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

161. 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 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

2009 DARE.

162. Infection control in anaesthesia

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: info@aagbi.org 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

2008 Association of Anaesthetists of GB and Ireland

163. Randomized clinical trial of stapled haemorrhoidopexy performed under local perianal block versus general anaesthesia (PubMed)

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

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2008 EvidenceUpdates

164. Nasal Fracture manipulation under local 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

2008 BestBETS

165. Epidural anaesthesia and survival after intermediate-to-high risk non-cardiac surgery: a population-based cohort study. (PubMed)

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

2008 Lancet

166. Peribulbar versus retrobulbar anaesthesia for cataract surgery. (PubMed)

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

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2008 Cochrane

167. Lidocaine 70mg/tetracaine 70mg (Rapydan 70mg/70mg medicated plaster) - for surface anaesthesia of the skin in connection with needle puncture and in cases of superficial surgical procedures

Lidocaine 70mg/tetracaine 70mg (Rapydan 70mg/70mg medicated plaster) - for surface anaesthesia of the skin in connection with needle puncture and in cases of superficial surgical procedures Secretariat - Delta House 50 West Nile Street Glasgow G1 2NP Telephone 0141 225 6997 Fax 0141 248 3778 E-mail rosie.murray@nhs.net Chairman Dr Kenneth R Paterson Published 09 June 2008 Scottish Medicines Consortium lidocaine 70mg / tetracaine 70mg (Rapydan 70 mg / 70 mg medicated plaster) (No. 483/08) EUSA (...) Pharma (Europe) Limited Statement of Advice 09 May 2008 ADVICE: in the absence of a submission from the holder of the marketing authorisation. lidocaine 70mg / tetracaine 70mg (Rapydan 70mg / 70mg medicated plaster) is not recommended for use within NHSScotland for surface anaesthesia of the skin in connection with needle puncture and in cases of superficial surgical procedures (such as excision of various skin lesions and punch biopsies) on normal skin in adults; or for surface anaesthesia

2008 Scottish Medicines Consortium

168. Intravenous versus inhalation anaesthesia for one-lung ventilation. (PubMed)

Intravenous versus inhalation anaesthesia for one-lung ventilation. The technique called one-lung ventilation can confine bleeding or infection to one lung, prevent rupture of a lung cyst or, more commonly, facilitate surgical exposure of the unventilated lung. During one-lung ventilation, anaesthesia is maintained either by delivering a volatile anaesthetic to the ventilated lung or by infusing an intravenous anaesthetic. It is possible that the method chosen to maintain anaesthesia may affect (...) patient outcomes.The objective of this review was to evaluate the effectiveness and safety of intravenous versus inhalation anaesthesia for one-lung ventilation.We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2006, Issue 3), MEDLINE, LILACS, EMBASE (from inception to June 2006), ISI web of Science (1945 to June 2006), reference lists of identified trials, and bibliographies of published reviews. We also contacted researchers in the field. There were

2008 Cochrane

169. Statement on Anaesthesia Care of Children in Healthcare Facilities Without Dedicated Paediatric Facilities

Statement on Anaesthesia Care of Children in Healthcare Facilities Without Dedicated Paediatric Facilities Review PS29 (2008) AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS ACN 055 042 852 STATEMENT ON ANAESTHESIA CARE OF CHILDREN IN HEALTHCARE FACILITIES WITHOUT DEDICATED PAEDIATRIC FACILITIES 1. INTRODUCTION Anaesthesia for children is an area of practice in which the College strongly recommends specific training and experience. The College therefore recommends that a healthcare facility (...) which is not dedicated to paediatric care but which proposes to manage children for anaesthesia and surgery should develop a policy which details criteria for management of anaesthesia, surgery and nursing care. This policy should be developed and documented jointly by representatives of the anaesthesia, surgical and nursing staffs and should be reviewed at intervals of not more than five years. It must always be recognised that the initial treatment of paediatric emergencies may be necessary

2008 Australian and New Zealand College of Anaesthetists

170. Statement on Anaesthesia Care of Children in Healthcare Facilities Without Dedicated Paediatric Facilities

Statement on Anaesthesia Care of Children in Healthcare Facilities Without Dedicated Paediatric Facilities Review PS29 (2008) AUSTRALIAN AND NEW ZEALAND COLLEGE OF ANAESTHETISTS ACN 055 042 852 STATEMENT ON ANAESTHESIA CARE OF CHILDREN IN HEALTHCARE FACILITIES WITHOUT DEDICATED PAEDIATRIC FACILITIES 1. INTRODUCTION Anaesthesia for children is an area of practice in which the College strongly recommends specific training and experience. The College therefore recommends that a healthcare facility (...) which is not dedicated to paediatric care but which proposes to manage children for anaesthesia and surgery should develop a policy which details criteria for management of anaesthesia, surgery and nursing care. This policy should be developed and documented jointly by representatives of the anaesthesia, surgical and nursing staffs and should be reviewed at intervals of not more than five years. It must always be recognised that the initial treatment of paediatric emergencies may be necessary

