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Anaesthesia
Latest Evidence Newsletter
January 2017 (Quarterly)
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Lunchtime Drop-in Sessions
All sessions last one hour
January (13.00)
Tues 10th Literature Searching
Wed 18th Critical Appraisal
Thurs 26th Statistics
February (12.00)
Fri 3rd
Literature Searching
th
Mon 6
Critical Appraisal
th
Tue 14
Statistics
nd
Wed 22
Literature Searching
March (13.00)
Thurs 2nd
Critical Appraisal
Fri 10th
Interpreting Statistics
Mon 13th
Literature Searching
Tues 21st
Critical Appraisal
Weds 29th Interpreting Statistics
Librarians on demand!
Do you urgently need to find evidence to support your treatment of a
patient? Would you like immediate information about a particular
therapy, practice, condition, or other clinical need?
The Library can provide swift assistance with a range of our services,
including literature searches and access to full text articles.
You can discuss your urgent literature search needs with a librarian
immediately by calling extension 20105. A librarian can also be with you in your clinical area
usually within 15 minutes.
For speedy article requests and other library services, email [email protected]. If you
specify your urgent need, we will prioritise this.
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Contents
Updates ............................................................................................... 3
New Guidance: AAGBI ..................................................................... 4
Journals: Tables of Contents ................................................................ 5
Anaesthesia ...................................................................................... 5
Anesthesia & Analgesia..................................................................... 7
Anesthesiology ................................................................................. 9
British Journal of Anaesthesia ......................................................... 12
Current Opinion in Anaesthesiology ............................................... 15
Current Awareness Database Articles ............................................... 19
Your Outreach Librarian- Jo Hooper
Whatever your information needs, the library is here to help. As your Outreach Librarian I
offer literature searching services as well as training and guidance in searching the
evidence and critical appraisal – just email me at [email protected]
Outreach: Your Outreach Librarian can help facilitate evidence-based practise for all in the
oral and maxillofacial surgery team, as well as assisting with academic study and research.
We can help with literature searching, obtaining journal articles and books, and setting up
individual current awareness alerts. We also offer one-to-one or small group training in
literature searching, accessing electronic journals, and critical appraisal. Get in touch:
[email protected]
Literature searching: We provide a literature searching service for any library member. For
those embarking on their own research it is advisable to book some time with one of the
librarians for a 1 to 1 session where we can guide you through the process of creating a
well-focused literature research and introduce you to the health databases access via NHS
Evidence. Please email requests to [email protected].
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Updates
Latest relevant Systematic Reviews
Anaesthetic interventions for prevention of awareness during surgery
Anthony G Messina , Michael Wang , Marshall J Ward , Chase C Wilker , Brett B Smith , Daniel P
Vezina and Nathan Leon Pace
Online Publication Date: October 2016
Deliberate hypotension with propofol under anaesthesia for functional endoscopic sinus surgery
(FESS)
Polpun Boonmak , Suhattaya Boonmak and Malinee Laopaiboon
Online Publication Date: October 2016
Peri-articular/intra-articular infiltration analgesia with local anaesthetic versus nerve block for
postoperative pain and function in patients receiving major knee surgery
Lihua Peng , Su Min , Xin Sun , Ke Wei , Jun Dong , Yuanyuan Liu and Li Ren
Online Publication Date: October 2016
Combined femoral and sciatic nerve block versus femoral and local infiltration anesthesia for pain
control after total knee arthroplasty: a meta-analysis of randomized controlled trials
Source: PubMed - 07 December 2016
How does a neuraxial block compare with general anesthesia in adults undergoing hip fracture
surgery?
Source: Cochrane Clinical Answers - 14 November 2016
How does neuraxial blockade compare with general anesthesia and systemic analgesia when used
postoperatively?
