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 jon.brassey@tripdatabase.com
Anaesthesia
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
- General
- Sedation
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.
Top results for anaesthesia
21. APA Consensus Statement on updated fluid fasting guidelines for children prior to elective general anaesthesia
APA Consensus Statement on updated fluid fasting guidelines for children prior to elective general anaesthesia ‘We the undersigned representatives of our respective national societies agree that, based on the current convincing evidence base, unless there is a clear contra-indication, it is safe and recommended for all children able to take clear fluids*, to be allowed and encouraged to have them up to one hour before elective general anaesthesia’ Charles Stack, President, Association
2018 Association of Paediatric Anaesthetists of Great Britain and Ireland
22. Perioperative local anaesthesia for reducing pain following septal surgery. (PubMed)
Perioperative local anaesthesia for reducing pain following septal surgery. Septal surgery is a well-established procedure used to treat nasal obstruction due to deviation of the nasal septum, which is carried out under local or general anaesthesia. Local anaesthesia is used for postoperative pain control, but its effectiveness and safety are unclear.To assess the effectiveness of perioperative local anaesthesia for reducing pain in septal surgery and to evaluate the risk of associated (...) complications.The Cochrane ENT Information Specialist searched the Cochrane ENT Trial Register; Central Register of Controlled Trials; Ovid MEDLINE; Ovid Embase; CINAHL; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the search was 9 January 2018.Randomised controlled trials and cluster-randomised controlled trials involving adults or children (or both) who underwent septal surgery. We included studies comparing local anaesthesia versus
2018 Cochrane
23. Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery. (PubMed)
Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery. The use of anaesthetics in the elderly surgical population (more than 60 years of age) is increasing. Postoperative delirium, an acute condition characterized by reduced awareness of the environment and a disturbance in attention, typically occurs between 24 and 72 hours after surgery and can affect up to 60% of elderly surgical patients (...) . Postoperative cognitive dysfunction (POCD) is a new-onset of cognitive impairment which may persist for weeks or months after surgery.Traditionally, surgical anaesthesia has been maintained with inhalational agents. End-tidal concentrations require adjustment to balance the risks of accidental awareness and excessive dosing in elderly people. As an alternative, propofol-based total intravenous anaesthesia (TIVA) offers a more rapid recovery and reduces postoperative nausea and vomiting. Using TIVA
2018 Cochrane
24. Anaesthesia
Anaesthesia Top results for anaesthesia - Trip Database or use your Google+ account Find evidence fast ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: 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 (...) ) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: 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
2018 Trip Latest and Greatest
25. Injectable local anaesthetic agents for dental anaesthesia. (PubMed)
Injectable local anaesthetic agents for dental anaesthesia. Pain during dental treatment, which is a common fear of patients, can be controlled successfully by local anaesthetic. Several different local anaesthetic formulations and techniques are available to dentists.Our primary objectives were to compare the success of anaesthesia, the speed of onset and duration of anaesthesia, and systemic and local adverse effects amongst different local anaesthetic formulations for dental anaesthesia. We (...) define success of anaesthesia as absence of pain during a dental procedure, or a negative response to electric pulp testing or other simulated scenario tests. We define dental anaesthesia as anaesthesia given at the time of any dental intervention.Our secondary objective was to report on patients' experience of the procedures carried out.We searched the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library; 2018, Issue 1), MEDLINE (OVID SP), Embase, CINAHL PLUS, WEB OF SCIENCE
Full Text available with Trip Pro
2018 Cochrane
26. Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children. (PubMed)
Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children. Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017.To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing (...) registry for related systematic reviews.We included RCTs comparing local or regional anaesthesia versus conventional analgesia with a pain outcome beyond three months after elective, non-orthopaedic surgery.At least two review authors independently assessed trial quality and extracted data and adverse events. We contacted study authors for additional information. We presented outcomes as pooled odds ratios (OR) with 95% confidence intervals (95% CI), based on random-effects models (inverse variance
