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ncement of clinical artificial intelligence tools. METHODS: A total of 377 videolaryngoscopy videos from YouTube were used to create 6 varied datasets, each differing in patient diversity and image count. The study also incorporates data augmentation techniques to enhance these datasets further. Two machine-learning models, YOLOv5-Small and YOLOv8-Small, were trained and evaluated on metrics such as

with chronic pain conditions, and what is published is derived from studies involving pharmacologic and psychological interventions. We here calculate these values based on data collected from 144 participants of a previously published multicenter clinical trial investigating the effects of a single treatment with percutaneous cryoneurolysis. METHODS: In the original trial, we enrolled patients with

OCUS). The aim of this study was to prospectively compare lung ultrasound with clinical auscultation to confirm OLV before thoracic surgery in pediatric patients. METHODS: This prospectively blinded feasibility study included 40 patients ranging in age from 0 to 20 years. After confirmation of lung separation by the primary anesthesia team using FOB, the sonographer and the auscultator, both blinded

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itating neuraxial anesthesia complication associated with significant maternal morbidity if undertreated. In this nationwide study, we examine the racial and ethnic disparities in the inpatient utilization of EBP after obstetric PDPH in the United States. METHODS: In this retrospective observational study, we used the National Inpatient Sample, a nationally representative database of discharge records

n the public sector, the anesthetic workforce in these hospitals consists mainly of nonspecialist (general practitioner) junior doctors with limited supervision. The Essential Steps in Managing Obstetric Emergencies (ESMOE) training program for interns was introduced in 2008 to reduce maternal deaths in SA. Training is not consistently offered at all intern-training institutions and it has not been

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US Clinical registry databases were searched. Studies comparing phenylephrine boluses (both therapeutic and prophylactic) with infusion (both fixed- and variable-rate) assessing various feto-maternal outcomes were included. The primary outcome was the incidence of maternal hypotension. Secondary maternal outcomes included the incidence of reactive hypertension, bradycardia, nausea, or vomiting; secondary

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ernal morbidity and mortality in all income settings globally. Themes associated with worse maternal mortality rate (MMR), challenges health care workers face, public health priority areas, and initiatives to help countries achieve the United Nations Sustainable Development Goal targets for MMR are discussed. MMRs are higher in low- and middle-income countries (LMICs) compared to high-income countries

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The guidelines from the Project for Universal Management of Airways for preventing unrecognised oesophageal intubation is a comprehensive and vital piece of work [1]. There is an important emphasis on shared communication regarding tracheal tube placement and a simple, sequential, process to follow in the absence of sustained exhaled carbon dioxide. However, we believe there are additional simple steps

Nathanson et al. [1], supported by Kane et al. in a subsequent letter [2], call for mandatory standards of training for rare anaesthetic events and mandatory safety preparedness. Their implicit assumption is that, with more training, anaesthetists will become less error-prone, performance will improve and, therefore, outcomes from uncommon, life-threatening peri-operative events will also improve.

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BACKGROUND Antibiotics play a crucial role in preventing surgical site infections, yet adherence to Infectious Disease Society of America (IDSA) guidelines varies widely. This qualitative study aimed to explore factors influencing perioperative antibiotic administration and assess the potential impact of a clinical decision support (CDS) tool on guideline adherence. METHODS In this qualitative study

Lumbar cerebrospinal fluid (CSF) drainage is one of the few preventative and therapeutic practices that may reduce spinal cord ischemia in high-risk thoracic endovascular aortic aneurysm repair (TEVAR). Although this is part of clinical guidelines in open thoracoabdominal aortic repair, there are no randomized controlled trials that provide convincing evidence on the protection conferred by CSF drainage

BACKGROUND The incidence of severe adverse events in children with SARS-CoV-2 undergoing anaesthesia has not been well established. We examined the relationship between SARS-CoV-2 infection and severe perioperative adverse events in children. METHODS This multicentre (21 North American institutions), retrospective cohort study included children <18 years old, with American Society of Anesthesiologists

SummaryIntroductionPoint‐of‐care gastric ultrasound is an emerging tool in peri‐operative practice. However, data on the technical challenges of gastric ultrasound, which are essential for optimised training, remain scarce. We analysed gastric ultrasound examinations performed after basic training to identify factors associated with difficulty.MethodsThis was an analysis of data from a prospective

SummaryBackgroundPatients undergoing major surgery frequently experience major uncontrolled bleeding. The aim of this systematic review and meta‐analysis was to evaluate the clinical efficacy of using viscoelastic haemostatic assays to manage peri‐operative bleeding in elective surgery.MethodsWe searched PubMed/MEDLINE and Embase databases for randomised controlled trials according to pre‐determined

Voltage-gated potassium channel subfamily q member 4 (Kcnq4) is predominantly expressed by hair cells and auditory neurons and regulates the neuronal excitability in the auditory pathway. Although it is further detected in myelinated large-diameter dorsal root ganglia (DRG) neurons in the periphery, the expression and function of Kcnq4 channel in nociceptors remains unknown. Here we showed that Kcnq4

Life cycle assessment is increasingly used in the healthcare sector to facilitate more environmentally informed supply and medication use. A thorough life cycle assessment comparing the carbon impacts of 10 different single-use anaesthetic drug trays yielded surprising findings. Although life cycle assessment can guide decision-making, results must be interpreted clinically and in light of all available

