1,449 results
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2. An EAACI position paper on the investigation of perioperative immediate hypersensitivity reactions.
- Author
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Garvey, Lene Heise, Ebo, Didier G., Mertes, Paul‐Michel, Dewachter, Pascale, Garcez, Tomaz, Kopac, Peter, Laguna, José Julio, Chiriac, Anca Mirela, Terreehorst, Ingrid, Voltolini, Susanna, and Scherer, Kathrin
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ALLERGIES , *TASK forces , *PHARMACOLOGY , *ANESTHESIOLOGISTS - Abstract
Perioperative immediate hypersensitivity reactions are rare. Subsequent allergy investigation is complicated by multiple simultaneous drug exposures, the use of drugs with potent effects and the many differential diagnoses to hypersensitivity in the perioperative setting. The approach to the investigation of these complex reactions is not standardized, and it is becoming increasingly apparent that collaboration between experts in the field of allergy/immunology/dermatology and anaesthesiology is needed to provide the best possible care for these patients. The EAACI task force behind this position paper has therefore combined the expertise of allergists, immunologists and anaesthesiologists. The aims of this position paper were to provide recommendations for the investigation of immediate‐type perioperative hypersensitivity reactions and to provide practical information that can assist clinicians in planning and carrying out investigations. [ABSTRACT FROM AUTHOR]
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- 2019
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3. Why be sustainable? The Australian and New Zealand College of Anaesthetists Professional Document PS64: and its accompanying background paper.
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McGain, Forbes, Ma, Scott C. Y., Burrell, Rob H., Percival, Vanessa G., Roessler, Peter, DWeatherall, Andrew, Weber, Ingo A., Kayak, Eugenie A., Ma, Scott Cy, and Weatherall, Andrew D
- Abstract
Healthcare's environmental sustainability is increasingly an area of research and advocacy focus. The Australian and New Zealand College of Anaesthetists (ANZCA) has produced a professional document, PS64, Statement on Environmental Sustainability in Anaesthesia and Pain Medicine Practice, and a background paper, PS64 BP. The purpose of the statement is to affirm ANZCA's commitment to environmental sustainability and support anaesthetists in promoting environmentally sustainable work practices. This article presents the main features of PS64 and its background paper, and the associated supporting evidence. The healthcare sector is highly interconnected with activities that emit pollution to air, water and soils, considerably adding to humanity's collective ecological footprint. As anaesthetists, we are uniquely high-carbon doctors due to our work anaesthetising with greenhouse gases (particularly desflurane and nitrous oxide) and our exposure and contribution to large amounts of resource and energy use and waste generation in operating theatres. Discussion is made of the improving research base of anaesthetic life-cycle assessments--that is, cradle-tograve studies of how much energy, water and so on a product or process requires throughout its entire life. Thereafter, reducing, reusing and recycling as well as water use are examined. Ongoing research efforts within environmentally sustainable anaesthesia are highlighted. Environmentally sustainable anaesthesia requires scholarship, health advocacy, leadership, communication and collaboration. The focus is placed on practical initiatives within PS64 and the background paper that can be achieved by all anaesthetists striving towards more sustainable healthcare practices that reduce waste, reap financial benefits and improve health. [ABSTRACT FROM AUTHOR]
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- 2019
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4. Understanding malignant hyperthermia: a discussion paper.
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Khan, Ehsan
- Abstract
Malignant hyperthermia (MH) is an autosomal dominant condition that may be triggered by a number of drugs used in anaesthesia including halogenated volatile inhalation anaesthetics and depolarising muscle relaxants like succinylcholine (suxamethonium). With this condition such drugs precipitate an abnormal calcium ion release inside the muscle cell. This leads to an uncontrolled increase in muscle metabolism that rapidly depletes cellular oxygen and increases carbon dioxide generation with subsequent breakdown of muscle cell integrity. Owing to the wide spread increase in skeletal muscle metabolism the body temperature increases rapidly. The sequela of these molecular dysfunctions may lead to circulatory collapse, acute renal failure and can be fatal if not treated promptly. The manifestation of MH normally occurs on induction of anaesthesia but can occur up to 24 hours after induction. Operating theatre practitioners must be alert to the possibility of this condition occurring during the perioperative period. [ABSTRACT FROM AUTHOR]
- Published
- 2007
5. MAGnesium-oral supplementation to reduce PAin in patients with severe PERipheral arterial occlusive disease: the MAG-PAPER randomised clinical trial protocol
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Francesco Rizzo, Luca Bisighini, Andrea Rizzolo, Laura Lamberti, Nicola Latronico, Stefano Bonardelli, Sergio Zappa, Maddalena Turin, Marta Zangrandi, Cosetta Minelli, and Monica Aida Venturini
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Male ,Pregabalin ,Total intravenous anesthesia ,Administration, Oral ,Neuropathic pain ,Anaesthesia ,Validation ,Protocol ,Major depression ,Medicine ,Magnesium ,VASCULAR MEDICINE ,Pain Measurement ,Aged, 80 and over ,Morphine ,Chronic pain ,General Medicine ,Middle Aged ,Analgesics, Opioid ,Italy ,Hyperalgesia ,Research Design ,Drug Therapy, Combination ,Female ,Life Sciences & Biomedicine ,Oxycodone ,Receptor ,medicine.drug ,Adult ,medicine.medical_specialty ,Efficacy ,Adolescent ,Pain ,Arterial Occlusive Diseases ,Placebo ,Young Adult ,Medicine, General & Internal ,Double-Blind Method ,General & Internal Medicine ,Postoperative analgesia ,Humans ,Brief Pain Inventory ,VASCULAR SURGERY ,Aged ,Science & Technology ,business.industry ,medicine.disease ,Sulfate ,Clinical trial ,Linear Models ,Physical therapy ,Intractable pain ,business - Abstract
Introduction Magnesium exerts analgaesic effects in several animal pain models, as well as in patients affected by acute postoperative pain and neuropathic chronic pain. There is no evidence that magnesium can modulate pain in patients with peripheral arterial occlusive disease (PAOD). We describe the protocol of a single-centre randomised double-blind clinical trial aimed at assessing the efficacy of oral magnesium supplementation in controlling severe pain in patients with advanced PAOD. Methods and analysis Adult patients affected by PAOD at stages III and IV of Leriche-Fontaine classification, who are opioid-naive, and who have been admitted to our Acute Pain Service for intractable pain, will be eligible. Patients will be randomised to the control group, treated with standard therapy (oxycodone and pregabalin) plus placebo for 2 weeks, or to the experimental group (standard therapy plus magnesium oxide). Patients will be evaluated on days 0, 2, 4, 6, 8, 12 and 14; the following information will being collected: daily oxycodone dose; average and maximum pain (Numerical Rating Scale); pain relief (Pain Relief Scale); characteristics of the pain (Neuropathic Pain Scale); impact of pain on the patient9s daily activities (Brief Pain Inventory). The primary outcome will be oxycodone dosage needed to achieve satisfactory analgaesia on day 14. Secondary outcomes will be pain relief on day 2, time needed to achieve satisfactory analgaesia and time needed to achieve a pain reduction of 50%. A sample size calculation was performed for the primary outcome, which estimated a required sample size of 150 patients (75 per group). Ethics and dissemination Ethical approval of the study protocol has been obtained from Comitato Etico Provinciale di Brescia, Brescia, Italy. Trial results will be disseminated through scientific journal manuscripts and scientific conference presentations. Trial registration number NCT02455726.
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- 2015
6. John Davies Thomas: Chloroformist in London and pioneer South Australian doctor.
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Haridas, Rajesh P
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ANESTHESIOLOGY ,ETHERS - Abstract
John Davies Thomas (1844-1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship's surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. Surveys conducted in Europe and North America had established that the mortality from chloroform was eight to ten times higher than that from ether. At that time, chloroform was the most widely administered anaesthetic in Australia. Thomas' paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas' papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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7. Reported analgesic and anaesthetic administration to non‐human primates undergoing experimental surgical procedure: 2010‐2015.
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Bertrand, Henri Georges Michel Justin, Sandersen, Charlotte, and Flecknell, Paul Andrew
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PRIMATES as laboratory animals ,OPERATIVE surgery ,ANALGESICS ,ANESTHETICS ,MEDICAL research ,CARPROFEN ,BUPRENORPHINE - Abstract
Abstract: Background: The use of non‐human primates (NHPs) in research remains a major societal concern with public expectations that appropriate anaesthetics and analgesics are used to minimize any pain or distress caused to animals undergoing invasive procedures. A literature review was conducted to examine the reporting of anaesthesia and analgesia methods used in non‐human primates undergoing surgical procedures, with recovery from anaesthesia. Methods: A total of 397 papers from peer‐review journals published between 2010 and 2015 were examined. Results: Only 25.9% of papers reported the analgesic regimen used, with carprofen and buprenorphine the 2 most widely used agents. Reporting of the anaesthetic regimens was included in 49.9% of papers. Ketamine and isoflurane were the most frequently used anaesthetic agents. Conclusions: Anaesthetic and analgesic regimens administered to NHPs remain poorly reported. This lack of detailed descriptions of protocols does little to reassure the public or regulatory authorities that appropriate high standards of perioperative care are employed. [ABSTRACT FROM AUTHOR]
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- 2018
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8. Intrathecal ropivacaine versus bupivacaine in a non-obstetric population- A meta-analysis and trial sequential analysis.
