Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4)
Latest & greatest articles for anaesthesia
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on anaesthesia or other clinical topics then use Trip today.
This page lists the very latest high quality evidence on anaesthesia and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.
What is Trip?
Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.
Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.
As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.
For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via firstname.lastname@example.org
Clinical Anaesthesia is used to induce a temporary medical state of controlled unconsciousness, inducing a loss of sensation or awareness. There are three main types of Anaesthesia:
Local and Regional
Anaesthesia is primarily used during surgical procedures to block pain. While unconscious, blood flow and heart rate is monitored.
Research and development in the use of Anaesthesia has helped anesthesiologists in the progression of patient safety before and after surgery and medical procedures. The developments and research of Anaesthesia through the years has massively influences medicine and surgery today.
Case studies and clinical trials help aid researchers in the development of aftercare during postoperative recovery. Research is a vital part in the field of Anaesthesia, it allows anesthesiologists to improve the delivery of patient safety while unconscious.
Learn more on the emerging technology in Anaesthesia and the advancements in Anaesthesia practise by searching Trip.
Epidural local anaesthetics versus opioid-based analgesic regimens for postoperative gastrointestinal paralysis, vomiting and pain after abdominal surgery. Gastrointestinal paralysis, nausea and vomiting and pain are major clinical problems following abdominal surgery. Anaesthetic and analgesic techniques that reduce pain and postoperative nausea and vomiting (PONV), while preventing or reducing postoperative ileus, may reduce postoperative morbidity, duration of hospitalization and hospital (...) costs. This review was first published in 2001 and was updated by new review authors in 2016.To compare effects of postoperative epidural analgesia with local anaesthetics versus postoperative systemic or epidural opioids in terms of return of gastrointestinal transit, postoperative pain control, postoperative vomiting, incidence of anastomotic leak, length of hospital stay and costs after abdominal surgery.We identified trials by conducting computerized searches of the Cochrane Central Register
Depth of anaesthesia monitoring during procedural sedation and analgesia: A systematic review and meta-analysis Processed electroencephalogram-based depth of anaesthesia monitoring devices provide an additional method to monitor level of consciousness during procedural sedation and analgesia. The objective of this systematic review was to determine whether using a depth of anaesthesia monitoring device improves the safety and efficacy of sedation.Systematic review and meta-analysis.Electronic (...) databases (CENTRAL; Medline; CINAHL) were searched up to May 2015.Randomised controlled trials that compared use of a depth of anaesthesia monitoring device to a control group who received standard monitoring during procedural sedation and analgesia were included. Study selection, data extraction and risk of bias assessment (Cochrane risk of bias tool) were performed by two reviewers. Safety outcomes were hypoxaemia, hypotension and adverse events. Efficacy outcomes were amount of sedation used
Storage of Drugs in Anaesthetic Rooms - Guidance on best practice from the RCoA and AAGBI Storage of Drugs in Anaesthetic Rooms Guidance on best practice from the RCoA and AAGBI1 Storage of Drugs in Anaesthetic Rooms Guidance on best practice from the RCoA and AAGBI The Royal College of Anaesthetists (RCoA) and Association of Anaesthetists of Great Britain and Ireland (AAGBI) recognise that secure drug storage makes an important contribution to patient safety, and the safety of the public (...) of Standard Operating Procedures (SOPs) covering each of the activities concerned with medicines use to ensure the safety and security of medicines stored and used in operating departments. 1 A particular situation not mentioned in the RPS document is that anaesthetic rooms, which function as a form of ‘annexe’ to the main operating theatre, are usually a place in which drugs and fluids are stored. During the conduct of an anaesthetic and surgery the anaesthetic room may temporarily and intermittently
