Latest & greatest articles for anaesthesia

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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. 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

22. 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

23. 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

24. 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

25. 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

26. 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

27. 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

28. 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

29. 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

30. 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

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2017 Cochrane

31. 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

32. 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

33. 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

2017 Australian and New Zealand College of Anaesthetists

34. Guidelines on Return to Anaesthesia Practice for Anaesthetists

Guidelines on Return to Anaesthesia Practice for Anaesthetists PS50 2017 Page 1 PS50 2017 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Return to Anaesthesia Practice for Anaesthetists 1. INTRODUCTION Anaesthesia is a high acuity specialty that requires the ability to make rapid and accurate clinical assessments, often concurrently with time-critical management decisions as well as undertake a range of technical skills. Performance of tasks at optimal levels depends (...) anaesthetists whose absence from clinical anaesthesia practice has been sufficient to warrant a formal return to practice program. Its purpose is to guide anaesthetists and those assisting them in developing, monitoring and successfully completing a return to practice program. The overall aim is to ensure that the returning anaesthetist provides safe and up-to-date care. Each individual anaesthetist has a responsibility to ensure that this is the case. 3. SCOPE This document applies to all anaesthetists

2017 Australian and New Zealand College of Anaesthetists

35. Guidelines for the Safe Management and Use of Medications in Anaesthesia

Guidelines for the Safe Management and Use of Medications in Anaesthesia PS51 2018 Page 1 PS51 2018 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines for the Safe Management and Use of Medications in Anaesthesia 1. INTRODUCTION The safe administration of drugs in anaesthesia encompasses the timely administration of medication to patients, the prevention of drug administration errors, and measures to reduce the opportunity to misdirect drugs. Estimates of the frequency (...) of 'medication errors' range from 1 in 20 administration events 1 , to 1 in 133 2 anaesthesia episodes. Many of these reported events were protocol or process errors (including mislabelling or omission of an appropriate drug), however a proportion of these errors will result in an adverse event for the patient. More than 3 million anaesthetics are administered in Australia and New Zealand annually suggesting a substantial contribution to iatrogenic adverse events. Anaesthetists must be aware

2017 Australian and New Zealand College of Anaesthetists

36. Statement on Staffing of Accredited Departments of Anaesthesia

Statement on Staffing of Accredited Departments of Anaesthesia PS42 2017 Page 1 PS42 2017 Australian and New Zealand College of Anaesthetists (ANZCA) Statement on Staffing of Accredited Departments of Anaesthesia 1. INTRODUCTION 1.1 Purpose and scope The Australian and New Zealand College of Anaesthetists (ANZCA) recognises the important role of anaesthesia departments providing training within the ANZCA training program. This document is intended to apply to anaesthesia departments accredited (...) staff have adequate allocated time for professional development. Anaesthetists who contribute more heavily to teaching, training, research and administration will require more sessions for clinical support activities. 2.1.1 Director of anaesthesia The director has a primary managerial responsibility to ensure that the department functions safely and efficiently. The director of anaesthesia must be a registered medical practitioner who holds the fellowship of ANZCA, or suitable anaesthesia

2017 Australian and New Zealand College of Anaesthetists

37. Guidelines on Monitoring During Anaesthesia

Guidelines on Monitoring During Anaesthesia PS18 2017 Page 1 PS18 2017 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Monitoring During Anaesthesia 1. PURPOSE Clinical observation and assessment by a vigilant anaesthetist is essential for safe patient care during anaesthesia. The purpose of these guidelines is to guide practitioners on monitoring standards that should be applied to clinical management in order to optimise patient safety and quality care. 2. SCOPE (...) The terms “anaesthetist”, “medical practitioner” and “practitioner” are used interchangeably in this document. Although this document is primarily aimed at anaesthetists, any practitioner responsible for patient monitoring during “anaesthesia” should follow these guidelines. The following applies to the management of patients undergoing general anaesthesia, major regional anaesthesia/analgesia or sedation (to be collectively described by the term “anaesthesia”) for diagnostic or therapeutic procedures

2017 Australian and New Zealand College of Anaesthetists

38. Guidelines on Monitoring During Anaesthesia Background Paper

Guidelines on Monitoring During Anaesthesia Background Paper PS18 BP 2017 Page 1 PS18 BP 2017 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Monitoring During Anaesthesia Background Paper PURPOSE Monitoring is an integral part of observation and recording contributing to the management of anaesthesia and outcomes. In the perioperative period clinical changes can occur rapidly and at times unexpectedly, and consequently it is fundamental that such changes are detected (...) from “Recommendations” to “Guidelines”. “Guidelines” offer advice on clinical and non- clinical aspects of the practice of anaesthesia and perioperative medicine, reflecting expert consensus and supported by other evidence when available. SCOPE PS18 is intended to apply wherever anaesthesia is administered and includes general anaesthesia, sedation, and major regional analgesia. While general anaesthesia and major regional analgesia is performed by anaesthetists, conscious sedation is administered

2017 Australian and New Zealand College of Anaesthetists

39. Position in the second stage of labour for women without epidural anaesthesia. (PubMed)

Position in the second stage of labour for women without epidural anaesthesia. For centuries, there has been controversy around whether being upright (sitting, birthing stools, chairs, squatting, kneeling) or lying down (lateral (Sim's) position, semi-recumbent, lithotomy position, Trendelenburg's position) have advantages for women giving birth to their babies. This is an update of a review previously published in 2012, 2004 and 1999.To determine the possible benefits and risks of the use (...) of different birth positions during the second stage of labour without epidural anaesthesia, on maternal, fetal, neonatal and caregiver outcomes.We searched Cochrane Pregnancy and Childbirth's Trials Register (30 November 2016) and reference lists of retrieved studies.Randomised, quasi-randomised or cluster-randomised controlled trials of any upright position assumed by pregnant women during the second stage of labour compared with supine or lithotomy positions. Secondary comparisons include comparison

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2017 Cochrane

40. New global surgical and anaesthesia indicators in the World Development Indicators dataset (PubMed)

New global surgical and anaesthesia indicators in the World Development Indicators dataset 29225929 2018 11 13 2059-7908 2 2 2017 BMJ global health BMJ Glob Health New global surgical and anaesthesia indicators in the World Development Indicators dataset. e000265 10.1136/bmjgh-2016-000265 Raykar Nakul P NP Department of Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA. Program in Global Surgery and Social Change, Harvard Medical School, Boston

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2017 BMJ global health