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5. Research priorities in regional anaesthesia: an international Delphi study

Author

Ferry, Jenny, Lewis, Owen, Lloyd, James, El-Boghdadly, Kariem, Kearns, Rachel, Albrecht, Eric, Altermatt, Fernando, Ashokka, Balakrishnan, Ayad, Amany E., Aziz, Ezzat S., Aziz, Lutful, Jagannathan, Balavenkatasubramanian, Bouarroudj, Noreddine, Chin, Ki Jinn, Delbos, Alain, de Gracia, Alex, Ip, Vivian H.Y., Kwofie, Kwesi, Layera, Sebastian, Lobo, Clara A., Mohammed, Mohammed, Moka, Eleni, Moreno, Milena, Morgan, Bethan, Polela, Arthur, Rahimzadeh, Poupak, Tangwiwat, Suwimon, Uppal, Vishal, Vaz Perez, Marcelo, Volk, Thomas, Wong, Patrick B.Y., Bowness, James S., and Macfarlane, Alan J.R.

Published
2024
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13. Efficacy and safety of intrathecal diamorphine: a systematic review and meta‐analysis with meta‐regression and trial sequential analysis.

Author

Grape, Sina, El‐Boghdadly, Kariem, Jaques, Cecile, and Albrecht, Eric

Subjects
POSTOPERATIVE nausea & vomiting, HEROIN, SEQUENTIAL analysis, MORPHINE, CONTROL groups
Abstract

Summary: Background: Intrathecal diamorphine is believed to provide postoperative analgesia but is associated with adverse effects such as nausea and vomiting. There is little evidence of synthesis regarding intrathecal diamorphine in the contemporary literature. We performed a systematic review, meta‐analysis with meta‐regression and trial sequential analysis to determine the magnitude of intrathecal diamorphine efficacy and safety. Methods: We systematically searched the literature for trials comparing intrathecal diamorphine with a control group in patients undergoing all types of surgery. The primary efficacy and safety outcomes were intravenous morphine consumption and incidence of postoperative nausea and vomiting at 24 h following surgery, respectively. Results: Twelve trials were identified, which included data for 712 patients. Intrathecal doses of diamorphine ranged from 100 μg to 2500 μg. Intravenous morphine consumption at 24 h postoperatively was significantly reduced in the intrathecal diamorphine group, with a mean difference (95%CI) of ‐8 mg (‐11 to ‐6), I2 = 93%, p < 0.001. There was a significant difference between three intrathecal diamorphine dosing subgroups but without correlation: mean differences (95%CI) ‐1 mg (‐3–0), ‐26 mg (‐40 to ‐11) and ‐6 mg (‐15–4) in patients receiving doses of 0–200 μg, 201–400 μg and > 400 μg, respectively (p = 0.003). Intrathecal diamorphine increased postoperative nausea and vomiting with a risk ratio (95%CI) of 1.37 (1.19–1.58), I2 = 7%, p < 0.001. There were no differences in postoperative nausea and vomiting between the three intrathecal diamorphine dosing subgroups. There was no correlation observed with meta‐regression of the primary efficacy and safety outcomes. The quality of evidence for all outcomes was very low. Conclusion: There is very low level of evidence that intrathecal diamorphine provides effective analgesia after surgery, while increasing postoperative nausea and vomiting with doses > 200 μg. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Single-bolus injection of local anesthetic, with or without continuous infusion, for interscalene brachial plexus block in the setting of multimodal analgesia: a randomized controlled unblinded trial.

