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

321. Obstetric Anaesthetic Services

suite 24 hours a day. 2. There must be a nominated consultant in charge of obstetric anaesthesia with time allocated for this role. 3. There should be a clear line of communication from the duty anaesthetist to the supervising consultant at all times. 4. The workload of the obstetric anaesthetist continues to increase. As a basic minimum there must be 12 consultant sessions per week to cover emergency work on delivery suite. 5. Scheduled obstetric anaesthetic activities (e.g. elective caesarean (...) (increased maternal co-morbidities such as obesity, increased maternal age, increased assisted conception, increasing immigrant population) • Does not take account of the impact of the changes to training in anaesthesia (in particular the effect of the European Working Time Regulations on training, associated paperwork and reduced trainee numbers) • Does not reflect the increased demand for the delivery of additional anaesthetic services such as anaesthetic clinics, maternity high dependency units (HDUs

2013 Association of Anaesthetists of GB and Ireland

322. Local anaesthetics in intraosseous access

Local anaesthetics in intraosseous access BestBets: Local anaesthetics in intraosseous access Local anaesthetics in intraosseous access Report By: Michael Stewart - St5 Emergency Medicine Search checked by Shelley Regan - St5 Emergency Medicine Institution: Blackpool Victoria Hospital, Blackpool, UK Date Submitted: 24th July 2013 Last Modified: 24th July 2013 Status: Green (complete) Three Part Question In [conscious adults receiving drugs or fluids via the intraosseous route] is [an initial (...) flush with local anaesthetic or with saline] more effective at [reducing pain]? Clinical Scenario Having been unable to obtain intravenous access you have just placed an intraosseous needle in a 30-year-old intravenous drug user who has attended the emergency department with a Glasgow coma scale score of 6, pinpoint pupils and respiratory rate of 3 following an opiate overdose. You are about to inject lidocaine to reduce the pain of the infusion when a passing colleague suggests that it is a waste

2013 BestBETS

323. Neuraxial anaesthesia for lower-limb revascularization. (Abstract)

Neuraxial anaesthesia for lower-limb revascularization. Lower-limb revascularization is a surgical procedure that is performed to restore an adequate blood supply to the limbs. Lower-limb revascularization surgery is used to reduce pain and sometimes to improve lower-limb function. Neuraxial anaesthesia is an anaesthetic technique that uses local anaesthetics next to the spinal cord to block nerve function. Neuraxial anaesthesia may lead to improved survival. This systematic review (...) ; 696 participants; four trials), and lower-limb amputation (OR 0.84, 95% CI 0.38 to 1.84; 465 participants; three trials). Pneumonia was less common after neuraxial anaesthesia than after general anaesthesia (OR 0.37, 95% CI 0.15 to 0.89; 201 participants; two trials). Evidence was insufficient for cerebral stroke, duration of hospital stay, postoperative cognitive dysfunction, complications in the anaesthetic recovery room and transfusion requirements. No data described nerve dysfunction

2013 Cochrane

324. Intravenous versus inhalation anaesthesia for one-lung ventilation. Full Text available with Trip Pro

Intravenous versus inhalation anaesthesia for one-lung ventilation. This is an update of a Cochrane Review first published in The Cochrane Library, Issue 2, 2008.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 an inhalation 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. Inhalation anaesthetics may impair hypoxic pulmonary vasoconstriction (HPV) and increase intrapulmonary shunt and hypoxaemia.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 (2012, Issue 11); MEDLINE

2013 Cochrane

325. A comparative evaluation of local application of the combination of eutectic mixture of local anesthetics and capsaicin for attenuation of venipuncture pain (Abstract)

A comparative evaluation of local application of the combination of eutectic mixture of local anesthetics and capsaicin for attenuation of venipuncture pain Topical capsaicin and eutectic mixture of local anesthetics (EMLA) have been found to be equally effective in minimizing the pain of venipuncture. After the injection of capsaicin, both tertiary amine local anesthetics and their quaternary ammonium derivatives can elicit a prolonged and predominantly sensory/nociceptor selective block. We

2013 EvidenceUpdates Controlled trial quality: uncertain

326. Combination of a reduced dose of an intrathecal local anesthetic with a small dose of an opioid: a meta-analysis of randomized trials Full Text available with Trip Pro