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Khalil, Rashaad S., Mehmud, Aaliya, Banerjee, Rahul, Malhotra, Rajiv, and Banerjee, Arnab
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SEQUENTIAL analysis ,BUPIVACAINE ,ROPIVACAINE ,RANDOM effects model - Abstract
Background and Aims: Intrathecal bupivacaine is used for anaesthesia and analgesia but is associated with hypotension. Ropivacaine is an alternative drug that may have fewer cardiotoxic and neurotoxic events. This meta-analysis investigated whether intrathecal ropivacaine is associated with reduced hypotension as compared to bupivacaine. Methods: The meta-analysis is registered in the International Prospective Register of Systematic Reviews (PROSPERO). The databases PubMed, Cinahl Plus, Google Scholar, and Scopus were searched, and papers from January 1980 to January 2023 were deemed eligible and filtered using predetermined inclusion and exclusion criteria. The primary outcome was the incidence of hypotension. Secondary outcomes were the duration of sensory block, duration of motor block, incidence of bradycardia, ephedrine usage, and duration of analgesia. Jadad scores were used to evaluate the quality of the papers. RevMan statistical software® utilised inverse variance and a random effect model to calculate the standardised mean difference with 95% confidence intervals for continuous variables and the Mantel--Haenszel test and the random effect model to calculate the odds ratio for dichotomous variables. Results: Thirty-three papers, including 2475 patients in total, were included. The Jadad score was between 1 and 5. The incidence of hypotension was significantly higher with intrathecal bupivacaine than with ropivacaine (P = 0.02). The duration of sensory block (P < 0.001) and motor block (P < 0.001) was prolonged with intrathecal bupivacaine. The duration of analgesia favoured intrathecal bupivacaine (P = 0.003). Conclusion: Intrathecal ropivacaine has a reduced incidence of hypotension and a reduced duration of sensory block compared to bupivacaine. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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9. Mini-endovascular aneurysm repair: a minimalist approach for a minimally invasive procedure
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Ahmet Ünlü and Ahmet Baris Durukan
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medicine.medical_specialty ,RD1-811 ,medicine.medical_treatment ,Femoral artery ,Endovascular aneurysm repair ,Aneurysm ,abdominal aortic aneurysm ,medicine.artery ,Occlusion ,local ,medicine ,Internal medicine ,vascular grafting ,Surgical repair ,Original Paper ,Groin ,business.industry ,Stent ,anaesthesia ,medicine.disease ,RC31-1245 ,Abdominal aortic aneurysm ,Surgery ,medicine.anatomical_structure ,stents ,Cardiology and Cardiovascular Medicine ,business - Abstract
Introduction Abdominal aortic aneurysms represent the majority of all aneurysms of the aorta. Endovascular aneurysm repair (EVAR) is an alternative procedure to surgical repair. Although general and regional anaesthesia are frequently used during EVAR procedures, local anaesthesia has become one of the anaesthesia options for which there is increasing experience. Aim We reported our EVAR cases in which we routinely used femoral local anaesthesia. Material and methods Between August 2016 and June 2020, the EVAR procedure was applied to 22 infrarenal abdominal aortic aneurysm patients under femoral local anaesthesia. Open femoral artery access through a groin incision was used in all patients. Patients were followed up for graft- and wound-related complications. Results The mean age of the patients was 72.59 ±6.6 years (min: 60, max: 84). Mean aneurysm sac diameter was 61.04 ±8.76 mm. Bifurcated stent graft was used in 21 (95.5%) patients. An aorto-uni-iliac stent graft was used for 1 (4.5%) patient due to contralateral total iliac occlusion. Endoleak was observed in 6 patients. In-hospital mortality was observed in 2 patients; both cases were ruptured with haemodynamic instability (9%). Revision in the groin area was performed in 3 (13.6%) patients due to local wound complications. Conclusions Although the EVAR procedure has been described as a safer and more easily applicable alternative to surgical repair, it is disadvantageous in terms of increasing treatment costs. Anaesthesia preference and incision size with a more minimalist approach can reduce the length of hospital stay and minimize the complications that may occur after the procedure, resulting in decreased costs.
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- 2021
10. General anaesthesia or sedation for percutaneous aortic valve implantation? The questionnaire results and authors’ experience
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Maria Damps, Kazimierz Kiermasz, Radosław Parma, Radosław Gocoł, Andrzej Ochała, Leszek Machej, Ewa Kucewicz-Czech, Damian Hudziak, and Andrzej Węglarzy
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Aortic valve ,Percutaneous ,RD1-811 ,medicine.medical_treatment ,Sedation ,Valve replacement ,medicine ,General anaesthesia ,Dexmedetomidine ,conversion ,Internal medicine ,Original Paper ,business.industry ,anaesthesia ,RC31-1245 ,medicine.anatomical_structure ,Anesthesia ,Perioperative care ,transcatheter aortic valve replacement ,Surgery ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Complication ,business ,medicine.drug - Abstract
Introduction Over the last two decades transcatheter aortic valve replacement (TAVR) has been approved for clinical use. The anaesthetic choice for this procedure is evolving. General anaesthesia was the predominant anaesthetic technique. Growing experience and advances in technology and economic considerations have led to an increasing interest in performing TAVR under monitored sedation. Aim The assessment of monitored sedation, called cooperative sedation, involves pharmacologically mediated suppression of consciousness and preservation of verbal contact in response to stimulation as a safe method of anaesthesia for TAVR. Material and methods Sixty out of 63 TAVR patients with femoral access received monitored sedation. Dexmedetomidine was administered in most of such cases (46 patients). A questionnaire was also carried out by staff involved in performing TAVR procedures, with more than 5 years of experience in it, concerning the method of anaesthesia and perioperative care. Results Conversion to general anaesthesia was required in 10% of patients (6 cases), only one as a patient-related complication (hypercarbia). The questionnaire carried out showed that anaesthesia and postoperative care after TAVR are underestimated. Conclusions The preliminary results regarding anaesthetic management in TAVR procedures demonstrate that monitored sedation is safe, provided that contraindications are observed.
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- 2021
11. Making the anaesthetised animal into a boundary object: an analysis of the 1875 Royal Commission on Vivisection
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Tarquin Holmes and Carrie Friese
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History ,Boundary object ,Biomedical Research ,Vivisection ,0507 social and economic geography ,Commission ,Social worlds ,Public opinion ,Anaesthesia ,Royal Commission ,History and Philosophy of Science ,Arts and Humanities (miscellaneous) ,Political science ,Boundary objects ,Animals ,Cruelty to animals ,Anesthesia ,0601 history and archaeology ,Philosophy of science ,business.industry ,05 social sciences ,Ruling class ,History, 19th Century ,Q Science (General) ,Nominated Paper ,06 humanities and the arts ,16. Peace & justice ,United Kingdom ,060105 history of science, technology & medicine ,Law ,business ,050703 geography - Abstract
This paper explores how, at the 1875 Royal Commission on Vivisection, the anaesthetised animal was construed as a boundary object around which “cooperation without consensus” (Star, in: Esterbrook (ed) Computer supported cooperative work: cooperation or conflict? Springer, London, 1993) could form, serving the interests of both scientists and animals. Advocates of anaesthesia presented it as benevolently intervening between the scientific agent and animal patient. Such articulations of ‘ethical’ vivisection through anaesthesia were then mandated in the 1876 Cruelty to Animals Act, and thus have had significant downstream effects on the regulation of laboratory animals in Britain and beyond. Constructing this ‘consensus’ around the anaesthetised animal, however, required first excluding abolitionists and inhumane scientists, and secondly limiting the interests of experimental animals to the avoidance of pain through anaesthesia and euthanasia, thereby circumventing the issue of their possible interest in future life. This consensus also served to secure the interests of vivisecting scientists and to limit the influence of public opinion in the laboratory to administrative procedure and scheduled inspection. The focus on anaesthesia was connected with discussions of what supporting infrastructures were required to ensure proper ethical procedure was carried out by scientists. In contrast to the much studied polarisation in British society between pro- and antivivisectionists after 1876, we understand the 1875 Commission as a conflict amongst scientists themselves, while also being an intra-class conflict amongst the ruling class (French in Antivivisection and medical science in Victorian society, Princeton University Press, Princeton, 1975).
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- 2020
12. Auditing the medico‐legal aspects of notekeeping for Caesarean section
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Corner, A.J.
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- 2003
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13. A practical guide to patient position and complication management in neurosurgery: a systematic qualitative review.
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De Cassai, Alessandro, Geraldini, Federico, Zarantonello, Francesco, Sella, Nicolò, Negro, Sebastiano, Andreatta, Giulio, Salvagno, Michele, Boscolo, Annalisa, Navalesi, Paolo, and Munari, Marina
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NEUROSURGERY ,MEDICAL literature ,PATIENT positioning ,SUPINE position ,ANESTHESIOLOGISTS ,MEDICAL screening - Abstract
Adequate patient positioning is of paramount importance in neurosurgery. Complications related to the position are common and make up for more than 16% of the claims towards anaesthesiologists and neurosurgeons. This paper aims to provide the anaesthesiologist with a practical guide to avoid common pitfalls related to the patient positioning process. We performed a systematic review of the medical literature for the identification, screening, and inclusion of articles. The bibliographic search was conducted on June 1st, 2021 by two of the authors. In this review, we included articles indexed by MEDLINE, Cochrane Library, or Google Scholar. We retrieved a total of 5706 unique papers from our initial search. However, after the initial screening, 5363 papers were removed is not related to our research leaving a total of 343 papers. We examined the full text of all the 343 articles including 68 of them in the final qualitative analysis. In this review we examine the most common neurosurgical positions: supine, sitting, lateral, park-bench, prone, jack-knife, and knee-chest. For each of them, the proper positioning and related complications are described. Particular attention is given to the prevention and management of these complications, providing a practical guide for clinicians. [ABSTRACT FROM AUTHOR]
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- 2022
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14. Anaesthetists’ records of pre‐operative assessment
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Simmonds, Mark and Petterson, Jane
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- 2000
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15. Preoperative communication between anaesthetists and patients with obesity regarding perioperative risks and weight management: a structured narrative review.
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Hodsdon, Anthony, Smith, Natalie Anne, and Story, David A.