Author

Rhyner, Patrick, Cachemaille, Matthieu, Goetti, Patrick, Rossel, Jean-Benoit, Boand, Melanie, Farron, Alain, and Albrecht, Eric

Abstract

Introduction Previous trials favored a continuous interscalene brachial plexus block over a single injection for major shoulder surgery. However, these trials did not administer a multimodal analgesic regimen. This randomized, controlled unblinded trial tested the hypothesis that a continuous infusion of local anesthetic for an interscalene brachial plexus block still provides superior analgesia after major shoulder surgery when compared with a single injection in the setting of multimodal analgesia, inclusive of intravenous dexamethasone, magnesium, acetaminophen and ketorolac. Methods Sixty patients undergoing shoulder arthroplasty or arthroscopic rotator cuff repair were randomized to receive a bolus of ropivacaine 0.5%, 20 mL, with or without a continuous infusion of ropivacaine 0.2% 4-8 mL/hour, for an interscalene brachial plexus block. Patients were provided with intravenous morphine patient-controlled analgesia. The primary outcome was cumulative intravenous morphine consumption at 24 hours postoperatively. Secondary outcomes included pain scores at rest and on movement, and functional outcomes, measured over 48 hours after surgery. Results Median (IQR) cumulative intravenous morphine consumption at 24 hours postoperatively was 10 mg (4-24) in the continuous infusion group and 14 mg (8-26) in the single injection group (p=0.74). No significant between-group differences were found for any of the secondary outcomes. Conclusions A continuous infusion of local anesthetic for an interscalene brachial plexus block does not provide superior analgesia after major shoulder surgery when compared with a single injection in the setting of multimodal analgesia, inclusive of intravenous dexamethasone, magnesium, acetaminophen and ketorolac. The findings of this study are limited by performance and detection biases. [ABSTRACT FROM AUTHOR]

Published
2024
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18. Standardizing nomenclature in regional anesthesia: an ASRA-ESRA Delphi consensus study of upper and lower limb nerve blocks

Author

El-Boghdadly, Kariem, primary, Albrecht, Eric, additional, Wolmarans, Morné, additional, Mariano, Edward R, additional, Kopp, Sandra, additional, Perlas, Anahi, additional, Thottungal, Athmaja, additional, Gadsden, Jeff, additional, Tulgar, Serkan, additional, Adhikary, Sanjib, additional, Aguirre, Jose, additional, Agur, Anne M R, additional, Altıparmak, Başak, additional, Barrington, Michael J, additional, Bedforth, Nigel, additional, Blanco, Rafael, additional, Bloc, Sébastien, additional, Boretsky, Karen, additional, Bowness, James, additional, Breebaart, Margaretha, additional, Burckett-St Laurent, David, additional, Carvalho, Brendan, additional, Chelly, Jacques E, additional, Chin, Ki Jinn, additional, Chuan, Alwin, additional, Coppens, Steve, additional, Costache, Ioana, additional, Dam, Mette, additional, Desmet, Matthias, additional, Dhir, Shalini, additional, Egeler, Christian, additional, Elsharkawy, Hesham, additional, Bendtsen, Thomas Fichtner, additional, Fox, Ben, additional, Franco, Carlo D, additional, Gautier, Philippe Emmanuel, additional, Grant, Stuart Alan, additional, Grape, Sina, additional, Guheen, Carrie, additional, Harbell, Monica W, additional, Hebbard, Peter, additional, Hernandez, Nadia, additional, Hogg, Rosemary M G, additional, Holtz, Margaret, additional, Ihnatsenka, Barys, additional, Ilfeld, Brian M, additional, Ip, Vivian H Y, additional, Johnson, Rebecca L, additional, Kalagara, Hari, additional, Kessler, Paul, additional, Kwofie, M Kwesi, additional, Le-Wendling, Linda, additional, Lirk, Philipp, additional, Lobo, Clara, additional, Ludwin, Danielle, additional, Macfarlane, Alan James Robert, additional, Makris, Alexandros, additional, McCartney, Colin, additional, McDonnell, John, additional, McLeod, Graeme A, additional, Memtsoudis, Stavros G, additional, Merjavy, Peter, additional, Moran, E M Louise, additional, Nader, Antoun, additional, Neal, Joseph M, additional, Niazi, Ahtsham U, additional, Njathi-Ori, Catherine, additional, O'Donnell, Brian D, additional, Oldman, Matt, additional, Orebaugh, Steven L, additional, Parras, Teresa, additional, Pawa, Amit, additional, Peng, Philip, additional, Porter, Steven, additional, Pulos, Bridget P, additional, Sala-Blanch, Xavier, additional, Saporito, Andrea, additional, Sauter, Axel R, additional, Schwenk, Eric S, additional, Sebastian, Maria Paz, additional, Sidhu, Navdeep, additional, Sinha, Sanjay Kumar, additional, Soffin, Ellen M, additional, Stimpson, James, additional, Tang, Raymond, additional, Tsui, Ban C H, additional, Turbitt, Lloyd, additional, Uppal, Vishal, additional, van Geffen, Geert J, additional, Vermeylen, Kris, additional, Vlassakov, Kamen, additional, Volk, Thomas, additional, Xu, Jeff L, additional, and Elkassabany, Nabil M, additional

