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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.
Postoperative Analgesia Using Peripheral Anesthetic Block of the Foot and Ankle Anesthetic block of the peripheral nerves in the foot and ankle is generally used as anesthesia. The increased use of anesthetic blocks has made this technique an increasingly safe method, and its use has been expanded to postoperative analgesia in foot and ankle surgeries. The objective of this study was to evaluate the analgesia time and pain intensity, using objective scores, after peripheral nerve block in foot (...) and ankle surgeries.Patients who underwent surgery by the foot and ankle group of our institution from March 2016 to January 2017 were invited to participate in this prospective, randomized, and blinded study after signing an informed consent form. The study was approved by the local ethics committee. In total, 57 patients and 59 feet (2 bilateral surgeries) were subjected to spinal anesthesia and were randomized into the group receiving peripheral nerve block in the foot and ankle (7.5 mg/mL
to these modalities. We compared a needle-free jet-injection system (J-Tip) with 1% buffered lidocaine to topical anesthetic (TA) cream for local anesthesia in infant LPs.This was a single-center randomized double-blind trial of J-Tip versus TA for infant LPs in an urban tertiary care children's hospital emergency department. A computer randomization model was used to allocate patients to either intervention. Patients aged 0 to 4 months were randomized to J-Tip syringe containing 1% lidocaine and a placebo TA (...) A Randomized Double Blind Trial of Needle-free Injected Lidocaine Versus Topical Anesthesia for Infant Lumbar Puncture Lumbar punctures (LPs) are commonly performed in febrile infants to evaluate for meningitis, and local anesthesia increases the likelihood of LP success. Traditional methods of local anesthesia require injection that may be painful or topical application that is not effective immediately. Recent advances in needle-free jet injection may offer a rapid alternative
Peripheral Nerve Block as a Supplement to Light or Deep General Anesthesia in Elderly Patients Receiving Total Hip Arthroplasty: A Prospective Randomized Study Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we investigated the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery (...) of elderly patients receiving total hip arthroplasty.Patients aged 65 years and older undergoing total hip arthroplasty were randomized into 3 groups: a general anesthesia without lumbosacral plexus block group, and 2 general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep). The extubation time and intraoperative consumption of propofol, sufentanil, and vasoactive agent were recorded. Postoperative delirium and early postoperative cognitive
An investigation into the effect of depth of anesthesia on postoperative pain in laparoscopic cholecystectomy surgery: a double-blind clinical trial Some studies have shown that deeper anesthesia is more effective on postoperative analgesia and reduces the need for sedative drugs. This study sought to investigate the effect of depth of anesthesia on postoperative pain in laparoscopic cholecystectomy.In this double-blind clinical trial, 60 patients undergoing laparoscopic cholecystectomy were (...) randomly divided into two groups: low bispectral index (L-BIS=35-44) and high bispectral index (H-BIS=45-55). Anesthesia protocol was the same for both groups (propofol and remifentanil). The pain intensity (at rest and during cough) was evaluated based on the visual analog scale scores in recovery and at 8, 16 and 24 hours after surgery.The mean pain score was significantly lower in patients in the L-BIS group at all examined times at rest and during cough than that in the H-BIS group. The number
infiltration of articaine can eliminate the need for palatal anesthesia during the extraction of primary molars. #2) Mittal/2015 102 children aged 5-12 years Randomized Controlled Trial Key results This study evaluated the effectiveness of two different anesthetic agents, 2% lidocaine 1/80,000 epinephrine and 4% articaine with 1/100,000 epinephrine, in children receiving extractions of maxillary primary molars by infiltration on the buccal mucosa without the need to give palatal anesthesia. The results (...) show no statistically significant difference between any of the objective and subjective factors evaluated in each group. The authors concluded that neither of the two types of anesthetics were able to achieve adequate palatal anesthesia. Evidence Search PubMed Clinical Queries: Palatal anesthesia, Children Comments on The Evidence Validity: In both studies, the authors used measuring tools for pain and behavior that have already been tested and validated. In both studies, the patients' age ranged
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
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 (...) tidal volumes due to leakage around an uncuffed ETT. To seal the airway adequately, uncuffed tubes may need to be exchanged for another tube with a larger diameter, which sometimes requires several attempts before the appropriate size is found. Uncuffed tubes also allow waste anaesthetic gases to escape, contributing significantly to operating room contamination and rendering the anaesthetic procedure more expensive. Our review summarizes the available data, to provide a current perspective
Glucosamine reduces the inhibition of proteoglycan metabolism caused by local anaesthetic solution in human articular cartilage: an in vitro study We assessed whether local anaesthetics caused inhibition of proteoglycan metabolism in human articular cartilage and whether the addition of Glucosamine sulphate could prevent or allow recovery from this adverse effect on articular cartilage metabolism.Cartilage explants obtained from 13 femoral heads from fracture neck of femur patients (average age (...) to 70% (p = 0.004).Our results showed that all local anaesthetic solutions inhibited proteoglycan metabolism in articular cartilage and the addition of Glucosamine was able to reduce the inhibition of metabolism caused by 0.5% Bupivacaine. Intra-articular injection of local anaesthetics requires careful consideration of risks and benefits.