2018 Cochrane
27. Use of platelet transfusions prior to lumbar punctures or epidural anaesthesia for the prevention of complications in people with thrombocytopenia. (PubMed)
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, subarachnoid 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 regarding the correct management of these patients. The risk of bleeding appears to be low
Full Text available with Trip Pro
2018 Cochrane
28. Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children. (PubMed)
Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children. Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition. This review was originally published in 2012 and updated in 2017.To compare local anaesthetics and regional anaesthesia versus conventional analgesia for the prevention of PPP beyond three months in adults and children undergoing (...) registry for related systematic reviews.We included RCTs comparing local or regional anaesthesia versus conventional analgesia with a pain outcome beyond three months after elective, non-orthopaedic surgery.At least two review authors independently assessed trial quality and extracted data and adverse events. We contacted study authors for additional information. We presented outcomes as pooled odds ratios (OR) with 95% confidence intervals (95% CI), based on random-effects models (inverse variance
2018 Cochrane
29. Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia
Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia Discover Portal Discover Portal Inhaled anaesthesia with anti-sickness medication in children has the same risk of vomiting as intravenous anaesthesia Published on 27 February 2018 doi: Post-operative vomiting is common in children. One strategy is to use (...) group versus 32% inhalation anaesthetic plus antiemetic group (risk ratio 0.99, 95% CI 0.77 to 1.27; 4 trials, 558 children). A similar amount of time was spent in the post-anaesthesia unit (mean difference ‑8.93 minutes, 95% CI ‑22.0 to 4.18). No other adverse events were reported in the trials. What does current guidance say on this issue? The Association of Paediatric Anaesthetists of Great Britain & Ireland (2016) suggest intravenous anaesthesia is considered in children at high risk of sickness
2018 NIHR Dissemination Centre
30. Regional anaesthesia could improve fistula function for kidney dialysis
Regional anaesthesia could improve fistula function for kidney dialysis Regional anaesthesia could improve fistula function for kidney dialysis Discover Portal Discover Portal Regional anaesthesia could improve fistula function for kidney dialysis Published on 25 July 2017 doi: Use of regional anaesthesia when creating a fistula for vascular access may reduce the risk of failure by about 70%. Easy access to blood vessels is important when someone needs kidney dialysis and the commonest (...) procedure is forming of an artificial link between arteries and veins, called a fistula. Unfortunately some newly formed fistulas fail because the blood vessel is not “patent” or open wide enough to work properly. This systematic review found four randomised controlled trials of adults having surgery to make an arteriovenous fistula for kidney dialysis. The trials compared how well the fistulas worked when they had been formed using regional anaesthesia compared with those formed using local anaesthesia
2018 NIHR Dissemination Centre
31. Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours
Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours Discover Portal Discover Portal Two types of anaesthesia are safe for hip and knee replacements but one may reduce the time spent in hospital by a few hours Published on 15 March 2016 doi: Neuraxial anaesthesia, administered around the nerves (...) in the spine, was found to be as safe as general anaesthesia for people undergoing total hip or knee replacements. This review found a similar risk of dying, infection, nerve damage and blood clots in people regardless of the type of anaesthesia. Hospital stay was reduced on average by 0.4 days in the neuraxial anaesthesia group, though the significance to patients or impact on costs was not explored. Using neuraxial anaesthesia took no longer to perform than general anaesthesia. Hip and knee replacements
2018 NIHR Dissemination Centre
32. Epidural anaesthesia helps return of bowel function after abdominal surgery
