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Beyond the scope: it is not only blade geometry of videolaryngoscopes but also the interplay with the adjuncts Anaesthesia (IF 7.5) Pub Date : 2024-07-18 Martin Petzoldt, Viktor A. Wünsch, Vera Köhl
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Simulated altitude for prehabilitation: alternatives await in less rarified air Anaesthesia (IF 7.5) Pub Date : 2024-07-18 Brendon H. Roxburgh
Brown et al. [1] investigated simulated altitude (hypoxic training) as a form of prehabilitation. Participants stayed in a residential hypoxia facility for 1 week in normoxic conditions and 1 week in hypoxic conditions (FIO2 15%). Although haemoglobin and erythropoietin concentration appeared to increase across the hypoxic week, this came at significant cost (e.g. physiological/clinical, environmental
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Mandatory training for rare anaesthetic events Anaesthesia (IF 7.5) Pub Date : 2024-07-15 Michael H. Nathanson, David G. Bogod, William Harrop‐Griffiths
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Anaesthesia associates' clinical activity, case mix, supervision and involvement in peri-operative cardiac arrest: analysis from the 7th National Audit Project Anaesthesia (IF 7.5) Pub Date : 2024-07-11 Tim M. Cook, Andrew D. Kane, Richard A. Armstrong, Emira Kursumovic, Lee Varney, Iain K. Moppett, Jasmeet Soar
We analysed the clinical practice of anaesthesia associates in the UK, as reported to the 7th National Audit Project of the Royal College of Anaesthetists, and compared these with medically qualified anaesthetists.
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Prevalence of neurocognitive disorders 5 years after elective orthopaedic surgery Anaesthesia (IF 7.5) Pub Date : 2024-07-10 Kelly J. Atkins, Brendan Silbert, David A. Scott, Lis A. Evered
Peri-operative neurocognitive disorders are one of the most common complications affecting older adults after anaesthesia and surgery. It is not clear how exposure to surgery and anaesthesia contributes to the prevalence of long-term neurocognitive disorders. This study aimed to report the prevalence of neurocognitive disorders, and explore pre-operative factors associated with neurocognitive disorders
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Anaesthesia associates and scope of practice: saying the unsayable Anaesthesia (IF 7.5) Pub Date : 2024-07-11 Mike Charlesworth
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Universal paediatric videolaryngoscopy and glottic view grading: a prospective observational study Anaesthesia (IF 7.5) Pub Date : 2024-07-11 Phillip B. Sasu, Nelly Gutsche, Rilana Kramer, Katharina Röher, Eva M. Zeidler, Tanja Peters, Vera Köhl, Linda Krause, Christian Zöllner, Thorsten Dohrmann, Martin Petzoldt
SummaryBackgroundAlthough videolaryngoscopy has been proposed as a default technique for tracheal intubation in children, published evidence on universal videolaryngoscopy implementation programmes is scarce. We aimed to determine if universal, first‐choice videolaryngoscopy reduces the incidence of restricted glottic views and to determine the diagnostic performance of the Cormack and Lehane classification
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Regional anaesthesia for knee arthroplasty in the UK: survey of practice Anaesthesia (IF 7.5) Pub Date : 2024-07-08 Georgina Findlay, Simon Chillingworth, David Semple, Nicholas D. Clement, David M. Griffith
Analgesia that facilitates early mobilisation is crucial for achieving the best possible outcome after knee arthroplasty and may reduce chronic post-surgical pain [1]. Peri-articular local infiltration anaesthesia offers effective analgesia and is recommended by the National Institute for Health and Care Excellence [2]. Regional anaesthesia techniques such as adductor canal block offer a desirable
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Development and maintenance of direct laryngoscopy skills using a videolaryngoscope with a Macintosh‐shaped blade Anaesthesia (IF 7.5) Pub Date : 2024-07-08 Lucy Corbett, Fiona E. Kelly, Tim M. Cook
Strøm et al. [1] raised concerns that anaesthetists have become deskilled in direct laryngoscopy, or have not learned the skills at all, due to increased use of videolaryngoscopy. The authors highlight the benefits of videolaryngoscopy, including reduced rates of failed tracheal intubation [2] and improved first-pass tracheal intubation success [2], and state that “opting for a videolaryngoscope as
