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

41. Effects of fascia iliaca compartment block combined with general laryngeal mask airway anesthesia in children undergoing femoral fracture surgery: a randomized trial Full Text available with Trip Pro

Effects of fascia iliaca compartment block combined with general laryngeal mask airway anesthesia in children undergoing femoral fracture surgery: a randomized trial Postoperative agitation after general anesthesia is a common complication in children; however, pain or uncomfortable feeling is the main reason of emergence agitation. Here, we have investigated the effects of fascia iliaca compartment block (FICB) combined with general laryngeal mask airway (LMA) anesthesia in children undergoing (...) femoral surgery.Eighty children undergoing femoral surgery were randomly divided into two groups: FICB + LMA group and control group (n=40). The FICB + LMA group received FICB combined with general LMA anesthesia, and the control group received tracheal intubation general anesthesia alone. Anesthesia was maintained with nitrous oxide and sevoflurane. Hemodynamic parameters were monitored, and pain was assessed by verbal numeric score within 24 hours postoperatively. Time to extubation, time

2019 EvidenceUpdates

42. Regional Analgesia Added to General Anesthesia Compared With General Anesthesia Plus Systemic Analgesia for Cardiac Surgery in Children: A Systematic Review and Meta-analysis of Randomized Clinical Trials (Abstract)

Regional Analgesia Added to General Anesthesia Compared With General Anesthesia Plus Systemic Analgesia for Cardiac Surgery in Children: A Systematic Review and Meta-analysis of Randomized Clinical Trials The aim of this systematic review was to compare the effects of regional analgesic (RA) techniques with systemic analgesia on postoperative pain, nausea and vomiting, resources utilization, reoperation, death, and complications of the analgesic techniques in children undergoing cardiac (...) evidence), intensive care unit length of stay (mean difference, -0.10 hours; 95% CI, -1.31 to 1.12 hours; low-quality evidence), hospital length of stay (mean difference, -0.02 days; 95% CI, -1.16 to 1.12 days; low-quality evidence), reoperation (RR, 0.76; 95% CI, 0.17-3.28; low-quality evidence), death (RR, 0.50; 95% CI, 0.05-4.94; low-quality evidence), and respiratory depression (RR, 2.06; 95% CI, 0.20-21.68; very low-quality evidence). No trial reported signs of local anesthetic toxicity or lasting

2019 EvidenceUpdates

43. Peripartum Analgesia and Anesthesia for the Breastfeeding Mother

• The decision to use a particular anesthetic technique for cesarean delivery (i.e., neuraxial versus general anesthe- sia) should be individualized based on anesthetic, obstet- ric, maternal, and fetal risk factors. There is a preference for neuraxial anesthesia over general anesthesia for most cesarean deliveries, but general anesthesia may be most appropriate in certain circumstances such as profound fetal bradycardia, ruptured uterus, severe maternal hemorrhage, and severe placental abruption 22 (IB-IV (...) effects, such as a transverse abdominis plane block, particularly if the cesarean delivery required general anesthesia, or the use of wound infiltration with a local anesthetic, may decrease systemic opioid consumption, provide better comfort during breastfeeding, and de- crease time to first breastfeed 50,51 (IIA). Postpartum pain management In addition to evaluating the effects of analgesia used during labor—or in the subset of women who may have had an intrapartum cesarean delivery after neuraxial

2019 Academy of Breastfeeding Medicine

44. Effect of Intravenous Dexmedetomidine During General Anesthesia on Acute Postoperative Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials (Abstract)

Effect of Intravenous Dexmedetomidine During General Anesthesia on Acute Postoperative Pain in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies.Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials. The relative risk and weighted mean difference (WMD) were used to analyze the outcomes (...) ; 95% CI, -5.20 to -1.03), reduced the risk of rescue analgesics (relative risk=0.49; 95% CI, 0.33-0.71), and the interval to first rescue analgesia was prolonged (WMD=34.93; 95% CI, 20.27-49.59).Intravenous DEX effectively relieved the pain intensity, extended the pain-free period, and decreased the consumption of opioids during postoperative recovery of adults in general anesthesia.

