortality, with adjusted OR (95%CI) of 1.61 (0.96-2.72) for night vs...
August 27, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30151823/effect-of-a-single-pre-operative-125-mg-dose-of-methylprednisolone-on-postoperative-delirium-in-hip-fracture-patients-a-randomised-double-blind-placebo-controlled-trial
#6
C G Clemmesen, T H Lunn, M T Kristensen, H Palm, N B Foss
Postoperative delirium is common after hip fracture surgery, and may have a neuro-inflammatory cause. We conducted a single-centre, randomised, double-blind, placebo-controlled trial of 117 older hip fracture patients to see if a single, pre-operative intravenous dose of 125 mg methylprednisolone could reduce the severity and/or incidence of postoperative delirium, assessed using the Confusion Assessment Method delirium severity score. Modified intention-to-treat analysis found no significant difference in our primary outcome, median (IQR [range]) cumulative Confusion Assessment Method delirium severity score over the first three postoperative days between the methylprednisolone and placebo groups (1 (0-6 [0-39]) vs...
August 27, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30144024/an-analysis-of-retractions-of-papers-authored-by-scott-reuben-joachim-boldt-and-yoshitaka-fujii
#7
U M McHugh, S M Yentis
We analysed how long it has taken for papers authored by Scott Reuben, Joachim Boldt and Yoshitaka Fujii to be retracted: investigations into these three anaesthetists have shown much of their research to be unethical or fraudulent. To date, 94% of their combined papers requiring retraction have been retracted; however, only 85% of the retraction notices were compliant with guidelines produced by the Committee on Publication Ethics. We contacted the Editors-in-Chief and/or publishers of all the journals containing articles that had been identified as requiring retraction but had not yet been retracted...
August 24, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30133695/the-effect-of-rate-of-injection-on-injection-pressure-profiles-measured-using-in-line-and-needle-tip-sensors-an-in-vitro-study
#8
A Saporito, C Quadri, N Kloth, X Capdevila
Alongside ultrasonic visualisation, measurement of injection pressure is an effective tool for reducing the risk of intraneural injection during peripheral nerve block. The aim of this study was to compare injection pressure profiles when measured along the injection line with the pressure measured directly at the needle tip using different rates of injection. A syringe pump delivered a 5-ml injection of saline into silicone gel at three different speeds (5 ml.min-1 , 10 ml.min-1 and 15 ml.min-1 ). Fibreoptic pressure sensors recorded real-time pressure profiles of the injection pressure directly at the needle tip and along the injection line...
August 22, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30112809/paediatric-intensive-care-and-neonatal-intensive-care-airway-management-in-the-united-kingdom-the-pic-nic-survey
#9
K E Foy, E Mew, T M Cook, J Bower, P Knight, S Dean, K Herneman, B Marden, F E Kelly
In 2011, the Fourth National Audit Project (NAP4) reported high rates of airway complications in adult intensive care units (ICUs), including death or brain injury, and recommended preparation for airway difficulty, immediately available difficult airway equipment and routine use of waveform capnography monitoring. More than 80% of UK adult intensive care units have subsequently changed practice. Undetected oesophageal intubation has recently been listed as a 'Never Event' in UK practice, with capnography mandated...
August 15, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30088269/the-use-of-charcoal-filters-in-malignant-hyperthermia-have-they-found-their-place
#10
EDITORIAL
J G Bilmen, P M Hopkins
No abstract text is available yet for this article.
August 8, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30084238/an-innovative-collaborative-interdisciplinary-approach-to-new-paediatric-tracheostomy-safety-guidelines
#11
EDITORIAL
R J MacKinnon, M S Volk
No abstract text is available yet for this article.
August 7, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30084176/validation-of-the-cognitive-recovery-assessments-with-the-postoperative-quality-of-recovery-scale-in-patients-with-low-baseline-cognition
#12
A J Bowyer, J Heiberg, D I Sessler, S Newman, A G Royse, C F Royse
Patients with pre-surgery cognitive impairment cannot currently be assessed for cognitive recovery after surgery using the Postoperative Quality of Recovery Scale (PostopQRS), as they would mathematically be scored as recovered. We aimed to validate a novel method to score cognitive recovery in patients with low-baseline cognition, using the number of low-score tests rather than their numerical values. Face validity was demonstrated in 86 participants in whom both the Postoperative Quality of Recovery Scale and an 11-item neuropsychological battery were performed...