Effect of Xenon Anesthesia Compared to Sevoflurane and Total Intravenous Anesthesia for Coronary Artery Bypass Graft Surgery on Postoperative Cardiac Troponin Release: An International, Multicenter, Phase 3, Single-blinded, Randomized Noninferiority Trial Ischemic myocardial damage accompanying coronary artery bypass graft surgery remains a clinical challenge. We investigated whether xenon anesthesia could limit myocardial damage in coronary artery bypass graft surgery patients, as has been (...) reported for animal ischemia models.In 17 university hospitals in France, Germany, Italy, and The Netherlands, low-risk elective, on-pump coronary artery bypass graft surgery patients were randomized to receive xenon, sevoflurane, or propofol-based total intravenous anesthesia for anesthesia maintenance. The primary outcome was the cardiac troponin I concentration in the blood 24 h postsurgery. The noninferiority margin for the mean difference in cardiac troponin I release between the xenon
Ankle Block vs Single-Shot Popliteal Fossa Block as Primary Anesthesia for Forefoot Operative Procedures: Prospective, Randomized Comparison Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic (...) effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures.All patients having elective outpatient orthopedic forefoot procedures were invited to participate in the study. Patients were prospectively randomized to receive either an ultrasound-guided AB or PFB by a board-certified anesthesiologist prior to their procedure. Intraoperative conversion to general anesthesia and postanesthesia care unit (PACU) opioid requirements were
Babies Can Safely Breastfeed After Their Mothers Have Local Anesthesia for a Dental Procedure UTCAT3266, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Babies Can Safely Breastfeed After Their Mothers Have Local Anesthesia for a Dental Procedure Clinical Question Are babies whose mothers have local anesthesia for dental procedures at increased risk for ingesting the anesthetic? Clinical Bottom Line It is safe (...) for a mother to breastfeed after having local anesthesia for a dental procedure. This is based on a clinical study showing that the amount of lidocaine in the breast milk was low. Local anesthesia is widely used in all general dental practices and accepted by patients. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID Author / Year Patient Group Study type (level of evidence) #1) Giuliani/2001 7 nursing mothers between the ages of 23-39 Noncontrolled clinical study Key
Dichlorobenzyl alcohol and amylmetacresol and the local anaesthetic lidocaine (Triolif) - for sore throat Triolif® × Insert searchphrase to search the website Insert searchphrase to search the website > > > Triolif® Conclusion Triolif lozenges contain a combination of the antiseptic active substances, 2,4-dichlorobenzyl alcohol and amylmetacresol and the local anaesthetic lidocaine. Triolif is available over the counter (pharmacy-only) and is indicated for sore throat in adults and adolescents
Anesthetic Cream Use During Office Pessary Removal and Replacement: A Randomized Controlled Trial To estimate the effect of lidocaine-prilocaine cream on patient pain at the time of office pessary removal and reinsertion.In this double-blind, randomized placebo-controlled trial, participants undergoing routine pessary care in a urogynecology office at a tertiary referral center were randomized to application of 4 g of either lidocaine-prilocaine or placebo cream 5 minutes before pessary change
Perioperative Management of Elderly Patients with Gastrointestinal Malignancies: The Contribution of Anesthesia Elderly patients suffering from gastrointestinal malignancies are particularly prone to perioperative complications. Elderly patients often present with reduced physiological reserves, and comorbidities can limit treatment options and promote complications. Surgeons and anesthesiologists must be aware of strategies required to deal with this vulnerable subgroup.We provide a brief
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
Intraoperative "Analgesia Nociception Index"-Guided Fentanyl Administration During Sevoflurane Anesthesia in Lumbar Discectomy and Laminectomy: A Randomized Clinical Trial The "Analgesia Nociception Index" (ANI; MetroDoloris Medical Systems, Lille, France) is a proposed noninvasive guide to analgesia derived from an electrocardiogram trace. ANI is scaled from 0 to 100; with previous studies suggesting that values ≥50 can indicate adequate analgesia. This clinical trial was designed (...) to investigate the effect of intraoperative ANI-guided fentanyl administration on postoperative pain, under anesthetic conditions optimized for ANI functioning.Fifty patients aged 18 to 75 years undergoing lumbar discectomy or laminectomy were studied. Participants were randomly allocated to receive intraoperative fentanyl guided either by the anesthesiologist's standard clinical practice (control group) or by maintaining ANI ≥50 with boluses of fentanyl at 5-minute intervals (ANI group). A standardized
statement with the ACSQHC supporting user-applied labelling standardisation for all injectable medicines and fluids 4 . In New Zealand PHARMAC is considering labelling recommendations. 3.2.3 With the increasing use of infusions for anaesthesia as well as for regional analgesia there is the potential for drug errors to occur. To minimise these errors, it is advisable to ensure that devices delivering intravenous medications are readily differentiated from those delivering local anaesthetics. Colour (...) drug events. Anesthesiology. 2016;124(1): 25-34. doi: 10.1097/ALN.0000000000000904 2. Webster CS, Merry AF, Larsson L, McGrath KA, Weller J. The frequency and nature of drug administration error during anaesthesia. Anaesth Intensive Care [serial online]. 2001;29(5):494-500. From: http://www.aaic.net.au.ezproxy.anzca.edu.au/Document/?D=2000210. Accessed 12 October 2016 3. Department of Health, Therapeutic Goods Administration [Internet] 2016 From: https://www.legislation.gov.au/Details/F2016L01285 4
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
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