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REGULATION of body weight ,OVERWEIGHT persons ,MOTIVATIONAL interviewing ,KEYWORD searching ,DATABASE searching - Abstract
Background: Individuals with obesity frequently present for anaesthesia and surgery. Good communication during the preoperative consultation can optimise the provision of relevant health information and guide improvement of health status preoperatively. Methods: We planned a systematic literature review to assess existing guidelines and evidence of effectiveness for how anaesthetists should communicate with patients who have obesity in the preoperative period about perioperative risks and weight management. Database searches used keywords related to perioperative weight loss conversations. We found no papers that directly addressed our aim. The literature identified as most relevant was analysed in the form of a narrative review. Results: The majority of suggestions for weight loss conversations came from primary care. Four primary themes potentially relevant to anaesthetists were identified: barriers to such conversations, communication tools, language and communication and specific recommendations. Identified barriers included lack of skills, training, poor remuneration, pessimism and time constraints for clinicians. Established discussion tools including the '5A's' approach (Assess, Advise, Agree, Assist, Arrange) and motivational interviewing may hold promise to improve preoperative conversations. The papers highlighted a need for empathetic language, including use of patient-specific language where possible. Conclusions: There are currently no published guidelines for how anaesthetists could most effectively discuss weight in the perioperative period with patients who have obesity. Much of the literature for obesity communication is based on the primary care setting. The perioperative period may represent an increased time of receptiveness for patients. Guidelines for discussions about weight management and associated perioperative risk are suggested. [ABSTRACT FROM AUTHOR]
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- 2020
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16. Visual response properties of neurons in the superficial layers of the superior colliculus of awake mouse
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De Franceschi, Gioia and Solomon, Samuel G.
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Neurons ,vision ,functional properties ,Superior Colliculi ,genetic structures ,tectum ,receptive field ,anaesthesia ,Mice ,Visual Perception ,Animals ,Wakefulness ,Research Paper ,Neuroscience - Abstract
Key points In rodents, including mice, the superior colliculus is the major target of the retina, but its visual response is not well characterized.In the present study, extracellular recordings from single nerve cells in the superficial layers of the superior colliculus were made in awake, head‐restrained mice, and their responses to visual stimuli were measured.It was found that these neurons show brisk, highly sensitive and short latency visual responses, a preference for black over white stimuli, and diverse responses to moving patterns.At least five broad classes can be defined by variation in functional properties among units.The results of the present study demonstrate that eye movements have a measurable impact on visual responses in awake animals and show how they may be mitigated in analyses. Abstract The mouse is an increasingly important animal model of visual function in health and disease. In mice, most retinal signals are routed through the superficial layers of the midbrain superior colliculus, and it is well established that much of the visual behaviour of mice relies on activity in the superior colliculus. The functional organization of visual signals in the mouse superior colliculus is, however, not well established in awake animals. We therefore made extracellular recordings from the superficial layers of the superior colliculus in awake mice, while the animals were viewing visual stimuli including flashed spots and drifting gratings. We find that neurons in the superficial layers of the superior colliculus of awake mouse generally show short latency, brisk responses. Receptive fields are usually ‘ON–OFF’ with a preference for black stimuli, and are weakly non‐linear in response to gratings and other forms of luminance modulation. Population responses to drifting gratings are highly contrast sensitive, with a robust response to spatial frequencies above 0.3 cycles degree−1 and temporal frequencies above 15 Hz. The receptive fields are also often speed‐tuned or direction‐selective. Analysis of the response across multiple stimulus dimensions reveals at least five functionally distinct groups of units. We also find that eye movements affect measurements of receptive field properties in awake animals, and show how these may be mitigated in analyses. Qualitatively similar responses were obtained in urethane‐anaesthetized animals, although receptive fields in awake animals had higher contrast sensitivity, shorter visual latency and a stronger response to high temporal frequencies., Key points In rodents, including mice, the superior colliculus is the major target of the retina, but its visual response is not well characterized.In the present study, extracellular recordings from single nerve cells in the superficial layers of the superior colliculus were made in awake, head‐restrained mice, and their responses to visual stimuli were measured.It was found that these neurons show brisk, highly sensitive and short latency visual responses, a preference for black over white stimuli, and diverse responses to moving patterns.At least five broad classes can be defined by variation in functional properties among units.The results of the present study demonstrate that eye movements have a measurable impact on visual responses in awake animals and show how they may be mitigated in analyses.
- Published
- 2018
17. Current recommendations for airway management techniques in COVID-19 patients without respiratory failure undergoing General anaesthesia: a nonsystematic literature review
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Agnė Kraujelytė, Elija Januškevičiūtė, Eglė Kontrimavičiūtė, Milda Grigonytė, Nomeda Rima Valevičienė, Giedrius Šėmys, Greta Bružytė-Narkienė, and Oresta Kriukelytė
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medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,medicine.medical_treatment ,lcsh:Medicine ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,medicine ,Intubation ,General anaesthesia ,030212 general & internal medicine ,Anaesthesia ,preoxygenation ,airway management ,difficult airway ,SARS-CoV-2 ,COVID-19 ,Intensive care medicine ,Review Papers ,Team composition ,business.industry ,lcsh:R ,General Medicine ,anaesthesia ,Respiratory failure ,Preparedness ,Airway management ,business ,Airway - Abstract
Background. Since severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) first emerged, many articles have been published on airway management for coronavirus disease 2019 (COVID-19) patients. However, there is a lack of clear and concise conceptual framework for working with infected patients without respiratory failure undergoing general anaesthesia compared to noninfected patients. The aim of this article is to review current literature data on new challenges for anaesthesia providers, compare standard airway management techniques protocols with new data, and discuss optimisation potential. Materials and methods. Literature search was performed in Google Scholar and PubMed databases using these keywords and their combinations: anaesthesia, preoxygenation, airway management, difficult airway, SARS-CoV-2, COVID-19. The following nonsystematic review is based on a comprehensive literature search of available data, wherein 41 articles were chosen for detailed analysis. Summarised and analysed data are presented in the article. Results. SARS-CoV-2 has unique implications for airway management techniques in patients without respiratory failure undergoing general anesthesia. Main differences with the standard practice include: institutional preparedness, team composition principles, necessary skills, equipment, drugs, intubation and extubation strategies. Failed or difficult intubation is managed with predominance of emergency front of neck access (FONA) due to increased aerosol generation. Conclusions. Airway management techniques in COVID-19 patients without respiratory failure are more challenging than in noninfected patients undergoing general anaesthesia. Safe, accurate and swift actions avoid unnecessary time delay ensuring the best care for patients, and reduce risk of contamination for staff. Appropriate airway strategy, communication, minimisation of time for aerosol generating procedures and ramped-up position aid to achieve these goals. During the pandemic, updated available literature data may change clinical practice as new evidence emerges. © 2021 Milda Grigonytė, Agnė Kraujelytė, Elija Januskeviciūtė, Giedrius Sėmys, Greta Bružytė-Narkienė, Oresta Kriukelytė, Eglė Kontrimaviciūtė, Nomeda Rima Valevicienė. Published by Vilnius University Press.
- Published
- 2021
18. A systematic review of using flexible bronchoscopy to remove foreign bodies from paediatric patients.
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Chantzaras, Anastasios‐Panagiotis, Panagiotou, Panagiota, Karageorgos, Spyridon, and Douros, Konstantinos
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BRONCHOSCOPY ,FOREIGN bodies ,CHILD patients ,LARYNGEAL masks - Abstract
Aim: Our aim was to summarise the evidence about flexible bronchoscopy for paediatric airway foreign body aspiration cases. Methods: We searched the PubMed database from 1 January 2001 to 9 October 2021 for peer‐review papers published in English on the use, and success rates, of flexible bronchoscopy as the first‐line treatment for foreign body aspiration cases. This process identified 243 potential papers. Results: We studied 23 papers comprising 2588 cases of foreign body aspiration and flexible bronchoscopy successfully removed the foreign bodies in 87.1% of cases. Complication rates were low in the 983 patients studied in 18 papers. The foreign bodies were organic materials in 78.3% of 1371 patients and mainly lodged in the right bronchial tree in 50.5% of 1402 patients. General anaesthesia was used before flexible bronchoscopy in 14/23 studies and laryngeal mask airways were mostly used in 10/23 studies to secure the airway during the procedure. Ancillary equipment was used to assist the foreign body removal in 57.3% of 1808 cases and these were usually baskets. Conclusion: Flexible bronchoscopy was a feasible and safe therapeutic procedure for selected foreign body aspiration cases. Future studies need to focus on comparing the clinical outcomes of flexible and rigid bronchoscopies. [ABSTRACT FROM AUTHOR]
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- 2022
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19. Barriers to and facilitators of using cognitive aids in perioperative emergencies: An integrative review.
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Almoite-Eeles, Simon and Foran, Paula
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HEALTH services accessibility ,CORPORATE culture ,HUMAN services programs ,PERSONNEL management ,CINAHL database ,EMERGENCY medical services ,SYSTEMATIC reviews ,MEDLINE ,THEMATIC analysis ,ANESTHESIOLOGY ,ONLINE information services ,SOCIAL support ,PERIOPERATIVE care ,COGNITION ,OPERATING rooms - Abstract
Problem identification: Perioperative emergencies, although infrequent, may lead to significant morbidity and mortality associated with anaesthesia and/or surgery. Human factor errors account for between 43 to 65 per cent of sentinel events in the perioperative environment. Cognitive aids were introduced to reduce a user's cognitive workload and assist in adherence to key interventions during emergencies. Despite the availability of these aids, implementation of their use remains low. This integrative literature review will identify the barriers to and facilitators of the implementation of cognitive aids during perioperative emergencies. Literature search: An electronic database search of EBSCO databases (CINAHL Complete, Health Source: Nursing/Academic Edition, MEDLINE, MEDLINE Complete), Pubmed and Scopus were conducted to obtain contemporary literature. Duplicates were removed and inclusion and exclusion criteria were applied. A total of 14 articles were identified for inclusion. Data evaluation and synthesis: Included articles were critically analysed and appraised using the JBI critical appraisal tools to assess for the methodological quality of the research, and the National Health and Medical Research Council (NHMRC) evidence hierarchy to assess for reliability and validity. A data extraction table (literature matrix) was used to record the article's author, date of publication, research title, population, study design, level of evidence, key findings, implications for practice and limitations. This aided in synthesis of the selected studies, thematic analysis and drawing conclusions. Implications for practice: Strong design and staff education were identified as facilitators of cognitive aid implementation while poor design and lack of organisational support were identified as barriers to cognitive aid implementation. Nursing leaders and educators have a vital role to play in gaining organisational support to provide staff education and training and develop appropriately designed cognitive aids. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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20. Role of artificial intelligence in perioperative monitoring in anaesthesia.
