Validation of a simple tool for anxiety trait screening in children presenting for surgery
Conclusions. Our study determined the performance of a simple faces scale to measure the preoperative anxiety trait in children aged 8 –18 yr. This tool is potentially helpful for clinicians aiming to identify patients at risk of preoperative anxiety and to assign them to targeted management. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 16, 2017 Category: Anesthesiology Source Type: research
Effect of isotonic versus hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers
Conclusions. Even at maintenance rate, isotonic solutions caused lower urine output, characterized by decreased aldosterone concentrations indicating (unintentional) volume expansion, than hypotonic solutions and were associated with hyperchloraemia. Despite their lower sodium and potassium content, hypotonic fluids were not associated with hyponatraemia or hypokalaemia.Clinical trial registration. ClinicalTrials.gov (NCT02822898) and EudraCT (2016-001846-24). (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 16, 2017 Category: Anesthesiology Source Type: research
Use of an anaesthesia workstation barrier device to decrease contamination in a simulated operating room
Conclusions. The results of this study suggest that application of a barrier device to the anaesthesia workstation during induction and intubation might reduce contamination of the intraoperative environment. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 16, 2017 Category: Anesthesiology Source Type: research
Emergency front-of-neck access: scalpel or cannula —and the parable of Buridan’s ass †
Maintaining oxygenation is the principal purpose of airway management. Oxygen delivery in airway crises is aimed at preventing cardiac arrest and limiting hypoxic consequences before quickly moving on to secure the airway or wake the patient up if appropriate. Currently, there is debate12 concerning the most appropriate method to facilitate oxygenation during a ‘can’t intubate, can’t oxygenate’ (CICO) scenario while a definitive airway is secured. Emergency front-of-neck access (FONA) courses include a critical analysis of cannula cricothyroidotomy as part of their curricula. This has been driven by widespread acce...
Source: British Journal of Anaesthesia - May 16, 2017 Category: Anesthesiology Source Type: research
Addition of droperidol to prophylactic ondansetron and dexamethasone in children at high risk for postoperative vomiting. A randomized, controlled, double-blind study
Conclusions: The addition of DRO to a combination of OND and DEX did not decrease POV frequency below that obtained with the two-drug combination in children at high risk of POV, but increased the risk of drowsiness. The combination of DEX and OND should be recommended in children with a high risk of POV.Clinical trial registration. NCT01739985. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Comparative total and unbound pharmacokinetics of cefazolin administered by bolus versus continuous infusion in patients undergoing major surgery: a randomized controlled trial
Conclusions. Our study demonstrates that intraoperative continuous infusions of cefazolin increase the achievement of target plasma concentrations, even with lower infusion doses. Renal function and body weight are important when considering the need for alternative dosing regimens.Clinical trial registration. NCT02058979. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Financial and environmental costs of reusable and single-use anaesthetic equipment
Conclusions. For an Australian hospital with six operating rooms, converting from single-use to reusable anaesthetic equipment saved more than AUD$30 000 (£18 000) per annum, but increased the CO2 emissions by almost 10%. The CO2 offset is highly dependent on the power source mix, while water consumption is greater for reusable equipment. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Early or late fresh frozen plasma administration in newborns and small infants undergoing cardiac surgery: the APPEAR randomized trial
Conclusions. In infants undergoing cardiac surgery, FFP in the priming solution appears slightly superior to late administration in terms of postoperative bleeding.Clinical trial registration:www.ClinicalTrials.gov, NCT02738190. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Effect of caudal block using different volumes of local anaesthetic on optic nerve sheath diameter in children: a prospective, randomized trial
Conclusions: Caudal block with a high volume of local anaesthetic can cause a greater increase in ICP than caudal block with a low volume of local anaesthetic. However, caudal block with 1.0 ml kg−1 of local anaesthetic can also result in a significant increase in ICP.Clinical trial registration. NCT02768493. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Efficacy and safety of carbetocin given as an intravenous bolus compared with short infusion for Caesarean section - double-blind, double-dummy, randomized controlled non-inferiority trial
Conclusions. Administration of carbetocin as short infusion does not compromise uterine tone and has similar cardiovascular side-effects as a slow i.v. bolus. In accordance with current recommendations for oxytocin, carbetocin can safely be administered as short -infusion during planned or unplanned CS.Clinical trial registration. ClinicalTrials.gov NCT02221531 andwww.kofam.ch SNCTP000001197. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Patient choice compared with no choice of intrathecal morphine dose for caesarean analgesia: a randomized clinical trial
Conclusions: Women who were given a choice and chose the larger ITM dose correctly anticipated a greater postoperative opioid requirement and more pain compared with women who chose the smaller dose. Simply being offered a choice did not impact opioid use or pain scores after caesarean delivery.Trial Registration: ClinicalTrials.gov (NCT01425762). (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Burst-suppression ratio underestimates absolute duration of electroencephalogram suppression compared with visual analysis of intraoperative electroencephalogram
Conclusions. Our findings suggest that SedLine® (machine)-generated indices might underestimate the minutes of EEG suppression, thereby reducing the sensitivity for detecting patients at risk for POD. Thus, the monitoring of machine-generated BSR and PSI ™ might benefit from the addition of a visual tracing of the EEG to achieve a more accurate and real-time guidance of anaesthesia depth monitoring and the ultimate goal, to reduce the risk of POD. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Total haemoglobin mass, but not haemoglobin concentration, is associated with preoperative cardiopulmonary exercise testing-derived oxygen-consumption variables
Conclusions. In contrast to [Hb], tHb-mass is an important determinant of physical fitness before major elective surgery. Further studies should determine whether low tHb-mass is predictive of poor outcome and whether targeted increases in tHb-mass might thus improve outcome. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Go/no-go decision in anaesthesia: wide variation in risk tolerance amongst anaesthetists
Conclusions. It is clear that safety decisions cannot be made in isolation and that clinicians must consider operational requirements, such as throughput, when making a go/no-go decision. The level of variability in decision-making was surprising, particularly for scenarios that appeared to go against guidelines. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
Measuring the anaesthesia clinical learning environment at the department level is feasible and reliable
Conclusions. Our results confirm that, using this instrument, individual departments can obtain acceptable precision in results with achievable trainee numbers. Additionally, with the exception of departments with few trainees, implementation proved feasible across a training region. Repeated use would allow departments or accrediting bodies to monitor their individual learning environment and the impact of changes such as the introduction of new curricular elements, or local initiatives to improve trainee experience. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - May 15, 2017 Category: Anesthesiology Source Type: research