Published
2023
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31. Core outcome set for peripheral regional anesthesia research: a systematic review and Delphi study

Author

Hill, Jeremy, primary, Ashken, Toby, additional, West, Simeon, additional, Macfarlane, Alan James Robert, additional, El-Boghdadly, Kariem, additional, Albrecht, Eric, additional, Chin, Ki Jinn, additional, Fox, Ben, additional, Gupta, Ashwani, additional, Haskins, Stephen, additional, Haslam, Nat, additional, Hogg, Rosemary MG, additional, Hormis, Anil, additional, Johnston, David F, additional, Mariano, Edward R, additional, Merjavy, Peter, additional, Moll, Timothy, additional, Parry, James, additional, Pawa, Amit, additional, Russon, Kim, additional, Sebastian, Maria Paz, additional, Turbitt, Lloyd, additional, Womack, Jonathan, additional, and Chazapis, Maria, additional

Published
2022
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33. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Author

Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene R., Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S., Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, Moran, E M Louise, Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene R., Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S., Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, and Moran, E M Louise

Abstract

Background and objectives: Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Results: Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia.

Published
2022

34. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project.

Author

UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'anesthésiologie, Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene, Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S, Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, Moran, E M Louise, UCL - SSS/IONS/NEUR - Clinical Neuroscience, UCL - (SLuc) Service d'anesthésiologie, Ahmed, Hassan M, Atterton, Benjamin P, Crowe, Gillian G, Barratta, Jaime L, Johnson, Mark, Viscusi, Eugene, Adhikary, Sanjib, Albrecht, Eric, Boretsky, Karen, Boublik, Jan, Breslin, Dara S, Byrne, Kelly, Ch'ng, Alan, Chuan, Alwin, Conroy, Patrick, Daniel, Craig, Daszkiewicz, Andrzej, Delbos, Alain, Dirzu, Dan Sebastian, Dmytriiev, Dmytro, Fennessy, Paul, Fischer, H Barrie J, Frizelle, Henry, Gadsden, Jeff, Gautier, Philippe, Gupta, Rajnish K, Gürkan, Yavuz, Hardman, Harold David, Harrop-Griffiths, William, Hebbard, Peter, Hernandez, Nadia, Hlasny, Jakub, Iohom, Gabriella, Ip, Vivian H Y, Jeng, Christina L, Johnson, Rebecca L, Kalagara, Hari, Kinirons, Brian, Lansdown, Andrew Kenneth, Leng, Jody C, Lim, Yean Chin, Lobo, Clara, Ludwin, Danielle B, Macfarlane, Alan James Robert, Machi, Anthony T, Mahon, Padraig, Mannion, Stephen, McLeod, David H, Merjavy, Peter, Miscuks, Aleksejs, Mitchell, Christopher H, Moka, Eleni, Moran, Peter, Ngui, Ann, Nin, Olga C, O'Donnell, Brian D, Pawa, Amit, Perlas, Anahi, Porter, Steven, Pozek, John-Paul, Rebelo, Humberto C, Roqués, Vicente, Schroeder, Kristopher M, Schwartz, Gary, Schwenk, Eric S, Sermeus, Luc, Shorten, George, Srinivasan, Karthikeyan, Stevens, Markus F, Theodoraki, Kassiani, Turbitt, Lloyd R, Valdés-Vilches, Luis Fernando, Volk, Thomas, Webster, Katrina, Wiesmann, T, Wilson, Sylvia H, Wolmarans, Morné, Woodworth, Glenn, Worek, Andrew K, and Moran, E M Louise

