Latest & greatest articles for anaesthesia

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This page lists the very latest high quality evidence on anaesthesia 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.

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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

221. Comparison of propofol/remifentanil and sevoflurane/remifentanil for maintenance of anaesthesia for elective intracranial surgery

Comparison of propofol/remifentanil and sevoflurane/remifentanil for maintenance of anaesthesia for elective intracranial surgery 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.

2005 NHS Economic Evaluation Database.

222. Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. (PubMed)

Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial. Awareness is an uncommon complication of anaesthesia, affecting 0.1-0.2% of all surgical patients. Bispectral index (BIS) monitoring measures the depth of anaesthesia and facilitates anaesthetic titration. In this trial we determined whether BIS-guided anaesthesia reduced the incidence of awareness during surgery in adults.We did a prospective, randomised, double-blind, multicentre (...) trial. Adult patients at high risk of awareness were randomly allocated to BIS-guided anaesthesia or routine care. Patients were assessed by a blinded observer for awareness at 2-6 h, 24-36 h, and 30 days after surgery. An independent committee, blinded to group identity, assessed every report of awareness. The primary outcome measure was confirmed awareness under anaesthesia at any time.Of 2463 eligible and consenting patients, 1225 were assigned to the BIS group and 1238 to the routine care group

2004 Lancet Controlled trial quality: predicted high

223. Anaesthesia, surgery, and challenges in postoperative recovery. (PubMed)

Anaesthesia, surgery, and challenges in postoperative recovery. Surgical injury can be followed by pain, nausea, vomiting and ileus, stress-induced catabolism, impaired pulmonary function, increased cardiac demands, and risk of thromboembolism. These problems can lead to complications, need for treatment in hospital, postoperative fatigue, and delayed convalescence. Development of safe and short-acting anaesthetics, improved pain relief by early intervention with multimodal analgesia (...) , and stress reduction by regional anaesthetic techniques, beta-blockade, or glucocorticoids have provided important possibilities for enhanced recovery. When these techniques are combined with a change in perioperative care a pronounced enhancement of recovery and decrease in hospital stay can be achieved, even in major operations. The anaesthetist has an important role in facilitating early postoperative recovery by provision of minimally-invasive anaesthesia and pain relief, and by collaborating

2003 Lancet

224. Perioperative management and monitoring in anaesthesia. (PubMed)

Perioperative management and monitoring in anaesthesia. In recent years, several risk factors for adverse outcome in patients undergoing anaesthesia have been identified. Besides human errors, cardiovascular and respiratory complications are associated with substantial morbidity. Assessment of complications has promoted the introduction of basic physiological monitoring in clinical practice. Whether monitoring directly affects outcome is not proven; however, circumstantial evidence suggests (...) that basic cardiorespiratory monitoring decreases the incidence of serious accidents. Prevention of hypothermia also reduces anaesthesia-related morbidity. Measurement of body temperature is mandatory, and active warming is a simple, effective technique to avoid hypothermia. Evidence is growing that patients with known or suspected coronary artery disease should be treated with beta blockers perioperatively. Whether the type of anaesthesia-ie, general or regional-is relevant to perioperative mortality

2003 Lancet

225. Anaesthesia: the patient's point of view. (PubMed)

Anaesthesia: the patient's point of view. Patients scheduled for surgical procedures continue to express concerns about their safety, outcome, and comfort. All medical interventions carry risks, but the patient often considers anaesthesia as the intervention with the greatest risk. Many still worry that they will not wake up after their surgery, or that they will be awake during the operation. Such events have received attention from the media, but are very rare. Challenges to improve (...) the comfort of patients continue, especially with regard to the almost universal problems of nausea, vomiting, and pain after surgery. A newer concern is that patients will develop some degree of mental impairment that may delay return to a full work and social lifestyle for days and weeks. Developments in technology, education, and training have had a major effect on anaesthetic practice, so that anaesthesia is increasingly regarded as safe for the patient. This article explores patients' concerns

2003 Lancet

226. Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. (PubMed)

