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Anaesthesia

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https://www.readbyqxmd.com/read/28805242/size-matters
#1
S W Choi, D M H Lam
No abstract text is available yet for this article.
August 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28805239/a-comparison-of-gastric-emptying-of-soluble-solid-meals-and-clear-fluids-matched-for-volume-and-energy-content-a-pilot-crossover-study
#2
T Okabe, H Terashima, A Sakamoto
We previously demonstrated that the gastric emptying time of different liquids with the same volume mainly depended on their energy content, regardless of differences in composition. In this crossover study, we investigated whether the same applies when soluble solid foods are ingested with water. Ten healthy volunteers ingested one of five test diets consisting of two test meals (Calorie Mate(®) 100 and 200 kcal) and three test solutions (water and glucose solutions of 100 and 200 kcal), each given in a volume of 400 ml, and then underwent ultrasonography to measure the gastric antral cross-sectional area every 10 min for 120 min...
August 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28805238/ultrasound-assessment-of-gastric-contents-in-children-undergoing-elective-ear-nose-and-throat-surgery-a-prospective-cohort-study
#3
F-P Desgranges, A-C Gagey Riegel, C Aubergy, M de Queiroz Siqueira, D Chassard, L Bouvet
Ultrasound examination of the gastric antrum allows reliable assessment of gastric contents and volume. Postoperative assessment of gastric contents before recovery from anaesthesia could help the physician to choose the most appropriate extubation technique after surgery in children. In this prospective observational study, we assessed whether significant changes occurred in gastric contents during the intra-operative period in children undergoing elective ear, nose and throat (ENT) surgery. Children aged between six months and 16 years were recruited consecutively...
August 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28771680/safety-and-efficacy-of-rescue-flexible-bronchoscopic-intubation-using-the-bentson-floppy-tip-guidewire-via-a-supraglottic-airway-in-critically-ill-children
#4
D Cross, A Nyman, P James, A Durward
Difficulty in tracheal intubation in paediatric intensive care patients is associated with increased morbidity and mortality. Delays to intubation and interruption to oxygenation and ventilation are poorly tolerated. We developed a safe and atraumatic tracheal intubation technique. A floppy-tipped guidewire and airway exchange catheter were placed to a pre-determined length under bronchoscopic guidance while oxygenation and ventilation was maintained via a supraglottic airway device (SAD). We performed a retrospective review of this technique on patients who were either known to have or who had an unexpected difficultly in intubation...
August 3, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28762464/the-mid-point-transverse-process-to-pleura-mtp-block-a-new-end-point-for-thoracic-paravertebral-block
#5
I Costache, L de Neumann, C J Ramnanan, S L Goodwin, A Pawa, F W Abdallah, C J L McCartney
Current descriptions of thoracic paravertebral block techniques require the needle tip to be anterior to the superior costotransverse ligament. We hypothesised that an injection point midway between the posterior border of the transverse process and the pleura would result in spread to the paravertebral space. We completed bilateral injections of 5 ml methylene blue 0.2% midway between the posterior border of the transverse process and the pleura at T2, T4, T6, T8 and T10 in three unembalmed cadavers. The presence of methylene blue dye at the nerve root in the paravertebral space, the corresponding intercostal nerve and sympathetic chain at the level of injection, and at additional levels, was examined...
August 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28758187/differences-between-patients-and-clinicians-research-priorities-from-the-anaesthesia-and-peri-operative-care-priority-setting-partnership
#6
O Boney, M H Nathanson, M P W Grocott, L Metcalf
The James Lind Alliance Anaesthesia and Peri-operative Care Priority Setting Partnership was a recent collaborative venture bringing approximately 2000 patients, carers and clinicians together to agree priorities for future research into anaesthesia and critical care. This secondary analysis compares the research priorities of 303 service users, 1068 clinicians and 325 clinicians with experience as service users. All three groups prioritised research to improve patient safety. Service users prioritised research about improving patient experience, whereas clinicians prioritised research about clinical effectiveness...
July 31, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28744910/the-illusion-of-informed-consent
#7
EDITORIAL
N Chrimes, S D Marshall
No abstract text is available yet for this article.
