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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.
• 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
aspects of cesarean anesthesia ( e.g. , when an anesthesiology consult is appropriate) and of labor analgesia ( e.g. , parenteral opioids) that an obstetrician would use to counsel their patients. These guidelines also include perianesthetic management of other obstetric procedures and emergencies. Methodology Definition of Perioperative Obstetric Anesthesia For the purposes of these updated guidelines, obstetric anesthesia refers to peripartum anesthetic and analgesic activities performed during (...) 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
for the patient. Anesthesiology. 2000;93(2):556-564. Jenkins K. Baker AB. Consent and anaesthetic risk. Anaesthesia. 2003;58(10):962-984. National Health and Medical Research Council. General guidelines for medical practitioners on providing information to patients. Canberra: National Health and Medical Research Council, 2004. From: https://www.nhmrc.gov.au/guidelines-publications/e57 Accessed 28 September 2015 Royal College of Nursing. Clinical Practice Guidelines: Perioperative fasting in Adults (...) of Major Regional Anaesthesia) or anaesthesia (as defined above). However, these guidelines should be followed by any practitioner responsible for administering drugs that have the potential for alteration of a patient’s conscious state, at all levels of sedation through to general anaesthesia, as well as techniques requiring the use of large volumes of local anaesthetic. (See PS02 Statement on Credentialing and Defining the Scope of Clinical Practice in Anaesthesia and PS09 Guidelines on Sedation
potential causative agents and maintain anaesthesia. • Important culprits: antibiotics, neuromuscular blocking agents, patent blue. • Consider chlorhexidine as cause (impregnated catheters, lubricants, cleansing agents). • Consider i.v. colloids as a possible cause. • Change to inhalational anaesthetic agent (if not already). ? Give 100% oxygen and ensure adequate ventilation: • Maintain the airway and, if necessary, secure it with tracheal tube. ? Elevate patient’s legs if there is hypotension (...) by the clinician in the light of the clinical data presented and the diagnostic and treatment options 3-11 High central neuraxial block v.1 • Can occur with deliberate or accidental injection of local anaesthetic drugs into the subarachnoid space. • Symptoms are – in sequence – hypotension and bradycardia – difficulty breathing – paralysis of the arms – impaired consciousness – apnoea and unconsciousness. • Progression through this sequence can be slow or fast. Box A: INDUCING ANAESTHESIA • Consider reduced
Reference Manager Save my selection Regional Anesthesia and Pain Medicine: doi: 10.1097/AAP.0000000000000763 REGIONAL ANESTHESIA AND ACUTE PAIN: SPECIAL ARTICLE Free From the *Mayo Clinic, Rochester, MN; †Katholieke Universiteit, Leuven, Belgium; ‡Bielefeld Hospital, Bielefeld, Germany; §Massachusetts General Hospital, Boston, MA; and ∥Northwestern University, Chicago, IL. Accepted for publication January 21, 2018. Address correspondence to: Terese T. Horlocker, MD, Department of Anesthesiology (...) Regional Anesthesia in the Patient Receiving Antithrombotic or Thrombolytic Therapy Regional Anesthesia in the Patient Receiving Antithrombotic... : Regional Anesthesia and Pain Medicine You may be trying to access this site from a secured browser on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers , use your username or email along with your password to log in. Remember me on this computer Register for a free account Registered
, and as such, require sterilisation. Laryngoscope handles, being non-critical devices, should be cleaned with detergent and water between each patient use. If contaminated with blood, they should be washed and disinfected. 22.214.171.124 Bougies Re-use of these items has been associated with cross-infection. It is preferable that alternative single-use intubation aids are employed when possible. 4.2.3 Anaesthetic breathing systems In practice, most departments of anaesthesia use these circuits for more than one patient (...) anaesthesia. Breathing bags should be cleaned with detergent and water between each patient use or replaced if single use. 4.2.4 Sampling lines for side stream gas analysis These need not ordinarily be sterilised before reuse. Sampled gas should not be returned to the anaesthetic circuit unless it is first passed though a viral filter (0.2 µm mesh). 4.2.5 Anaesthetic machines Routine daily sterilisation or disinfection of internal components of the anaesthetic machine is not necessary if a bacterial/viral