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Garg, Shaloo and Kapoor, Mukul Chandra
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CLINICAL decision support systems ,ARTIFICIAL intelligence ,DATA privacy ,ANESTHESIA ,INTENSIVE care units - Abstract
Artificial intelligence (AI) is making giant strides in the medical domain, and the field of anaesthesia is not untouched. Enhancement in technology, especially AI, in many fields, including medicine, has proven to be far superior, safer and less erratic than human decision-making. The intersection of anaesthesia and AI holds the potential for augmenting constructive advances in anaesthesia care. AI can improve anaesthesiologists' efficiency, reduce costs and improve patient outcomes. Anaesthesiologists are well placed to harness the advantages of AI in various areas like perioperative monitoring, anaesthesia care, drug delivery, post-anaesthesia care unit, pain management and intensive care unit. Perioperative monitoring of the depth of anaesthesia, clinical decision support systems and closed-loop anaesthesia delivery aid in efficient and safer anaesthesia delivery. The effect of various AI interventions in clinical practice will need further research and validation, as well as the ethical implications of privacy and data handling. This paper aims to provide an overview of AI in perioperative monitoring in anaesthesia. [ABSTRACT FROM AUTHOR]
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- 2024
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21. Apnoea is not necessary for flexible ureteroscopy and lasertripsy of renal stones: a prospective study over 6 years
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Hui Ching Ho, Amelia Pietropaolo, Carolyn Way, Sarah Prattley, Bhaskar K. Somani, Lily Whitehurst, and Thomas Hughes
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Original Paper ,medicine.medical_specialty ,Respiratory complications ,complications ,Demographics ,medicine.diagnostic_test ,business.industry ,urolithiasis ,Mean age ,anaesthesia ,General Medicine ,Flexible ureteroscopy ,apnoea ,Surgery ,medicine ,RIRS ,Ureteroscopy ,ureteroscopy ,Prospective cohort study ,Complication ,General anaesthetic ,business - Abstract
Introduction Temporary apnoea is often practiced during flexible ureteroscopy and lasertripsy (FURSL) for renal stones to reduce the potential movement of kidney secondary to respiratory excursions. While apnoea can help, it can also lead to respiratory complications, longer operative duration and ultimately prolong the length of hospital stay (LOS). The aim of this study was to look at the outcomes of FURSL without the use of apnoea. Material and methods Over a 6-year period from March 2012–June 2018, consecutive cases of adult FURSL were prospectively evaluated. Patients underwent surgical and anaesthetic counselling, pre-operative assessment and protocol-based general anaesthetic without using apnoea. Data on patient and stone demographics, operative details, LOS, stone-free rate (SFR) and complication rates were collected and analysed. Results A total of 292 patients underwent FURSL, with a mean age of 57 years and male:female ratio of 1.6:1. Pre and post-operative stents were inserted in 28.8% and 81.2%, a ureteral access sheath (UAS) was used in 61.6%. The mean single and cumulative stone sizes were 10.2 ±5.9 mm and 14.3 ±10.4 mm respectively. For a mean operative time of 48.8 ±25.5 minutes, the SFR was 88.7%. The median length of stay was 0 days with 216 (74.0%) patients discharged the same day and a further 48 (16.4%) discharged within 24 hours. There were 11 complications, of which 10 were Clavien I/II, and 1 was Clavien IV. Conclusions Ureteroscopy can be safely performed without respiratory apnoea, using anaesthetic and surgical protocols. It improves day-case rates for FURSL and minimizes complications.
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- 2020
22. Do direct oral anticoagulants (DOACs) cause delayed surgery, longer length of hospital stay, and poorer outcome for hip fracture patients?
- Author
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Jan-Erik Gjertsen, Ola E. Dahl, Lars B. Engesæter, Sunniva Leer-Salvesen, Eva Dybvik, Bjørn Liljestrand Husebø, and Anette Hylen Ranhoff
- Subjects
medicine.medical_specialty ,Surgical delay ,Direct oral anticoagulants (DOAC) ,Hip fracture ,Anaesthesia ,New oral anticoagulants (NOAC) ,03 medical and health sciences ,0302 clinical medicine ,Orthogeriatrics ,medicine ,Delayed surgery ,General anaesthesia ,030212 general & internal medicine ,030222 orthopedics ,business.industry ,Medical record ,Trauma center ,Odds ratio ,Perioperative ,medicine.disease ,Surgery ,business ,Hospital stay ,Research Paper - Abstract
Key summary points Aim The aim of this study was to determine whether DOAC-users with a hip fracture have delayed surgery, longer length of hospital stay or altered risk of bleeding complications compared to non-users. Findings DOAC-users with a hip fracture did not have increased surgical delay, length of stay or risk of reported bleeding complications compared to patients without anticoagulation prior to surgery. Message Our study does not support delayed surgery for DOAC-users suffering a hip fracture., Purpose The perioperative consequences of direct oral anticoagulants (DOACs) in hip fracture patients are not sufficiently investigated. The primary aim of this study was to determine whether DOAC-users have delayed surgery compared to non-users. Secondarily, we studied whether length of hospital stay, mortality, reoperations and bleeding complications were influenced by the use of DOAC. Methods The medical records of 314 patients operated for a hip fracture between 2016 and 2017 in a single trauma center were assessed. Patients aged
- Published
- 2020
23. A quality analysis of clinical anaesthesia study protocols from the Chinese clinical trials registry according to the SPIRIT statement
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Taixiang Wu, Yunxia Zuo, Jiajin Li, Lei Yang, Di Yang, and Shouming Chen
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business.industry ,quality analysis ,010102 general mathematics ,anaesthesia ,clinical study ,01 natural sciences ,Clinical trial ,Clinical study ,03 medical and health sciences ,0302 clinical medicine ,Oncology ,Anesthesia ,Medicine ,SPIRIT ,030212 general & internal medicine ,protocol ,0101 mathematics ,Clinical Research Paper ,business ,Trial registration - Abstract
Objective To learn about the overall quality of clinical anaesthesia study protocols from the Chinese Clinical Trials Registry and to discuss the way to improve study protocol quality. Methods We defined completeness of each sub-item in SPIRIT as N/A (not applicable) or with a score of 0, 1, or 2. For each protocol, we calculated the proportion of adequately reported items (score = 2 and N/A) and unreported items (score = 0). Protocol quality was determined according to the proportion of reported items, with values >50% indicating high quality. Protocol quality was determined according to the proportion of reported items. For each sub-item in SPIRIT, we calculated the adequately reported rate (percentage of all protocols with score 2 and NA on one sub-item) as well as the unreported rate (percentage of all protocols with score 0 on one sub-item). Results Total 126 study protocols were available for assessment. Among these, 88.1% were assessed as being of low quality. By comparison, the percentage of low-quality protocols was 88.9% after the publication of the SPIRIT statement. Among the 51 SPIRIT sub-items, 18 sub-items had an unreported rate above 90% while 16 had a higher adequately reported rate than an unreported rate. Conclusions The overall quality of clinical anaesthesia study protocols registered in the ChiCTR was poor. A mandatory protocol upload and self-check based on the SPIRIT statement during the trial registration process may improve protocol quality in the future.
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- 2018
24. Predicting Prolonged Apnea During Nurse-Administered Procedural Sedation: Machine Learning Study
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Joanna Sutherland, Matteo Parotto, Navpreet Kamboj, Sebastian Mafeld, Carla R. Jungquist, Aaron Conway, and Kristina Chang
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medicine.medical_treatment ,anesthesia ,Logistic regression ,Machine learning ,computer.software_genre ,ALARM ,nursing ,Alarm management ,patient safety ,medicine ,informatics ,medical informatics ,procedural sedation and analgesia ,Original Paper ,Capnography ,Receiver operating characteristic ,medicine.diagnostic_test ,business.industry ,conscious sedation ,Apnea ,Sleep apnea ,anaesthesia ,apnea ,sleep apnea ,medicine.disease ,capnography ,apnoea ,machine learning ,sedation ,Procedural sedation and analgesia ,Artificial intelligence ,medicine.symptom ,business ,computer - Abstract
Background Capnography is commonly used for nurse-administered procedural sedation. Distinguishing between capnography waveform abnormalities that signal the need for clinical intervention for an event and those that do not indicate the need for intervention is essential for the successful implementation of this technology into practice. It is possible that capnography alarm management may be improved by using machine learning to create a “smart alarm” that can alert clinicians to apneic events that are predicted to be prolonged. Objective To determine the accuracy of machine learning models for predicting at the 15-second time point if apnea will be prolonged (ie, apnea that persists for >30 seconds). Methods A secondary analysis of an observational study was conducted. We selected several candidate models to evaluate, including a random forest model, generalized linear model (logistic regression), least absolute shrinkage and selection operator regression, ridge regression, and the XGBoost model. Out-of-sample accuracy of the models was calculated using 10-fold cross-validation. The net benefit decision analytic measure was used to assist with deciding whether using the models in practice would lead to better outcomes on average than using the current default capnography alarm management strategies. The default strategies are the aggressive approach, in which an alarm is triggered after brief periods of apnea (typically 15 seconds) and the conservative approach, in which an alarm is triggered for only prolonged periods of apnea (typically >30 seconds). Results A total of 384 apneic events longer than 15 seconds were observed in 61 of the 102 patients (59.8%) who participated in the observational study. Nearly half of the apneic events (180/384, 46.9%) were prolonged. The random forest model performed the best in terms of discrimination (area under the receiver operating characteristic curve 0.66) and calibration. The net benefit associated with the random forest model exceeded that associated with the aggressive strategy but was lower than that associated with the conservative strategy. Conclusions Decision curve analysis indicated that using a random forest model would lead to a better outcome for capnography alarm management than using an aggressive strategy in which alarms are triggered after 15 seconds of apnea. The model would not be superior to the conservative strategy in which alarms are only triggered after 30 seconds.