Abstract

Documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as ≥75% agreement and weak consensus as 50%-74% agreement. Seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. By means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia.

Published
2022

35. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Author

Gürkan, Yavuz (ORCID 0000-0002-2307-6943 & YÖK ID 154129), Ahmed, Hassan M.; Atterton, Benjamin P.; Crowe, Gillian G.; Barratta, Jaime L.; Johnson, Mark; Viscusi, Eugene; Adhikary, Sanjib; Albrecht, Eric; Boretsky, Karen; Boublik, Jan; Breslin, Dara S.; Byrne, Kelly; Ch'ng, Alan; Chuan, Alwin; Conroy, Patrick; Daniel, Craig; Daszkiewicz, Andrzej; Delbos, Alain; Dirzu, Dan Sebastian; Dmytriiev, Dmytro; Fennessy, Paul; Fischer, H. Barrie J.; Frizelle, Henry; Gadsden, Jeff; Gautier, Philippe; Gupta, Rajnish K.; Hardman, Harold David; Harrop-Griffiths, William; Hebbard, Peter; Hernandez, Nadia; Hlasny, Jakub; Iohom, Gabriella; Ip, Vivian H. Y.; Jeng, Christina L. .; Johnson, Rebecca L.; Kalagara, Hari; Kinirons, Brian; Lansdown, Andrew Kenneth; Leng, Jody C.; Lim, Yean Chin; Lobo, Clara; Ludwin, Danielle B.; Macfarlane, Alan James Robert; Machi, Anthony T.; Mahon, Padraig; Mannion, Stephen; McLeod, David H.; Merjavy, Peter; Miscuks, Aleksejs; Mitchell, Christopher H.; Moka, Eleni; Moran, Peter; Ngui, Ann; Nin, Olga C.; O'Donnell, Brian D.; Pawa, Amit; Perlas, Anahi; Porter, Steven; Pozek, John-Paul; Rebelo, Humberto C.; Roques, Vicente; Schroeder, Kristopher M.; Schwartz, Gary; Schwenk, Eric S.; Sermeus, Luc; Shorten, George; Srinivasan, Karthikeyan; Stevens, Markus F.; Theodoraki, Kassiani; Turbitt, Lloyd R.; Valdes-Vilches, Luis Fernando; Volk, Thomas; Webster, Katrina; Wiesmann, T.; Wilson, Sylvia H.; Wolmarans, Morne; Woodworth, Glenn; Worek, Andrew K.; Moran, E. M. Louise, Koç University Hospital, School of Medicine, Gürkan, Yavuz (ORCID 0000-0002-2307-6943 & YÖK ID 154129), Ahmed, Hassan M.; Atterton, Benjamin P.; Crowe, Gillian G.; Barratta, Jaime L.; Johnson, Mark; Viscusi, Eugene; Adhikary, Sanjib; Albrecht, Eric; Boretsky, Karen; Boublik, Jan; Breslin, Dara S.; Byrne, Kelly; Ch'ng, Alan; Chuan, Alwin; Conroy, Patrick; Daniel, Craig; Daszkiewicz, Andrzej; Delbos, Alain; Dirzu, Dan Sebastian; Dmytriiev, Dmytro; Fennessy, Paul; Fischer, H. Barrie J.; Frizelle, Henry; Gadsden, Jeff; Gautier, Philippe; Gupta, Rajnish K.; Hardman, Harold David; Harrop-Griffiths, William; Hebbard, Peter; Hernandez, Nadia; Hlasny, Jakub; Iohom, Gabriella; Ip, Vivian H. Y.; Jeng, Christina L. .; Johnson, Rebecca L.; Kalagara, Hari; Kinirons, Brian; Lansdown, Andrew Kenneth; Leng, Jody C.; Lim, Yean Chin; Lobo, Clara; Ludwin, Danielle B.; Macfarlane, Alan James Robert; Machi, Anthony T.; Mahon, Padraig; Mannion, Stephen; McLeod, David H.; Merjavy, Peter; Miscuks, Aleksejs; Mitchell, Christopher H.; Moka, Eleni; Moran, Peter; Ngui, Ann; Nin, Olga C.; O'Donnell, Brian D.; Pawa, Amit; Perlas, Anahi; Porter, Steven; Pozek, John-Paul; Rebelo, Humberto C.; Roques, Vicente; Schroeder, Kristopher M.; Schwartz, Gary; Schwenk, Eric S.; Sermeus, Luc; Shorten, George; Srinivasan, Karthikeyan; Stevens, Markus F.; Theodoraki, Kassiani; Turbitt, Lloyd R.; Valdes-Vilches, Luis Fernando; Volk, Thomas; Webster, Katrina; Wiesmann, T.; Wilson, Sylvia H.; Wolmarans, Morne; Woodworth, Glenn; Worek, Andrew K.; Moran, E. M. Louise, Koç University Hospital, and School of Medicine