serve only as guidelines for the care of breastfeeding mothers and infants and do not delineate an exclusive course of treatment or serve as standards of medical care. Variations in treatment may be appropriate according to the needs of an individual patient. Background T hereislittlerigorousinformationinthescienti?c literature about anesthesia or procedural sedation in breastfeeding mothers. Recommendations in this area typi- cally focus on pharmacologic properties of anesthetic agents, limited (...) , single doses of meperidine/pethidine or diazepam are unlikely to affect the breastfeeding infant. 15 (III) Local anesthetics given by injection or topical application are considered safe for breastfeeding mothers. 2,3 (IV) Regional anesthesia. Regional anesthesia, including spinal, epidural, or peripheral nerve block, should be con- sidered whenever possible, whether for intraoperative anes- thesia or postoperative analgesia. 3 (IV) Regional anesthesia reduces the need for intraoperative medications
Guidelines on Equipment to Manage a Difficult Airway During Anaesthesia Background Paper PS56 BP 2012 Page 1 PS56 BP 2012 Australian and New Zealand College of Anaesthetists (ANZCA) Guidelines on Equipment to Manage a Difficult Airway During Anaesthesia Background Paper INTRODUCTION Airway complications are a leading cause of morbidity and mortality in anaesthesia. 1 Effective management of a difficult airway is a core skill for anaesthetists, and depends on the timely availability of suitable (...) with the emergency”. 2 In the Australian Incident Monitoring Study (AIMS), equipment deficiencies, which were mainly due to “failure to check”, contributed to five of the 14 factors that were identified in the 85 difficult intubation reports. 4 The 1000 anaesthesia incidents reported to this study from 2002-2006 showed an appreciable increase in difficult and failed intubations compared with the first 2000 reports. 5 A review from the American Society of Anesthesiologists (ASA) closed claims database comparing
organisational factors such as overbooked or reorganised surgical lists) and highlight these at the WHO premeet/team brief 5. During induction of anaesthesia, practitioners should adhere to suitable dosing of intravenous agent, check anaesthetic effect before paralysis or instrumentation of the airway and maintain anaesthetic administration, including during transfer of patients (which is facilitated by a simple ABCDE checklist) 6. If AAGA is suspected during maintenance (e.g., by patient movement), prompt (...) to consent . This section incorporates that new evidence, and extends the results of NAP5 to focus specifically on the AAGA-related aspects of consent. There are two guiding principles: (a) to provide information on risk, its mitigation and use of appropriate monitoring, and allay anxieties about AAGA; (b) to offer a choice of anaesthetic technique, where possible.5 Association of Anaesthetists Association of Anaesthetists 5 Pre-hospital information (pre-assessment clinic) General anaesthesia
the interest of a local anesthetic before arterial sampling of blood by a study randomized in insu double and versus placebo. Study Design Go to Layout table for study information Study Type : Interventional (Clinical Trial) Actual Enrollment : 136 participants Allocation: Randomized Intervention Model: Parallel Assignment Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor) Primary Purpose: Treatment Official Title: Evaluation of Local Anesthesia Before Arterial Puncture (...) Local Anesthesia Before Arterial Puncture for Blood Gas Analysis Local Anesthesia Before Arterial Puncture for Blood Gas Analysis - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more studies before adding more. Local Anesthesia Before
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
Recovery Room Book, 4 th edition. New York: Oxford University Press, 2009. 3. NCEPOD. Changing the Way we Operate. www.ncepod.org.uk/pdf/2001/01full.pdf (accessed 18/10/12). 4. Kluger MT, Bullock MFM. Recovery room incidents: a review of 419 reports from the Anaesthetic Incident Monitoring Study (AIMS). Anaesthesia 2002; 57: 1060-66. 5. Healthcare Improvement Scotland. National Overview September 2005, Anaesthesia – Care Before, During and After Anaesthesia. http://www.healthcareimprovementscotland.org (...) requirements in the immediate postoperative period. 6.2 Can apply knowledge of effects of pharmacology of anaesthetic agents and of surgery upon the respiratory system. Understands the effects of anaesthesia and surgery on respiratory function. Describe the signs and symptoms of inadequate reversal of neuromuscular blockade and central respiratory depression. See competency 11. 6.3 Can assess respiration. Describes postoperative patterns of respiration. Describe the signs of obstructed breathing. Can