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- 2021
25. Reported analgesic and anaesthetic administration to rodents undergoing experimental surgical procedures.
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Stokes, E. L., Flecknell, P. A., and Richardson, C. A.
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ANALGESICS ,LABORATORY rats ,ANESTHETICS ,ISOFLURANE ,SURGERY ,ANIMALS - Abstract
A structured literature review was carried out to assess recent trends in the administration of analgesics and anaesthetics to laboratory rats and mice undergoing surgical procedures. The ScienceDirect database was used to systematically identify studies published in peer-reviewed journals over two periods (2000-2001 and 2005-2006), 86 studies from each time period were included in the review. The total number of animals that underwent surgery, species used, type of procedure, anaesthetic regimen and analgesic administration were noted for each study. There was an increase in the reported administration of systemic analgesics from 10% in 2000-2001 to 20% in 2005-2006. Buprenorphine was the most commonly reported analgesic in both periods (2000-2001: 78%, 2005-2006: 35%) and reporting the use of non-steroidal anti-inflammatory drugs increased from 11% to 53%. There was also a change in reported anaesthetic practices, notably a decrease in the use of pentobarbital and an increase in the use of isoflurane and ketamine/xylazine. Although reported administration of analgesics has increased and there has been some refinement in the selection of anaesthetic agents used, the findings of this review suggest that there is still significant scope for improvement with respect to the perioperative care of laboratory rodents. [ABSTRACT FROM AUTHOR]
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- 2009
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26. Sevoflurane preconditioning ameliorates traumatic spinal cord injury through caveolin-3-dependent cyclooxygenase-2 inhibition
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Ningxian Wei, Lihui Wang, Gang Shao, Weidong Wu, Danhui Kong, Lixin Wang, Yansheng Du, and Yingchun Qin
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0301 basic medicine ,Sevoflurane ,Proinflammatory cytokine ,sevoflurane preconditioning ,03 medical and health sciences ,0302 clinical medicine ,Paralysis ,medicine ,traumatic spinal cord injury ,biology ,business.industry ,anaesthesia ,COX-2 ,medicine.disease ,Spinal cord ,Caveolin 3 ,030104 developmental biology ,medicine.anatomical_structure ,Oncology ,Apoptosis ,Anesthesia ,biology.protein ,Cav-3 ,Cyclooxygenase ,medicine.symptom ,business ,Reperfusion injury ,030217 neurology & neurosurgery ,medicine.drug ,Research Paper - Abstract
Acute traumatic spinal cord injury (tSCI) results in a lifetime of paralysis associated with a host of medical complications. The developing secondary complications of tSCI may result in further chronic neurodegenerative diseases. Sevoflurane preconditioning (SF-PreCon) has shown guaranteed protective effects in myocardial or cerebral ischemic/reperfusion injury. However, the role of SF-PreCon in tSCI still remains to be elucidated. Here, we found that SF-PreCon ameliorated the developing secondary complications through reducing the apoptosis rate and the secretion of inflammatory cytokines in injured spinal cord tissues, and therefore enhancing the recovery after tSCI. Notably, we demonstrated that SF-PreCon ameliorates tSCI through inhibiting Cycloxygenase-2 (COX-2). Importantly, we verified that SF-PreCon inhibits the expression of COX-2 and reduces the apoptosis rate after tSCI via the induction of Caveolin-3 (Cav-3). Taken together, our results suggest that SF-PreCon ameliorates tSCI via Cav-3-dependent COX-2 inhibition and provide an economical and practical method against the secondary injury after tSCI.
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- 2017
27. The effects of intra- and post-operative anaesthesia and analgesia choice on outcome after gastric cancer resection: a retrospective study
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Xiaoyu Zheng, Yang Xu, Yu Wang, Hong Chen, Guonian Wang, and Liping Wang
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medicine.medical_specialty ,Visual analogue scale ,Nausea ,overall survival ,medicine.medical_treatment ,patient-controlled analgesia ,03 medical and health sciences ,0302 clinical medicine ,030202 anesthesiology ,Medicine ,General anaesthesia ,business.industry ,Patient-controlled analgesia ,Proportional hazards model ,gastric cancer ,Incidence (epidemiology) ,Retrospective cohort study ,anaesthesia ,epidural and or general anaesthesia ,Surgery ,Oncology ,Anesthesia ,Vomiting ,Clinical Research Paper ,medicine.symptom ,business ,030217 neurology & neurosurgery - Abstract
// Yu Wang 1 , Liping Wang 1 , Hong Chen 1 , Yang Xu 1 , Xiaoyu Zheng 1 and Guonian Wang 1 1 Department of Anaesthesiology, Cancer Hospital of Harbin Medical University, Harbin, China Correspondence to: Guonian Wang, email: // Keywords : anaesthesia, epidural and or general anaesthesia, patient-controlled analgesia, gastric cancer, overall survival Received : February 13, 2017 Accepted : March 01, 2017 Published : March 30, 2017 Abstract Background: Epidural use can provide a better short-term outcome and protect patients from the postoperative development of tumour recurrence and metastases. In this study, we sought to assess the effects of intra- and postoperative anaesthesia and analgesia choice on outcome after gastric cancer resection, searched for evidence of interaction between intra-and postoperative epidural use and outcomes of gastric cancer patients. Methods: Four thousand two hundred and eighteen cases of gastric cancer were identified from the Records of Hospital Patients. Patients who received only general anesthesia (GA group) or epidural anesthesia combined with general anesthesia (EGA group), were administered patient-controlled intravenous or epidural analgesia for 72-120 hours postoperatively. Flatus time, length of stay in hospital, incidence of nausea and vomiting, and visual analogue scale (VAS ) scores were collected for evaluating the short-outcome of the patients. A Kaplan-Meier log-rank test was used for a univariable analysis, and Cox proportional hazards regressions were used for a multivariable analysis of the survival time in both groups. Results: The VAS scores and incidence of nausea and vomiting in the EGA group were lower than the GA group. There was a significant association between intra-and postoperative epidural use and improved survival. Conclusions: These results indicated that epidural anaesthesia combined with general anaesthesia and patient-controlled epidural analgesia may be associated with the improved overall survival in gastric cancer patients who underwent resection.
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- 2017
28. Days at Home after Surgery: An Integrated and Efficient Outcome Measure for Clinical Trials and Quality Assurance
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Fredrik Granath, Lars Eriksson, Tobias Svensson, Jennifer R. Reilly, Linn Hallqvist, Paul S. Myles, and Max Bell
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medicine.medical_specialty ,Survival ,Audit ,01 natural sciences ,Anaesthesia ,03 medical and health sciences ,Postoperative complications ,0302 clinical medicine ,Health care ,Medicine ,030212 general & internal medicine ,0101 mathematics ,lcsh:R5-920 ,business.industry ,010102 general mathematics ,General Medicine ,Perioperative ,medicine.disease ,Comorbidity ,Surgery ,Clinical trial ,Patient-reported outcome measures ,Metric (unit) ,lcsh:Medicine (General) ,business ,Quality assurance ,Cohort study ,Research Paper - Abstract
Background: Surgical audit, sometimes including public reporting, is an important foundation of high quality health care. We aimed to assess the validity of a novel outcome metric, days at home up to 30 days after surgery, as a surgical outcome measure in clinical trials and quality assurance. Methods: This was a multicentre, registry-based cohort study. We used prospectively collected hospital and national healthcare registry data obtained from patients aged 18 years or older undergoing a broad range of surgeries in Sweden over a 10-year period. The association between days at home up to 30 days after surgery and patient (older age, poorer physical status, comorbidity) and surgical (elective or non-elective, complexity, duration) risk factors, process of care outcomes (re-admissions, discharge destination), clinical outcomes (major complications, 30-day mortality) and death up to 1 year after surgery were measured. Findings: From January, 2005, to December, 2014, we obtained demographic and perioperative data on 636,885 patients from 21 Swedish hospitals. Mortality at 30 days and one year was 1.8% and 7.3%, respectively. The median (IQR) days at home up to 30 days after surgery was 27 (23–29), being significantly lower among high-risk patients, those recovering from more complex surgical procedures, and suffering serious postoperative complications (all p
- Published
- 2018
29. Postoperative analgesia and side effects of oral or injectable metamizole (dipyrone) in dogs and cats.
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Stadnicki, Jakub and Raillard, Mathieu
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AGRANULOCYTOSIS ,DIPYRONE ,DOGS ,CATS ,ANALGESIA ,CANNABINOID receptors ,BLOOD cell count ,VETERINARY dentistry - Abstract
This document is a summary of a search conducted on various databases to find relevant articles on the topic of metamizole (also known as dipyrone) and its use in dogs and cats for pain relief. The search yielded three relevant papers, which were reviewed to assess the effectiveness and safety of metamizole for postoperative pain management in cats and dogs. The studies found that metamizole may help reduce postoperative pain levels in healthy cats and dogs undergoing ovariohysterectomy, but it was not effective as the sole analgesic in dogs. The studies did not find any evidence of higher incidence of side effects with metamizole use. However, the studies had limitations such as small sample sizes and lack of detail on randomization and blinding techniques. The document emphasizes that the application of this evidence should consider multiple factors and individual circumstances. The authors encourage library patrons to contribute to the evidence base by sharing their information needs or writing knowledge summaries. The document concludes with a disclaimer stating that the opinions expressed in the summaries are those of the authors and not necessarily reflective of the views of the organization. [Extracted from the article]
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- 2023
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30. Updated guideline on equipment to manage difficult airways: Australian and New Zealand College of Anaesthetists.
