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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.
Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment Chambers D, Paulden M, Paton F, Heirs M, Duffy S, Craig D, Hunter J, Wilson J, Sculpher M, Woolacott N Record Status This is a bibliographic record (...) of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been made for the HTA database. Citation Chambers D, Paulden M, Paton F, Heirs M, Duffy S, Craig D, Hunter J, Wilson J, Sculpher M, Woolacott N. Sugammadex for the reversal of muscle relaxation in general anaesthesia: a systematic review and economic assessment . Health Technology Assessment 2010; 14(39): 1-211 Authors' conclusions Study found that sugammadex may be a cost-effective option
Local anaesthesia for pain control during outpatient hysteroscopy: systematic review and meta-analysis Local anaesthesia for pain control during outpatient hysteroscopy: systematic review and meta-analysis Local anaesthesia for pain control during outpatient hysteroscopy: systematic review and meta-analysis Cooper NA, Khan KS, Clark TJ CRD summary This review concluded that paracervical local anaesthetic injection was the best method of pain control for women who undergo hysteroscopy as out (...) -patients. The authors' conclusion reflected the evidence available. However, given the limitations of the review and available evidence, the conclusions appear overly strong in favour of the one method. Authors' objectives To compare the effects of different types of local anaesthesia for pain control during outpatient hysteroscopy. Searching MEDLINE, EMBASE, CINAHL and The Cochrane Library were searched without language restrictions from inception to September 2008; search terms were reported
Cost-effectiveness analysis of general anaesthesia versus local anaesthesia for carotid surgery (GALA Trial) Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
A comparison of regional and general anaesthesia for total replacement of the hip or knee: a meta-analysis We performed a meta-analysis to evaluate the relative efficacy of regional and general anaesthesia in patients undergoing total hip or knee replacement. A comprehensive search for relevant studies was performed in PubMed (1966 to April 2008), EMBASE (1969 to April 2008) and the Cochrane Library. Only randomised studies comparing regional and general anaesthesia for total hip or knee (...) replacement were included. We identified 21 independent, randomised clinical trials. A random-effects model was used to calculate all effect sizes. Pooled results from these trials showed that regional anaesthesia reduces the operating time (odds ratio (OR) -0.19; 95% confidence interval (CI) -0.33 to -0.05), the need for transfusion (OR 0.45; 95% CI 0.22 to 0.94) and the incidence of thromboembolic disease (deep-vein thrombosis OR 0.45, 95% CI 0.24 to 0.84; pulmonary embolism OR 0.46, 95% CI 0.29 to 0.80
Regional block versus general anaesthesia for caesarean section and neonatal outcomes: a population-based study Anaesthesia guidelines recommend regional anaesthesia for most caesarean sections due to the risk of failed intubation and aspiration with general anaesthesia. However, general anaesthesia is considered to be safe for the foetus, based on limited evidence, and is still used for caesarean sections.Cohorts of caesarean sections by indication (that is, planned repeat caesarean section (...) , failure to progress, foetal distress) were selected from the period 1998 to 2004 (N = 50,806). Deliveries performed under general anaesthesia were compared with those performed under spinal or epidural, for the outcomes of neonatal intubation and 5-minute Apgar (Apgar5) <7.The risk of adverse outcomes was increased for caesarean sections under general anaesthesia for all three indications and across all levels of hospital. The relative risks were largest for low-risk planned repeat caesarean
Music during caesarean section under regional anaesthesia for improving maternal and infant outcomes. Evidence on the benefits of music during caesarean section under regional anaesthesia to improve clinical and psychological outcomes for mothers and infants has not been established.To evaluate the effectiveness of music during caesarean section under regional anaesthesia for improving clinical and psychological outcomes for mothers and infants.We searched the Cochrane Pregnancy and Childbirth (...) Group's Trials Register (30 September 2008).We included randomised controlled trials comparing music added to standard care during caesarean section under regional anaesthesia to standard care alone.Two review authors, Malinee Laopaiboon and Ruth Martis, independently assessed eligibility, risk of bias in included trials and extracted data. We analysed continuous outcomes using a mean difference (MD) with a 95% confidence interval (CI).One trial involving 76 women who planned to have their babies