Combination of a reduced dose of an intrathecal local anesthetic with a small dose of an opioid: a meta-analysis of randomized trials We tested whether the combination of a reduced dose of a local anesthetic (LA) with an opioid compared with a standard dose of the same LA alone guaranteed adequate intraoperative anesthesia and postoperative analgesia and decreased LA-related adverse effects. We systematically searched (to November 2012) for randomized comparisons of combinations of a reduced (...) dose of an LA with a concomitant opioid (experimental) with a standard dose of the LA alone (control) in adults undergoing surgery with single-injection intrathecal anesthesia without general anesthesia. We included 28 trials (1393 patients). In experimental groups, the median decrease in LA doses was 40% (range, 12%-70%). There was no difference between experimental and control groups in the need for intraoperative opioids or general anesthesia for failed block or in the duration of postoperative

2013 EvidenceUpdates

327. Supplemental oxygen for caesarean section during regional anaesthesia. (Abstract)

Supplemental oxygen for caesarean section during regional anaesthesia. Supplementary oxygen is routinely administered to low-risk pregnant women during an elective caesarean section under regional anaesthesia; however, maternal and foetal outcomes have not been well established.The primary objective was to determine whether supplementary oxygen given to low-risk term pregnant women undergoing elective caesarean section under regional anaesthesia can prevent maternal and neonatal desaturation (...) under regional anaesthesia and compared outcomes with, and without, oxygen supplementation.Two review authors independently extracted data, assessed methodological quality and performed subgroup and sensitivity analyses.We included 10 trials with a total of 683 participants. Supplementary oxygen administration varied widely in dose and duration between trials. No cases of maternal desaturation were reported, although none of the 10 trials focused on maternal desaturation. Significant differences

2013 Cochrane

328. On the utility of diagnostic instruments for pediatric delirium in critical illness: an evaluation of the Pediatric Anesthesia Emergence Delirium Scale, the Delirium Rating Scale 88, and the Delirium Rating Scale-Revised R-98

On the utility of diagnostic instruments for pediatric delirium in critical illness: an evaluation of the Pediatric Anesthesia Emergence Delirium Scale, the Delirium Rating Scale 88, and the Delirium Rating Scale-Revised R-98 PEDSCCM.org Criteria abstracted from series in Review Posted: founded 1995 Questions or comments?

2013 PedsCCM Evidence-Based Journal Club

329. Administration of Anesthesia by Anesthesiologists Versus Non-Physicians for Patients Undergoing Cataract Surgery: Clinical Effectiveness, Cost-Effectiveness, and Guidelines

. For uncomplicated procedures, properly trained non-medical staff may administer subconjunctival or sub-Tenon’s blocks. An anesthesiologist should be available on site when local anesthetic blocks are being administered for more complex or longer cataract procedures. Administration of Anesthesiology by Anesthesiologists Versus Non-Physicians During Cataract Surgery 2 REFERENCES SUMMARIZED Health Technology Assessments No literature identified. Systematic Reviews and Meta-analyses No literature identified (...) . Randomized Controlled Trials No literature identified. Non-Randomized Studies 1. Bassett K, Smith SW, Cardiff K, Bergman K, Aghajanian J, Somogyi E. Nurse anaesthetic care during cataract surgery: a comparative quality assurance study. Can J Ophthalmol. 2007 Oct;42(5):689-94. PubMed: PM17891197 Economic Evaluations No literature identified. Guidelines and Recommendations 2. Local anaesthesia for ophthalmic surgery [Internet]. Joint Guidelines for the Royal College of Anaesthetists and the Royal College

2013 Canadian Agency for Drugs and Technologies in Health - Rapid Review

330. Immediate Post-anaesthesia recovery

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

2013 Association of Anaesthetists of GB and Ireland

331. Locoregional anesthesia for endovascular aneurysm repair

Locoregional anesthesia for endovascular aneurysm repair 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.

2013 DARE.

332. Articane Provides Longer Lasting Anesthesia in Buccal Infiltration Compared to Lidocaine on Healthy Teeth

on healthy teeth than lidocaine 2% 1:100,000 epi with a 95% Cl. Evidence Search (("Carticaine"[Mesh]) AND "Lidocaine"[Mesh]) AND "Anesthesia"[Mesh] Comments on The Evidence Brandt and colleagues analyzed a set of randomized controlled trials and systematic reviews, with a total of 269 patients, comparing anesthetic length of both articaine 4% 1:100,000 epi and lidocaine 2% 1:100,000 epi. Lidocaine was used as the gold standard. Compilation of the article titles was done electronically, which resulted (...) Articane Provides Longer Lasting Anesthesia in Buccal Infiltration Compared to Lidocaine on Healthy Teeth UTCAT2437, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Articane Provides Longer Lasting Anesthesia in Buccal Infiltration Compared to Lidocaine on Healthy Teeth Clinical Question In a patient undergoing buccal infiltration is articaine longer lasting compared to lidocane on healthy teeth? Clinical Bottom Line

2013 UTHSCSA Dental School CAT Library

333. Children With Obstructive Sleep Apnea Receiving Dental Procedures Under General Anesthesia are at Increase Risk For Respiratory Complications During Recovery?