2018 EvidenceUpdates

45. Maternal position in the second stage of labour for women with epidural anaesthesia. Full Text available with Trip Pro

Maternal position in the second stage of labour for women with epidural anaesthesia. Epidural analgesia in labour prolongs the second stage and increases instrumental delivery. It has been suggested that a more upright maternal position during all or part of the second stage may counteract these adverse effects. This is an update of a Cochrane Review published in 2017.To assess the effects of different birthing positions (upright or recumbent) during the second stage of labour, on maternal

2018 Cochrane

46. Anaesthetic management during intracranial mechanical thrombectomy: systematic review and meta-analysis of current data (Abstract)

Anaesthetic management during intracranial mechanical thrombectomy: systematic review and meta-analysis of current data Our aim was to compare the clinical outcome of patients with ischaemic stroke with anterior large vessel occlusion treated with stent retrievers and/or contact aspiration mechanical thrombectomy (MT) under general anaesthesia (GA) or conscious sedation non-GA through a systematic review and meta-analysis.The literature was searched using PubMed, Embase and Cochrane databases (...) to identify studies reporting on anaesthesia and MT. Using fixed or random weighted effect, we evaluated the following outcomes: 3-month mortality, modified Rankin Score (mRs) 0-2, recanalisation success (thrombolysis in cerebral infarction (TICI) ≥2b) and symptomatic intracerebral haemorrhagic (sICH) transformation.We identified seven cohorts (including three dedicated randomised controlled trials), totalling 1929 patients (932 with GA). Over the entire sample, mortality, mRs 0-2, TICI≥2b and sICH rates

2018 EvidenceUpdates

47. Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial Full Text available with Trip Pro

Effect of Cricoid Pressure Compared With a Sham Procedure in the Rapid Sequence Induction of Anesthesia: The IRIS Randomized Clinical Trial The use of cricoid pressure (Sellick maneuver) during rapid sequence induction (RSI) of anesthesia remains controversial in the absence of a large randomized trial.To test the hypothesis that the incidence of pulmonary aspiration is not increased when cricoid pressure is not performed.Randomized, double-blind, noninferiority trial conducted in 10 academic (...) centers. Patients undergoing anesthesia with RSI were enrolled from February 2014 until February 2017 and followed up for 28 days or until hospital discharge (last follow-up, February 8, 2017).Patients were assigned to a cricoid pressure (Sellick group) or a sham procedure group.Primary end point was the incidence of pulmonary aspiration (at the glottis level during laryngoscopy or by tracheal aspiration after intubation). It was hypothesized that the sham procedure would not be inferior

2018 EvidenceUpdates

48. Norepinephrine Infusion for Preventing Postspinal Anesthesia Hypotension during Cesarean Delivery: A Randomized Dose-finding Trial (Abstract)

Norepinephrine Infusion for Preventing Postspinal Anesthesia Hypotension during Cesarean Delivery: A Randomized Dose-finding Trial Norepinephrine has been recently introduced for prophylaxis against postspinal hypotension during cesarean delivery; however, no data are available regarding its optimum dose. The objective of this study is to compare three infusion rates of norepinephrine for prophylaxis against postspinal hypotension during cesarean delivery.The authors conducted a double-blinded

2018 EvidenceUpdates

49. Policy for Selecting Anesthesia Providers for the Delivery of Office-based Deep Sedation/General Anesthesia

and special needs populations. Advanced training in recognition and manage- ment of pediatric emergencies is critical in providing safe sedation and anesthetic care. 1 Close collaboration between the dentist and the anesthesia providers can provide access to care, establish an enhanced level of patient cooperation, improve surgical quality, and offer an elevated level of patient safety during the delivery of dental care. Federal, state, and local credentialing and licensure laws, regulations, and codes (...) dental office, noting any that may be unique to these clinical circumstances? DS/GA= Deep sedation/General anesthesia. SHCN= Special health care needs. OMFS= Oral and maxillofacial surgery. * During the oral and maxillofacial surgery training program, a resident’s assignment to the department of anesthesiology “must be for a minimum of five months, should be consecutive and one of these months should be dedicated to pediatric anesthesia”. 11 This anesthesia experience is supplemented throughout

