Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3 or #4)
Latest & greatest articles for anesthesia
The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials and many other forms of evidence. If you wanted the latest trusted evidence on anesthesia or other clinical topics then use Trip today.
This page lists the very latest high quality evidence on anesthesia and also the most popular articles. Popularity measured by the number of times the articles have been clicked on by fellow users in the last twelve months.
What is Trip?
Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality research evidence to support their practice and/or care.
Trip has been online since 1997 and in that time has developed into the internet’s premier source of evidence-based content. Our motto is ‘Find evidence fast’ and this is something we aim to deliver for every single search.
As well as research evidence we also allow clinicians to search across other content types including images, videos, patient information leaflets, educational courses and news.
For further information on Trip click on any of the questions/sections on the left-hand side of this page. But if you still have questions please contact us via firstname.lastname@example.org
Clinical anesthesia is used to induce a temporary medical state of controlled unconsciousness, inducing a loss of sensation or awareness. There are three main types of anesthesia:
Local and Regional
Anesthesia 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 anesthesia has helped anesthesiologists in the progression of patient safety before and after surgery and medical procedures. The developments and research of anesthesia 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 anesthesia, it allows anesthesiologists to improve the delivery of patient safety while unconscious.
Learn more on the emerging technology in anesthesia and the advancements in anesthesia practise by searching Trip.
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
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
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 (...) (April 1, 2009-March 31, 2015 set in the Canadian province of Ontario) of adult patients aged 18 years and older undergoing major surgeries expected to last at least 2 hours and requiring a hospital stay of at least 1 night.Complete intraoperative handover of anesthesia care from one physician anesthesiologist to another compared with no handover of anesthesia care.The primary outcome was a composite of all-cause death, hospital readmission, or major postoperative complications, all within 30
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
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
Nociception Monitoring for General Anesthesia: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Nociception Monitoring for General Anesthesia: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines | CADTH.ca Find the information you need Nociception Monitoring for General Anesthesia: A Review of Clinical Effectiveness, Cost-Effectiveness, and Guidelines Nociception Monitoring for General Anesthesia: A Review of Clinical Effectiveness, Cost-Effectiveness (...) , and Guidelines Last updated: December 12, 2018 Project Number: RC1050-000 Product Line: Research Type: Devices and Systems Report Type: Summary with Critical Appraisal Result type: Report Question What is the clinical effectiveness of nociception monitoring on pain, opioid/pain medication consumption and/or opioid-related adverse events in adult surgical patients who have undergone general anesthesia? What is the cost-effectiveness of nociception monitoring on pain, opioid/pain medication consumption
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
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 (...) 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
Evidence Unclear on Effectiveness of Palatal Anesthesia in Controlling Pain and Improving Behavior of Pediatric Patients UTCAT3298, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Evidence Unclear on Effectiveness of Palatal Anesthesia in Controlling Pain and Improving Behavior of Pediatric Patients Clinical Question For children that need a dental extraction or stainless-steel crown (SSC) for primary maxillary molars (...) due to dental caries, will buccal and palatal lidocaine anesthesia, as compared to buccal lidocaine anesthesia only, improve their behavior and increase compliance in the dental chair during procedure? Clinical Bottom Line In pediatric patients, the effectiveness of buccal and palatal anesthesia, as compared to buccal anesthesia only, in controlling pain, improving behavior, and increasing compliance in the dental chair is not clearly supported by literature. Best Evidence (you may view more info
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
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
Intermittent Catheterization for Post-Operative Patients with Spinal Anesthesia: Guidelines Intermittent Catheterization for Post-Operative Patients with Spinal Anesthesia: Guidelines | CADTH.ca Find the information you need Intermittent Catheterization for Post-Operative Patients with Spinal Anesthesia: Guidelines Intermittent Catheterization for Post-Operative Patients with Spinal Anesthesia: Guidelines Published on: November 28, 2017 Project Number: RB1171-000 Product Line: Research Type (...) : Devices and Systems Report Type: Summary of Abstracts Result type: Report Question What are the evidence-based guidelines regarding the use of in-and-out or intermittent catheters to prevent urinary retention in post-operative patients who have received spinal anesthesia? Key Message No relevant literature was identified regarding the use of in-and-out or intermittent catheters to prevent urinary retention in post-operative patients who have received spinal anesthesia. Tags kidney, anesthesia
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
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
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 (...) %; P< .0001). Recovery room vomiting, airway obstruction, respiratory depression, sedation, emergence time, time spent in the recovery room as well as total intraoperative fentanyl administration, hypnotic parameters, and incidence of intraoperative movement were not different between groups.Patients receiving intraoperative ANI-guided fentanyl administration during sevoflurane anesthesia for lumbar discectomy and laminectomy demonstrated decreased pain in the recovery room, likely as a result
Effectiveness of preoperative intranasal dexmedetomidine, compared with oral midazolam, for the prevention of emergence delirium in the pediatric patient undergoing general anesthesia: a systematic review. Emergence delirium is defined as a cognitive disturbance during emergence from general anesthesia resulting in hallucinations, delusions and confusion manifested by agitation, restlessness, involuntary physical movement and extreme flailing in bed. Postoperative emergence delirium develops (...) in 12% to 18% of all children undergoing general anesthesia for surgery. This post-anesthetic phenomenon changes cognitive and psychomotor behavior, and puts pediatric patients and health care personnel at risk of injury. A newer drug, dexmedetomidine, is a selective alpha-2 agonist, which works in the brain and spinal cord that has sedative, analgesic and anxiolytic properties. Dexmedetomidine also has the ability to lower the overall anesthetic requirements by reducing sympathetic outflow
Safety Aspects of Postanesthesia Care Unit Discharge without Motor Function Assessment after Spinal Anesthesia: A Randomized, Multicenter, Semiblinded, Noninferiority, Controlled Trial Postanesthesia care unit (PACU) discharge without observation of lower limb motor function after spinal anesthesia has been suggested to significantly reduce PACU stay and enhance resource optimization and early rehabilitation but without enough data to allow clinical recommendations.A multicenter, semiblinded (...) , noninferiority randomized controlled trial of discharge from the PACU with or without assessment of lower limb motor function after elective total hip or knee arthroplasty under spinal anesthesia was undertaken. The primary outcome was frequency of a successful fast-track course (length of stay 4 days or less and no 30-day readmission). Noninferiority would be declared if the odds ratio (OR) for a successful fast-track course was no worse for those patients receiving no motor function assessment versus those