Source: Cochrane Clinical Answers - 08 November 2016
New Guidance: AAGBI
Managing Conflicts of Interest in the NHS: A Consultation
22 December 2016
Shortlist announced for the AAGBI Award for Innovation in Anaesthesia, Critical Care and Pain
15 December 2016
A good year for innovation in anaesthesia
28 October 2016
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Journals: Tables of Contents
Click on the hyperlinked title (+ Ctrl) for contents. If you require any of the
articles in full please email: [email protected]
Anaesthesia
January 2017; Volume 72, Issue 1
Editorials
What Anaesthesia is doing to combat scientific misconduct and investigate data fabrication and
falsification (pages 3–4)
A. A. Klein
Design counsel: the role of clinicians in the prototyping and standard setting of anaesthetic
equipment (pages 5–8)
T. Meek
Beware the Trojan Horse – a timely reality check about re-using single-use devices (pages 8–12)
P. Hopkins and S. Patel
Can systematic reviews with sparse data be trusted? (pages 12–16)
A. Afshari, J. Wetterslev and A. F. Smith
Original Articles
Evidence for non-random sampling in randomised, controlled trials by Yuhji Saitoh (pages 17–27)
J. B. Carlisle and J. A. Loadsman
Performance of adjustable pressure-limiting (APL) valves in two different modern anaesthesia
machines (pages 28–34)
J. Thomas, M. Weiss, A. R. Schmidt and P. K. Buehler
GE Healthcare response: performance of adjustable pressure limiting (APL) valves in two different
modern anaesthesia machines (pages 34–35)
T. McCormick
Contamination of single-use bronchoscopes in critically ill patients (pages 36–41)
B. A. McGrath, S. Ruane, J. McKenna and S. Thomas
A prospective, cohort evaluation of major and minor airway management complications during
routine anaesthetic care at an academic medical centre (pages 42–48)
J. M. Huitink, P. P. Lie, I. Heideman, E. P. Jansma, R. Greif, N. van Schagen and A. Schauer
Cerebral oxygenation during changes in vascular resistance and flow in patients on cardiopulmonary
bypass – a physiological proof of concept study (pages 49–56)
N. H. Sperna Weiland, D. Brevoord, D. A. Jöbsis, E. M. F. H. de Beaumont, V. Evers, B. Preckel,
Intelligence quotient scores at the age of 6 years in children anaesthetised before the age of 5 years
(pages 57–62)
I. J. de Heer, H. Tiemeier, S. E. Hoeks and F. Weber
Laboratory evaluation of a novel anaesthesia delivery device (pages 63–72)
A. Paul, J. N. Clark, I. E. Salama, B. J. Jenkins, N. Goodwin, A. R. Wilkes, P. F. Mahoney and J. E. Hall
A radiologic and anatomic assessment of injectate spread following transmuscular quadratus
lumborum block in cadavers (pages 73–79)
S. D. Adhikary, K. El-Boghdadly, Z. Nasralah, N. Sarwani, A. M. Nixon and K. J. Chin
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An observational study of critical care physicians' assessment and decision-making practices in
response to patient referrals (pages 80–92)
M. Charlesworth, M. Mort and A. F. Smith
Guidelines
AAGBI: Consent for anaesthesia 2017 : Association of Anaesthetists of Great Britain and Ireland
(pages 93–105)
S. M. Yentis, A. J. Hartle, I. R. Barker, P. Barker, D. G. Bogod, T. H. Clutton-Brock, A. Ruck Keene,
Review Article
The effect of inhaled nitric oxide in acute respiratory distress syndrome in children and adults: a
Cochrane Systematic Review with trial sequential analysis (pages 106–117)
O. Karam, F. Gebistorf, J. Wetterslev and A. Afshari
Statistically Speaking
Fifty percent of anaesthetists are worse than average at understanding statistics and risk (pages
118–121)
B. Gibbison
Classifying variables (pages 122–123)
S. W. Choi and D. M. H. Lam
Correspondence
Retention of laryngoscopy skills in novices (page 124)
D. Jain
Retention of laryngoscopy skills in medical students – a reply (pages 124–125)
R. McCahon
Abandoning first generation supraglottic airway devices in paediatric anaesthesia (pages 125–126)
J. P. Montague and C. J. Halloran
Ultra-low dose spinal anaesthesia for hip fracture surgery (page 126)
K. Godai
Duration of low-dose spinal anaesthesia for hip fracture surgery (pages 127–128)
S. White
Vascular access after axillary lymph node surgery (page 128)
S. Wydall and E. Aziz
Vascular access after axillary lymph node surgery – a reply (pages 128–129)
A. Bodenham
Vascular access, cerebral air embolism and hyperbaric oxygen therapy (pages 129–130)
P. Bothma and A. Obideyi
Does mannitol contribute to hypotension after parenteral paracetamol administration in critical
care? (page 130)
A. Nair
Engineering jargon (pages 130–131)
A. Maddock
‘Go-between’ study: walk times and talk times (page 131)
J. T. A. Wedgwood
‘Go-between’ study: walk times and talk times – a reply (pages 131–132)
T. Cook, S. R. MacDougall-Davis and L. Kettley
Visualising odds ratios (pages 132–133)
T. L. Samuels
Correction
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Correction (page 134)
This article corrects:
The ‘go-between’ study: a simulation study comparing the ‘Traffic Lights’ and ‘SBAR’ tools as a
means of communication between anaesthetic staff1
Vol. 71, Issue 7, 764–772,
Anesthesia & Analgesia
January 2017; Volume 124, Issue 1
Infographics
From Contact to Contactless Pulse Oximetry: Can You Measure Me Now?
Wanderer, Jonathan P.; Nathan, Naveen
Anesthesia & Analgesia. 124(1):1, January 2017.
Editorial
Trends and Challenges in Clinical Monitoring: Papers From the 2015 IAMPOV Symposium
Bickler, Philip E.; Cannesson, Maxime; Shelley, Kirk H.