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Endlich, Yasmin, Hore, Phillipa J, Baker, Paul A, Beckmann, Linda A, Bradley, William P, Chan, Kah L E, Chapman, Gordon A, Jephcott, Christopher G A, Kruger, Peter S, Newton, Alastair, and Roessler, Peter
- Subjects
CRITICAL care medicine ,UNIVERSITIES & colleges - Abstract
The Australian and New Zealand College of Anaesthetists (ANZCA) recently reviewed and updated the guideline on equipment to manage a difficult airway. An ANZCA-established document development group, which included representatives from the Australasian College for Emergency Medicine and the College of Intensive Care Medicine of Australia and New Zealand, performed the review, which is based on expert consensus, an extensive literature review, and bi-nationwide consultation. The guideline (PG56(A) 2021, https://www.anzca.edu.au/getattachment/02fe1a4c-14f0-4ad1-8337-c281d26bfa17/PS56-Guideline-on-equipment-to-manage-difficult-airways) is accompanied by a detailed background paper (PG56(A)BP 2021, https://www.anzca.edu.au/getattachment/9ef4cd97-2f02-47fe-a63a-9f74fa7c68ac/PG56(A)BP-Guideline-on-equipment-to-manage-difficult-airways-Background-Paper), from which the current recommendations are reproduced on behalf of, and with the permission of, ANZCA. The updated 2021 guideline replaces the 2012 version and aims to provide an updated, objective, informed, transparent, and evidence-based review of equipment to manage difficult airways. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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31. To Study The Effect Of Magnesium Sulfate With Propofol Induction Of Anaesthesia On Succinylcholine-Induced Fasciculations And Myalgia.
- Author
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Verma, Rachna, Yadav, Hina, Reddy, Sravan, Kumar, Deepak, Muzammil, Shukla, Deepak, and Gautam, Sanni Deyol
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- *
MAGNESIUM sulfate , *MYALGIA , *PROPOFOL , *ANESTHESIA , *ELECTIVE surgery - Abstract
BACKGROUND: Succinylcholine is a commonly used muscle relaxant in anaesthesia that is associated with significant side effects, including muscle fasciculations and postoperative myalgia. Succinylcholine is used to facilitate tracheal intubation, especially in emergency situations when the risk of aspiration of gastric contents is present. AIM AND OBJECTIVE: This research paper investigates the effect of administering magnesium sulfate in conjunction with propofol induction on succinylcholine-induced fasciculations and myalgia. MATERIAL & METHODS: A total of 80 adult patients scheduled for elective surgery under general anaesthesia were divided into two groups (group I and II). The group I patients were treated with magnesium sulphate (40 mg/kg weight) in 10 ml volume while Group II patients were pretreated with normal saline (0.9% in 10 ml volume). They were given slowly intravenously over a period of 10 mim. Then Anesthesia was induced with fentanyl 1.5 mcg/kg and propofol 2 mg/kg, followed by administration of succinylcholine 2 mg/kg intravenously. Muscle fasciculation and Myalgia were observed after 24 hours of surgery. They were graded as nil, mild, moderate and severe. RESULTS: The overall incidence of muscle fasciculation in group I was 52.5% while it was 100% in group II. In group I, 22.5%,12 % mild and moderate muscle fasciculation were developed and no severe cases of fasciculation were observed. While in group II, 52.5% moderate, 40 % mild and 7.5% severe muscle fasciculation were observed. Postoperative myalgia was observed after 24 hrs, and it was observed that patients of Group I were not showing any sign and symptoms of myalgia while in group II, 12.5% were mild, 7.5% were moderate and 80% were negative for myalgia. CONCLUSION: The study found that the administration of magnesium sulfate significantly reduced both the incidence and severity of succinylcholine-induced fasciculations and myalgia, suggesting a beneficial role for magnesium sulfate in anesthesia protocols. [ABSTRACT FROM AUTHOR]
- Published
- 2024
32. Evidence for compromised data integrity in studies of liberal peri-operative inspired oxygen.
- Author
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Myles, P. S., Carlisle, J. B., and Scarr, B.
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DATA integrity ,SURGICAL site infections ,STATISTICAL errors ,OXYGEN - Abstract
In 2016 the World Health Organization recommended intra-operative ventilation with 80% inspired oxygen to reduce surgical site infection rates, based upon a meta-analysis of 15 randomised controlled trials, of which two were by Mario Schietroma's research group. Five trials by this group have been retracted for duplication, plagiarism, statistical error and lack of ethical approval. We analysed 40 papers by this group: 24 randomised controlled trials (5064 participants) and 16 observational studies (1847 patients). There was evidence that data integrity was compromised in 38 out of the 40 analysed papers. The distribution of baseline characteristics in randomised controlled trials was unlikely, p = 1.5 × 10-8 : continuous variables within trials were heterogeneous, p = 1.9 × 10-9 , and categorical variables were homogeneous, p = 8.5 × 10-20 . Effects of interventions varied less than expected between studies: for categorical variables, for instance postoperative wound infection, p < 1 × 10-7 , and for continuous variables, for instance HLA-DR concentration, p = 0.00001. Of 184 calculable p values, for baseline variables or results, 179 (98%) were incorrect, ranging from three orders of magnitude too small to 10 orders of magnitude too large. Twenty-one graphs occurred 81 times in 23 out of 40 papers. Liberal peri-operative oxygen did not reduce surgical site infection in a meta-analysis of 20 trials that excluded seven trials by Mario Schietroma and colleagues (odds ratio (95%CI) 0.89 (0.73-1.08); p = 0.23). An update by the World Health Organization has now excluded trials of liberal oxygen by Schietroma's group, four of which have not been retracted. We conclude that Mario Schietroma's work should not inform practice until investigated. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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33. Up-to-date literature review and issues of sedation during digestive endoscopy.
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Lu-Lu Lv and Meng-Meng Zhang
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LITERATURE reviews ,ENDOSCOPY ,PROPOFOL infusion syndrome ,PATIENT selection ,PATIENT monitoring ,ANALGESIA - Abstract
Sedation is common during digestive endoscopy to provide comfort and pain relief for patients. However, the use of sedation in endoscopy also poses potential risks, and recent issues have been raised regarding its safety and administration. This literature review paper will discuss the most recent developments in the field of sedation in digestive endoscopy, including the adverse events that might be associated with sedation and how to manage it, the legal issues associated with administration, the impact of COVID-19 on sedation practices, and sedation in special situations. It will also touch upon the current guidelines and recommendations for sedation, including the importance of patient selection and monitoring and the need for training and certification for endoscopists administering sedation. The review will also analyse studies evaluating the safety and efficacy of various sedation techniques, including propofol, midazolam, and others. It will examine the benefits and drawbacks of these agents. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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34. Turning the page on 2021: an eventful year for the British Journal of Anaesthesia.
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Hemmings, Hugh C. and Hemmings, Hugh C Jr
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- *
ELECTRONIC publications , *ANESTHESIA , *OPEN access publishing , *ELECTRONIC paper , *COVID-19 pandemic - Abstract
The British Journal of Anaesthesia (BJA) had an eventful 2021, following what was a cataclysmic 2020 for the whole world. Despite the tragic challenges of multiple waves of the COVID-19 pandemic and the unparalleled burdens this created for everyone working in anaesthesia and critical care, the BJA underwent a major transformation during 2021. The BJA strongly supported research and education relevant to the pandemic, and to the broader missions of anaesthesia, critical, and pain medicine. Innovations to the BJA in 2021 included a special section on COVID-19 and the Anaesthetist; a new open access journal in the BJA stable; creation of a new social media editor position; new webinar and author interview series; transition to a new manuscript management system; and a move away from paper to electronic publication. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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35. “A new order of poisonous substances”: revisiting Robert M. Glover’s dissertation on the physiological effects of bromine, chlorine, and iodine compounds
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Perkins-McVey, Matthew
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- 2024
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36. Anaesthesia of the posterior urethra and pain reduction during cystoscopy - a randomized controlled trial
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Piotr Radziszewski, Marcin Łykowski, Sławomir Poletajew, Sylwia Bender, Bartosz Sutkowski, Paweł Pudełko, and Tomasz Piecha
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Lidocaine ,Urology ,Urinary system ,law.invention ,Urology: Original paper ,Randomized controlled trial ,law ,Clinical endpoint ,medicine ,cystoscopy ,Bladder cancer ,medicine.diagnostic_test ,business.industry ,Gastroenterology ,Obstetrics and Gynecology ,Cystoscopy ,anaesthesia ,medicine.disease ,Urethra ,medicine.anatomical_structure ,Anesthesia ,Relative risk ,bladder cancer ,Surgery ,urethra ,business ,medicine.drug - Abstract
INTRODUCTION Standard intra-urethral instillation of anaesthetic gel may not sufficiently exclude pain perception during cystoscopy. AIM To evaluate the impact of the anaesthesia within the posterior urethra on pain intensity related to cystoscopy in men. MATERIAL AND METHODS One hundred and twenty-seven men undergoing cystoscopy were prospectively enrolled in the study. Patients were randomly assigned to the experimental or control group (66 vs. 61 patients). Intra-urethral instillation of 2% lidocaine gel was done in both groups. In the experimental group, the posterior urethra was additionally anaesthetized with distribution of the lidocaine gel by catheterisation. The study endpoints were pain intensity at successive time points of the procedure assessed on a numeric rating scale, overall pain intensity assessed on a Likert scale, the need for analgesics during 6 h after the procedure, and the frequency of urinary tract infections (UTIs) during 14 days after the procedure. RESULTS Pain perception during cystoscopy did not differ significantly between the two groups (p > 0.05). However, after 6 h patients in the experimental group were more likely to declare that the cystoscopy was painless (81.8% vs. 70.2%, relative risk = 1.17). The need for analgesics and the incidence of UTI were similar in both groups (p > 0.05). Statistically significant differences regarding pain perception were observed depending on patients' age and the number of transurethral procedures performed in the past, with no relation to type of anaesthesia (p < 0.05). CONCLUSIONS Anaesthesia of the posterior urethra is not more efficacious in reducing pain related to cystoscopy than standard instillation of anaesthetic gel. However, it improves the general perception of the procedure, and hence may positively influence patients' compliance.