of pediatric emergencies is critical in providing safe sedation and anesthetic care. During deep sedation/general anesthesia in the dental setting, there must be at least two individuals pre- sent with the skills in patient rescue and pediatric advanced life support (e.g., PALS) and capable of managing any emergency event. 4 One of the two must be an independent observer who sole responsibility is to constantly observe the patient’s vital signs, levels of sedation, airway patency, and adequacy (...) ., the responsible dental practitioner) must be trained in and capable of providing pediatric advanced life support and skilled in assisting the independent observer with the rescue of a child with any of the adverse events described above. Personnel experienced in post anesthetic recovery care and trained in advanced resuscitative techniques (e.g., PALS) must be in attendance and provide continuous respiratory and car- diovascular monitoring during the recovery period. 4 The supervising anesthesia provider
, and technology: What we (physicians) can do versus what we should do for the patient. Anesthesiology. 2000;93(2):556-564. Jenkins K. Baker AB. Consent and anaesthetic risk. Anaesthesia. 2003;58(10):962- 984. Medical Council of New Zealand. Good medical practice. Wellington: Medical Council of New Zealand, 2013. From: https://www.mcnz.org.nz/assets/News-and- Publications/good-medical-practice.pdf Accessed 28 September 2015 National Health and Medical Research Council. General guidelines for medical (...) with adjustable gastric bands. 4. Reports of adverse patient events in association with administration of large volumes of local anaesthetic 4.1. Under Section 3 Scope of PS07, the following statement appears: “…these guidelines should be followed by any practitioner responsible for administering drugs that have the potential for alteration of a patient’s conscious Page 4 PS07 BP 2016 state, at all levels of sedation through to general anaesthesia, as well as techniques requiring the use of large volumes
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
. 6. Campbell M. Caudal anesthesia in children. Am J Urol . 1933; 30: 245–249. 7. Ecoffey C, Dubousset AM, Samii K. Lumbar and thoracic epidural anesthesia for urologic and upper abdominal surgery in infants and children. Anesthesiology . 1986; 65: 87–90. | | | 8. Murat I, Delleur MM, Esteve C, Egu JF, Raynaud P, Saint-Maurice C. Continuous extradural anaesthesia in children. Clinical and haemodynamic implications. Br J Anaesth . 1987; 59: 1441–1450. | | 9. Bromage PR, Benumof JL. Paraplegia (...) 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 on the server. Please enable scripts and reload this page. Login No user account? Lippincott Journals Subscribers
for what could be a dif?cult laryngoscopy. Therefore, the recommendation is that single-use laryngoscopes are not mandatory in anaesthesia for tonsil and adenoid surgery. Those purchasing laryngoscopes with single-use blades (and other single-use devices) have a responsibility to ensure that the performance of the instruments is at least as good as that of the standard reusable alternatives. Anaesthetic management of cases of CJD Thisadvice covers known cases, suspected cases and those who are at risk (...) fluids. Anesthesiology 1990; 73: 619–24. 7 OrrNW.Isamasknecessaryintheoperating theatre? Annals of the Royal College of Surgeons of England 1981; 63: 390–2. 8 Mitchell NJ, Hunt S. Surgical face masks in modern operating rooms – a costly and unnecessary ritual? Journal of Hospital Infection 1991; 18: 239–42. 9 McLure HA, Tallboys CA, Yentis SM, Azadian BS. Surgical face masks and downward disposal of bacteria. Anaesthesia 1998; 53: 624–6. 10 Philips BJ, Ferguson S, Armstrong P, Anderson P, Anderson FM
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
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
Radial artery blood gas sampling: a randomized controlled trial of lidocaine local anesthesia. Radial artery puncture is a common procedure and yet the role of local anesthesia for reducing the pain of this procedure continues to be debated. Clinical practice is variable and there is potential for substantial financial savings. This is the first randomized trial to investigate the effectiveness of subcutaneously injected lidocaine anesthesia on the perceived pain of radial artery puncture (...) and the financial impact.Between December 2012 and April 2013, 43 patients in the Emergency Department were randomized into the intervention group to receive lidocaine 1% 1 mL subcutaneously or the control group (to receive no local anesthesia) prior to radial artery puncture for blood gas sampling. Pain was rated on a 10 cm visual analogue scale and procedural variables collected for between group analyses.Overall, 41 participants were included. Subcutaneously injected lidocaine anesthesia did not reduce