In the December issue …
The final issue of 2017 is accompanied by a special bonus issue freely available on line: the Royal College of Anaesthetists 25th Anniversary Special Issue (see editorial by Hemmings& Hunter, pages 1073--4). This collection of narrative reviews and special articles is based on presentations from the “Landmarks in UK Anaesthesia” meeting held in London in March 2017. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - November 16, 2017 Category: Anesthesiology Source Type: research
Correlational studies of unconsciousness under anaesthesia: how far can preclinical studies take us?
Determining the electrophysiological correlates of loss of consciousness (LOC) and recovery of consciousness (ROC) under anaesthesia is a holy grail of biomedical science.1 From a purely practical perspective, a non-invasive metric that tracks sensory awareness and is robust to the combination of anaesthetic drugs and patient factors would be a welcome addition to the anaesthetist ’s perioperative tool kit.2 From a theoretical perspective, such a metric would prove invaluable for endeavours to understand the neural basis of consciousness, and in particular, sensory awareness.2 The contribution by Plourde and Arseneau3 in...
Source: British Journal of Anaesthesia - November 16, 2017 Category: Anesthesiology Source Type: research
Cerebral blood flow and its autoregulation - when will there be some light in the black box?
When considering autoregulation, it is interesting to first consider the cerebral perfusion of a giraffe. Although their necks are about 2.5 m long, they must be able to drink water from the ground level of the oasis and then eat leaves from trees, causing large changes in cerebral perfusion pressure. Fortunately nature has provided them with several cardiovascular, anatomical and physiological adaptions to enable them to do so withou t fainting.1 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - November 16, 2017 Category: Anesthesiology Source Type: research
Intraoperative permissive oliguria – how much is too much?
Acute kidney injury (AKI) after general surgery is a serious complication. In abdominal surgery the incidence is around 13%, and it is associated with increased postoperative morbidity, length of hospital stay and a 13-fold increase in the relative risk of in-hospital or 30-day mortality.12 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - November 16, 2017 Category: Anesthesiology Source Type: research
Landmarks in UK anaesthesia
The celebrations in 2017 marking the award of a Royal Charter to the College of Anaesthetists 25 yr ago have been wide ranging and highly successful. They have acknowledged the significant contributions that the Royal College of Anaesthetists (RCoA) has since made to postgraduate education and training, to healthcare quality and patient safety, and to acute medical care both in hospital and beyond. Meetings have been held around the UK to demonstrate the commitment and accomplishments of the RCoA to all its fellows. A major part of the celebrations was the RCoA Anniversary Meeting organized under the leadership of Dr Ra...
Source: British Journal of Anaesthesia - November 16, 2017 Category: Anesthesiology Source Type: research
25th Annual Meeting of Chinese Society of Anesthesiology
Zhengzhou China, September 7-10, 2017 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - November 16, 2017 Category: Anesthesiology Source Type: research
Predicting delirium: are we there yet?
British Journal of Anaesthesia, 2017; 119(2): 281 –3, DOI10.1093/bja/aex082 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - November 8, 2017 Category: Anesthesiology Source Type: research
Effectiveness of enhanced pulse oximetry sonifications for conveying oxygen saturation ranges: a laboratory comparison of five auditory displays
British Journal of Anaesthesia, 2017; 1 –7, DOI10.1093/bja/aex343 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - October 28, 2017 Category: Anesthesiology Source Type: research
Effect of gum chewing on gastric volume and emptying: a prospective randomized crossover study
ConclusionsChewing gum does not affect gastric emptying of water and does not change gastric fluid volume measured 2 h after ingestion of water.Clinical trial registrationNCT02673307. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - October 20, 2017 Category: Anesthesiology Source Type: research
Low end-tidal CO 2 as a real-time severity marker of intra-anaesthetic acute hypersensitivity reactions
ConclusionsAn etCO2 value below 2.6 kPa (20 mm Hg) could be useful for prompt diagnosis of severe intra-anaesthetic AHR, and could facilitate early treatment with titrated doses of epinephrine.Clinical trial registrationNCT01637220. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - October 20, 2017 Category: Anesthesiology Source Type: research
Cost-effectiveness of a systematic e-assessed follow-up of postoperative recovery after day surgery: a multicentre randomized trial
ConclusionsThis study shows that RAPP can be cost-effective but had no effect on QALY. RAPP can be a cost-effective tool in providing low-cost health-care contacts and in systematically assessing the quality of postoperative recovery.Clinical trial registrationNCT02492191. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - October 20, 2017 Category: Anesthesiology Source Type: research
Evaluation of postoperative recovery in day surgery patients using a mobile phone application: a multicentre randomized trial
ConclusionsMeasurement of patient-reported outcomes using a smartphone-based application was associated with decreased discomfort from several postoperative symptoms. Systematic e-assessment can thereby increase patients ’ quality of recovery and identify key areas for improvement in perioperative care.Clinical trial registrationNCT02492191. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - October 20, 2017 Category: Anesthesiology Source Type: research
Novel stabilization technique for insertion of Bonfils intubating endoscope: the “pool cue” grip
We describe the “pool cue” grip, a technique that we use as part of our standard Bonfil insertion and teaching method. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - October 20, 2017 Category: Anesthesiology Source Type: research
Obstetric neuraxial anaesthesia in the context of maternal immune thrombocytopenia: secondary analysis of a retrospective cohort study
Editor —Immune thrombocytopenia (ITP) is an autoimmune condition affecting 1–10 in 10 000 pregnancies.1 The bleeding risk associated with significant thrombocytopenia poses a challenge peripartum, particularly for placement of neuraxial anaesthesia, where evidence to guide practice remains scant.2 Our aim is to describe our experience with neuraxial anaesthesia in the setting of ITP in pregnancy at two tertiary-level academic institutions. The report is a secondary analysis of a retrospective study of pregnant women with ITP at two tertiary-level Canadian academic institutions: Mount Sinai Hospital (MSH), Toronto and...
Source: British Journal of Anaesthesia - October 20, 2017 Category: Anesthesiology Source Type: research
Effect of isotonic vs hypotonic maintenance fluid therapy on urine output, fluid balance, and electrolyte homeostasis: a crossover study in fasting adult volunteers. Reply from the authors
Editor —We read with interest the comments by Leroy& Hoorn1 and Moritz& Ayus,2 mainly focusing on the occurrence of hyponatraemia after the use of hypotonic maintenance solutions, an association extensively demonstrated in paediatric populations. First and foremost, we set out to investigate whether, how and how much fluid retention could be induced by isotonic compared with hypotonic maintenance fluid therapy.3 All prior studies systematically neglected this potential side-effect. Although the clinical impact remains to be judged in dedicated trials, fluid retention of the magnitude we observed will not be regar...
Source: British Journal of Anaesthesia - October 20, 2017 Category: Anesthesiology Source Type: research