2008 Australian and New Zealand College of Anaesthetists

171. Recommendations for the Pre-Anaesthesia Consultation

Recommendations for the Pre-Anaesthesia Consultation PS07 2017 Page 1 PS07 2017 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Pre-Anaesthesia Consultation and Patient Preparation 1. INTRODUCTION Adequate pre-anaesthesia consultation has been identified as an important factor in patient safety. The terms “pre-anaesthesia consultation” and “anaesthesia” in this document refer not only to situations pertinent to the administration of general anaesthesia but also (...) includes those related to regional anaesthesia/analgesia and sedation. Consultation with a patient prior to anaesthesia by an anaesthetist or a medical practitioner whose scope of practice includes anaesthesia is essential (see PS57 Statement on the Duties of an Anaesthetist, PS59 Statement on Roles in Anaesthesia and Perioperative Care, and Good Medical Practice: A Code of Conduct for Doctors in Australia 1 ). “Consultation” differs from “assessment” in that an assessment (medical or nursing

2008 Australian and New Zealand College of Anaesthetists

172. General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. (PubMed)

General anaesthesia versus local anaesthesia for carotid surgery (GALA): a multicentre, randomised controlled trial. The effect of carotid endarterectomy in lowering the risk of stroke ipsilateral to severe atherosclerotic carotid-artery stenosis is offset by complications during or soon after surgery. We compared surgery under general anaesthesia with that under local anaesthesia because prediction and avoidance of perioperative strokes might be easier under local anaesthesia than under (...) general anaesthesia.We undertook a parallel group, multicentre, randomised controlled trial of 3526 patients with symptomatic or asymptomatic carotid stenosis from 95 centres in 24 countries. Participants were randomly assigned to surgery under general (n=1753) or local (n=1773) anaesthesia between June, 1999 and October, 2007. The primary outcome was the proportion of patients with stroke (including retinal infarction), myocardial infarction, or death between randomisation and 30 days after surgery

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2008 Lancet

173. Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia

Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia Kushwaha R, Hutchings W, Davies C, Rao N G Record Status This is a critical abstract of an economic evaluation that meets the criteria for inclusion on NHS EED. Each abstract (...) contains a brief summary of the methods, the results and conclusions followed by a detailed critical assessment on the reliability of the study and the conclusions drawn. CRD summary The study compared the costs and effects of two options for open haemorrhoidectomy, the use of either local or general anaesthesia, in patients with third-degree haemorrhoids. The authors concluded that both anaesthetic approaches had similar clinical outcomes in terms of pain and patient expectations, but that local

2008 NHS Economic Evaluation Database.

174. Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia (PubMed)

Randomized clinical trial comparing day-care open haemorrhoidectomy under local versus general anaesthesia Day-care open haemorrhoidectomy under local anaesthesia (LH) may be the most cost-effective approach to haemorrhoidectomy. This prospective randomized trial compared outcome after LH from patients' and clinical perspectives with that after day-care open haemorrhoidectomy under general anaesthesia (GH).Forty-one patients with third-degree haemorrhoids were randomized to LH (19) or GH (22

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2008 EvidenceUpdates

175. Guideline for the Use of General Anaesthesia (GA) in Paediatric Dentistry

Guideline for the Use of General Anaesthesia (GA) in Paediatric Dentistry May 2008 final 1 UK National Clinical Guidelines in Paediatric Dentistry Guideline for the Use of General Anaesthesia (GA) in Paediatric Dentistry Contents: 1. Introduction 2. Indications for the use of GA in children 3. Circumstances and conditions suitable for GA 4. Circumstances and conditions which do NOT justify GA 5. Children with medical problems 6. Explanation of risk 7. Treatment planning 7.1 Radiographs 7.2 (...) that children and adolescents receive safe and effective pain control. A range of techniques are available, comprising four overlapping categories: behavioural techniques, local anaesthesia (LA), conscious sedation, and general anaesthesia (GA) (Figure 1). Particular emphasis is placed on the importance of comprehensive treatment planning to ensure a satisfactory standard of oral health after a dental GA. 2. Indications for the use of GA in children. There are essentially only two indications for GA

2008 Royal College of Surgeons of England

176. Epidural analgesia/anaesthesia versus systemic intravenous opioid analgesia in the management of blunt thoracic trauma.