Abstract

Background and objectives: documentation is important for quality improvement, education, and research. There is currently a lack of recommendations regarding key aspects of documentation in regional anesthesia. The aim of this study was to establish recommendations for documentation in regional anesthesia. Methods: following the formation of the executive committee and a directed literature review, a long list of potential documentation components was created. A modified Delphi process was then employed to achieve consensus amongst a group of international experts in regional anesthesia. This consisted of 2 rounds of anonymous electronic voting and a final virtual round table discussion with live polling on items not yet excluded or accepted from previous rounds. Progression or exclusion of potential components through the rounds was based on the achievement of strong consensus. Strong consensus was defined as >= 75% agreement and weak consensus as 50%-74% agreement. Results: seventy-seven collaborators participated in both rounds 1 and 2, while 50 collaborators took part in round 3. In total, experts voted on 83 items and achieved a strong consensus on 51 items, weak consensus on 3 and rejected 29. Conclusion: by means of a modified Delphi process, we have established expert consensus on documentation in regional anesthesia., European Society of Regional Anaesthesia and Pain Therapy (ESRA); ASRA Pain Medicine

Published
2022

36. The Relationship Between Postoperative Opioid Analgesia and Sleep Apnea Severity in Patients Undergoing Hip Arthroplasty: A Randomized, Controlled, Triple-Blinded Trial

Author

Albrecht,Eric, Pereira,Pedro, Bayon,Virginie, Berger,Mathieu, Wegrzyn,Julien, Antoniadis,Alexander, Heinzer,Raphaël, Albrecht,Eric, Pereira,Pedro, Bayon,Virginie, Berger,Mathieu, Wegrzyn,Julien, Antoniadis,Alexander, and Heinzer,Raphaël