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28744857/the-effect-of-pre-operative-methylprednisolone-on-early-endothelial-damage-after-total-knee-arthroplasty-a-randomised-double-blind-placebo-controlled-trial
#8
V Lindberg-Larsen, S R Ostrowski, M Lindberg-Larsen, M L Rovsing, P I Johansson, H Kehlet
We wished to evaluate whether inhibition of the systemic inflammatory response by a single pre-operative dose of methylprednisolone reduced markers of early endothelial damage after fast-track total knee arthroplasty. We randomly allocated 70 patients undergoing elective unilateral total knee arthroplasty (1:1) to receive either pre-operative intravenous methylprednisolone 125 mg (methylprednisolone group) or isotonic saline (control group). All procedures were performed under spinal anaesthesia without a tourniquet, using a standardised multimodal analgesic regime...
July 26, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28741685/missing-in-action-where-have-all-the-data-gone
#9
S W Choi, D M H Lam
No abstract text is available yet for this article.
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28741676/the-association-of-abdominal-muscle-with-outcomes-after-scheduled-abdominal-aortic-aneurysm-repair
#10
N Shah, L Abeysundara, P Dutta, M Christodoulidou, S Wylie, T Richards, N Schofield
Sarcopenia is the degenerative loss of core muscle mass. It is an aspect of frailty, which is associated with increased rates of peri-operative harm. We assessed the association of the cross-sectional areas of abdominal muscles, including psoas, with survival during a median (IQR [range]) follow-up of 3.8 (3.2-4.4 [0.0-5.1]) years after scheduled endovascular (132) or open (5) abdominal aortic aneurysm repair in 137 patients. In multivariate analysis, mortality hazard (95%CI) was independently associated with: age, 1...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28741667/an-evaluation-of-the-validity-of-the-pre-operative-oxygen-uptake-efficiency-slope-as-an-indicator-of-cardiorespiratory-fitness-in-elderly-patients-scheduled-for-major-colorectal-surgery
#11
B C Bongers, A E Berkel, J M Klaase, N L van Meeteren
This study aimed to investigate the validity of the oxygen uptake efficiency slope as an objective and submaximal indicator of cardiorespiratory fitness in elderly patients scheduled for major colorectal surgery. Patients ≥ 60 years of age, with a metabolic equivalent score using the Veterans Activity Questionnaire ≤ 7 and scheduled for major colorectal surgery participated in a pre-operative cardiopulmonary exercise test. The oxygen uptake efficiency slope was calculated up to different exercise intensities, using 100%, 90% and 80% of the exercise data...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28741653/a-randomised-controlled-trial-of-oral-chloral-hydrate-vs-intranasal-dexmedetomidine-before-computerised-tomography-in-children
#12
V M Yuen, B L Li, D K Cheuk, M K M Leung, T W C Hui, I C Wong, W W Lam, S W Choi, M G Irwin
Chloral hydrate is commonly used to sedate children for painless procedures. Children may recover more quickly after sedation with dexmedetomidine, which has a shorter half-life. We randomly allocated 196 children to chloral hydrate syrup 50 mg.kg(-1) and intranasal saline spray, or placebo syrup and intranasal dexmedetomidine spray 3 μg.kg(-1) , 30 min before computerised tomography studies. More children resisted or cried after drinking chloral hydrate syrup than placebo syrup, 72 of 107 (67%) vs. 42 of 87 (48%), p = 0...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28741652/a-randomised-controlled-trial-of-rectus-sheath-bupivacaine-and-intrathecal-bupivacaine-without-or-with-intrathecal-morphine-vs-intrathecal-bupivacaine-and-morphine-after-caesarean-section
#13
M W Lui, T K T Li, F Lui, C Y T Ong
We recruited 144 women of whom 131 underwent scheduled caesarean section and were allocated to intrathecal bupivacaine without (46) or with (47) morphine and postoperative rectus sheath bupivacaine; or intrathecal bupivacaine with morphine and postoperative rectus sheath saline (38). We measured postoperative pain with a 10-point numeric rating scale. The mean (SD) areas under the curve for pain on movement during 48 postoperative hours were 273.5 (63.6), 223.8 (80.7) and 223.8 (80.7), respectively, p = 0.008...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28741649/the-effect-of-metrics-based-feedback-on-acquisition-of-sonographic-skills-relevant-to-performance-of-ultrasound-guided-axillary-brachial-plexus-block
#14
O M A Ahmed, T Niessen, B D O'Donnell, A G Gallagher, D S Breslin, A DunnGalvin, G D Shorten
The objective of this study was to examine the effect of metrics-based vs. non-metrics-based feedback on novices learning predefined competencies for acquisition and interpretation of sonographic images relevant to performance of ultrasound-guided axillary brachial plexus block. Twelve anaesthetic trainees were randomly assigned to either metrics-based-feedback or non-metrics-based feedback groups. After a common learning phase, all participants attempted to perform a predefined task that involved scanning the left axilla of a single volunteer...
