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Latest & greatest articles for anaesthesia
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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.
Joint professional guidance on the use of general anaesthesia in young children 18 April, 2017 Joint professional guidance on the use of general anaesthesia in young children Executive summary • Studies on immature animals have demonstrated that general anaesthetic agents can induce changes in the central nervous system. Some of these studies have also suggested longer-term effects on learning and memory tests. • To date the results from both epidemiological studies and prospective trials (...) in the human infant have failed to show adverse effects on cognitive development from a single anaesthetic episode of short duration (less than an hour). Data from longer exposures and multiple exposures to surgery and anaesthesia are difficult to interpret due to multiple confounding variables. • Continuing to use reliable familiar techniques for paediatric anaesthesia is emphasised. There is no evidence of a particular anaesthetic technique being better than another in terms of influencing any potential
Total intravenous anaesthesia versus inhalational anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic surgery. Rapid implementation of robotic transabdominal surgery has resulted in the need for re-evaluation of the most suitable form of anaesthesia. The overall objective of anaesthesia is to minimize perioperative risk and discomfort for patients both during and after surgery. Anaesthesia for patients undergoing robotic assisted surgery is different from anaesthesia (...) for patients undergoing open or laparoscopic surgery; new anaesthetic concerns accompany robotic assisted surgery.To assess outcomes related to the choice of total intravenous anaesthesia (TIVA) or inhalational anaesthesia for adults undergoing transabdominal robotic assisted laparoscopic gynaecological, urological or gastroenterological surgery.We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2016 Issue 5), Ovid MEDLINE (1946 to May 2016), Embase via OvidSP (1982 to May 2016
Does the exposure to general anaesthesia in children affect long-term academic and cognitive performance? Does the exposure to general anaesthesia in children affect long-term academic and cognitive performance? - Evidencias en pediatría Searching, please wait Show menu Library Management You did not add any article to your library yet. | Search Evidence-Based decision making Evidence-Based decision making Show menu Library Management You did not add any article to your library yet. × User (...) Password Log in × Reset password If you need to reset your password please enter your email and click the Send button. You will receive an email to complete the process. Email Send × Library Management × March 2017. Volume 13. Number 1 Does the exposure to general anaesthesia in children affect long-term academic and cognitive performance? Rating: 0 (0 Votes) Reviewers: , . | Newsletter Free Subscription Regularly recieve most recent articles by e-mail Subscribe × Newsletter subscription: Email Confirm
Position in the second stage of labour for women with epidural anaesthesia. Epidural analgesia for pain relief in labour prolongs the second stage of labour and results in more instrumental deliveries. It has been suggested that a more upright position of the mother during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane review first published in 2013.To assess the effects of different birthing positions (upright and recumbent) during
Topical anaesthesia for needle-related pain in newborn infants. Hospitalised newborn neonates frequently undergo painful invasive procedures that involve penetration of the skin and other tissues by a needle. One intervention that can be used prior to a needle insertion procedure is application of a topical local anaesthetic.To evaluate the efficacy and safety of topical anaesthetics such as amethocaine and EMLA in newborn term or preterm infants requiring an invasive procedure involving
Consent for anaesthesia Published by The Association of Anaesthetists of Great Britain & Ireland 21 Portland Place, London, W1B 1PY Tel: 020 7631 1650 Fax: 020 7631 4352 Email: firstname.lastname@example.org www.aagbi.org January 2017 AAGBI: Consent for anaesthesia 2017This guideline was originally published in Anaesthesia. If you wish to refer to this guideline, please use the following reference: Association of Anaesthetists of Great Britain and Ireland. AAGBI: Consent for anaesthesia 2017. Anaesthesia 2017 (...) ; 72: 93-105. This guideline can be viewed online via the following URL: http://onlinelibrary.wiley.com/doi/10.1111/anae.13762/fullGuidelines AAGBI: Consent for anaesthesia 2017 Association of Anaesthetists of Great Britain and Ireland S. M. Yentis, 1 A. J. Hartle, 2 I. R. Barker, 3 P. Barker, 4 D. G. Bogod, 5 T. H. Clutton-Brock, 6 A. Ruck Keene, 7 S. Leifer, 8 A. Naughton 9 and E. Plunkett 10 1 Consultant Anaesthetist, Chelsea and Westminster Hospital, London and Honorary Reader, Imperial College
Hyperbaric versus isobaric bupivacaine for spinal anaesthesia for caesarean section. Bupivacaine is an amide local anaesthetic used in hyperbaric and isobaric forms. These are administered intrathecally into the spine to provide regional anaesthesia for caesarean section. Several trials have compared hyperbaric and isobaric bupivacaine but none have conclusively shown the benefit of either. This review was first published in 2013 and updated in 2016.Our objectives were to:1. Determine (...) the effectiveness of hyperbaric bupivacaine compared to isobaric bupivacaine for spinal anaesthesia in women undergoing caesarean section;2. Determine the safety of hyperbaric bupivacaine compared to isobaric bupivacaine for spinal anaesthesia in women undergoing caesarean section.We originally searched the following databases to January 2011: CENTRAL, MEDLINE and Embase.For this update, we reran our search in the above databases from January 2011 to March 2016; two studies are awaiting a response from authors
