In the October BJA …
This issue of the BJA contains a special section onpain medicine that includes articles on acute and chronic pain in the context of anaesthesia. The main section of the Journal includes a number of articles relevant to perioperative outcomes insepsis and septic shock, and incardiac,abdominal, and lung resection surgery. There are also articles on the impact ofnon-depolarising neuromuscular blocking agents, beta-blockers, and statins on perioperative outcomes. The Neurosciences and Neuroanaesthesia section features three articles and three editorials related to anaesthetic effects onneuronal network connectivity as it relat...
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Review: Brown ’s Atlas of Regional Anesthesia . E Farag and L Mounir-Soliman (editors) & amp; Brown ’s Regional Anesthesia Review . E Farag and L Mounir-Soliman (editors)
Review:Brown ’s Atlas of Regional Anesthesia.FaragE and Mounir-SolimanL (editors), 5th edn, 2017. Published by Elsevier. Pp. 376. Price $199.99. ISBN-13: 978-0323354905. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
24th Annual Meeting of the Chinese Society of Anesthesiology
Guangzhou, China, August 25 –28, 2016 (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 28, 2017 Category: Anesthesiology Source Type: research
Peripheral i.v. analysis (PIVA) of venous waveforms for volume assessment in patients undergoing haemodialysis
ConclusionsPIVA is a minimally invasive, novel modality for detecting changes in fluid volume status, respiratory rate and pulse rate in spontaneously breathing patients with peripheral i.v. cannulas. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Heterogeneity of studies in anesthesiology systematic reviews: a meta-epidemiological review and proposal for evidence mapping
AbstractHeterogeneity among the primary studies included in a systematic review (SR) is one of the most challenging considerations for systematic reviewers. Current practices in anaesthesiology SRs have not been evaluated, but traditional methods may not provide sufficient information to evaluate the true nature of these differences. We address these issues by examining the practices for evaluating heterogeneity in anesthesiology reviews. Also, we propose a mapping method for presenting heterogeneous aspects of the primary studies in SRs.We evaluated heterogeneity practices reported in SRs published in highly ranked anesth...
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Volumes of the spinal canal and caudal space in children zero to three years of age assessed by magnetic resonance imaging: implications for volume dosage of caudal blockade
ConclusionsThe spinal volumes of interest show a linear correlation to height and weight whereas a curvilinear correlation was found for age. The volume of the epidural space per segment was found to be significantly higher at the lumbar level compared with the caudal and thoracic levels. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Point-of-care paediatric gastric sonography: can antral cut-off values be used to diagnose an empty stomach?
ConclusionsThe RLD position produces the most sensitive and specific CSA cut-off value where an antral CSA of ≤ 3.07 cm2 in the RLD position presents with acceptable performance in the ability to discriminate an empty antrum in paediatric patients over 1 yr of age. As age increases, the sensitivity and specificity of this test increases in the RLD position. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
SmartPilot ® view-guided anaesthesia improves postoperative outcomes in hip fracture surgery: a randomized blinded controlled study
ConclusionsSmartPilot® View-guided anaesthesia reduces intraoperative hypotension duration, occurrence of postoperative complications and length of stay in hip fracture surgery patients.Clinical trial registrationNCT 02556658. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Use of a hand-held digital cognitive aid in simulated crises: the MAX randomized controlled trial
ConclusionThe use of a hand-held cognitive aid was associated with better technical performance of residents dealing with simulated crises. These findings could help digital cognitive aids to find their way into daily medical practice and improve the quality of health care when dealing with high-stakes crises.Clinical trial registrationNCT02678819. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Lost in translation? Comparing the effectiveness of electronic-based and paper-based cognitive aids
It is now established that the use of cognitive aids, such as checklists and algorithms leads to improved technical1 and team performance2 during anaesthetic emergencies. The unpredictable nature of emergencies means that it is difficult to examine these outside of a simulation setting. Consequently, it is challenging to prove these observed behaviours translate to improved patient outcomes, although many anecdotal reports exist.34 Research is now focused on the nature of these cognitive aids and how they can be integrated into the clinical setting, working with, rather than against the instincts of experienced practitione...
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Does variable training lead to variable care?
Entrants to anaesthesia training programs in the developed world are broadly comparable in terms of readiness for specialist training as a result of global standards established by the World Federation for Medical Education. While the context of national health systems has undeniable significance, the competencies required to provide anaesthesia for patients undergoing surgery should also be broadly comparable. In this issue of the British Journal of Anaesthesia, Jonker and colleagues1 report wide variability in anaesthesia training programmes across the European Union (EU), and variable certification processes. Could this...
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Hypertension and cataract surgery under loco-regional anaesthesia: not to be ignored?
The presence of sight-impairing opacification, cataract, is an age-related condition. Modern phacoemulsification procedures allow cataract removal safely and efficiently under loco-regional anaesthesia.1 Increasing numbers of patients with comorbid conditions, including dementia, diabetes mellitus, cardiovascular disease on concurrent antithrombotics and hypertension, present for cataract surgery. TheBritish Journal of Anaesthesia has recently addressed anaesthesia-related issues for ophthalmic surgery in patients with dementia,2 diabetes mellitus3 and anticoagulation.4 This editorial addresses issues related specifically ...
Source: British Journal of Anaesthesia - September 27, 2017 Category: Anesthesiology Source Type: research
Systematic review to determine which validated measurement tools can be used to assess risk of problematic analgesic use in patients with chronic pain
Conclusions. For predicting prescription opioid misuse, thepain medication questionnaire (PMQ) and thescreener and opioid assessment for patients with pain (SOAPP) had the best evidence; both developed and validated in five separate studies (four each of acceptable quality). Thecurrent opioid misuse measure (COMM) performed best screening for current misuse, developed and validated in three studies of acceptable quality. A small number of tools may accurately predict, or identify, opioid misuse. There are none for non-opioid analgesics, where there is a potential need. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 14, 2017 Category: Anesthesiology Source Type: research
Comparison of the paediatric blade of the Pentax-AWS and Ovassapian airway in fibreoptic tracheal intubation in patients with limited mouth opening and cervical spine immobilization by a semi-rigid neck collar: a randomized controlled trial
ConclusionsCombined use of the paediatric blade of a Pentax Airway Scope and a fibreoptic bronchoscope enabled rapid tracheal intubation, minimizing the use of external manoeuvres of the airway, in patients with limited mouth opening and cervical spine immobilization by semi-rigid neck collars, compared with use of the Ovassapian airway and the fibreoptic bronchoscope.Clinical trial registrationNCT02827110. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 14, 2017 Category: Anesthesiology Source Type: research
Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial
ConclusionsAn early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear.Clinical trial registrationNCT01693172. (Source: British Journal of Anaesthesia)
Source: British Journal of Anaesthesia - September 13, 2017 Category: Anesthesiology Source Type: research