- Published
- 2016
37. Does computerized anaesthesia reduce pain during local anaesthesia in paediatric patients for dental treatment? A systematic review and meta‐analysis.
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Smolarek, Priscila de Camargo, Wambier, Letícia M., Siqueira Silva, Leonardo, and Chibinski, Ana Cláudia Rodrigues
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ANESTHESIA ,CHILD patients ,PAIN management ,COMPUTERS in dentistry ,PAIN perception ,META-analysis ,SYSTEMATIC reviews ,BEHAVIOR disorders in children - Abstract
This systematic review and meta‐analysis analysed whether pain and disruptive behaviour can be decreased by the use of computerized local dental anaesthesia (CDLA) in children. The literature was screened to select randomized clinical trials that compared computerized and conventional anaesthesia. The primary outcome was pain perception during anaesthesia; the secondary, disruptive behaviour. The risk of bias of individual papers and the quality of the evidence were evaluated. After search, 8389 records were found and 20 studies remained for the qualitative and quantitative syntheses. High heterogeneity was detected for both outcomes. For the pain perception, the overall analysis showed a standard mean difference of −0.78 (−1.31, −0.25) favouring CDLA; however, when only studies at low risk of bias were analysed (subgroup analysis), there was no difference between the two techniques [−0.12(−0.46, 0.22)]. For disruptive behaviour, no differences were detected for continuous [−0.26 (−0.68, 0.16)] or dichotomous data [0.81 (0.62, 1.06)]. The quality of evidence was judged as low for pain perception and very low for disruptive behaviour. It is concluded that there is no difference in the pain perception and disruptive behaviour in children subjected to computerized or conventional dental local anaesthesia. Notwithstanding, the quality of the available evidence is low. [ABSTRACT FROM AUTHOR]
- Published
- 2020
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38. The history of the College of Anaesthetists of South Africa.
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Gopalan, P. D. and Daniel, C. H.
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ANESTHESIOLOGISTS ,UNIVERSITIES & colleges ,PHYSICIANS ,SURGEONS ,MEDALS - Abstract
This paper reviews the history of the College of Anaesthetists of South Africa (CASA), starting with the establishment of the College of Physicians and Surgeons of South Africa (CPSSA), the subsequent formation of the Faculty of Anaesthetists as part of the College of Surgeons of South Africa (FFACSSA), to its present form as the CASA. This review includes major milestones achieved over the years, including international recognition, key role players involved, development of examinations, medals and awards given as well as individuals honoured by the CASA. [ABSTRACT FROM AUTHOR]
- Published
- 2022
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39. Low-Dose Propofol with Peribulbar Anaesthesia for Cataract Surgery.
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Ahmed, Mahmoud, Krishna, Yamini, Popova, Petya, Herbert, Rose, Sidaras, Gediminas, Choudhary, Anshoo, and Kaye, Stephen B.
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LOCAL anesthesia ,CATARACT surgery ,PATIENT reported outcome measures ,PROPOFOL - Abstract
In this paper, we investigate the effect of sedation using low-dose propofol on patient reported outcome measures (PROMS) in patients undergoing cataract surgery. This is a randomised, single-blinded observational prospective study. Patients undergoing elective cataract surgery using peribulbar anaesthesia over consecutive cataract lists were selected for this trial. Patients were randomised to receive either no sedation or low-dose propofol (20 to 30 mg followed by 10 mg increments until the patient developed slurred speech alone) prior to the administration of local anaesthesia. Pain, satisfaction, anxiety, needle recall, pulse, and blood pressure (BP) were measured. A total of 97 patients were included, 50 of whom received propofol. There were 4 senior surgeons and anaesthetists. There were no ocular or systemic complications and all patients had uncomplicated surgery. Anxiety (p = 0.026), needle recall (p < 0.001), difference in systolic BP (p = 0.043), and pulse (p = 0.046) were dependent on patient age (p < 0.001) and the use of propofol (p = 0.007). Lower pain was associated with propofol (p = 0.008), as well as lower anxiety (p = 0.002), and increased patient age (p = 0.014). The administration of propofol was significantly associated with lower needle recall (p < 0.001), pre- to post-operative difference in systolic BP (p = 0.029), and mean BP (p = 0.044). Low-dose propofol given immediately prior to administration of local anaesthesia was associated with reduced pain and needle recall, as well as lower BP. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
40. Patterns of intensive care unit emergencies.
- Author
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Yartsev, Alex and Yang, Feibi
- Subjects
INTENSIVE care units ,AUDITING ,CONFIDENCE intervals ,ANESTHESIA ,RETROSPECTIVE studies ,MEDICAL emergencies ,HOSPITAL mortality ,SEVERITY of illness index ,WORKFLOW ,CRITICAL care medicine ,DESCRIPTIVE statistics ,ODDS ratio ,WORKING hours ,ELECTRONIC health records ,DATA analysis software - Abstract
Objective: Little is known about the epidemiology of medical emergencies occurring in the intensive care unit (ICU). The aim of this study is to draw attention to the importance of auditing emergency events in the ICU. We hypothesised that emergency events occurring in the ICU would be clustered during periods of decreased medical and nursing attention and would occur in patients who had a higher illness severity and a greater risk of death. Methods: A retrospective observational cohort study was carried out in a 36-bed tertiary intensive care unit. The data capture all intensive care patients admitted to the ICU from 1 January to 1 December 2020. The number of emergency events occurring during each clock hour was correlated with ICU shift staffing patterns. In-hospital mortality and illness severity scores for patients experiencing emergency events were compared with those for all other ICU patients. Results: Serious medical emergencies were most frequent during the day, specifically during the morning ICU round (30% of all such events occurred between 08:00 and 12:00 hours), and there were peaks of incidence in the hour following each nursing and medical shift handover (following shift change times at 08:00, 15:00 and 21:00 hours). Agitation-related emergency events were least frequent during the periods of nursing day shift and afternoon shift overlap (07:00–08:00 hours and 13:00–15:00 hours). Patients who experienced serious medical emergency events in the ICU had a higher in-hospital mortality rate (28.3%) compared with the overall ICU mortality of 10.5% (OR = 4.89, 95% CI: 3.04–7.86). Conclusions: Patients who deteriorate suddenly in the ICU have greater illness severity and a significantly increased risk of death. The incidence of serious emergency events correlates with patterns of ICU staffing and work routines. This has implications for rostering, clinical workflow and education program design. What is known about the topic? Some common quality assurance indicators may underrepresent the true incidence of critical events or their impact on ICU team workload, given that often only adverse outcomes are captured Our study is significant because it captures all such workload. What does this paper add? By identifying periods of peak internal emergency activity, our study demonstrates the utility of collecting internal ICU emergency data for purposes of roster coordination. What are the implications for practitioners? We propose consistent senior medical presence and minimised non-essential interruptions during the hours of peak activity. Our method is easily reproducible and our findings, although from a single centre, are broadly generalisable, given that we discuss their similarity with other published works. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
41. Effect of midazolam premedication on the dose of propofol for laryngeal mask airway insertion in children
- Author
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Bhaskar, Priyesh, Malik, Anita, Kapoor, Rajni, Kohli, Monica, Agarwal, Jyotsana, and Harjai, Mamta
- Subjects
Anaesthesia ,lcsh:RD78.3-87.3 ,lcsh:Pharmacy and materia medica ,Anesthesiology and Pain Medicine ,lcsh:Anesthesiology ,Midazolam ,Laryngospasm ,lcsh:RS1-441 ,Pharmacology (medical) ,Laryngeal mask airway ,General Pharmacology, Toxicology and Pharmaceutics ,Propofol ,Research Paper - Abstract
Background: The present study was conducted on 120 pediatric patients of ASA Grade I and II of either sex aged 3-12 years scheduled for pediatric surgeries under general anaesthesia. Patients & Methods: All patients were randomly divided into Group A and Group B. Group A was further divided into 3 subgroups of unpremedicated patients who received 3, 4 and 5 mg kg -1 propofol only designated as A1, A2 and A3 respectively. Group B was further divided into subgroups of premedicated patients with midazolam (0.05 mg kg -1 ) intravenous and received 3, 4 and 5 mg kg -1 propofol designated as B1, B2 and B3 respectively. Results: Results showed that increasing dose of propofol decreases the adverse events like inadequate jaw relaxation, limb movements, coughing, gagging and laryngospasm. Midazolam when added to propofol further reduces the incidence of adverse events and provides more favorable environment for insertion of LMA. At higher doses of propofol (5 mg kg -1 ), hypotension is a major problem due to its cardiovascular depressant action. Therefore, 4 mg kg -1 propofol along with midazolam is the optimum dose because there is more hemodynamic stability and we get better conditions for LMA insertion. Conclusion: Midazolam is an effective premedication in children which is synergistic with propofol and reduces its effective dose, required for LMA insertion.
