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Anaesthesia

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https://www.readbyqxmd.com/read/28921577/time-for-training
#1
EDITORIAL
N W Penfold, C Carey
No abstract text is available yet for this article.
September 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28921503/time-spent-in-the-clinical-environment-is-the-most-important-aspect-of-medical-education-we-need-to-protect-it
#2
EDITORIAL
A J England, B J Jenkins
No abstract text is available yet for this article.
September 18, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28921537/nasotracheal-intubation-over-a-bougie-vs-non-bougie-intubation-a-prospective-randomised-controlled-trial-in-older-children-and-adults-using-videolaryngoscopy
#3
R O Abrons, M B Zimmerman, Y M S El-Hattab
Conventionally, nasotracheal intubation has consisted of blind nasal passage and external manipulation of the tube through the glottis ('conventional technique'), a technique associated with a high incidence of nasal trauma. We evaluated a novel technique for routine asleep (i.e. post-induction) nasotracheal intubation using a bougie ('bougie technique'), which uses a nasopharyngeal airway to guide a paediatric bougie nasotracheally for use as a Seldinger tracheal intubation guide. Two hundred and fifty-seven older children (> 8 years) and adults were randomly assigned to videolaryngoscopy-assisted nasotracheal intubation using either the conventional or the bougie technique...
September 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28913921/analgesic-efficacy-of-local-infiltration-analgesia-vs-femoral-nerve-block-after-anterior-cruciate-ligament-reconstruction-a-systematic-review-and-meta-analysis
#4
REVIEW
K R Kirkham, S Grape, R Martin, E Albrecht
Many published reports consider blockade of the femoral nerve distribution the best available analgesic treatment after anterior cruciate ligament reconstruction. However, some argue that an alternative approach of infiltrating local anaesthetic into the surgical site has similar efficacy. The objectives of this meta-analysis were to compare the analgesic and functional outcomes of both treatments following anterior ligament reconstruction. The primary outcomes were pain scores at rest (analogue scale, 0-10) in the early (0-2 postoperative hours), intermediate (3-12 hours) and late postoperative periods (13-24 hours)...
September 15, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28913901/real-time-continuous-monitoring-of-injection-pressure-at-the-needle-tip-for-peripheral-nerve-blocks-description-of-a-new-method
#5
C Quadri, A Saporito, X Capdevila
The measurement of injection pressure during the performance of peripheral nerve blocks can be pivotal to detect intraneural placement of the needle tip and thus avoid intrafascicular injection. However, injection pressure can only be measured along the injection line (tubing), which is influenced by several factors. The primary aim of this feasibility study was to describe and validate the principle of a novel nerve-block needle conceived for real-time continuous monitoring of injection pressures at the needle tip...
September 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28913862/the-effect-of-neuromuscular-blockade-on-the-efficiency-of-facemask-ventilation-in-patients-difficult-to-facemask-ventilate-a-prospective-trial
#6
S Soltész, P Alm, A Mathes, M Hellmich, J Hinkelbein
Facemask ventilation of the lungs can be an important rescue intervention in a 'cannot intubate' scenario. We assessed the effect of neuromuscular blockade on expiratory tidal volumes in patients with expected difficulty in mask ventilation. The lungs of patients with at least three predictors of difficulty in mask ventilation were ventilated using a facemask held with two hands, with mechanical ventilation set in a pressure-controlled mode. Tidal volumes were recorded before and after the establishment of complete neuromuscular block...
September 14, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28891203/effects-of-epidural-volume-extension-by-saline-injection-on-the-efficacy-and-safety-of-intrathecal-local-anaesthetics-systematic-review-with-meta-analysis-meta-regression-and-trial-sequential-analysis
#7
REVIEW
M Heesen, S Weibel, M Klimek, R Rossaint, L R Arends, P Kranke
Epidural volume extension, a modification of combined spinal-epidural anaesthesia, involves the epidural injection of saline in order to increase the spread of drugs given intrathecally. Results from individual studies have so far been contradictory and we aimed to gather the available evidence for this technique. We performed a systematic literature search for randomised, controlled trials comparing epidural volume extension after spinal injection with a control group without epidural injection in patients undergoing surgery...