Epidural anaesthesia helps return of bowel function after abdominal surgery Epidural anaesthesia helps return of bowel function after abdominal surgery Discover Portal Discover Portal Epidural anaesthesia helps return of bowel function after abdominal surgery Published on 27 September 2016 doi: High quality evidence suggests that an epidural anaesthetic (with or without an opioid) promotes the return of gut function after abdominal surgery. This is when compared to an opioid based regimen (...) and may reduce the need for opioids. This updated Cochrane review compared the effects of giving an epidural anaesthetic with giving opioids after abdominal surgery. Opioids could either be injected directly into the bloodstream or given through an epidural. What did this study do? The review pooled the results of 94 randomised controlled trials including 5,846 adults undergoing any form of abdominal surgery under general anaesthesia. Treatment groups received an epidural containing local anaesthetic
2018 NIHR Dissemination Centre
33. General versus spinal anaesthesia for caesarean section: a quasi-controlled trial. (PubMed)
General versus spinal anaesthesia for caesarean section: a quasi-controlled trial. General anaesthesia and spinal anaesthesia are commonly used for caesarean sections. The aim of this study was to compare the outcomes from caesarean sections with these two types of anaesthesia.In this quasi-controlled trial, we enrolled women undergoing caesarean sections at Al-Helal Al-Emirati Hospital, Rafah, Gaza Strip. Women were assigned either to general anaesthesia (20% intravenous propofol (...) for anaesthesia induction followed by atracurium for muscle relaxation, and nitrous oxide and oxygen for anaesthesia maintenance) or to spinal anaesthesia (0·5% hyperbaric solution bupivacaine with 20 μg fentanyl intrathecally). Outcome measures were length of hospital stay, length of operation, postoperative pain assessment by visual analogue scales (VAS; range 0-10, where 0 is no pain and 10 is very bad pain) 1 hour after the operation, time from anaesthesia to demand for analgesia, amount of analgesics
2018 Lancet
34. Loco-regional versus general anaesthesia for elective endovascular aneurysm repair - results of a cohort study and a meta-analysis.
Loco-regional versus general anaesthesia for elective endovascular aneurysm repair - results of a cohort study and a meta-analysis. The aim of this study was to investigate whether patients undergoing elective endovascular aneurysm repair (EVAR) with loco-regional anaesthetic techniques have better outcomes than those treated with general anaesthesia (GA).We retrospectively evaluated outcomes of EVAR performed with regional anaesthesia (RA) or GA over a five-year period. Furthermore, we (...) studies found a significantly lower perioperative mortality (OR 0.70, 95 % CI 0.52-0.95, P = 0.02) and morbidity (OR 0.73, 95 % CI 0.55-0.96, P = 0.02) in patients treated with loco-regional anaesthetic techniques compared to those treated with GA. Our sub-group analysis demonstrated that both local anaesthesia (LA) (P = 0.003) and RA (P < 0.0001) were associated with a significantly shorter LOS compared to GA.Local and/or regional anaesthetic techniques may be advantageous over GA in elective EVAR
2018 VASA. Zeitschrift fur Gefasskrankheiten
35. Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia
Randomized clinical trial of immersive virtual reality tour of the operating theatre in children before anaesthesia A virtual reality (VR) tour of the operating theatre before anaesthesia could provide a realistic experience for children. This study was designed to determine whether a preoperative VR tour could reduce preoperative anxiety in children.Children scheduled for elective surgery under general anaesthesia were randomized into a control or VR group. The control group received (...) conventional information regarding anaesthesia and surgery. The VR group watched a 4-min video showing Pororo, the famous little penguin, visiting the operating theatre and explaining what is in it. The main outcome was preoperative anxiety, assessed using the modified Yale Preoperative Anxiety Scale (m-YPAS) before entering the operating theatre. Secondary outcomes included induction compliance checklist (ICC) and procedural behaviour rating scale (PBRS) scores during anaesthesia.A total of 69 children
2017 EvidenceUpdates
36. Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under. (PubMed)
Cuffed versus uncuffed endotracheal tubes for general anaesthesia in children aged eight years and under. Since the introduction of endotracheal intubation in paediatrics, uncuffed endotracheal tubes (ETTs) have been the standard of care for children under eight years old, based on the presumption that complications, particularly postoperative stridor, are higher with cuffed ETTs. The major disadvantages of uncuffed ETTs cited for this shift in procedure include the difficulty in achieving (...) on the use of cuffed versus uncuffed endotracheal tubes in children of eight years old or less.To assess the risks and benefits of cuffed versus uncuffed endotracheal tubes during general anaesthesia in children up to eight years old.We searched CENTRAL, MEDLINE, Embase, CINAHL, LILACS and Google Scholar databases from their inception until March 2017. We also searched databases of ongoing trials, and checked references and citations. We imposed no restriction by language.We included randomized and quasi