Abstract

Eric Albrecht,1 Pedro Pereira,1 Virginie Bayon,2 Mathieu Berger,2 Julien Wegrzyn,3 Alexander Antoniadis,3 Raphaël Heinzer2 1Department of Anesthesia, University Hospital of Lausanne and University of Lausanne, Lausanne, Vaud, Switzerland; 2Center for Investigation and Research in Sleep, University Hospital of Lausanne and University of Lausanne, Lausanne, Vaud, Switzerland; 3Department of Orthopedic Surgery, University Hospital of Lausanne and University of Lausanne, Lausanne, Vaud, SwitzerlandCorrespondence: Eric Albrecht, Department of Anesthesia, University Hospital of Lausanne, Rue du Bugnon 46, Lausanne, 1011, Switzerland, Tel +41 79 556 63 41, Email eric.albrecht@chuv.chPurpose: Residual postoperative pain after hip arthroplasty is usually treated with oral opioids. While classic opioids are associated with respiratory depression and worsening of sleep apnea, tramadol has been reported to preserve respiratory function. However, this has not been investigated in a prospective trial using respiratory polygraphy. This randomized controlled triple-blinded trial tested the hypothesis that postoperative treatment with oral opioids such as oxycodone would increase sleep apnea severity, measured with a respiratory polygraphy, compared with oral tramadol.Patients and Methods: Sixty patients undergoing hip arthroplasty under spinal anesthesia with 15 mg isobaric bupivacaine 0.5% were randomized to receive postoperative pain treatment with either oral oxycodone (controlled-release 10 mg every 12 hours and immediate-release 5 mg every 4 hours as needed) or oral tramadol (controlled-release 100 mg every 8 hours and immediate-release 50 mg every 4 hours as needed). Respiratory polygraphy was performed on the first postoperative night. The primary outcome was the apnea-hypopnea index in the supine position. Secondary outcomes included the oxygen desaturation index, postoperative pain scores and intravenous morphine consumption.Results: Mean supine apnea-hypopnea index on po

Published
2022

38. PECS2 or PICK2

Author

Elkassabany, Nabil M, primary, Mariano, Edward R, additional, Kopp, Sandra, additional, Albrecht, Eric, additional, Wolmarans, Morné, additional, and El-Boghdadly, Kariem, additional

Published
2022
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40. Recommendations for effective documentation in regional anesthesia: an expert panel Delphi consensus project

Author

Ahmed, Hassan M, primary, Atterton, Benjamin P, additional, Crowe, Gillian G, additional, Barratta, Jaime L, additional, Johnson, Mark, additional, Viscusi, Eugene, additional, Adhikary, Sanjib, additional, Albrecht, Eric, additional, Boretsky, Karen, additional, Boublik, Jan, additional, Breslin, Dara S, additional, Byrne, Kelly, additional, Ch'ng, Alan, additional, Chuan, Alwin, additional, Conroy, Patrick, additional, Daniel, Craig, additional, Daszkiewicz, Andrzej, additional, Delbos, Alain, additional, Dirzu, Dan Sebastian, additional, Dmytriiev, Dmytro, additional, Fennessy, Paul, additional, Fischer, H Barrie J, additional, Frizelle, Henry, additional, Gadsden, Jeff, additional, Gautier, Philippe, additional, Gupta, Rajnish K, additional, Gürkan, Yavuz, additional, Hardman, Harold David, additional, Harrop-Griffiths, William, additional, Hebbard, Peter, additional, Hernandez, Nadia, additional, Hlasny, Jakub, additional, Iohom, Gabriella, additional, Ip, Vivian H Y, additional, Jeng, Christina L, additional, Johnson, Rebecca L, additional, Kalagara, Hari, additional, Kinirons, Brian, additional, Lansdown, Andrew Kenneth, additional, Leng, Jody C, additional, Lim, Yean Chin, additional, Lobo, Clara, additional, Ludwin, Danielle B, additional, Macfarlane, Alan James Robert, additional, Machi, Anthony T, additional, Mahon, Padraig, additional, Mannion, Stephen, additional, McLeod, David H, additional, Merjavy, Peter, additional, Miscuks, Aleksejs, additional, Mitchell, Christopher H, additional, Moka, Eleni, additional, Moran, Peter, additional, Ngui, Ann, additional, Nin, Olga C, additional, O'Donnell, Brian D, additional, Pawa, Amit, additional, Perlas, Anahi, additional, Porter, Steven, additional, Pozek, John-Paul, additional, Rebelo, Humberto C, additional, Roqués, Vicente, additional, Schroeder, Kristopher M, additional, Schwartz, Gary, additional, Schwenk, Eric S, additional, Sermeus, Luc, additional, Shorten, George, additional, Srinivasan, Karthikeyan, additional, Stevens, Markus F, additional, Theodoraki, Kassiani, additional, Turbitt, Lloyd R, additional, Valdés-Vilches, Luis Fernando, additional, Volk, Thomas, additional, Webster, Katrina, additional, Wiesmann, T, additional, Wilson, Sylvia H, additional, Wolmarans, Morné, additional, Woodworth, Glenn, additional, Worek, Andrew K, additional, and Moran, E M Louise, additional