July 25, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28737223/a-network-meta-analysis-of-the-clinical-properties-of-various-types-of-supraglottic-airway-device-in-children
#15
REVIEW
T Mihara, A Asakura, G Owada, A Yokoi, K Ka, T Goto
We conducted both conventional pairwise and Bayesian network meta-analyses to compare the clinical properties of supraglottic airway devices in children. We searched six databases for randomised clinical trials. Our primary end-points were oropharyngeal leak pressure, risk of insertion failure at first attempt, and blood staining risk. The risk of device failure, defined as the abandonment of the supraglottic airway device and replacement with a tracheal tube or another device, was also analysed. Sixty-five randomised clinical trials with 5823 participants were identified, involving 16 types of supraglottic airway device...
July 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28737211/closing-in-on-the-best-supraglottic-airway-for-paediatric-anaesthesia
#16
EDITORIAL
A K Nørskov, C V Rosenstock, J Leahy, C Walsh
No abstract text is available yet for this article.
July 24, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28703290/the-association-between-peri-operative-acute-risk-change-arc-and-long-term-survival-after-cardiac-surgery
#17
T G Coulson, M Bailey, C M Reid, L Tran, D V Mullany, J A Smith, D Pilcher
Acute risk change has been described as the difference in calculated mortality risk between the pre-operative and postoperative periods of cardiac surgery. We aimed to assess whether this was associated with long-term survival after cardiac surgery. We retrospectively analysed 22,570 cardiac surgical patients, with minimum and maximum follow-up of 1.0 and 6.7 years. Acute risk change was calculated as the arithmetic difference between pre- and postoperative mortality risk. 'Rising risk' represented an increase in risk from pre- to postoperative phase...
July 13, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28696015/strength-of-commonly-used-spinal-needles-the-ability-to-deform-and-resist-deformation
#18
A Pillai, R S Monteiro, S W Choi, S M Yentis, D Bogod
We investigated the strength of commonly used spinal needles in relation to the amount of deformation, and registered forces during standardised testing. We investigated differences between manufacturers for the same length and gauge of Luer and non-Luer needles, and examined the effect of the internal stylet in terms of needle strength. A specialised rig was designed to perform the testing in both the horizontal and axial plane, reflecting common industrial tests and clinical use. Needles from four commonly used manufacturers were used (Vygon, Becton Dickinson, B Braun, and Pajunk)...
July 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28695993/sugammadex-when-should-we-be-giving-it
#19
EDITORIAL
C R Bailey
No abstract text is available yet for this article.
July 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28695980/arterial-to-end-tidal-carbon-dioxide-difference-in-children-undergoing-mechanical-ventilation-of-the-lungs-during-general-anaesthesia
#20
C Onodi, P K Bühler, J Thomas, A Schmitz, M Weiss
Capnography (ETCO2 ) is routinely used as a non-invasive estimate of arterial carbon dioxide (PaCO2 ) levels in order to modify ventilatory settings, whereby it is assumed that there is a positive gap between PaCO2 and ETCO2 of approximately 0.5 kPa. However, negative values (ETCO2 > PaCO2 ) can be observed. We retrospectively analysed arterial to end-tidal carbon dioxide differences in 799 children undergoing general anaesthesia with mechanical ventilation of the lungs in order to elucidate predictors for a negative gap...
July 11, 2017: Anaesthesia
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