2017 Cochrane
37. Techniques for preventing hypotension during spinal anaesthesia for caesarean section. (PubMed)
Techniques for preventing hypotension during spinal anaesthesia for caesarean section. Maternal hypotension is the most frequent complication of spinal anaesthesia for caesarean section. It can be associated with nausea or vomiting and may pose serious risks to the mother (unconsciousness, pulmonary aspiration) and baby (hypoxia, acidosis, neurological injury).To assess the effects of prophylactic interventions for hypotension following spinal anaesthesia for caesarean section.We searched (...) Cochrane Pregnancy and Childbirth's Trials Register (9 August 2016) and reference lists of retrieved studies.Randomised controlled trials, including full texts and abstracts, comparing interventions to prevent hypotension with placebo or alternative treatment in women having spinal anaesthesia for caesarean section. We excluded studies if hypotension was not an outcome measure.Two review authors independently assessed study quality and extracted data from eligible studies. We report 'Summary
Full Text available with Trip Pro
2017 Cochrane
38. Guidelines for the Safe Management and Use of Medications in Anaesthesia Background Paper
Guidelines for the Safe Management and Use of Medications in Anaesthesia Background Paper PS51 BP 2018 Page 1 PS51 BP 2018 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines for the Safe Management and Use of Medications in Anaesthesia Background Paper 1. PURPOSE OF REVIEW PS51, previously titled Guidelines for the Safe Administration of Injectable Drugs in Anaesthesia, was promulgated in 2009. PS51 is referenced and referred to by healthcare facility administration, fellows (...) to propofol. As propofol is a drug used for the induction and maintenance of anaesthesia it must be immediately available and thus restricting access has the potential to impact on the safe conduct of anaesthesia. However, propofol should be securely stored at all times when not immediately required, for example overnight and between operating sessions. The accompanying professional document provides guidance to the profession and hospitals to avoid the implementation of a multitude of solutions across
2017 Australian and New Zealand College of Anaesthetists
39. Statement on Staffing of Accredited Departments of Anaesthesia Background Paper
Statement on Staffing of Accredited Departments of Anaesthesia Background Paper PS42 BP 2016 Page 1 PS42 BP 2016 Australian and New Zealand College of Anaesthetists (ANZCA) Statement on Staffing of Accredited Departments of Anaesthesia Background Paper 1. PURPOSE OF REVIEW This professional document was reviewed in 2013 as part of the usual five year review cycle. There had been changes in terminology and the employment environment and, as a consequence, the document required updating to meet (...) contemporary expectations. 2. BACKGROUND This document applies to accredited departments of anaesthesia. These departments provide the majority of training within the ANZCA training program. They should be adequately staffed to provide this training, particularly in regard to providing adequate supervision of trainees. The department must provide a safe high quality clinical service and be able to effectively manage the service. Consequently, though the document primarily addresses anaesthesia staff
2017 Australian and New Zealand College of Anaesthetists
40. Guidelines on Return to Anaesthesia Practice for Anaesthetists Background Paper
Guidelines on Return to Anaesthesia Practice for Anaesthetists Background Paper PS50 BP 2017 Page 1 PS50 BP Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Return to Anaesthesia Practice for Anaesthetists Background Paper 1. PURPOSE OF REVIEW PS50 was originally promulgated in 2004 and re-published without revision in 2013. The current review has been undertaken to fulfill the following: 1.1 Meet ANZCA’s mission “to serve the community by fostering safe and high (...) quality patient care in anaesthesia, perioperative medicine and pain medicine; 1.2 Provide support to anaesthetists who are returning to anaesthesia practice after absence for any reason; 1.3 Assist regulatory authorities and other bodies who have mandated return to practice programs for anaesthetists. The title of the document has been changed from PS50 Recommendations on Practice Re-entry for a Specialist Anaesthetist to PS50 Guidelines on Return to Anaesthesia Practice for an Anaesthetist