- Published
- 2010
42. Sedated masculinity: the use of anaesthesia during vasectomy in Israel.
- Author
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Friedman, Noga and Hashiloni-Dolev, Yael
- Subjects
VASECTOMY ,MASCULINITY ,STERILIZATION (Birth control) ,ANESTHESIA ,TWILIGHT ,SEMI-structured interviews - Abstract
Vasectomy is considered a permanent form of contraception for men that can help reduce reproductive inequality. Its underutilisation in the context of the threats it may pose to perceptions of traditional masculinity has been closely investigated, but the lived experience of the procedure itself has been largely overlooked. This paper examines the experience of having a vasectomy in Israel, focusing on the recommended form of anaesthesia. Drawing on 15 semi-structured interviews with Israeli men who have experienced vasectomy, we found that the choice of anaesthesia has a significant impact on the meaning and experience of vasectomy. Unlike the widespread use of local anaesthesia during vasectomy in other countries, vasectomy in Israel is performed almost exclusively under twilight sedation administered intravenously. Based on our findings, we argue that framing vasectomy as an operation that requires sedation is related to views of masculinity and reproduction. Our data suggest that vasectomy in Israel is constituted as a potentially traumatic event, and anaesthesia is employed to protect patients from feelings of embarrassment and discomfort. We conclude that the prevailing method of sedation perpetuates the silencing and marginalisation of vasectomy as a contraceptive method, and consequently, its very limited accessibility in Israel. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
43. Weltmeister im Schneckentempo - eine Umfrage zum Status quo der Digitalisierung in Anästhesie und Intensivmedizin.
- Author
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Kagerbauer, S., Dohmen, S., Reyle-Hahn, S., Balzer, F., Brodowski, C., Ulm, B., Pickert, G., Jungwirth, B., and Blobner, M.
- Subjects
HOSPITALS ,ANESTHESIA ,ANESTHESIOLOGISTS ,ATTITUDES of medical personnel ,DIGITAL health ,SURVEYS ,DOCUMENTATION ,CRITICAL care medicine - Abstract
Copyright of Anaesthesiologie & Intensivmedizin is the property of DGAI e.V. - Deutsche Gesellschaft fur Anasthesiologie und Intensivmedizin e.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2023
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44. The science of climate change and the effect of anaesthetic gas emissions.
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Slingo, J. M. and Slingo, M. E.
- Subjects
- *
CLIMATOLOGY , *CLIMATE change , *CARBON emissions , *ANESTHETICS , *GLOBAL warming - Abstract
Summary: The dedication of the international anaesthetic community to reducing the environmental impact of healthcare is important and to be celebrated. When this is underpinned by robust science, it has the potential to make a real difference. However, volatile anaesthetic agents have been widely promoted in the medical literature as damaging to the climate, leading to a drive to remove them from clinical practice. This is based on notional 'CO2‐equivalent' values created using the simple emission metric known as the global warming potential. Here, we assert that when proper consideration is given to the science of climate change, volatile anaesthetic gas emissions cannot be simply equated to real carbon dioxide emissions, and that their climate impact is vanishingly small. This paper gives anaesthetists a framework to make informed choices founded on climate science and calls for attention to be refocused on the urgent need to reduce the real carbon dioxide emissions associated with healthcare. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
45. The significance of race-related differences in anaesthesiological setting.
- Author
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Szymonek, Katarzyna, Kędziora, Bartosz, Tomczyk, Hubert, Podlińska, Iwona, and Onichimowski, Dariusz
- Subjects
- *
ETHNIC groups , *RACIAL differences , *DISEASE prevalence , *THERAPEUTICS , *DISEASE progression - Abstract
Introduction: The human species shows a great variability. The differences involve culture, customs, appearance but they also come to include some biological or physiological aspects which have a potential bearing on the course of diseases and the effects of treatment. Over the recent years, the increasing globalisation and improved travel opportunities have resulted in a growing mass mobility. The arrival of people representing other ethnicities may pose a challenge to doctors traditionally offering treatment to individuals within ethnically homogenous societies. Aim: The paper aims to present a comprehensive summary of state-of-the-art knowledge on race-related differences which may be of great importance for patient management in anaesthesiological setting. Material and methods: This paper is based on the available literature. Results and discussion: A literature review reveals a number of anatomical, pharmacokinetic and pharmacodynamic differences between the races. Moreover, particular ethnic groups show dissimilarities in the prevalence of some diseases requiring modifications in anaesthesiological management. Conclusions: Prior to the commencement of treatment, patient’s ethnicity and the consequent differences in terms of physiology should be recognised and considered in the treatment to ensure it is conducted appropriately and safely. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
46. Building a critical incident peer response team: A full theatre team welfare intervention.
- Author
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Civil, Nina M and Hoskins, Jeffrey D
- Abstract
The psychological impact (second victim effect) of in-theatre critical incidents is increasingly recognised. Different styles of psychological support programme have recently been published, including some utilising 'near in time' peer support. Most of these programmes either target their support to individuals, or focus on one vocational group rather than the multidisciplinary team. However, the in-theatre team consists of different craft groups who nonetheless function as a single team and are therefore 'peers'. This paper sets out the design and implementation of a critical incident peer response programme at Waikato Hospital, New Zealand, which provides peer-led group psychological first aid to full theatre teams. The programme is administered by trained representatives from multiple in-theatre craft groups including nurses, midwives, anaesthetic technicians, recovery room nurses, surgeons and anaesthetists. It emphasises team education and peer support, and has a wholly welfare focus. The programme has voluntary participation but mandatory activation triggers so that individuals do not need to seek support actively at a time when they may not recognise the need to do so. The programme is becoming embedded in the Waikato Hospital theatre culture so that participating in psychological support is normalised following a critical event. This framework is shared in the hope that it will assist other hospitals to develop welfare interventions to support full theatre teams. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
47. Feasibility of Eyetracking in Critical Care Environments - A Systematic Review.
- Author
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KLAUSEN, Andreas, RÖHRIG, Rainer, and LIPPRANDT, Myriam
- Abstract
Achieving a good understanding of the socio-technical system in critical or emergency situations is important for patient safety. Research in humancomputer interaction in the field of anesthesia or surgery has the potential to improve usability of the user interfaces and enhance patient safety. Therefore eyetracking is a technology for analyzing gaze patterns. It can also measure what is being perceived by the physician during medical procedures. The aim of this review is the applicability of eye-tracker in the domain of simulated or real environments of anesthesia, surgery or intensive care. We carried out a literature research in PubMed. Two independent researchers screened the titles and abstracts. The remaining 8 full-papers were analyzed based on the applicability of eye-trackers. The articles contain topics like training of surgeons, novice vs. experts or the cognitive workload. None of the publications address our goal. The applicability or limitations of the eye-tracker technology were stated incidentally. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
48. Anaesthesia practices for Caesarean section amongst non-physician anaesthesia providers at an Ethiopian referral hospital.
- Author
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White, Victoria Emma, Asfaw, Gebrehiwot, and Moore, Jolene Nina
- Subjects
ANESTHESIA ,HOSPITAL care ,DISEASE risk factors ,QUESTIONNAIRES - Abstract
Sub-Saharan Africa faces high rates of maternal mortality and there is an urgent need to reduce this. Shortfalls in access to safe surgery and anaesthetic care result in avoidable maternal death. Providing quality training to anaesthesia providers is of key importance to reduce mortality. This mixed-methods prospective study incorporated workplace observations of anaesthesia for Caesarean section, a paper-based questionnaire and semi-structured, face-to-face interviews in Felege Hiwot Referral Hospital in Ethiopia. A total of 67 Caesarean section cases under spinal anaesthesia provided by 12 non-physician anaesthetists were observed and a 92% (n = 11) response rate to questionnaires obtained. Deficiencies were observed in communication, pre-operative assessment, spinal height evaluation and application of lateral tilt, while interviews revealed anaesthesia provider perceptions of hierarchy within the surgical team and deficiency in anticipation of potential complications. This study suggests that focusing on communication and anticipation of complications could aid providers in preventing and preparing for complications. [ABSTRACT FROM AUTHOR]
- Published
- 2021
- Full Text
- View/download PDF
49. The financial and environmental costs of reusable and single-use plastic anaesthetic drug trays.
- Author
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McGAIN, F., McALISTER, S., McGAVIN, A., and STORY, D.
- Subjects
TRAYS ,MEDICAL supplies ,WASTE recycling ,CARBON dioxide ,COST - Abstract
The article describes a study which compared the financial and environmental costs of reusable and single-use/disposable plastic anaesthetic drug trays using a life cycle assessment (LCA) model. LCA modeling revealed that single-use plastic trays are more expensive, produced more carbon dioxide, and consumed more water as compared to the reusable trays.
- Published
- 2010
50. Adaptation of informed consent for anaesthesia to plain language standard.
- Author
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Romanik, Wojciech, Piekot, Tomasz, and Tymiński, Radosław
- Subjects
STANDARD language ,INFORMED consent (Medical law) ,READABILITY (Literary style) ,ANESTHESIA ,PLAINS ,POLISH language - Abstract
Introduction. The paper describes the process of editing and validating documents on the basis of which a patient gives their informed consent for anaesthesia before surgery. Our objective was to adapt such documents to plain language standards, thanks to which they will be more accessible to an average patient. Material and methods. Two documents were drafted: Information about anaesthesia and Informed consent for anaesthesia. Within the editing process, we applied the principles of Plain Polish worked out for the Polish language. Results. Similar documents available in Polish medical institutions were collected. For the comparison of the texts, the readability formula – Plain Language Index (PLI) – recently available in Poland was used. This algorithm assesses 10 properties of the style and, based on these, it measures the simplicity of the text. Conclusions. Both documents which we designed obtained the standard of plain language (PLI 50% and more). They turned out to be the most accessible out of all the texts examined. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
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