BACKGROUND Recent advances in artificial intelligence (AI) have enabled development of natural language algorithms capable of generating coherent texts. We evaluated the quality, validity, and safety of this generative AI in preoperative anaesthetic planning. METHODS In this exploratory, single-centre, convergent mixed-method study, 10 clinical vignettes were randomly selected, and ChatGPT (OpenAI

BACKGROUND The Gompertz-Makeham law describes a characteristic pattern of mortality in human populations where the death rate is near constant between ages 18 and 30 yr (Makeham law) and rises exponentially thereafter (Gompertz law). This pattern has not been described in surgical populations, but if true, it would have important implications for understanding surgical risk and design and interpretation

BACKGROUND The Trial Remifentanil DEXmedetomidine (TREX) trial aimed to determine whether, in children less than 2 yr old, low-dose sevoflurane/dexmedetomidine/remifentanil anesthesia is superior to standard-dose sevoflurane anesthesia in terms of global cognitive function at 3 yr of age. The aim of the current secondary analyses was to compare incidence of intraoperative hypotension and bradycardia

BACKGROUND The efficacy of serratus anterior plane block for treatment of pain after minimally invasive thoracic surgery remains unclear. This trial assesses the impact of serratus anterior plane block on postoperative opioid consumption and on measures of early recovery after thoracoscopic lung resection. METHODS Patients undergoing minimally invasive anatomic lung resection at a single center were

BACKGROUND Total hip replacement surgery is performed to improve quality of life (QoL). We explored the association between multimorbidity and change in QoL after total hip replacement. METHODS Analysis of patients included in the NHS England hip replacement Patient Reported Outcome Measures (PROMs) database with complete preoperative from 3 to 6 months postoperative EQ-5D QoL data from April 2013

Advancements in clinical science have shown the necessity for a paradigm shift away from a biomedical toward a biopsychosocial approach. Yet, the translation from clinical science into clinical practice is challenging. The aim of this study was to assess the short-term and mid-term changes in pain knowledge and attitudes and guideline-adherent recommendations of healthcare professionals (HCP) by means

Deciding the optimal time for surgery in patients with pre-existing comorbid disease is complex. A careful balance of risks is required to weigh up the therapeutic benefits of surgery against an increased risk of perioperative adverse outcomes, whereas the subsequent risk of adverse events and mortality is more dependent on pre-existing conditions. A study in a recent issue of BJA shows that people

BACKGROUND Prescription rates for buprenorphine in opioid use disorder are increasing, and recent guidelines recommend its continuation during and after surgery; however, evidence from clinical outcome studies is limited. We tested the hypotheses that 1) perioperative continuation of buprenorphine does not result in higher pain scores and 2) that this approach does not result in higher supplemental

BACKGROUND The GAS trial demonstrated evidence that most neurodevelopmental outcomes at 2 years and 5 years of age in infants who received a single general anaesthetic (GA) for elective inguinal herniorrhaphy were clinically equivalent when compared to infants who did not receive GA. More than 20% of the children in the trial had at least one subsequent anaesthetic exposure after their initial surgery

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The Sequential Organ Failure Assessment (SOFA) score was developed to describe the morbidity of patients who are critically ill [1] and is still used widely. However, some of the original score constituents no longer align with contemporary critical care clinical practice. Proposals to update the score including the addition and/or update of SOFA score constituents are yet to be evaluated [2]. The

SummaryBackgroundThe dural puncture epidural technique is a modification of the combined spinal‐epidural technique. Data comparing the two techniques are limited. We performed this randomised study to compare the quality of labour analgesia following initiation of analgesia with the dural puncture epidural vs. the combined spinal‐epidural technique.MethodsTerm parturients requesting labour epidural

There is growing acceptance for combining complementary and integrative health (CIH) therapies with standard rehabilitative care (SRC) for chronic pain management, yet little evidence on the best sequence of therapies. We investigated whether starting with CIH therapies or SRC is more effective in reducing pain impact. Participants were 280 service members with predominantly (88%) musculoskeletal chronic

In phase II clinical trials, NaV1.8 channels were identified as viable targets to treat acute pain. Results were modest, however, and NaV1.8 pore blockers must be given systemically, potentially leading to adverse effects, especially during prolonged use. A local, long-lasting approach is desirable, yet local anesthetics are neither specific nor long-lasting. In lieu of a pore blocker approach, we

BACKGROUND The acute hypoxic ventilatory response is a critical chemoreflex originating at the carotid bodies. This study investigates the impact of low-dose i.v. esketamine on the ventilatory response to 20 min of isocapnic hypoxia to test the hypothesis that esketamine does not affect hypoxic ventilation. METHODS In this open-label study, 18 healthy subjects received a 3-h escalating i.v. infusion

This narrative review evaluates the evidence regarding the protection offered by isolation gowns, approaches to imparting antimicrobial activity to gowns, and the environmental impacts of gown use, particularly during the COVID-19 pandemic. We conducted a search of the Medline, PubMed, and Google Scholar databases for articles published between January 1, 2019 to February 20, 2024. We found that current

SummaryIntroductionSodium‐glucose co‐transporter 2 inhibitors are a novel class of antihyperglycaemic drugs used in the management of type 2 diabetes, that improve glycaemic control, cardiovascular outcomes and promote weight loss. They are also approved for the treatment of heart failure and chronic kidney disease in patients with or without diabetes. This narrative review discusses the peri‐operative