Transient neurologic symptoms (TNS) following spinal anaesthesia with lidocaine versus other local anaesthetics. Spinal anaesthesia has been in use since the turn of the late 19th century. The most serious complication of this technique is damage to the spinal cord or nerve roots resulting in lasting neurologic sequelae. Such serious adverse effects seldom happen. There has been an increase in the number of reports during the last nine years implicating lidocaine as a possible cause (...) of temporary and permanent neurologic complications after spinal anaesthesia. Follow-up of patients who received uncomplicated spinal anaesthesia revealed that some of them developed pain in the lower extremities after an initial full recovery. This painful condition that occurs in the immediate post-operative period was named "transient neurologic symptoms" (TNS).The objectives of this review were to study the frequency of TNS and neurologic complications after spinal anaesthesia with lidocaine, compared

2003 Cochrane

227. Clinical and economic choices in anaesthesia for day surgery: a prospective randomised controlled trial

Clinical and economic choices in anaesthesia for day surgery: a prospective randomised controlled trial Clinical and economic choices in anaesthesia for day surgery: a prospective randomised controlled trial Clinical and economic choices in anaesthesia for day surgery: a prospective randomised controlled trial Elliott R A, Payne K, Moore J K, Harper N J, St Leger A S, Moore E W, Thoms G M, Pollard B J, McHugh G A, Bennett J, Lawrence G, Kerr J, Davies L M Record Status This is a critical (...) analysis. Study population The study population comprised adults (aged 18 years and over) and paediatric patients (aged 3 to 12 years) who were eligible for day case surgery. The inclusion criteria for the study specified patients undergoing day case surgery and patients assessed as fit for anaesthesia by one of the participating anaesthetists. The exclusion criteria specified patients undergoing a pregnancy termination, expected use of suxamethonium, or use of sedative pre-medication. Setting

2003 NHS Economic Evaluation Database.

228. Local, regional, or general anaesthesia in groin hernia repair: multicentre randomised trial. (PubMed)

Local, regional, or general anaesthesia in groin hernia repair: multicentre randomised trial. In specialised centres, local anaesthesia is almost always used in groin hernia surgery; whereas in routine surgical practice, regional or general anaesthesia are the methods of choice. In this three-arm multicentre randomised trial, we aimed to compare the three methods of anaesthesia and to determine the extent to which general surgeons can reproduce the excellent results obtained with local (...) anaesthesia in specialised hernia centres.Between January, 1999, and December, 2001, 616 patients at ten hospitals, were randomly assigned to have either local, regional, or general anaesthesia. Primary endpoints were early and late postoperative complications. Secondary endpoints were duration of surgery and anaesthesia, length of postoperative hospital stay, and time to normal activity. Analysis was by intention to treat.Intraoperative tolerance for local anaesthesia was high. In the early postoperative

2003 Lancet Controlled trial quality: uncertain

229. Comparison of upper airway collapse during general anaesthesia and sleep. (PubMed)

Comparison of upper airway collapse during general anaesthesia and sleep. Measurement of the collapsibility of the upper airway while a patient is awake is not a good guide to such collapsibility during sleep, presumably because of differences in respiratory drive, muscle tone, and sensitivity of reflexes. To assess whether a relation existed between general anaesthesia and sleep, we measured collapsibility of the upper airway during general anaesthesia and severity of sleep-disordered (...) breathing in 25 people who were having minor surgery on their limbs. Anaesthetised patients who needed positive pressure to maintain airway patency had more severe sleep-disordered breathing than did those whose airways remained patent at or below atmospheric pressure. Such an association was strongest during rapid-eye-movement (REM) sleep. Our findings suggest that sleep-disordered breathing should be considered in all patients with a pronounced tendency for upper airway obstruction during anaesthesia

2002 Lancet

230. Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal. (PubMed)

Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal. Withdrawal (detoxification) is necessary prior to drug-free treatment. It may also represent the end point of long-term opioid replacement treatment such as methadone maintenance. The availability of managed withdrawal is essential to an effective treatment system.To assess the effectiveness of interventions involving the administration of opioid antagonists to induce opioid withdrawal with concomitant heavy sedation (...) or anaesthesia.Multiple electronic databases (including MEDLINE, EMBASE, PsycLIT, Australian Medical Index, Cochrane Controlled Trials Register, and CINAHL) were systematically searched. Reference lists of retrieved studies, reviews and conference abstracts were handsearched.Randomised or quasi-randomised controlled trials that compared the administration of opioid antagonists under heavy sedation or anaesthesia with another form of treatment.One reviewer assessed studies for inclusion and undertook data extraction