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Stylet vs. bougie for hyperangulated videolaryngoscopy: fragility, generalisability and the Cooper manoeuvre Anaesthesia (IF 7.5) Pub Date : 2024-07-08 Luke A. Perry, Nicholas C. Chrimes
We read with interest the recent study by Eum et al. [1], but do not feel it convincingly establishes the superiority of bougie over stylet use during hyperangulated videolaryngoscopy. The results of the trial are statistically significant but also fragile. We calculated a fragility index of 1, indicating that just one patient allocated to the bougie group would have required a second attempt at tracheal
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Global Capnography Project: implementation of capnography in Malawi – an international anaesthesia quality improvement project: a follow up Anaesthesia (IF 7.5) Pub Date : 2024-07-08 Andrew N. O'Donoghue, Ellen P. O'Sullivan
We previously described the introduction of capnography to a low-income country, resulting in early recognition of critical airway events [1]. We now describe findings from a follow-up survey in the same setting. The original study was carried out over two visits in early and late 2017. At that time, information on the ‘capnography gap’ (the gap between need and availability) was ascertained from eight
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A holistic approach to maternal mental health: beyond epidural analgesia Anaesthesia (IF 7.5) Pub Date : 2024-06-28 Tejal Kothari, Suni Halder, Akshay Shah
Mental health conditions are one of the leading causes of maternal death in the UK [1]. Research in this area is limited, partly due to the difficulties (ethical, logistical and safety concerns) in conducting randomised controlled trials in pregnant women and Tan et al. are to be commended for their efforts [2]. Although they found that epidural labour analgesia did not lower the incidence of postpartum
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Stylets, bougies and hyperangulated videolaryngoscopy: a reply Anaesthesia (IF 7.5) Pub Date : 2024-06-28 Darhae Eum
We would like to thank Cook [1] for his interest in our research [2] and the opportunity to further discuss the use of hyperangulated videolaryngoscopes and their adjuncts. While our study found that using a bougie increased the first-attempt tracheal intubation success rate compared with a stylet, under circumstances such as specific patient characteristics or practitioner experience a stylet might
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Abstracts of the Trainee Conference 2024, 27–28 June 2024, Glasgow, UK Anaesthesia (IF 7.5) Pub Date : 2024-06-26
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Gastric ultrasound and mitigating risk of glucagon‐like peptide‐1 receptor agonists: a reply Anaesthesia (IF 7.5) Pub Date : 2024-06-26 Peter C.‐A. Kam, Tamara Y. Milder, David A. Milder
We thank Drs Hurley and Kearsley for their comments [1] on our review on the implications of glucagon-like peptide-1 (GLP-1) receptor agonists on peri-operative care [2], and for drawing the attention of anaesthetists to the limitations and issues of interpretation of gastric ultrasonography. We agree that caution must be exercised concerning the routine introduction of gastric ultrasonography without
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Comparing hyperangulated videolaryngoscopy and Macintosh videolaryngoscopy – more than meets the eye Anaesthesia (IF 7.5) Pub Date : 2024-06-26 Lauren M. Hughes, Ellen P. O'Sullivan
We read with interest the study by Köhl et al. [1] comparing hyperangulated videolaryngoscopy with Macintosh videolaryngoscopy in adult patients with anticipated difficult airway management. We welcome research in this area as, while the benefits of videolaryngoscopy over direct laryngoscopy are now clear in adult patients in a range of clinical scenarios [2], the literature comparing different videolaryngoscope
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Increasing multimorbidity and the evolving peri‐operative model of care Anaesthesia (IF 7.5) Pub Date : 2024-06-26 Cathriona Murphy