August 7, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30084167/postoperative-anaemia-balancing-the-risks-of-anaemia-and-transfusion
#13
EDITORIAL
S P Hatton, A F Smith
No abstract text is available yet for this article.
August 7, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30074240/performance-of-cardiac-output-monitoring-in-the-peri-operative-setting
#14
EDITORIAL
M A Gillies, M R Edwards
No abstract text is available yet for this article.
August 3, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30074237/the-effect-of-haemodynamic-and-peripheral-vascular-variability-on-cardiac-output-monitoring-thermodilution-and-non-invasive-pulse-contour-cardiac-output-during-cardiothoracic-surgery
#15
J Truijen, B E Westerhof, Y-S Kim, W J Stok, B A de Mol, B Preckel, M W Hollmann, J J van Lieshout
While haemodynamic variability interferes with the assumption of constant flow underlying thermodilution cardiac output calculation, variability in (peripheral) arterial vascular physiology may affect pulse contour cardiac output methods. We compared non-invasive finger arterial pressure-derived continuous cardiac output measurements (Nexfin® ) with cardiac output measured using thermodilution during cardiothoracic surgery and determined the impact of cardiovascular variability on either method. We compared cardiac output derived from non-invasive finger arterial pressure with cardiac output measured by thermodilution at four grades (A-D) of cardiovascular variability...
August 3, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30062783/multidisciplinary-guidelines-for-the-management-of-paediatric-tracheostomy-emergencies
#16
LETTER
C Doherty, R Neal, C English, J Cooke, D Atkinson, L Bates, J Moore, S Monks, M Bowler, I A Bruce, N Bateman, M Wyatt, J Russell, R Perkins, B A McGrath
Temporary and permanent tracheostomies are required in children to manage actual or anticipated long-term ventilatory support, to aid secretion management or to manage fixed upper airway obstruction. Tracheostomies may be required from the first few moments of life, with the majority performed in children < 4 years of age. Although similarities with adult tracheostomies are apparent, there are key differences when managing the routine and emergency care of children with tracheostomies. The National Tracheostomy Safety Project identified the need for structured guidelines to aid multidisciplinary clinical decision making during paediatric tracheostomy emergencies...
July 31, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30062700/an-international-consensus-statement-on-the-management-of-postoperative-anaemia-after-major-surgical-procedures
#17
REVIEW
M Muñoz, A G Acheson, E Bisbe, A Butcher, S Gómez-Ramírez, A A Khalafallah, H Kehlet, S Kietaibl, G M Liumbruno, P Meybohm, R Rao Baikady, A Shander, C So-Osman, D R Spahn, A A Klein
Despite numerous guidelines on the management of anaemia in surgical patients, there is no pragmatic guidance for the diagnosis and management of anaemia and iron deficiency in the postoperative period. A number of experienced researchers and clinicians took part in a two-day expert workshop and developed the following consensus statement. After presentation of our own research data and local policies and procedures, appropriate relevant literature was reviewed and discussed. We developed a series of best-practice and evidence-based statements to advise on patient care with respect to anaemia and iron deficiency in the postoperative period...
July 31, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30043507/premedication-in-children-does-taste-matter
#18
EDITORIAL
V M Yuen, C R Bailey
No abstract text is available yet for this article.
July 24, 2018: Anaesthesia
https://www.readbyqxmd.com/read/30019747/the-effect-of-high-flow-nasal-oxygen-on-hospital-length-of-stay-in-cardiac-surgical-patients-at-high-risk-for-respiratory-complications-a-randomised-controlled-trial
#19
V Zochios, T Collier, G Blaudszun, A Butchart, M Earwaker, N Jones, A A Klein
There has been increased interest in the prophylactic and therapeutic use of high-flow nasal oxygen in patients with, or at risk of, non-hypercapnic respiratory failure. There are no randomised trials examining the efficacy of high-flow nasal oxygen in high-risk cardiac surgical patients. We sought to determine whether routine administration of high-flow nasal oxygen, compared with standard oxygen therapy, leads to reduced hospital length of stay after cardiac surgery in patients with pre-existing respiratory disease at high risk for postoperative pulmonary complications...
July 18, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29998563/attempt-xyz-airway-management-at-the-opposite-end-of-the-alphabet
#20
EDITORIAL
N Chrimes, S D Marshall
No abstract text is available yet for this article.
July 11, 2018: Anaesthesia
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