2002 Cochrane

231. Comparison of hemodynamics, recovery profile, and early postoperative pain control and costs of remifentanil versus alfentanil-based total intravenous anaesthesia (TIVA)

Comparison of hemodynamics, recovery profile, and early postoperative pain control and costs of remifentanil versus alfentanil-based total intravenous anaesthesia (TIVA) Comparison of hemodynamics, recovery profile, and early postoperative pain control and costs of remifentanil versus alfentanil-based total intravenous anaesthesia (TIVA) Comparison of hemodynamics, recovery profile, and early postoperative pain control and costs of remifentanil versus alfentanil-based total intravenous (...) anaesthesia (TIVA) Ozkose Z, Cok O Y, Tuncer B, Tufekcioglu S, Yardim S 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. Health technology The use of two combinations of drugs for total intravenous anaesthesia, remifentanil plus propofol (RP) versus

2002 NHS Economic Evaluation Database.

232. Is intercostal block for pain management in thoracic surgery more successful than epidural anaesthesia?

Is intercostal block for pain management in thoracic surgery more successful than epidural anaesthesia? Is intercostal block for pain management in thoracic surgery more successful than epidural anaesthesia? Is intercostal block for pain management in thoracic surgery more successful than epidural anaesthesia? Wurnig P N, Lackner H, Teiner C, Hollaus P H, Pospisil M, Fohsl-Grande B, Osarowsky M, Pridun N S Record Status This is a critical abstract of an economic evaluation that meets (...) intercostal space at the end of the operation. The patients in the EPC group had a catheter placed in the epidural space at the thoracic level before the induction of general anaesthesia. All of the patients received a baseline analgesic medication with non-steroidal anti-inflammatory drugs. They also received extra subcutaneous opiate injections if required. Type of intervention Anaesthesia. Economic study type Cost-effectiveness analysis. Study population The study population comprised patients

2002 NHS Economic Evaluation Database.

233. Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. (PubMed)

Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial. Epidural block is widely used to manage major abdominal surgery and postoperative analgesia, but its risks and benefits are uncertain. We compared adverse outcomes in high-risk patients managed for major surgery with epidural block or alternative analgesic regimens with general anaesthesia in a multicentre randomised trial.915 patients undergoing major abdominal surgery with one of nine defined comorbid states (...) to identify high-risk status were randomly assigned intraoperative epidural anaesthesia and postoperative epidural analgesia for 72 h with general anaesthesia (site of epidural selected to provide optimum block) or control. The primary endpoint was death at 30 days or major postsurgical morbidity. Analysis by intention to treat involved 447 patients assigned epidural and 441 control.255 patients (57.1%) in the epidural group and 268 (60.7%) in the control group had at least one morbidity endpoint or died

2002 Lancet Controlled trial quality: predicted high

234. Anaesthesia for hip fracture surgery in adults. (PubMed)

Anaesthesia for hip fracture surgery in adults. The majority of hip fracture patients are treated surgically, requiring anaesthesia.To compare different types of anaesthesia for surgical repair of hip fractures (proximal femoral fractures) in adults.We searched the Cochrane Musculoskeletal Injuries Group specialised register (December 2000), MEDLINE (1996 to December Week 4 2000) and reference lists of relevant articles.Randomised and quasi-randomised trials comparing different methods (...) of anaesthesia for hip fracture surgery in skeletally mature persons. The primary focus of this review was the comparison of regional (spinal or epidural) anaesthesia versus general anaesthesia; this has been expanded to include other comparisons. The use of nerve blocks pre-operatively or in conjunction with general anaesthesia is evaluated in another review. The primary outcome was mortality.Two reviewers independently assessed trial quality, using a nine item scale, and extracted data. Results were pooled

