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Serum electrolytes In ASA PS 1 and 2 patients scheduled to undergo elective surgery, will routine preoperative serum electrolytes (Na, K) testing change anaesthetic management or patient outcomes after surgery? Chest X-ray In ASA PS 1 and 2 patients scheduled to undergo elective surgery, will routine preoperative chest X-ray testing change anaesthetic management or patient outcomes after surgery? Preamble Preoperative investigations are essential for planning, stratification, optimisation and perioperative management of patients undergoing surgical procedures and to improve patient outcomes. Liver function tests In ASA PS 1 and 2 patients scheduled to undergo elective surgery, will routine preoperative liver function testing change anaesthetic management or patient outcomes after surgery?. [Extracted from the article]

Background and Aims: Bag mask ventilation (BMV) allows for oxygenation and ventilation of patients until a definitive airway is secured and when definitive airway is difficult/impossible. This study hypothesised that the EO (thumb and index finger form a O shape around the mask) technique of mask holding provides better mask seal with the novices compared to the classic EC clamp technique (thumb and index finger form a C shape around the mask). Methods: Sixty patients participated in this double blinded, prospective, crossover study. The patients were randomly allocated to either EC or EO group. After adequate anaesthesia and neuromuscular blockade, a novice (experience of less than five attempts at BMV) held the mask with preferred hand with the allotted technique, while the ventilator provided five breaths at set pressure control of 15 cm H2O with one second each for inspiration and expiration. After recording the exhaled tidal volume (primary objective) for each breath for five consecutive breaths, the study was repeated with the other technique. Secondary outcome variables were minute ventilation, audible mask and epigastric leak. Results: The tidal volume and minute ventilation were significantly better with EO technique compared with the EC technique (P = 0.001, a tidal volume difference of 46 mL and P = 0.001, a minute volume difference of 0.51 L). Conclusion: The EO technique provides better mask seal (superior tidal volumes) than the conventional EC technique during single-handed mask holding performed by novices in the absence of other factors contributing to difficulty in mask ventilation. [ABSTRACT FROM AUTHOR]

With a large output of medical literature coming out every year, it is impossible for readers to read every article. Critical appraisal of scientific literature is an important skill to be mastered not only by academic medical professionals but also by those involved in clinical practice. Before incorporating changes into the management of their patients, a thorough evaluation of the current or published literature is an important step in clinical practice. It is necessary for assessing the published literature for its scientific validity and generalizability to the specific patient community and reader's work environment. Simple steps have been provided by Consolidated Standard for Reporting Trial statements, Scottish Intercollegiate Guidelines Network and several other resources which if implemented may help the reader to avoid reading flawed literature and prevent the incorporation of biased or untrustworthy information into our practice. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about the use of the standard gum elastic bougie (GEB) for for aiding laryngoscopy and intubation by inserting it into the lumen of the endotracheal tube (ETT) in the previous issue.

We describe the successful anesthetic management of a 14-year-old child, a corrected case of transposition of great vessels in childhood and presently with residual atrial septal defect, peripheral cyanosis, and neurological deficit of lower limb presented for tendoachillis lengthening. [ABSTRACT FROM AUTHOR]

The article explores the uses of melatonin in humans, including its role in regulation of the circadian rhythm, various indications in anaesthesia such as hypnosis and anxiolysis, and prevention of emergence agitation and delirium. It notes the very few side effects of melatonin with virtually no serious or life-threatening complications when exogenously administered. Also noted are the high therapeutic index of melatonin, lack of life-threatening adverse effects, and ease of access.

A letter to the editor is presented in response to the article "Magnification to avoid medication errors," by J. Sajjanshetty and colleagues in the 2015 issue.

A letter to the editor is presented in response to the article "Awake Airway Control in Patients With Anticipated Difficult Mask Ventilation," by P. Kundra et al. in a 2014 issue.