Children With Obstructive Sleep Apnea Receiving Dental Procedures Under General Anesthesia are at Increase Risk For Respiratory Complications During Recovery? UTCAT2348, Found CAT view, CRITICALLY APPRAISED TOPICs University: | | ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM View the CAT / Title Children With Obstructive Sleep Apnea Receiving Dental Procedures Under General Anesthesia are at Increase Risk For Respiratory Complications During Recovery? Clinical Question For children with history (...) of obstructive sleep apnea undergoing dental rehabilitation under general anesthesia, as compared to the general population, would they have an increase risk of complications during recovery? Clinical Bottom Line Evidence shows that children with history of obstructive sleep apnea (1-3% of children) should be evaluated and followed up closely since they are at higher risk for respiratory complications after general anesthesia. Best Evidence (you may view more info by clicking on the PubMed ID link) PubMed ID

2013 UTHSCSA Dental School CAT Library

334. Anesthesia Among Patients Undergoing Knee Arthroplasty

, et al. Comparative perioperative outcomes associated with neuraxial versus general anesthesia for simultaneous bilateral total knee arthroplasty. Reg Anesth Pain Med. 2012 Nov;37(6):638-44. (11) Memtsoudis SG, Sun X, Chiu YL, Stundner O, Liu SS, Banerjee S, et al. Perioperative comparative effectiveness of anesthetic technique in orthopedic patients. Anesthesiology. 2013 May;118(5):1046-58. (12) Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes S, Callaghan JJ. Differences in short-term complications (...) are general and regional. According to definitions from the Canadian Anesthesiologists’ Society, general anesthesia is a reversible state of complete unconsciousness with loss of memory, pain relief, and muscle relaxation induced by drugs typically administered intravenously or by inhaled induction. (1) Regional anesthesia is the injection of a local anesthetic to an area of the body close to a nerve or group of nerves that supply function or feeling to the area of body involved in an operation. (1) When

2013 Health Quality Ontario

335. Statement on the Minimum Safety Requirements for Anaesthetic Machines and Workstations for Clinical Practice Background Paper

Statement on the Minimum Safety Requirements for Anaesthetic Machines and Workstations for Clinical Practice Background Paper PS54 BP 2013 Page 1 PS54 BP 2013 Australian and New Zealand College of Anaesthetists (ANZCA) Statement on the Minimum Safety Requirements for Anaesthetic Machines and Workstations for Clinical Practice Background Paper PURPOSE Anaesthetic machines are fundamental to anaesthesia. They have continued to evolve in sophistication and functionality, becoming increasingly (...) and consequently this was not incorporated. In addition it was considered that the recommended testing of the anaesthetic machine by the anaesthetist before use would be sufficient to ensure the safe functioning of the machine. At the close of the pilot phase, the title of the document was amended, consistent with the broader suite of ANZCA professional documents. SUMMARY Anaesthetic machines are fundamental to anaesthesia and have continued to evolve in sophistication and functionality, as well as diversity

2013 Australian and New Zealand College of Anaesthetists

336. Statement on the Minimum Safety Requirements for Anaesthetic Machines and Workstations for Clinical Practice

by AS/NZS 3200.2.13:2005. 1 ANZCA’s monitoring recommendations are outlined in College professional document PS18 Recommendations on Monitoring During Anaesthesia. 1.5.4 Basic draw-over systems and draw-over capable field anaesthetic machines. 1.5.4.1 The use of field equipment for teaching or continuing professional development in anaesthetising locations in Australia and New Zealand is acceptable when directly supervised by anaesthetists experienced in the principles and use of such equipment and when (...) approved by the Page 2 PS54 2013 head of department or his or her equivalent. Monitoring must comply with College professional document PS18 Recommendations on Monitoring During Anaesthesia. 2. ANAESTHETIC MACHINE SAFETY ASSESSMENT 2.1 Anaesthetic machines must be assessed for safety, reliability and functionality at least once a year by a specialist anaesthetist, or other person, with the required skill and technical knowledge. 2.2 This assessment will result in a classification of each machine