2001 Cochrane

235. Opioid antagonists under sedation or anaesthesia for opioid withdrawal. (PubMed)

Opioid antagonists under sedation or anaesthesia for opioid withdrawal. Withdrawal (detoxification) is necessary prior to drug-free treatment. It may also represent the end point of long-term treatment such as methadone maintenance. The availability of managed withdrawal is essential to an effective treatment system.To assess the effectiveness of interventions involving the administration of opioid antagonists to induce opioid withdrawal with concomitant heavy sedation or anaesthesia.Multiple (...) electronic databases (including MEDLINE, EMBASE, PsycLIT, Australian Medical Index, Cochrane Clinical Trials Register, and CINAHL) were systematically searched. Reference lists of retrieved studies, reviews and conference abstracts were handsearched.Randomised or quasi-randomised controlled trials that compared the administration of opioid antagonists under sedation or anaesthesia with another form of treatment.One reviewer assessed studied for inclusion and undertook data extraction. Inclusion decisions

2001 Cochrane

236. Patient and hospital benefits of local anaesthesia for carotid endarterectomy

Patient and hospital benefits of local anaesthesia for carotid endarterectomy Patient and hospital benefits of local anaesthesia for carotid endarterectomy Patient and hospital benefits of local anaesthesia for carotid endarterectomy McCarthy R J, Walker R, McAteer P, Budd J S, Horrocks M 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. Health technology The use of local anaesthesia (LA) and general anaesthesia (GA) during carotid endarterectomy (CEA). The GA patients received intravenous midazolam (2 - 3 mg) at induction, then fentanyl or alfentanil and propofol, and were maintained on a mixture of isofluorane, air and oxygen. The LA patients were premedicated with temazepam (20 - 30 mg) and promethazine (25 mg). The regional block consisted

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2001 NHS Economic Evaluation Database.

237. Pain after transrectal ultrasonography-guided prostate biopsy: the advantages of periprostatic local anaesthesia

Pain after transrectal ultrasonography-guided prostate biopsy: the advantages of periprostatic local anaesthesia Pain after transrectal ultrasonography-guided prostate biopsy: the advantages of periprostatic local anaesthesia Pain after transrectal ultrasonography-guided prostate biopsy: the advantages of periprostatic local anaesthesia Seymour H, Perry M J, Lee-Elliot C, Dundas D, Patel U 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. Health technology The health intervention examined in the study was periprostatic local anaesthesia (LA) during prostatic biopsy guided by transrectal ultrasonography (TRUS). Type of intervention Other: anaesthesia. Economic study type Cost-effectiveness analysis. Study population The study population

2001 NHS Economic Evaluation Database.

238. Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl

Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl Comparative analysis of costs of total intravenous anaesthesia with propofol and remifentanil vs. balanced anaesthesia with isoflurane and fentanyl Epple J, Kubitz J, Schmidt H, Motsch J, Bottiger B W (...) , Martin E, Bach A 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. Health technology The use of total intravenous anaesthesia with remifentanil and propofol (TIVA-RP) before surgery. The anaesthetic regimen consisted of propofol (1.5 mg/kg

2001 NHS Economic Evaluation Database.

239. General versus spinal/epidural anaesthesia for surgery for hip fractures in adults. (PubMed)

General versus spinal/epidural anaesthesia for surgery for hip fractures in adults. The majority of hip fracture patients are treated surgically, requiring anaesthesia.To compare different types of anaesthesia for surgical repair of hip fractures (proximal femoral fractures) in adults. This is primarily regional (spinal or epidural) anaesthesia versus inhalation general anaesthesia, but also includes ketamine anaesthesia versus inhalation general anaesthesia.We searched the Cochrane (...) Musculoskeletal Injuries Group trials register, Medline, selected orthopaedic and anaesthetic journals and conference proceedings, and reference lists of relevant articles. Date of the most recent search: August 1999.Randomised and quasi-randomised trials comparing different methods of anaesthesia for hip fracture surgery in skeletally mature persons. Trials comparing the use of local nerve blocks are not considered in this review. Neither are trials using different types of drugs or techniques with one type

2000 Cochrane

240. Perioperative local anaesthesia for reducing pain following tonsillectomy. (PubMed)

Perioperative local anaesthesia for reducing pain following tonsillectomy. Pain relief after tonsillectomy is an important part of post-operative management. Sometimes local anaesthetics are administed to the tonsillar region, but their effectiveness in relieving pain has not been formally assessed.To assess the effects of pre- and post-operative local anaesthesia for pain reduction following tonsillectomy.Cochrane Controlled Trials Register, Medline, Embase and the Oxford Pain Database

2000 Cochrane