2018 American Academy of Pediatric Dentistry

50. A Randomized Controlled Trial Comparing Epidural Analgesia Versus Continuous Local Anesthetic Infiltration Via Abdominal Wound Catheter in Open Liver Resection (Abstract)

A Randomized Controlled Trial Comparing Epidural Analgesia Versus Continuous Local Anesthetic Infiltration Via Abdominal Wound Catheter in Open Liver Resection To compare outcomes following open liver resection (OLR) between patients receiving thoracic epidural (EP) versus abdominal wound catheters plus patient-controlled analgesia (AWC-PCA).Patients were randomized 1:1 to either EP or AWC-PCA within an enhanced recovery protocol. Primary outcome was length of stay (LOS), other variables (...) included functional recovery, pain scores, peak flow, vasopressor and fluid requirements, and postoperative complications.Between April 2015 and November 2017, 83 patients were randomized to EP (n = 41) or AWC-PCA (n = 42). Baseline demographics were comparable. No difference was noted in LOS (EP 6 d (3-27) vs AWC-PCA 6 d (3-66), P = 0.886). Treatment failure was 20% in the EP group versus 7% in the AWC-PCA (P = 0.09). Preoperative anesthetic time was shorter in the AWC-PCA group, 49 minutes versus 62

2018 EvidenceUpdates

51. Effects of Combined Lower Thoracic Epidural/General Anesthesia on Pain Control in Patients Undergoing Elective Lumbar Spine Surgery: A Randomized Controlled Trial (Abstract)

Effects of Combined Lower Thoracic Epidural/General Anesthesia on Pain Control in Patients Undergoing Elective Lumbar Spine Surgery: A Randomized Controlled Trial Randomized controlled trial.Our objective was to compare postoperative pain relief and operating field condition of single-shot, low-thoracic epidural anesthesia combined with general anesthesia versus general anesthesia alone.Prior studies have suggested that continuous epidural analgesia provides better postoperative pain relief (...) and less intraoperative blood loss, but with the risk of the epidural catheter contaminating the surgical field.A total of 22 patients scheduled for elective lumbar spine surgery were enrolled and randomly allocated into two groups. Group B (block) received a single-shot epidural block with 0.25% bupivacaine plus 4 mg of morphine with a total volume of 10 mL before receiving general anesthesia with desflurane, and cisatracurium. Group G (general) received general anesthesia alone with desflurane

2018 EvidenceUpdates

52. 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

53. Evidence Basis for Regional Anesthesia in Ambulatory Anterior Cruciate Ligament Reconstruction: Part I-Femoral Nerve Block (Abstract)

Evidence Basis for Regional Anesthesia in Ambulatory Anterior Cruciate Ligament Reconstruction: Part I-Femoral Nerve Block The optimal management of pain after ambulatory anterior cruciate ligament reconstruction (ACLR) is unclear. Femoral nerve block (FNB) is purported to enhance postoperative analgesia, but its effectiveness in the setting of modern multimodal analgesia is unclear. This systematic review examines the effect of adding FNB to multimodal analgesia on analgesic outcomes after

2018 EvidenceUpdates

54. Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic

patients and frequently used dental anesthetic techniques. Recommendations: 1. Dry mucosa. 2. Topical anesthetic. 3. Initial infiltration along long axis of dental tooth. 4. Local anesthesia of the adjacent segment may be needed; therefore change needle direction at initial puncture site towards pre-maxilla, crossing cleft towards other side. Evidence Search Search (((cleft lip and palate)) AND local anesthetic) AND dental treatment Comments on The Evidence Validity: Limited articles with low level (...) Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic UTCAT3331, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Dentists Treating Cleft Lip and/or Palate Patients Will Need to Consider Anatomical Variations when Delivering Local Anesthetic Clinical Question In cleft lip and palate patients, will altered anesthetic techniques be more effective