September 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28891046/the-association-of-postoperative-pulmonary-complications-in-109-360-patients-with-pressure-controlled-or-volume-controlled-ventilation
#8
A Bagchi, M I Rudolph, P Y Ng, F P Timm, D R Long, S Shaefi, K Ladha, M F Vidal Melo, M Eikermann
We thought that the rate of postoperative pulmonary complications might be higher after pressure-controlled ventilation than after volume-controlled ventilation. We analysed peri-operative data recorded for 109,360 adults, whose lungs were mechanically ventilated during surgery at three hospitals in Massachusetts, USA. We used multivariable regression and propensity score matching. Postoperative pulmonary complications were more common after pressure-controlled ventilation, odds ratio (95%CI) 1.29 (1.21-1.37), p < 0...
September 11, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28872662/current-options-in-aerosolised-drug-therapy-for-children-receiving-respiratory-support
#9
REVIEW
S Trend, B S von Ungern-Sternberg, S G Devadason, A Schultz, M L Everard
Inhalation of aerosolised medications are the mainstay of treatment for a number of chronic lung diseases and have several advantages over systemically-administered medications. These include more rapid onset of action for drugs such as β-adrenergic agonists when compared with oral medication, high luminal doses for inhaled antibiotics when used to treat endobronchial infection, and an improved therapeutic index compared with systemic delivery for these and other classes of drugs such as corticosteroids. The use of aerosolised drugs to treat patients whose tracheas are intubated is less well established, in part because systemic delivery via the intravenous route can be a simpler alternative for many drugs...
September 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28872658/evidence-of-hysteresis-in-propofol-pharmacodynamics
#10
P O Sepúlveda, E Carrasco, L F Tapia, M Ramos, F Cruz, P Conget, Q F B Olivares, I Cortínez
It is commonly assumed that loss of responsiveness and recovery of responsiveness occur at similar concentrations of propofol. However, the 'conscious' and 'anaesthetised' conditions produced by general anaesthetics may behave as two bistable states. We hypothesised that loss of responsiveness and recovery of responsiveness occur at different propofol concentrations. Propofol was administered to 19 healthy volunteers by effect-site target-controlled infusion using increasing and decreasing stable concentration steps of 7 min...
September 5, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28861909/major-trauma-and-the-need-for-massive-transfusion
#11
EDITORIAL
A F Smith, S W Choi
No abstract text is available yet for this article.
September 1, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28832941/major-trauma-in-older-people-implications-for-anaesthesia-and-intensive-care-medicine
#12
EDITORIAL
R Griffiths, D Surendra Kumar
No abstract text is available yet for this article.
August 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28832935/the-view-from-the-top-is-it-worth-recording-for-posterity
#13
EDITORIAL
B J Jenkins
No abstract text is available yet for this article.
August 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28832924/the-effect-of-acetazolamide-on-intra-ocular-pressure-after-trendelenburg-positioning-a-randomised-double-blind-crossover-trial-in-volunteers
#14
P Vitish-Sharma, A J King, A Abbas, C Maxwell-Armstrong, B Guo, A G Acheson
Recent evidence suggests Trendelenburg positioning can produce a significant rise in intra-ocular pressure. Peri-operative vision loss in patients undergoing laparoscopic colorectal surgery has been reported with the rise in intra-ocular pressure suggested as a possible factor. Acetazolamide decreases intra-ocular pressure by reducing the formation of aqueous humour, so we aimed to investigate if it could attenuate the intra-ocular pressure rise that can occur in the Trendelenburg position. Nine healthy volunteers were recruited and randomly assigned to a double-blind crossover comparison of placebo or acetazolamide with a minimal 4 days' washout period before the second study day...
August 22, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28805242/size-matters
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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