Are perioperative therapeutic doses of statins associated with postoperative pain and opioid consumption after hip surgery under spinal anaesthesia?
Conclusions. This is the first large retrospective clinical study that investigates the effects of statin use on postoperative pain and opioid consumption. We observed no difference between statin users and non-users during the initial 72 h after hip surgery. Our findings do not support the routine use of statins as part of an analgesic regimen. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Low-dose buprenorphine infusion to prevent postoperative hyperalgesia in patients undergoing major lung surgery and remifentanil infusion: a double-blind, randomized, active-controlled trial
Conclusions. Low-dose buprenorphine infusion prevents the development of secondary hyperalgesia around the surgical incision but shows no long-term efficacy at three months follow-up. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Gender, power and leadership: the effect of a superior ’s gender on respiratory therapists’ ability to challenge leadership during a life-threatening emergency
Conclusions. The study showed a significant effect of superiors ’ gender on a respiratory therapist’s ability to challenge leadership. A female staff anaesthetist was challenged more often and with greater assertiveness and effectiveness. This has implications for an educational intervention targeting the ability to challenge a wrong decision by a supervisor and emphasizing the effect of gender on the willingness to speak up. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Disruption of cortical network activity by the general anaesthetic isoflurane
ConclusionsDisruption of horizontal activity spread and of layer 1 facilitation of thalamo-cortical responses likely contribute to the mechanism by which suppression of cortical feedback connections disrupts sensory awareness under anaesthesia. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Brain functional connectivity differentiates dexmedetomidine from propofol and natural sleep
ConclusionsThalamic connectivity with key nodes of arousal and saliency detection networks was relatively preserved during N3 sleep and dexmedetomidine-induced unresponsiveness as compared to propofol. These network effects may explain the rapid recovery of oriented responsiveness to external stimulation seen under dexmedetomidine sedation.Trial registry numberCommittee number: ‘Comité d’Ethique Hospitalo-Facultaire Universitaire de Liège’ (707); EudraCT number: 2012-003562-40; internal reference: 20121/135; accepted on August 31, 2012; Chair: Prof G. Rorive. As it was considered a phase I clinical trial, this prot...
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Preadmission statin use improves the outcome of less severe sepsis patients - a population-based propensity score matched cohort study
ConclusionsIn this national cohort study, preadmission statin therapy before sepsis development was associated with a 12% reduction in mortality when compared with patients who never received a statin. There were no consistent beneficial effects of statins in all patient subgroups. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Age and other perioperative risk factors for postoperative systemic inflammatory response syndrome after cardiac surgery
ConclusionsWe have demonstrated that advanced patient age is associated with a decreased risk of postoperative SIRS among cardiac surgery patients, where patients aged over 72 yr had the lowest risk. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Humour therapy intervention to reduce stress and anxiety in paediatric anaesthetic induction, a pilot study
Editor —Hospitalization is a particularly negative experience for the paediatric population. Infants experiencing surgery can develop problematic behaviour, such as preoperative anxiety (50–75%)1 and postoperative negative behavioural changes (75%), sleep and eating disorders, cognitive alterations, enuresis and disobedience. These complications can persist for several months after the surgical procedure.2 In addition, it is well known that stress slows the healing process, decreases inflammatory responses, and likewise increases fear and anxiety. From a pathophysiological point of view, the increase in levels of circu...
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Treatment of chronic venous ulcers with topical sevoflurane: a retrospective clinical study
Editor —Chronic venous ulcers are a common problem with a significant repercussion on quality of life.1 Eighty-five per cent of venous or mixed aetiology chronic ulcers are painful, with one group reporting a mean pain visual analogue scale (VAS) of 4.6.2 Chronic pain usually reduces adherence to treatment and impairs healing.3 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Is the bougie redundant in direct laryngoscopic grade 3 intubations?
A 51-year-old woman presented for major elective colorectal surgery with predicted difficult intubation (Mallampati score 3, small mouth opening) and a video laryngoscope was prepared as a ‘plan B’. After induction, the patient’s lungs were easily ventilated with a bag valve mask. Direct laryngoscopy was performed that demonstrated a grade 3 view. An experienced operator intubated successfully using a bougie, which was carefully advanced in one attempt blindly behind the epiglot tis into the trachea. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Reply to Tobin and colleagues
Editor —We thank Tobin and colleagues1 for their constructive remarks on our Editorial.2 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
An algorithm for suboptimally placed supraglottic airway devices: the choice of videolaryngoscope
Editor —We agree with Zundert and colleagues1 that anaesthetists sometimes accept lower standards for supraglottic airway device (SAD) placement than for tracheal tube placement. They advocate the use of videolaryngoscopy to correct a suboptimal SAD position using an algorithm, however they do not make any specific recommendation about which type of videolaryngoscope to use. A variety of classifications of videolaryngoscopes exist,2 –5 and some classes (for example, channelled videolaryngoscopes) might prove to be very difficult to use in this situation; some may even cause trauma in the reduced space available when an...
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Routine videolaryngoscopy is likely to improve skills needed to use a videolaryngoscope when laryngoscopy is difficult
Editor –We read Dr Marathe and colleagues’1 comments with great interest. Their survey, though small, is interesting as it explores current attitudes to videolaryngoscopy (VL). In our department, we are familiar with individual reticence to use VL and identified the same before introduction of universal availability of VL in 2014. In our hospital, 92% of trainee anaesthetists were opposed to a trial of universal VL in 2014, primarily because of training concerns. Within eight months this reticence was replaced with widespread enthusiasm and uptake: 95% then reported that VL had enhanced their training and their develop...
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
The paradox in the current use of videolaryngoscopes in the UK
Editor —The recent national survey by Cook and Kelly1 is the first to provide a comprehensive overview of the current usage and practices of videolaryngoscopes (VLs) in UK clinical practice. We feel we can add to this area and would like to present some of the results of a regional survey on VLs that we conducted to gain an understanding of current practices and decision-making in the use of VLs in general airway management in the operating theatre (OT). The survey was conducted electronically via SurveyMonkey (San Mateo, CA, USA) and was distributed to 10 departments of anaesthesia in the London Deanery (London, UK) in ...
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Response to: Emergency front-of-neck access: scalpel or cannula —and the parable of Buridan’s ass
Editor —I was interested to read the editorial by Greenland and colleagues1 that contributes further to the debate that has raged for some time over whether a cannot intubate, cannot oxygenate (CICO) situation should be managed with a fine needle or scalpel cricothyroidotomy approach. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