2018 UTHSCSA Dental School CAT Library

55. The Periodontal Ligament (PDL) Injection for Anesthesia of Primary Mandibular Teeth is Less Traumatic and as Effective as the Inferior Alveolar Nerve Block (IANB) Injection

dentistry. IANB is commonly used but can induce higher post-operative trauma due to residual numbing affect to lip and tongue, risk of trismus, and facial nerve palsy. PDL injection is a simpler technique that provides adequate pain control, shorter post-operative anesthesia and overall, and uses less anesthetic solution. Specialty/Discipline (Endodontics) (General Dentistry) (Pediatric Dentistry) (Restorative Dentistry) Keywords anesthesia, inferior alveolar nerve block, intraligamental injection (...) The Periodontal Ligament (PDL) Injection for Anesthesia of Primary Mandibular Teeth is Less Traumatic and as Effective as the Inferior Alveolar Nerve Block (IANB) Injection UTCAT3326, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title The Periodontal Ligament (PDL) Injection for Anesthesia of Primary Mandibular Teeth is Less Traumatic and as Effective as the Inferior Alveolar Nerve Block (IANB) Injection Clinical Question

2018 UTHSCSA Dental School CAT Library

56. Intravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia (Abstract)

Intravenously Administered Lidocaine and Magnesium During Thyroid Surgery in Female Patients for Better Quality of Recovery After Anesthesia Although systemic lidocaine and magnesium have been widely studied as perioperative analgesic adjuvants, they have been rarely evaluated with respect to recovery quality under the same conditions. We compared the quality of recovery 40 (QoR-40) scores of female patients who received intravenous lidocaine, magnesium, and saline during thyroidectomy (...) intravenously during anesthesia led to better quality of postoperative recovery measured by QoR-40 compared with the group C. Magnesium was found to be insufficient to induce any significant improvement with the dose used in the present study.

2018 EvidenceUpdates

57. Perioperative local anaesthesia for reducing pain following septal surgery. Full Text available with Trip Pro

no treatment/placebo. We also included studies comparing different types of local anaesthesia to each other (i.e. local injection, the addition of an anaesthetic agent to nasal packing, where used, and sphenopalatine ganglion block).We used the standard methodological procedures expected by Cochrane. The primary outcome was postoperative pain intensity at 12, 24 and 48 hours measured by visual analogue scale (VAS) or another pain outcome tool including numerical or verbal rating scales. Secondary outcomes (...) 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

2018 Cochrane

58. Intravenous versus inhalational maintenance of anaesthesia for postoperative cognitive outcomes in elderly people undergoing non-cardiac surgery. Full Text available with Trip Pro

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

59. Anesthesia

on the emerging technology in anesthesia and the advancements in anesthesia practise by searching Trip. Top results for anesthesia 1. Practice Guidelines for Obstetric Anesthesia Practice Guidelines for Obstetric Anesthesia:An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology* | Anesthesiology | ASA Publications 468217175 ASA Publications Log in to access full content You must be logged in to access (...) this feature. ASA members enjoy complimentary access to ASA publications, as well as a variety of educational resources. Non (...) -ASA Members Login Free Practice Parameter | February 2016 Practice Guidelines for Obstetric Anesthesia : An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology* Author Notes This article is featured in “This Month in Anesthesiology ,” page 1A. This article is featured

2018 Trip Latest and Greatest

60. Anaesthesia

technology in Anaesthesia and the advancements in Anaesthesia practise by searching Trip. Top results for anaesthesia 1. The European Society of Regional Anaesthesia and Pain Therapy and the American Society of Regional Anesthesia and Pain Medicine Joint Committee Practice Advisory on Controversial Topics in Pediatric Regional Anesthesia The European Society of Regional Anaesthesia and Pain Therap... : Regional Anesthesia and Pain Medicine You may be trying to access this site from a secured browser (...) with a needle DATA COLLECTION AND ANALYSIS: From the reports of the clinical trials we extracted data regarding clinical outcomes including pain, number of infants with methaemoglobin level 5% and above, number of needle 2017 6. Local anaesthetics and regional anaesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children. BACKGROUND: Regional anaesthesia may reduce the rate of persistent postoperative pain (PPP), a frequent and debilitating condition

2018 Trip Latest and Greatest