High initial concentration versus low initial concentration sevoflurane for inhalational induction of anaesthesia. Sevoflurane induction for general anaesthesia has been reported to be safe, reliable and well accepted by patients. Sevoflurane induction uses either low or high initial concentrations. The low initial concentration technique involves initially administering a low concentration of sevoflurane and gradually increasing the concentration of the dose until the patient is anaesthetized (...) . The high initial concentration technique involves administering high concentrations from the beginning, then continuing with those high doses until the patient is anaesthetized. This review was originally published in 2013 and has been updated in 2016.We aimed to compare induction times and complication rates between high and low initial concentration sevoflurane anaesthetic induction techniques in adults and children who received inhalational induction for general anaesthesia. We defined 'high
The effect of music on the level of cortisol, blood glucose and physiological variables in patients undergoing spinal anesthesia. Surgical procedures performed using spinal anesthetic techniques present a special challenge to anesthesiologists, because patients are awake and are exposed to multiple anxiety provoking visual and auditory stimuli. Therefore, this study was carried out to define the effect of music on the level of cortisol, blood glucose and physiological variables in patients (...) under spinal anesthesia. In this semi-experimental research, 90 men aging from 18-48 years with ASA (acetylsalicylic acid) class I, who underwent urological and abdominal surgery, were investigated. Patients were divided randomly into three groups of thirty subjects. Music group (headphone with music), Silence group (headphone without music) and the control group (without interference). The level of cortisol and blood sugar was measured half an hour before and after the operation. Moreover
Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood. Exposure of young animals to commonly used anesthetics causes neurotoxicity including impaired neurocognitive function and abnormal behavior. The potential neurocognitive and behavioral effects of anesthesia exposure in young children are thus important to understand.To examine if a single anesthesia exposure in otherwise healthy young children was associated (...) , 17.3 months at surgery/anesthesia; 9.5% female) and the unexposed siblings (44% female) had IQ testing at mean ages of 10.6 and 10.9 years, respectively. All exposed children received inhaled anesthetic agents, and anesthesia duration ranged from 20 to 240 minutes, with a median duration of 80 minutes. Mean IQ scores between exposed siblings (scores: full scale = 111; performance = 108; verbal = 111) and unexposed siblings (scores: full scale = 111; performance = 107; verbal = 111) were
Unilateral paravertebral block compared with subarachnoid anesthesia for the management of postoperative pain syndrome after inguinal herniorrhaphy: a randomized controlled clinical trial Inguinal herniorrhaphy is a common surgical procedure. The aim of this investigation was to determine whether unilateral paravertebral block could provide better control of postoperative pain syndrome compared with unilateral subarachnoid block (SAB). A randomized controlled study was conducted using 50 (...) patients with unilateral inguinal hernias. The patients were randomized to receive either paravertebral block (S group) or SAB (C group). Paravertebral block was performed by injecting a total of 20 mL of 0.5% levobupivacaine from T9 to T12 under ultrasound guidance, whereas SAB was performed by injecting 13 mg of 0.5% levobupivacaine at the L3 to L4 level. Data regarding anesthesia, hemodynamic changes, side effects, time spent in the postanesthesia care unit, the Karnofsky Performance Status, acute
Psychological preparation and postoperative outcomes for adults undergoing surgery under general anaesthesia. In a review and meta-analysis conducted in 1993, psychological preparation was found to be beneficial for a range of outcome variables including pain, behavioural recovery, length of stay and negative affect. Since this review, more detailed bibliographic searching has become possible, additional studies testing psychological preparation for surgery have been completed and hospital (...) randomized controlled trials of adult participants (aged 16 or older) undergoing elective surgery under general anaesthesia. We excluded studies focusing on patient groups with clinically diagnosed psychological morbidity. We did not limit the search by language or publication status. We included studies testing a preoperative psychological intervention that included at least one of these seven techniques: procedural information; sensory information; behavioural instruction; cognitive intervention