I read with interest the recent study by the STARSurg and EuroSurg Collaboratives examining the association between multimorbidity and postoperative mortality in patients undergoing major surgery [1]. The evolution of peri-operative medicine to date has been varied and unstandardised. Surprisingly, while this analysis did not show a difference in mortality or complications among multimorbid patients
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The association between epidural labour analgesia and postpartum depression: a reply Anaesthesia (IF 7.5) Pub Date : 2024-06-24 Chin Wen Tan, Hon Sen Tan, Helen Yu Chen, Tze‐Ern Chua, Ban Leong Sng
We thank Rao et al. for their interest in our paper [1]. We collected the demographics and data on various questionnaires before delivery and allowed patients to recall and fill in any missing data (if any) given the dynamic and progressive nature of labour. Hence, we apologise for any confusion in the manuscript, whereby the phrase “assessed within 24 hours after delivery” was, in fact, referring
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Efficacy and safety of intrathecal diamorphine: a systematic review and meta‐analysis with meta‐regression and trial sequential analysis Anaesthesia (IF 7.5) Pub Date : 2024-06-24 Sina Grape, Kariem El‐Boghdadly, Cecile Jaques, Eric Albrecht
SummaryBackgroundIntrathecal diamorphine is believed to provide postoperative analgesia but is associated with adverse effects such as nausea and vomiting. There is little evidence of synthesis regarding intrathecal diamorphine in the contemporary literature. We performed a systematic review, meta‐analysis with meta‐regression and trial sequential analysis to determine the magnitude of intrathecal
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Variation in the amount of leakage containing inhalational anaesthetics in the breathing circuits of anaesthesia machines Anaesthesia (IF 7.5) Pub Date : 2024-06-24 Joho Tokumine, Kiyoshi Moriyama, Tomoko Yorozu
We found the article by Mulier et al. intriguing [1]. The authors cited our data [2] to estimate sevoflurane loss due to system leak in anaesthesia machines during maintenance of general anaesthesia. Their calculations suggest that leak was constant, which is inaccurate. The amount of leak is proportional to the pressure difference between the interior and exterior of the breathing circuit. The internal
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Gastric ultrasound and mitigating risk of glucagon-like peptide-1 receptor agonists Anaesthesia (IF 7.5) Pub Date : 2024-06-19 Cian Hurley, Rosemarie Kearsley
We read with great interest the review by Milder et al. on the implications of glucagon-like peptide-1 (GLP-1) receptor agonists on peri-operative care and welcome recommendations on this topic [1]. Increasing reports of gastric regurgitation with pulmonary aspiration in patients taking these drugs have prompted multiple international peri-operative recommendations. The role of peri-operative gastric
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Usability contributing to reduced uptake of videolaryngoscopy Anaesthesia (IF 7.5) Pub Date : 2024-06-19 Amol Lotlikar
Videolaryngoscopes continue to garner significant attention due to their technical advantages over traditional direct laryngoscopy, including higher first-pass success rates and improved visualisation of glottic structures [1]. Despite compelling evidence and recommendations [2], their use falls short of these guidelines and direct laryngoscopy remains the first choice of device for most clinicians
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Myocardial injury secondary to adrenaline toxicity Anaesthesia (IF 7.5) Pub Date : 2024-06-14 Benjamin Stretch, Alexander Bell, Navpreet Kaur
We wanted to thank Dodd et al. for their guidelines on peri-operative anaphylaxis [1]. Yang et al. raise concerns about the use of intravenous adrenaline [2]. In peri-operative anaphylaxis the benefit of early use is likely to vastly outweigh the risks. With regards to adrenaline toxicity, no published guidelines exist despite multiple case series of life-threatening and fatal reactions [3, 4]. In
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Useful metrics for ethical decision making: a reply Anaesthesia (IF 7.5) Pub Date : 2024-06-13 Julia M. Slingo, Mary E. Slingo