Intravenous versus inhalational techniques for rapid emergence from anaesthesia in patients undergoing brain tumour surgery. Brain tumour surgery usually is carried out with the patient under general anaesthesia. Over past years, both intravenous and inhalational anaesthetic agents have been used, but the superiority of one agent over the other is a topic of ongoing debate. Early and rapid emergence from anaesthesia is desirable for most neurosurgical patients. With the availability of newer (...) intravenous and inhalational anaesthetic agents, all of which have inherent advantages and disadvantages, we remain uncertain as to which technique may result in more rapid early recovery from anaesthesia.To assess the effects of intravenous versus inhalational techniques for rapid emergence from anaesthesia in patients undergoing brain tumour surgery.We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 6) in The Cochrane Library, MEDLINE via Ovid SP (1966 to June 2014
[Single Subcutaneous Palmar Injection vs. 2 Dorsal Injections for Finger Anaesthesia in Hand Surgery - Randomised Prospective Comparison of Application Pain and Efficacy]. This randomised prospective study compared pain during application and efficacy of the palmar subcutaneous single injection block (PSSIB) and the traditional dorsal 2 injection block (DTIB).During a 2 year period, a total of 190 patients with an average age of 43 years (18-82) and an isolated finger injury were included
Change in children's oral health-related quality of life following dental treatment under general anaesthesia for the management of dental caries: a systematic review. Dental caries has significant impact on children and their families and may necessitate treatment under general anaesthesia (GA). The use of oral health-related quality-of-life (OHRQoL) measures enables evaluation of dental treatment from a patient's perspective.This systematic review aimed to assess change in OHRQoL in children
Nitrous oxide-based versus nitrous oxide-free general anaesthesia and accidental awareness during general anaesthesia in surgical patients. Accidental awareness during general anaesthesia (AAGA) is when a patient unintentionally becomes conscious during a procedure performed with general anaesthesia and subsequently has explicit recall of this event. Incidence estimates for AAGA vary, with the most common estimate being one to two cases per 1000 general anaesthetics. Evidence linking nitrous (...) oxide use and an increased risk of AAGA has come from observational studies data but the literature is contradictory, with some studies finding a protective effect of nitrous oxide.To assess the effect of general anaesthesia including nitrous oxide on the risk of AAGA in patients aged five years and over.We searched the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and trial registers ((www.clinicaltrials.gov), the WHO International Clinical Trials
Effect of regional versus local anaesthesia on outcome after arteriovenous fistula creation: a randomised controlled trial. Arteriovenous fistulae are the optimum form of vascular access in end-stage renal failure. However, they have a high early failure rate. Regional compared with local anaesthesia results in greater vasodilatation and increases short-term blood flow. This study investigated whether regional compared with local anaesthesia improved medium-term arteriovenous fistula (...) patency.This observer-blinded, randomised controlled trial was done at three university hospitals in Glasgow, UK. Adults undergoing primary radiocephalic or brachiocephalic arteriovenous fistula creation were randomly assigned (1:1; in blocks of eight) using a computer-generated allocation system to receive either local anaesthesia (0·5% L-bupivacaine and 1% lidocaine injected subcutaneously) or regional (brachial plexus block [BPB]) anaesthesia (0·5% L-bupivacaine and 1·5% lidocaine with epinephrine
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
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
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
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
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 (...) ), MEDLINE (Ovid SP, 2003 to March 2014) and EMBASE (Ovid SP, 2003 to March 2014).We included randomized trials comparing different methods of anaesthesia for hip fracture surgery in adults. The primary focus of this review was the comparison of regional anaesthesia versus general anaesthesia. The use of nerve blocks preoperatively or in conjunction with general anaesthesia is evaluated in another review. The main outcomes were mortality, pneumonia, myocardial infarction, cerebrovascular accident, acute
Guidelines on Quality Assurance and Quality Improvement in Anaesthesia Background Paper PS58 BP 2018 Page 1 PS58 BP 2018 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Quality Assurance and Quality Improvement in Anaesthesia Background Paper 1. INTRODUCTION This document, previously TE09, was reprinted in 2012 as PS58; however, it was not reviewed at that time. With rising community expectations as well as the emphasis of continuing professional development (CPD (...) healthcare are encapsulated in the acronym STEEEP TM (Safety, Timeliness, Efficiency, Efficacy, Equitability, Patient-centredness). 2. PURPOSE The pursuit of QA and QI is desirable and strongly encouraged. It is an integral part of ANZCA’s Mission. Given the differing environments and clinical practices of fellows the intention of the accompanying guidelines is to inform fellows and to facilitate them achieving the highest level of quality care in anaesthesia, perioperative medicine, and pain medicine. 3