Use of platelet transfusions prior to lumbar punctures or epidural anaesthesia for the prevention of complications in people with thrombocytopenia. People with a low platelet count (thrombocytopenia) often require lumbar punctures or an epidural anaesthetic. Lumbar punctures can be diagnostic (haematological malignancies, epidural haematoma, meningitis) or therapeutic (spinal anaesthetic, administration of chemotherapy). Epidural catheters are placed for administration of epidural anaesthetic (...) . Current practice in many countries is to correct thrombocytopenia with platelet transfusions prior to lumbar punctures and epidural anaesthesia, in order to mitigate the risk of serious procedure-related bleeding. However, the platelet count threshold recommended prior to these procedures varies significantly from country to country. This indicates significant uncertainty among clinicians of the correct management of these patients. The risk of bleeding appears to be low but if bleeding occurs it can
Risks Associated With Anesthesia Services During Colonoscopy We aimed to quantify the difference in complications from colonoscopy with vs without anesthesia services.We conducted a prospective cohort study and analyzed administrative claims data from Truven Health Analytics MarketScan Research Databases from 2008 through 2011. We identified 3,168,228 colonoscopy procedures in men and women, aged 40-64 years old. Colonoscopy complications were measured within 30 days, including colonic (ie (...) , perforation, hemorrhage, abdominal pain), anesthesia-associated (ie, pneumonia, infection, complications secondary to anesthesia), and cardiopulmonary outcomes (ie, hypotension, myocardial infarction, stroke), adjusted for age, sex, polypectomy status, Charlson comorbidity score, region, and calendar year.Nationwide, 34.4% of colonoscopies were conducted with anesthesia services. Rates of use varied significantly by region (53% in the Northeast vs 8% in the West; P < .0001). Use of anesthesia service
Secondary PDL and Intraosseous Injections Are Both Effective at Anesthetizing Difficult-to-Anesthetize Mandibular Molars UTCAT3020, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Secondary PDL and Intraosseous Injections Are Both Effective at Anesthetizing Difficult-to-Anesthetize Mandibular Molars Clinical Question In patients with a mandibular molar that has irreversible pulpitis and inadequate anesthesia following (...) an inferior alveolar injection, are secondary intraosseous injections more effective at achieving successful anesthesia and reducing side effects than periodontal ligament (PDL) injections? Clinical Bottom Line Both secondary intraosseous and PDL injections can provide anesthesia for mandibular molars that have irreversible pulpitis, but intraosseous injections have a slightly higher effectiveness rate. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year
, a 7 year-old female experienced facial swelling. IV antihistamine was given and the swelling subsided. True IgE-mediated Type I hypersensitivity to lidocaine HCL was confirmed by skin prick test (SPT). No patient risk factors were reported, and an alternative local anesthetic was not considered or tested. Evidence Search ("Anesthesia, Dental/adverse effects"[Mesh] AND "Hypersensitivity"[Mesh]) AND "Anesthetics, Local"[Mesh] OR ("Anesthetics, Local"[Mesh] AND "hypersensitivity, delayed"[Mesh (...) True Allergic Reaction to Amide Local Anesthetics Such as Lidocaine Is Confirmed by Immunologic Testing UTCAT3062, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title True Allergic Reaction to Amide Local Anesthetics Such as Lidocaine Is Confirmed by Immunologic Testing Clinical Question For patients receiving injection of an amide local anesthetic such as lidocaine, is there a risk of true allergic reaction versus
Leg Movements During General Anesthesia 28239614 2019 02 26 2330-1619 3 5 2016 Sep-Oct Movement disorders clinical practice Mov Disord Clin Pract Leg Movements During General Anesthesia. 510-512 10.1002/mdc3.12310 Vanegas Nora N Office of the Clinical Director, National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA; Human Motor Control Section, National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA. Zaghloul Kareem K Surgical Neurology Branch, National (...) Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA. Hallett Mark M Human Motor Control Section, National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA. Lungu Codrin C Office of the Clinical Director, National Institute of Neurologic Disorders and Stroke, Bethesda, MD, USA. eng Z99 NS999999 NULL Intramural NIH HHS United States Case Reports 2016 03 24 United States Mov Disord Clin Pract 101630279 2330-1619 Leg Movements Parkinson Disease general anesthesia Conflict
