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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.
propofol sedation; ECG, electrocardiogram; MAC, monitored anesthesia care; NAAP, non-anesthesiologist–administered propofol sedation; NAPS, nurse-administered propofol sedation; RN, registered nurse. REFERENCES 1. Guyatt GH, Oxman AD, Vist GE, et al. GRADE: an emerging consensus on rating quality of evidence and strength of recommendations. BMJ 2008;336:924-6. 2. Practice guidelines for sedation and analgesia by non-anesthesiolo- gists. Anesthesiology 2002;96:1004-17. 3. Faigel DO, Baron TH, Goldstein (...) population. Clin Gastroenterol Hepatol 2012;10:58-64. 65. Tetzlaff JE, Vargo JJ, Maurer W. Nonoperating room anesthesia for the gastrointestinal endoscopy suite. Anesthesiol Clin 2014;32:387-94. 66. American Society of Anesthesiology. Statement on anesthesia care for endoscopic procedures 2014. Available at https://www.asahq.org/For- Members/Standards-Guidelines-and-Statements.aspx. Accessed June 14, 2015. 67. Practice guidelines for postanesthetic care: a report by the American Society
Inhalational versus IV Induction of Anesthesia in Children with a High Risk of Perioperative Respiratory Adverse Events: A Randomized Controlled Trial Limited evidence suggests that children have a lower incidence of perioperative respiratory adverse events when intravenous propofol is used compared with inhalational sevoflurane for the anesthesia induction. Limiting these events can improve recovery time as well as decreasing surgery waitlists and healthcare costs. This single center open (...) -label randomized controlled trial assessed the impact of the anesthesia induction technique on the occurrence of perioperative respiratory adverse events in children at high risk of those events.Children (N = 300; 0 to 8 yr) with at least two clinically relevant risk factors for perioperative respiratory adverse events and deemed suitable for either technique of anesthesia induction were recruited and randomized to either intravenous propofol or inhalational sevoflurane. The primary outcome
Comparison of Paravertebral Block by Anatomic Landmark Technique to Ultrasound-Guided Paravertebral Block for Breast Surgery Anesthesia: A Randomized Controlled Trial Paravertebral block (PVB) is an established technique for providing anesthesia for breast surgery. The primary objective was to compare anatomical landmark technique (ALT) to the ultrasound-guided (USG) PVB block for providing surgical anesthesia. Secondary objectives included comparison of perioperative analgesia (...) and complications.This randomized, controlled, observer-blinded study included 72 females, aged 18 to 65 years, American Society of Anesthesiologists physical status I or II, undergoing elective unilateral breast surgery. Study participants were randomized to the ALT group or USG group. Ipsilateral PVB was performed with the respective technique from T1 to T6. Five milliliters of local anesthetic mixture (0.5% ropivacaine, 5 μg/mL adrenaline, 1 μg/kg clonidine) was administered at each level. Paravertebral catheter
better analgesia for the patient needs to be examined. There has been no recent systematic review to provide evidence that hyaluronidase actually improves analgesia.To ascertain if adding hyaluronidase to local anaesthetic solutions for use in ophthalmic anaesthesia in adults results in a reduction of perceived pain during the operation and to assess harms, participant and surgical satisfaction, and economic impact.We carried out systematic searches in Cochrane Central Register of Controlled Trials (...) Use of hyaluronidase as an adjunct to local anaesthetic eye blocks to reduce intraoperative pain in adults. Hyaluronidase has been used over many decades as an adjunct to local anaesthetic solution to improve the speed of onset of eye blocks and to provide better akinesia and analgesia. With the evolution of modern eye surgery techniques, fast onset and akinesia are not essential requirements anymore. The assumption that the addition of hyaluronidase to local anaesthetic injections confers
of the patients, which might affect the perception of knee pain, was not evaluated. The follow-up period was 2 months; this period might be insufficient to validate the short-term effects of GNB.Ultrasound-guided GNB, when combined with a local anesthetic and corticosteroid, can provide short-term pain relief. However, the clinical benefit of corticosteroid administration was not clear in comparison with local anesthesia alone. Given the potential adverse effects, corticosteroids might not be appropriate (...) Ultrasound-Guided Genicular Nerve Block for Knee Osteoarthritis: A Double-Blind, Randomized Controlled Trial of Local Anesthetic Alone or in Combination with Corticosteroid Recently, several studies suggested that radiofrequency (RF) ablation of the genicular nerves is a safe and effective therapeutic procedure for intractable pain associated with chronic knee osteoarthritis (OA). Diagnostic genicular nerve block (GNB) with local anesthetic has been generally conducted before making decisions