Thank you for the opportunity to respond to the letter by Kalmar et al. and their endorsement of the significant scientific limitations of global warming potential (GWP) with respect to short-lived climate pollutants [1]. There are political reasons why the United Nations Framework Convention on Climate Change (UNFCCC) continues to use GWP100 as the common metric for reporting major, regulated greenhouse
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Confronting racial and ethnic disparities in children undergoing appendicectomy Anaesthesia (IF 7.5) Pub Date : 2024-06-08 Helen Blamey, Sara McDouall
We read with great interest the recent article by Sogbodjor et al. [1], which used data from the Children's Acute Surgical Abdomen Programme. The article raises important questions on why children in the UK from Black and other ethnic minority groups experienced more postoperative surgical complications. We would like to suggest some potential reasons for this health inequality. Pulse oximetry can
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High-flow nasal oxygen for procedural sedation: a trial sequential analysis Anaesthesia (IF 7.5) Pub Date : 2024-06-05 I-Wen Chen, Hsiu-Lan Weng, Kuo-Chuan Hung
We read with great interest the article by Thiruvenkatarajan et al. [1]. The authors provided a comprehensive analysis of 19 randomised controlled trials comparing the efficacy of high-flow nasal oxygen (HFNO) with conventional oxygen therapy in reducing hypoxaemia during procedural sedation across various procedure types and patient populations (i.e. adults and children) [1]. This provides confirmation
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The association between epidural labour analgesia and postpartum depression Anaesthesia (IF 7.5) Pub Date : 2024-06-05 Yuquan Rao, Sicong Wang, Xiaocou Wang
We read with great interest the article by Tan et al. [1]. which concluded that there was no significant difference in the risk of postpartum depression between patients who received epidural labour analgesia and those who utilised non-epidural analgesic modalities. However, certain aspects of the study warrant further attention. Although the study documented and compared the personal and family history
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Noradrenaline-induced changes in cerebral blood flow in health, traumatic brain injury and critical illness: a systematic review with meta-analysis Anaesthesia (IF 7.5) Pub Date : 2024-06-03 Lingzhong Meng, Yanhua Sun, Xu Zhao, Mads Rasmussen, Yazan Al-Tarshan, Deyi M. Meng, Ziyue Liu, David C. Adams, David L. McDonagh
Noradrenaline is a standard treatment for hypotension in acute care. The precise effects of noradrenaline on cerebral blood flow in health and disease remain unclear.
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Patterns of opioid use after surgical discharge: pain management beyond the first postoperative week Anaesthesia (IF 7.5) Pub Date : 2024-06-01 Hance Clarke, Joel Katz
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Stylets, bougies and hyperangulated videolaryngoscopy Anaesthesia (IF 7.5) Pub Date : 2024-06-01 Tim M. Cook
I enjoyed the article by Eum et al. [1], but as a very regular user of hyperangulated videolaryngoscopy, I am surprised by the results. In my practice and teaching, I advocate use of a stylet rather than a bougie with a hyperangulated videolaryngoscope blade. My rationale being that the stylet makes (or should make) the tracheal tube the same shape as the videolaryngoscope blade, which facilitates
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Direct vs. videolaryngoscopy for tracheal intubation Anaesthesia (IF 7.5) Pub Date : 2024-05-31 Camilla Strøm, Rasmus Winkel, Michael S. Kristensen
Cook [1], Ward [2] and associates advocate for the videolaryngoscope to be the primary tool for tracheal intubation, suggesting that the debate over video vs. direct laryngoscopy should be concluded. This has already occurred in many Danish anaesthetic departments. There are now anaesthetists who have never learned to use direct laryngoscopy and colleagues who have ceased training with it. This concerns
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Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe Anaesthesia (IF 7.5) Pub Date : 2024-05-27
Multimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery.