2013 Australian and New Zealand College of Anaesthetists

337. Guidelines for Health Practitioners Administering Local Anaesthesia Background Paper

practitioners with diverse qualifications and training, including specialist anaesthetists and specialist pain medicine physicians, other medical practitioners, dentists, podiatrists and nurses. The 2004 version of PS37 Statement on Local Anaesthesia and Allied Health Professionals acknowledged the diverse range of health practitioners administering local anaesthesia, the training required, the need for consideration of alternative anaesthetic techniques and the need for continuing medical management where (...) document, therefore, is to support uniform standards for the administration of local anaesthesia for medical, dental and surgical procedures by all health practitioners in Australia and New Zealand. BACKGROUND This professional document is intended to apply to all local anaesthetic techniques, including topical anaesthesia, field infiltration and peripheral nerve block (such as digital nerve block). This document is not intended to apply to orbital blocks, major regional anaesthesia and analgesia

2013 Australian and New Zealand College of Anaesthetists

338. Guidelines for Health Practitioners Administering Local Anaesthesia

anaesthesia include those related to the local anaesthetic drugs (for example, local anesthetic toxicity, allergic reaction), co- Page 2 PS37 2013 administered vasoconstrictors (for example, tachycardia, tachyarrhythmia or hypertension due to systemic absorption) or administration technique (for example, pain on injection, damage to nerves and/or adjacent structures). 5. PATIENT PREPARATION 5.1 Prior to the procedure, the health practitioner performing the procedure should provide the patient (...) ). 3. DEFINITION Local anaesthesia is the reduction or elimination of pain perception by drugs, which act locally to interfere with nerve conduction. Local anaesthetic drugs may be administered topically and/or by injection, either as field infiltration or peripheral nerve block (such as digital nerve block). 4. AIMS AND RISKS OF LOCAL ANAESTHESIA 4.1 The aims of local anaesthesia are to facilitate completion of the planned procedure without compromising patient safety 4.2 Risks of local

2013 Australian and New Zealand College of Anaesthetists

339. Statement on the Minimum Safety Requirements for Anaesthetic Machines and Workstations for Clinical Practice

by AS/NZS 3200.2.13:2005. 1 ANZCA’s monitoring recommendations are outlined in College professional document PS18 Recommendations on Monitoring During Anaesthesia. 1.5.4 Basic draw-over systems and draw-over capable field anaesthetic machines. 1.5.4.1 The use of field equipment for teaching or continuing professional development in anaesthetising locations in Australia and New Zealand is acceptable when directly supervised by anaesthetists experienced in the principles and use of such equipment and when (...) approved by the Page 2 PS54 2013 head of department or his or her equivalent. Monitoring must comply with College professional document PS18 Recommendations on Monitoring During Anaesthesia. 2. ANAESTHETIC MACHINE SAFETY ASSESSMENT 2.1 Anaesthetic machines must be assessed for safety, reliability and functionality at least once a year by a specialist anaesthetist, or other person, with the required skill and technical knowledge. 2.2 This assessment will result in a classification of each machine

2013 Australian and New Zealand College of Anaesthetists

340. Guidelines for Health Practitioners Administering Local Anaesthesia

anaesthesia include those related to the local anaesthetic drugs (for example, local anesthetic toxicity, allergic reaction), co- Page 2 PS37 2013 administered vasoconstrictors (for example, tachycardia, tachyarrhythmia or hypertension due to systemic absorption) or administration technique (for example, pain on injection, damage to nerves and/or adjacent structures). 5. PATIENT PREPARATION 5.1 Prior to the procedure, the health practitioner performing the procedure should provide the patient (...) ). 3. DEFINITION Local anaesthesia is the reduction or elimination of pain perception by drugs, which act locally to interfere with nerve conduction. Local anaesthetic drugs may be administered topically and/or by injection, either as field infiltration or peripheral nerve block (such as digital nerve block). 4. AIMS AND RISKS OF LOCAL ANAESTHESIA 4.1 The aims of local anaesthesia are to facilitate completion of the planned procedure without compromising patient safety 4.2 Risks of local

2013 Australian and New Zealand College of Anaesthetists