Utility of anesthetic block for endometrial ablation pain: a randomized controlled trial Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment, in premenopausal women who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists, and practice varies depending on physician or patient preference and hospital policy and setting.The aim of this study was to evaluate (...) whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation.This was a single-center single-blind randomized controlled trial conducted in an academic-affiliated community hospital. A total of 84 English-speaking premenopausal women, aged 30 to 55 years, who were undergoing outpatient endometrial ablation for benign disease were randomized to receive standardized paracervical injection of 20 mL 0.25
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
2018LancetControlled trial quality: predicted high
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
Anesthesia Assistance in Outpatient Colonoscopy and Risk of Aspiration Pneumonia, Bowel Perforation, and Splenic Injury The increase in use of anesthesia assistance (AA) to achieve deep sedation with propofol during colonoscopy has significantly increased colonoscopy costs without evidence for increased quality and with possible harm. We investigated the effects of AA on colonoscopy complications, specifically bowel perforation, aspiration pneumonia, and splenic injury.In a population-based
Initiation of labor analgesia with injection of local anesthetic through the epidural needle compared to the catheter The rationale for injection of epidural medications through the needle is to promote sooner onset of pain relief relative to dosing through the epidural catheter given that needle injection can be performed immediately after successful location of the epidural space. Some evidence indicates that dosing medications through the epidural needle results in faster onset and improved (...) quality of epidural anesthesia compared to dosing through the catheter, though these dosing techniques have not been compared in laboring women. This investigation was performed to determine whether dosing medication through the epidural needle improves the quality of analgesia, level of sensory blockade, or onset of pain relief measured from the time of epidural medication injection.In this double-blinded prospective investigation, healthy term laboring women (n=60) received labor epidural placement
Efficacy of local dexmedetomidine add-on for spermatic cord block anesthesia in patients undergoing intrascrotal surgeries: randomized controlled multicenter clinical trial The objective of this study was to evaluate the effect of adding dexmedetomidine (DEX) to bupivacaine on the quality of spermatic cord block anesthesia and postoperative analgesia.This is a randomized, double-blind study.This study was performed in an educational and research hospital.One hundred twenty adult males were
underwent surgery with complete handover of anesthesia care. The percentage of patients undergoing surgery with a handover of anesthesiology care progressively increased each year of the study, reaching 2.9% in 2015. In the unweighted sample, the primary outcome occurred in 44% of the complete handover group compared with 29% of the no handover group. After adjustment, complete handovers were statistically significantly associated with an increased risk of the primary outcome (adjusted risk difference (...) Association Between Handover of Anesthesia Care and Adverse Postoperative Outcomes Among Patients Undergoing Major Surgery. Handing over the care of a patient from one anesthesiologist to another occurs during some surgeries and might increase the risk of adverse outcomes.To assess whether complete handover of intraoperative anesthesia care is associated with higher likelihood of mortality or major complications compared with no handover of care.A retrospective population-based cohort study
Pre-operative Internal Medicine and Anesthesiology Consultations for Elective Surgeries: Clinical Effectiveness and Guidelines Pre-operative Internal Medicine and Anesthesiology Consultations for Elective Surgeries: Clinical Effectiveness and Guidelines | CADTH.ca Find the information you need Pre-operative Internal Medicine and Anesthesiology Consultations for Elective Surgeries: Clinical Effectiveness and Guidelines Pre-operative Internal Medicine and Anesthesiology Consultations for Elective (...) Surgeries: Clinical Effectiveness and Guidelines Last updated: July 10, 2018 Project Number: RB1236-000 Product Line: Research Type: Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What is the clinical effectiveness of an internal medical consultation as part of the pre-operative assessment for adults undergoing elective surgical procedures? What is the clinical effectiveness for an anesthesiology consultation as part of the pre-operative assessment for adults