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Embracing change: a collective call to address multimorbidity in surgical pathways Anaesthesia (IF 7.5) Pub Date : 2024-05-27 Sivesh K. Kamarajah, Aneel Bhangu, Shalini Ahuja, Jugdeep Dhesi, Joyce Yeung, Krishnarajah Nirantharakumar, Thomas Pinkney, Dion G. Morton
In 2023, Sir Chris Whitty, Chief Medical Officer for England, released a pivotal report highlighting the challenges posed by an ageing society, urging healthcare professionals to proactively respond to the rising rates of multimorbidity [1]. The World Health Organization has similarly emphasised the need for urgent solutions to adapt to the growing needs of the population with multimorbidity, affecting
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Hyperangulated vs. Macintosh videolaryngoscopy in adults with anticipated difficult airway management: a randomised controlled trial Anaesthesia (IF 7.5) Pub Date : 2024-05-25 Vera Köhl, Viktor A. Wünsch, Marie‐Claire Müller, Phillip B. Sasu, Thorsten Dohrmann, Tanja Peters, Josephine Tolkmitt, André Dankert, Linda Krause, Christian Zöllner, Martin Petzoldt
SummaryBackgroundIt is not certain whether the blade geometry of videolaryngoscopes, either a hyperangulated or Macintosh shape, affects glottic view, success rate and/or tracheal intubation time in patients with expected difficult airways. We hypothesised that using a hyperangulated videolaryngoscope blade would visualise a higher percentage of glottic opening compared with a Macintosh videolaryngoscope
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Redefining risk in peri‐operative frailty: towards routine frailty assessment and a whole pathway approach Anaesthesia (IF 7.5) Pub Date : 2024-05-22 Rose S. Penfold, Adam Hunt
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Impact of peri-operative frailty and operative stress on post-discharge mortality, readmission and days at home in Medicare beneficiaries Anaesthesia (IF 7.5) Pub Date : 2024-05-22 Chan Mi Park, Jessica J. Lie, Laiji Yang, Zara Cooper, Dae Hyun Kim
Understanding how patients' frailty and the physiological stress of surgical procedures affect postoperative outcomes may inform risk stratification of older patients undergoing surgery. The objective of the study was to examine the association of peri-operative frailty with mortality, 30-day readmission and days at home after non-cardiac surgical procedures of different physiological stress.
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Out‐of‐hospital cardiac arrest: pathways for extracorporeal cardiopulmonary resuscitation in the United Kingdom Anaesthesia (IF 7.5) Pub Date : 2024-05-17 Benjamin Stretch, Ben Singer
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Multiple failed intubation attempts in patients with rapid sequence induction are a thing of the past: a reply Anaesthesia (IF 7.5) Pub Date : 2024-05-16 Marc Kriege, Oliver Kunitz, Christoph Jänig, Axel Schmutz
We appreciate the interest shown by Wang et al. [1] and Xue et al. [2] for our recently published trial [3] and are grateful for the opportunity to comment further on this important topic. Their comments concur with our own. Xue et al. pinpointed the higher incidence of difficult tracheal intubations in our trial. Rapid sequence anaesthesia induction and intubation (RSI) aims to reduce the incidence
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Artificial intelligence in peri‐operative prediction model research: are we there yet? Anaesthesia (IF 7.5) Pub Date : 2024-05-15 Akshay Shah, Paula Dhiman
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Time for new guidelines to focus specifically on cardiac arrest in the peri‐operative period? Anaesthesia (IF 7.5) Pub Date : 2024-05-15 Stephanie Harrison, Alan D. Ashworth
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It ain't what you do (it's the way that you do it): modulating the host response in sepsis Anaesthesia (IF 7.5) Pub Date : 2024-05-15 Jonathan E. Millar, Annemarie B. Docherty
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The association of withholding or continuing angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers on acute kidney injury after non‐cardiac surgery Anaesthesia (IF 7.5) Pub Date : 2024-05-14 Jisun Choi, Dae Kyun Ryu, Seunghyeon Woo, Jeayoun Kim, Seungwon Lee, Boram Park, Kyeongman Jeon, MiHye Park