Published
2022
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46. Crotalus atrox venom‐induced cellular toxicity: Early wound progression involves reactive oxygen species.

Author

Brown, Lindsay E., Reyes, Giovanni, and Albrecht, Eric A.

Subjects
SNAKE venom, REACTIVE oxygen species, CROTALUS, VENOM, ORGANIC compounds, ORGANIC acids, NADPH oxidase
Abstract

Understanding the mechanisms that produce cellular cytotoxicity is fundamental in the field of toxicology. Cytotoxic stimuli can include organic toxins such as hemorrhagic snake venom, which can lead to secondary complications such as the development of necrotic tissue and profuse scarring. These clinical manifestations mimic cytotoxic responses induce by other organic compounds such as organic acids. We used hemorrhagic snake venom and human embryonic kidney cells (HEK 293T) as a model system to better understand the cellular responses involved in venom induced cytotoxicity. Cells stimulated with Crotalus atrox (CA) (western diamondback) venom for 4 or 10 h demonstrated significant cytotoxicity. Results from 2′,7′‐Dichlorodihydrofluorescein diacetate (H2DCF‐DA) assays determine CA venom stimulation induces a robust production of reactive oxygen species (ROS) over a 3‐h time course. In contrast, pretreatment with polyethylene glycol (PEG)‐catalase or N‐acetyl cysteine (NAC) prior to CA venom stimulation significantly blunted H2DCFDA fluorescence fold changes and showed greater cytoprotective effects than cells stimulated with CA venom alone. Pre‐ incubating HEK293T cells with the NADPH oxidase (NOX) pan‐inhibitor VAS2870 prior venom stimulation significantly minimized the venom‐induced oxidative burst at early timepoints (≤2 h). Collectively, our experiments show that pre‐application of antioxidants reduces CA venom induce cellular toxicity. This result highlights the importance of ROS in the early stages of cytotoxicity and suggests muting ROS production in noxious injuries may increase positive clinical outcomes. Understanding the mechanisms that produce cellular cytotoxicity is fundamental in the field of toxicology. We used hemorrhagic snake venom as a model system to better understand cytotoxicity from noxious stimuli. Cell stimulated with CA venom showed a robust production of reactive oxygen species (ROS). The pre‐application of antioxidants reduced CA venom‐induced ROS and cellular toxicity This result highlights the importance of ROS in the early stages of cytotoxicity and suggests muting ROS production in noxious injuries may increase positive clinical outcomes. [ABSTRACT FROM AUTHOR]

Published
2022
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49. MAILBAG.

Author

ADDLEMAN, AL, COOK, FRANK, BOYD, SUMMER, AUGUSTINE, KEN, CHRISTMAN, JOEL, FRIAR, AARON, SAMPLE, DAVID, DUNTEMAN, ROLLY, GUETSCHOW, RUSSELL, ALBRECHT, ERIC, BATES, JIM, JONES, KELLY W., and BACKHAUS, DANIEL

Subjects
SWINE farms, AGRICULTURE
Published
2023

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