Epidural analgesia/anaesthesia versus systemic intravenous opioid analgesia in the management of blunt thoracic trauma. BestBets: Epidural analgesia/anaesthesia versus systemic intravenous opioid analgesia in the management of blunt thoracic trauma. Epidural analgesia/anaesthesia versus systemic intravenous opioid analgesia in the management of blunt thoracic trauma. Report By: Dr Richard Parris - Consultant in Emergency Medicine Search checked by Barbara Scobie - ST3 in Emergency Medicine (...) anaesthesia OR thorax epidural] COCHRANE: Thoracic trauma [exp. thoracic injuries] AND [exp. analgesia-epidural OR anaesthesia-epidural OR injection-epidural OR analgesia-patient controlled OR analgesics-opioid] Search Outcome Medline produced 56 papers, EMBASE 103, of which four were relevant and of sufficient quality. Relevant Paper(s) Author, date and country Patient group Study type (level of evidence) Outcomes Key results Study Weaknesses Mackersie et al 1991 USA 32 patients recruited with: - 3

2007 BestBETS

177. Sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery. (PubMed)

Sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery. Local anaesthesia for cataract surgery can be provided by either sub-Tenon or topical anaesthesia. Although there is some work suggesting advantages to both techniques, there has been no recent systematic attempt to compare both techniques for all relevant outcomes.To compare the effectiveness of topical anaesthesia (with or without the addition of intracameral local anaesthetic) and sub-Tenon's anaesthesia in providing (...) pain relief during cataract surgery.We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, 2006, Issue 2); MEDLINE (1990 to July 2006); EMBASE (1990 to July 2006) and reference lists of articles. There were no constraints based on language or publication status.We included all randomized or quasi-randomized studies comparing sub-Tenon anaesthesia with topical anaesthesia for cataract surgery.Two authors independently assessed trial quality and extracted data. We

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2007 Cochrane

178. Topical anaesthesia alone versus topical anaesthesia with intracameral lidocaine for phacoemulsification. (PubMed)

Topical anaesthesia alone versus topical anaesthesia with intracameral lidocaine for phacoemulsification. Cataract is defined as loss of transparency of the natural lens and is usually an age-related phenomenon. The only recognized treatment available for cataract involves surgery. An ideal anaesthetic should allow for pain-free surgery with no systemic or local complications. It should be cost effective and should facilitate a stress-free procedure for surgeon and patient alike. Topical (...) anaesthesia involves applying anaesthetic eye drops to the surface of the eye prior to and during surgery. This has found large acceptance especially in the USA where it is used by 61% of cataract surgeons. Many surgeons who perform cataract surgery under topical anaesthesia also use intraoperative supplementary intracameral lidocaine (injected directly into the anterior chamber of the eye). The benefits and possible risks of intracameral lidocaine have been assessed by a number of randomized controlled

2007 Cochrane

179. Remifentanil for general anaesthesia: a systematic review

Remifentanil for general anaesthesia: a systematic review Remifentanil for general anaesthesia: a systematic review Remifentanil for general anaesthesia: a systematic review Komatsu R, Turan A M, Orhan-Sungur M, McGuire J, Radke O C, Apfel C C CRD summary This generally well-conducted review compared remifentanil with fentanyl, alfentanil or sufentanil for analgesia during general anaesthesia. The authors concluded that remifentanil induced deeper analgesia and anaesthesia. Patients given (...) remifentanil showed faster recovery times but needed post-operative analgesia more frequently. The review included a large number of patients and, despite some concerns about the synthesis, the authors' conclusions are likely to be reliable. Authors' objectives To evaluate the intra-operative and post-operative efficacy and safety of remifentanil as an analgesic supplement during general anaesthesia compared with other currently used opioids. Searching MEDLINE, an ISI index and the Cochrane Library were

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2007 DARE.

180. Recommendations for standards of monitoring during anaesthesia and recovery : fourth edition

Recommendations for standards of monitoring during anaesthesia and recovery : fourth edition Published by The Association of Anaesthetists of Great Britain and Ireland, 21 Portland Place, London W1B 1PY Telephone 020 76311650 Fax 020 7631 4352 www.aagbi.org March 2007 RECOMMENDATIONS FOR STANDARDS OF MONITORING DURING ANAESTHESIA AND RECOVERY 4th EditionMEMbERSHIp OF THE wORkING pARTY Dr R J S Birks Chairman/Vice President Dr L W Gemmell Council Member Dr E P O’Sullivan Council Member Prof D J (...) Rowbotham Council Member Prof J R Sneyd Council Member Ex-Officio Dr D K Whitaker President Prof M Harmer Immediate Past President Dr I H Wilson Honorary Treasurer Dr A W Harrop-Griffiths Honorary Secretary Prof W A Chambers Immediate Past Honorary Secretary Dr I G Johnston Honorary Membership Secretary Dr D G Bogod Editor-in-Chief, Anaesthesia This document will be reviewed regularly and may be revised or updated before the formal publication of a new edition. For the latest version, please refer

2007 Association of Anaesthetists of GB and Ireland