Supplemental oxygen for caesarean section during regional anaesthesia. Supplementary oxygen is routinely administered to low-risk pregnant women during an elective caesarean section under regional anaesthesia; however, maternal and foetal outcomes have not been well established. This is an update of a review first published in 2013.The primary objective was to determine whether supplementary oxygen given to low-risk term pregnant women undergoing elective caesarean section under regional (...) anaesthesia can prevent maternal and neonatal desaturation. The secondary objective was to compare the mean values of maternal and neonatal blood gas levels between mothers who received supplementary oxygen and those who did not (control group).We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, issue 11), MEDLINE (1948 to November 2014) and EMBASE (1980 to November 2014). The original search was first performed in February 2012. We reran the search in CENTRAL, MEDLINE, EMBASE
Spectral entropy monitoring for adults and children undergoing general anaesthesia. Anaesthetic drugs during general anaesthesia are titrated according to sympathetic or somatic responses to surgical stimuli. It is now possible to measure depth of anaesthesia using electroencephalography (EEG). Entropy, an EEG-based monitor can be used to assess the depth of anaesthesia using a strip of electrodes applied to the forehead, and this can guide intraoperative anaesthetic drug administration.The (...) primary objective of this review was to assess the effectiveness of entropy monitoring in facilitating faster recovery from general anaesthesia. We also wanted to assess mortality at 24 hours, 30 days, and one year following general anaesthesia with entropy monitoring.The secondary objectives were to assess the effectiveness of the entropy monitor in: preventing postoperative recall of intraoperative events (awareness) following general anaesthesia; reducing the amount of anaesthetic drugs used
) performed by an allergy specialist. Patients that continue to demonstrate true immunologic-like responses after negative challenge tests should be pre-medicated to reduce anxiety, and/or be treated with nitrous oxide, general anesthesia, or a local anesthetic without preservatives. Specialty/Discipline (Oral Medicine/Pathology/Radiology) (Endodontics) (General Dentistry) (Oral Surgery) (Periodontics) (Restorative Dentistry) Keywords Hypersensitivity, true allergy, local anesthetic, local anesthesia ID (...) True Allergic Responses to Local Anesthetics (LAs) Are Rare, and Safe Alternative Anesthetics Can Be Used for Common Dental Procedures UTCAT3010, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title True Allergic Responses to Local Anesthetics (LAs) Are Rare, and Safe Alternative Anesthetics Can Be Used for Common Dental Procedures Clinical Question In a patient who claims to have an allergy to local anesthetic, what
used for the comparison of neuraxial block versus general anaesthesia. Based on 11 studies that included 2152 participants, we did not find a difference between the two anaesthetic techniques for mortality at one month: risk ratio (RR) 0.78, 95% confidence interval (CI) 0.57 to 1.06; I(2) = 24% (fixed-effect model). Based on six studies that included 761 participants, we did not find a difference in the risk of pneumonia: RR 0.77, 95% CI 0.45 to 1.31; I(2) = 0%. Based on four studies that included (...) Anaesthesia for hip fracture surgery in adults. The majority of people with hip fracture are treated surgically, requiring anaesthesia.The main focus of this review is the comparison of regional versus general anaesthesia for hip (proximal femoral) fracture repair in adults. We did not consider supplementary regional blocks in this review as they have been studied in another review.We searched the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2014, Issue 3
Effectiveness of dexmedetomidine use in general anesthesia to prevent postoperative shivering: a systematic review. Postanesthetic shivering remains a significant source of distress following general anesthesia. Despite numerous studies investigating pharmacologic prophylaxis for postanesthetic shivering, no gold standard medication has been identified. Prophylactic dexmedetomidine administration has been examined as a possible preventative treatment modality for postanesthetic shivering (...) ; however its effectiveness has not been established.The objective of this review was to evaluate the effectiveness of intravenous prophylactic dexmedetomidine for reduction of postanesthetic shivering during the first two hours after general anesthesia. The participants included in this study were adults between 18 and 68 years of age receiving general anesthesia for any surgical procedure. Only participants with American Society of Anesthesiologist physical status I or II were included. Types