General anaesthesia or conscious sedation for reducing a dislocated hip prosthesis? BestBets: General anaesthesia or conscious sedation for reducing a dislocated hip prosthesis? General anaesthesia or conscious sedation for reducing a dislocated hip prosthesis? Report By: Nick Payne - Consultant in Emergency Medicine Search checked by Steve Jones - Consultant in Critical Care and Emergency Medicine Institution: Wythenshawe Hospital and Manchester Royal Infirmary Date Submitted: 1st March 2000 (...) Date Completed: 11th March 2009 Last Modified: 11th March 2009 Status: Green (complete) Three Part Question In [patients with dislocated hip prosthesis] does [general anaesthesia or conscious sedation] give a [better reduction rate]? Clinical Scenario An otherwise fit 71-year old lady presents to your department having slipped on the ballroom floor during a tea dance. She is unable to weight bear and has pain in her left hip. X-ray reveals a dislocation of her hip prosthesis, and she tells you
Paracervical local anaesthesia for cervical dilatation and uterine intervention. Cervical dilatation and uterine intervention can be performed under sedation, local or general anaesthesia for obstetrics and gynaecological conditions. Many gynaecologists use paracervical local anaesthesia (PLA) but its effectiveness is unclear.To determine the effectiveness and safety of paracervical anaesthesia for cervical dilatation and uterine intervention when compared with no treatment, placebo, other (...) methods of regional anaesthesia, systemic sedation and analgesia, or general anaesthesia (GA).We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 1), MEDLINE (1966 to January 2006), EMBASE (1980 to January 2006) and reference lists of articles.We included randomized or controlled clinical studies involving cervical dilatation and uterine intervention for obstetric and gynaecological conditions.Two authors independently evaluated studies, extracted
Sedation versus general anaesthesia for provision of dental treatment in under 18 year olds. A significant proportion of children have caries requiring restorations or extractions, and some of these children will not accept this treatment under local anaesthetic. Historically this has been managed in children by use of a general anaesthetic; however use of sedation may lead to reduced morbidity and cost. The aim of this review is to compare the efficiency of sedation versus general anaesthesia (...) for the provision of dental treatment for children and adolescents under 18 years.We evaluated the intra- and post-operative morbidity, effectiveness and cost effectiveness of sedation versus general anaesthesia for the provision of dental treatment for under 18 year olds.We searched The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library; Issue 4, 2008); MEDLINE (OVID) (1950 to October Week 2, 2008); EMBASE (OVID) (1974 to Week 42, 2008); System for information on Grey Literature
The Provision of Oral Care under General Anaesthesia in Special Care Dentistry - A Professional Consensus Statement The Provision of Oral Health Care under General Anaesthesia in Special Care Dentistry A Professional Consensus Statement A document produced by the British Society for Disability and Oral Health March 2009 2 Membership of the Working Group Dr Ken Dalley, Senior Dental Surgeon, Hampshire PCT and Honorary Clinical Lecturer in Special Care Dentistry, Eastman Dental Institute (...) Specialist, Adult Special Care, University Dental Hospital Cardiff. 3 Anaesthetic Consultation Dr Mike Blayney, Royal College of Anaesthetists, London. Consultant Anaesthetist, Noble's Isle of Man Hospital, Douglas, Isle of Man. Dr Ellen O’Sullivan, Association of Anaesthetists of Great Britain and Ireland, London. Consultant Anaesthetist, St. James’s Hospital, Dublin. Dr George Hamlin, Association of Dental Anaesthetists, London. Consultant Anaesthetist, Deputy Director of Anaesthesia, Royal Blackburn
Guidelines for the Safe Administration of Injectable Drugs 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
Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis Risks and side-effects of intrathecal morphine combined with spinal anaesthesia: a meta-analysis Gehling M, Tryba M CRD summary This review found the use of intrathecal morphine in combination with spinal anaesthesia for post-operative analgesia was associated with an increase in nausea, vomiting (...) and pruritus. The authors' conclusions reflected the evidence presented but some methodological weaknesses mean that the reliability of these conclusions is unclear. Authors' objectives To assess the frequency of side-effects in patients receiving intrathecal morphine in combination with spinal anaesthesia. Searching MEDLINE was searched from inception to 2007; search terms were reported. Reference lists of retrieved articles were also searched for additional studies. It was unclear if any language
Does regional anaesthesia improve outcome after total hip arthroplasty: a systematic review Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Systematic review of spinal anaesthesia using bupivacaine for ambulatory knee arthroscopy Untitled Document The CRD Databases will not be available from 08:00 BST on Friday 4th October until 08:00 BST on Monday 7th October for essential maintenance. We apologise for any inconvenience.
Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia The aim was to assess the feasibility of performing stapled haemorrhoidopexy under local anaesthesia.Fifty-eight patients with haemorrhoid prolapse were randomized to receive local or general anaesthesia. The perianal block was applied immediately peripheral to the external sphincter. Submucosal block was added after applying the purse-string suture. Patients reported average (...) and peak pain daily for 14 days using a visual analogue scale (VAS). They also completed anal symptom questionnaires before the operation and at follow-up. The surgeon assessed the restoration of the anal anatomy 3-6 months after surgery.The anal block was sufficient in all patients. The mean accumulated VAS score for average pain was 23.1 in the general anaesthesia group and 29.4 in the local anaesthesia group (P = 0.376); mean peak pain scores were 42.1 and 47.9 respectively (P = 0.537). Mean change
Infection control in anaesthesia Published by The Association of Anaesthetists of Great Britain and Ireland, 21 Portland Place, London W1B 1PY Telephone: 020 7631 1650 E-mail: email@example.com Website: www.aagbi.org October 2008 Infection Control in Anaesthesia 2 AAGBI SAFETY GUIDELINEMembership of the Working Party Dr Leslie Gemmell Chairman, Honorary Secretary Elect Dr Richard Birks President Elect Dr Patrick Radford Royal College of Anaesthetists Professor Don Jeffries CBE Emeritus Professor (...) of Virology, University of London Dr Geoffrey Ridgway Consultant Microbiologist Mr Douglas McIvor Medicines and Healthcare Products Regulatory Authority Ex officio Dr David Whitaker President Dr William Harrop-Griffiths Honorary Secretary Dr Iain Wilson Honorary Treasurer Dr Ian Johnston Honorary Membership Secretary Dr David Bogod Editor-in-Chief, Anaesthesia This guideline was originally published in Anaesthesia. If you wish to refer to this guideline, please use the following reference: Anaesthesia
Nasal Fracture manipulation under local anaesthesia BestBets: Should Nasal Fractures be manipulated under local anaesthesia? Should Nasal Fractures be manipulated under local anaesthesia? Report By: Oisin Powell - Spr Emergency Medicine Search checked by Deepak Doshi - Spr Emergency Medicine Institution: Cork University Hospital, Ireland. Date Submitted: 28th November 2007 Last Modified: 13th August 2008 Status: Green (complete) Three Part Question In [adults with displaced nasal fractures (...) ] does [digital manipulation under local anaesthesia vs manipulation under GA] produce [cosmetic appearance and airway patency comparable to manipulation under general anaesthesia, at acceptable pain levels for the patient]. Clinical Scenario In [adults with displaced nasal fractures] does [ digital manipulation under local anaesthesia] produce [cosmetic appearance and airway patency comparable to manipulation under general anaesthesia, at acceptable pain levels for the patient Search Strategy
Epidural anaesthesia and survival after intermediate-to-high risk non-cardiac surgery: a population-based cohort study. Although epidural anaesthesia and analgesia have numerous benefits, their effects on postoperative survival are unclear. We therefore undertook a population-based cohort study to determine whether perioperative epidural anaesthesia or analgesia is associated with improved 30-day survival.We used population-based linked administrative databases to do a retrospective cohort (...) study of 259 037 patients, aged 40 years or older, who underwent selected elective intermediate-to-high risk non-cardiac surgical procedures between April 1, 1994, and March 31, 2004, in Ontario, Canada. Propensity-score methods were used to construct a matched-pairs cohort that reduced important baseline differences between patients who received epidural anaesthesia or analgesia as opposed to those that did not. We then determined the association of epidural anaesthesia with 30-day mortality within
Peribulbar versus retrobulbar anaesthesia for cataract surgery. Cataract is a major cause of blindness worldwide. Unless medically contraindicated, cataract surgery is usually performed under local (regional) anaesthesia. Local anaesthesia involves the blockage of a nerve subserving a given part of the body by infiltration of the area around the nerve with local anaesthetic. The two main approaches in the eye are retrobulbar and peribulbar. There is debate over whether the peribulbar approach (...) provides more effective and safer anaesthesia for cataract surgery than retrobulbar block.The objective of this review was to assess the effects of peribulbar anaesthesia (PB) compared to retrobulbar anaesthesia (RB) on pain scores, ocular akinesia, patient acceptability and ocular and systemic complications.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2007, Issue 4); MEDLINE (1960 to December 2007); and EMBASE (1980 to December 2007).We included