SummaryBackgroundWithholding or continuing angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers peri‐operatively in non‐cardiac surgery remains controversial as they may result in intra‐operative hypotension and postoperative organ damage.MethodsWe included patients prescribed angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers who underwent surgical procedures
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Glucagon-like peptide-1 receptor agonists: a narrative review of clinical pharmacology and implications for peri-operative practice Anaesthesia (IF 7.5) Pub Date : 2024-05-13 David A. Milder, Tamara Y. Milder, Sophie S. Liang, Peter C.A. Kam
Glucagon-like peptide-1 receptor agonists are used increasingly in the management of patients living with type 2 diabetes mellitus and obesity. In patients using glucagon-like peptide-1 receptor agonists, a key concern in the peri-operative period is the increased risk of pulmonary aspiration due to delayed gastric emptying. This review provides an overview of the pharmacodynamic and pharmacokinetic
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Optimising peri-operative anaphylaxis management: end-tidal carbon dioxide monitoring and adrenaline titration: a reply Anaesthesia (IF 7.5) Pub Date : 2024-05-10 Amy Dodd, Paul J. Turner, Jasmeet Soar, Louise Savic
We thank Yang et al. [1] for their interest in our article [2] and for highlighting the difficulties of diagnosing peri-operative anaphylaxis in real time. The principal aim of this algorithm is to prevent respiratory or cardiovascular deterioration, cardiac arrest and death by promoting early effective treatment, which includes the early use of intravenous adrenaline irrespective of diagnostic uncertainty
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Advanced life support interventions during intra-operative cardiac arrest among adults as reported to the 7th National Audit Project of the Royal College of Anaesthetists Anaesthesia (IF 7.5) Pub Date : 2024-05-10 Jerry P. Nolan, Richard A. Armstrong, Andrew D. Kane, Emira Kursumovic, Matthew T. Davies, Iain K. Moppett, Tim M. Cook, Jasmeet Soar
Few existing resuscitation guidelines include specific reference to intra-operative cardiac arrest, but its optimal treatment is likely to require some adaptation of standard protocols.
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Patterns of opioid use after surgical discharge: a multicentre, prospective cohort study in 25 countries Anaesthesia (IF 7.5) Pub Date : 2024-05-09
Excessive opioid prescribing following surgery contributes to the growing opioid crisis. Prescribing practices are modifiable, yet data to guide appropriate prescription of opioids at surgical discharge remain sparse. This study aimed to evaluate factors associated with opioid consumption following discharge from surgery.
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Surgical closure of the neck following thyroid surgery: an important area of anatomy for the anaesthetist Anaesthesia (IF 7.5) Pub Date : 2024-05-10 Karen Collins, Benjamin Stretch, Rajeev Advani
We have been involved in the emergency management of life-threatening thyroid haematomas and followed the multidisciplinary consensus guidelines published in Anaesthesia, resulting in safe management of these patients [1]. We had expected to expose the Skin; Cut sutures; Open skin; Open muscles; and Pack the wound (SCOOP). However, on more than one occasion, surgical closure of the neck wound with
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Sarcopenia: it is time to attach more importance to this stealth killer in patients who are critically ill Anaesthesia (IF 7.5) Pub Date : 2024-05-08 Kunming Cheng, Cheng Li, Haiyang Wu
We read with great interest the recent article by Gustafson et al. [1]. The study evaluated the musculoskeletal health status of intensive care unit (ICU) survivors. Their findings suggested that, among 254 patients admitted to the ICU, 59% had musculoskeletal problems yet only 24% received physical therapy after discharge. Given the high incidence and risk of musculoskeletal disorders in patients
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Opioid analgesic exposure during the first trimester of pregnancy and the risk of major congenital malformations in infants: a systematic review and meta‐analysis† Anaesthesia (IF 7.5) Pub Date : 2024-05-08 Bianca Varney, Jonathan Brett, Helga Zoega, Malcolm B. Gillies, Madeline Powell, Brian T. Bateman, Antonia W. Shand, Sallie‐Anne Pearson, Alys Havard