A clinical trial comparing propofol versus propofol plus midazolam in diagnostic endoscopy of patients with a low anesthetic risk. propofol and midazolam are two of the most commonly used sedatives in upper gastrointestinal endoscopy (UGE). The objective of this study was to evaluate these two sedation regimens administered to patients who underwent an UGE with regard to security, efficiency, quality of exploration and patient response.a prospective, randomized and double-blind study (...) was performed which included 83 patients between 18 and 80 years of age of a low anesthetic risk (ASA - American Society of Anesthesiologists- I-II) who underwent a diagnostic UGE. Patients were randomized to receive sedation with either placebo plus propofol (group A) or midazolam plus propofol (group B).in group A, 42 patients received a placebo bolus (saline solution) and on average up to 115 mg of propofol in boluses of 20 mg. In group B, 41 patients received 3 mg of midazolam and an average of up to 83
Effect of Preemptive Acetaminophen Administered Within 1Â Hour of General Anesthesia on Gastric Residual Volume and pH in Children. Determine whether preoperative oral acetaminophen increases gastric residual volume and lowers gastric pH.Prospective, randomized.Healthy children, 1 to 14 years, having elective magnetic resonance imaging (MRI) were randomized to oral acetaminophen within 1 hour of induction versus fasting. Gastric volume and pH were measured immediately after intubation. Adverse (...) events were documented from induction through 72 hours post MRI.Thirty-seven children completed the study (16 treatment, 21 control). Gastric residual volume between groups was not significantly different. The acetaminophen group had significantly higher pH than control group (1.86 ± 0.42 vs 1.56 ± 0.34; P ≤ .044). Three children in the control and 6 in the treatment group experienced minor adverse events.Findings suggest administering oral acetaminophen prior to induction of anesthesia
The influence of local anesthesia depth on procedural pain during fluoroscopically-guided lumbar transforaminal epidural injections: a randomized clinical trial. To evaluate the influence of the depth of local anesthesia application on procedural pain during lumbar transforaminal epidural steroid injection (TFESI).Sixty-eight patients were enrolled who were scheduled for single-level, unilateral fluoroscopically-guided lumbar TFESI. Patients were randomly allocated to receive either (...) subcutaneous local anesthesia (group S) or deep local anesthesia (group D) for TFESI. The data related to pain and technical performance during the procedure was compared. Additionally, the incidence of injection site soreness was assessed 2 weeks after TFESI.Sixty-seven patients completed all assessments (group S, n=33; group D, n=34). There was no significant difference in procedural pain and discomfort level between the groups (P=0.151, P=0.183, respectively). Patients in group D showed lower behavioral
Tumescence Anesthesia Solution-Assisted Laser Ablation Treatment of Lower Limb Varicose Veins: The Effect of Temperature of the Tumescence Anesthesia Solution on Intraoperative and Postoperative Pain, Clinical Observations, and Comprehensive Nursing Care. To investigate the effect of cold and room temperature tumescence anesthesia solution (TAS) on the treatment of lower limb varicose veins via endovenous laser ablation.On the basis of the TAS temperature, patients were divided into two groups
Efficacy of Magnesium Sulfate Added to Local Anesthetic in a Transversus Abdominis Plane Block for Analgesia Following Total Abdominal Hysterectomy: A Randomized Trial Major abdominal surgeries are associated with severe pain, which can affect respiratory and cardiac functions if insufficiently treated; this increases postoperative morbidity.We aim at evaluating the efficacy of magnesium sulfate as an adjuvant to local anesthetic in an ultrasound-guided transversus abdominis plane (TAP) block
Nitrous oxide added at the end of isoflurane anesthesia hastens early recovery without increasing the risk for postoperative nausea and vomiting: a randomized clinical trial Nitrous oxide (N2O) has been reported to increase the risk of postoperative nausea and vomiting (PONV) in a dose-dependent manner. We investigated the effect of adding N2O at the end of isoflurane inhalational anesthesia on the recovery and incidence of PONV. Our hypothesis was that N2O would reduce the time to early (...) recovery without increasing the incidence of PONV.After obtaining ethics committee approval and written informed consent, 100 women at American Society of Anesthesiologists physical status I-III and scheduled for laparoscopic-assisted vaginal hysterectomy were randomized into two groups (G) according to the carrier gas: GO2 (air in 30% oxygen) and GN2O (the same mixture until the last 30 min of surgery, when 70% N2O in 30% oxygen was used). No PONV prophylaxis was given. Anesthesia was induced