SummaryBackgroundPrescribed opioid analgesics are frequently used to manage pain in pregnancy. However, the available literature regarding the teratogenic potential of opioid use during pregnancy has not been systematically summarised. This systematic review and meta‐analysis aimed to assess the quality of the evidence on these potential risks and calculate a pooled estimate of risk for any opioid
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A pilot project to test the feasibility of automated text messaging to collect multi-day patient-reported outcomes related to pain interference after total joint arthroplasty in veterans Anaesthesia (IF 7.5) Pub Date : 2024-05-07 Allison H. Dorogi, Oluwatobi O. Hunter, Daniel M. Gessner, Jody C. Leng, Alex Kou, Edward R. Mariano
Acute postoperative pain trajectories may differ between surgical procedures [1] and individuals who undergo the same procedure [2]. To date, clinical measurement of acute pain has been generally limited to pain intensity, which provides an inadequate assessment of recovery [3]. Despite recommendations to incorporate patient-reported outcomes into peri-operative pain assessment and management [3],
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Hospital-level flow measurement to detect nitrous oxide leakage Anaesthesia (IF 7.5) Pub Date : 2024-05-03 Justin J. Skowno, H. Reza Kahlaee, Andrew J. Inglis, Darren McKinnon, Kathryn Asher
Nitrous oxide has a significant carbon footprint, and global initiatives are in progress to diminish its environmental impact in agriculture, industry and healthcare [1]. It is piped to locations in many healthcare environments, and in some hospitals, these systems can leak most of the gas they carry (75–95%) [1]. Leak detection traditionally relies on static pressure testing, a time-consuming and
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The science of climate change and the effect of anaesthetic gas emissions: a reply Anaesthesia (IF 7.5) Pub Date : 2024-05-03 Christopher Prabhakar, Rakesh V. Sondekoppam, Vivian H. Y. Ip
Physicians are not climate scientists and are not trained in the intricacies of how greenhouse gases affect climate change. Hence it is refreshing to read the thought-provoking review article by Slingo and Slingo on the impact of volatile anaesthetic gas emissions on climate change [1]. They have suggested that only desflurane will have full radiative effect on global warming due to its longer atmospheric
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Airway management in patients with suspected or confirmed cervical spine injury Anaesthesia (IF 7.5) Pub Date : 2024-05-03 Matthew D. Wiles, Helen A. Iliff, Katherine Brooks, Egidio J. Da Silva, Mike Donnellon, Adrian Gardner, Matthew Harris, Caroline Leech, Steve Mathieu, Paul Moor, Lara Prisco, Kate Rivett, Frances Tait, Kariem El-Boghdadly
There are concerns that airway management in patients with suspected or confirmed cervical spine injury may exacerbate an existing neurological deficit, cause a new spinal cord injury or be hazardous due to precautions to avoid neurological injury. However, there are no evidence-based guidelines for practicing clinicians to support safe and effective airway management in this setting.
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Post‐intensive care syndrome: survival, but at what cost? Anaesthesia (IF 7.5) Pub Date : 2024-04-29 Caroline Sampson
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Incidence and impact of cardiovascular complications after major abdominal surgery Anaesthesia (IF 7.5) Pub Date : 2024-04-29 Rui‐Peng Zhong, Bing‐Cheng Zhao, Gui‐Ming Huang
The international, prospective cohort study (CArdiovaSCulAr outcomes after major abDominal surgEry, CASCADE) reported that postoperative cardiovascular complications, as defined by the Standardised Endpoints for Perioperative Medicine-Core Outcome Measures for Perioperative and Anaesthetic Care (StEP-COMPAC), occurred infrequently in patients undergoing major abdominal surgery (incidence 2.5%), but
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The science of climate change and the effect of anaesthetic gas emissions. Useful metrics for ethical decision making Anaesthesia (IF 7.5) Pub Date : 2024-04-23 Alain Kalmar, An Teunkens, Steffen Rex
We support the call by Slingo and Slingo for anaesthetists to adopt a sustainability framework informed by climate science, which urgently stresses the need to reduce our climate impact [1]. As rightly emphasised, the global warming potential (GWP) metric has faced criticism for overestimating the climate impact of short-lived climate pollutants and potentially leading opportunistic policymakers to