Anesthesia & Analgesia. 124(1):2-3, January 2017.
Peripheral Nerve Catheters: Ready for a Central Role?
Soffin, Ellen M.; YaDeau, Jacques T.
Anesthesia & Analgesia. 124(1):4-6, January 2017.
Maybe the Wand Does Matter?
Tung, Avery; Pittet, Jean-Francois
Anesthesia & Analgesia. 124(1):7-8, January 2017
Implementation of Massive Transfusion Protocols in the United States: The Relationship Between
Evidence and Practice
Chang, Ronald; Holcomb, John B.
Anesthesia & Analgesia. 124(1):9-11, January 2017.
Cardiovascular Anesthesiology
The Association Between Preoperative Hemoglobin A1C and Postoperative Glycemic Variability on
30-Day Major Adverse Outcomes Following Isolated Cardiac Valvular Surgery
Bardia, Amit; Khabbaz, Kamal; Mueller, Ariel;
Anesthesia & Analgesia. 124(1):16-22, January 2017.
Hemostasis
The Association Between Cyanosis and Thromboelastometry (ROTEM) in Children With Congenital
Heart Defects: A Retrospective Cohort Study
Laskine-Holland, Marie-Laure; Kahr, Walter H. A.; Crawford-Lean, Lynn;
Anesthesia & Analgesia. 124(1):23-29, January 2017.
Perioperative Echocardiography and Cardiovascular Education
Coronary Artery Fistula to Left Atrium Uncovered After Mitral Valve Replacement
Renew, Johnathan R.; Ritter, Matthew J.
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Anesthesia & Analgesia. 124(1):30-32, January 2017.
Ambulatory Anesthesiology and Perioperative Management
Association Between Perioperative Hyperglycemia or Glucose Variability and Postoperative Acute
Kidney Injury After Liver Transplantation: A Retrospective Observational Study
Yoo, Seokha; Lee, Ho-Jin; Lee, Hannah;
Anesthesia & Analgesia. 124(1):35-41, January 2017.
Anesthetic Clinical Pharmacology
Trends in Tramadol: Pharmacology, Metabolism, and Misuse
Miotto, Karen; Cho, Arthur K.; Khalil, Mohamed A.;
Anesthesia & Analgesia. 124(1):44-51, January 2017.
Preclinical Pharmacology
Cardiotoxic Antiemetics Metoclopramide and Domperidone Block Cardiac Voltage-Gated Na+
Channels
Stoetzer, Carsten; Voelker, Marc; Doll, Thorben
Anesthesia & Analgesia. 124(1):52-60, January 2017.
Technology, Computing, and Simulation
Advanced Uses of Pulse Oximetry for Monitoring Mechanically Ventilated Patients
Tusman, Gerardo; Bohm, Stephan H.; Suarez-Sipmann, Fernando
Anesthesia & Analgesia. 124(1):62-71, January 2017.
Capturing Essential Information to Achieve Safe Interoperability
Weininger, Sandy; Jaffe, Michael B.; Rausch, Tracy
Anesthesia & Analgesia. 124(1):83-94, January 2017.
The Need to Apply Medical Device Informatics in Developing Standards for Safe Interoperable
Medical Systems
Weininger, Sandy; Jaffe, Michael B.; Goldman, Julian M.
Anesthesia & Analgesia. 124(1):127-135, January 2017.
Anesthesiologist as Physiologist: Discussion and Examples of Clinical Waveform Analysis
Alian, Aymen A.
Anesthesia & Analgesia. 124(1):154-166, January 2017.
Tissue Oximetry and Clinical Outcomes
Bickler, Philip; Feiner, John; Rollins, Mark
Anesthesia & Analgesia. 124(1):72-82, January 2017
Active and Passive Optical Imaging Modality for Unobtrusive Cardiorespiratory Monitoring and Facial
Expression Assessment
Blazek, Vladimir; Blanik, Nikolai; Blazek, Claudia R.
Anesthesia & Analgesia. 124(1):104-119, January 2017.
Effects of Acute, Profound Hypoxia on Healthy Humans: Implications for Safety of Tests Evaluating
Pulse Oximetry or Tissue Oximetry Performance
Bickler, Philip E.; Feiner, John R.; Lipnick, Michael S.
Anesthesia & Analgesia. 124(1):146-153, January 2017.
Original Clinical Research Report
Applying Computer Models to Realize Closed-Loop Neonatal Oxygen Therapy
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Morozoff, Edmund; Smyth, John A.; Saif, Mehrdad
Anesthesia & Analgesia. 124(1):95-103, January 2017.
A Comparison of Measurements of Change in Respiratory Status in Spontaneously Breathing
Volunteers by the ExSpiron Noninvasive Respiratory Volume Monitor Versus the Capnostream...
Williams, George W. II; George, Christy A.; Harvey, Brian C.
Anesthesia & Analgesia. 124(1):120-126, January 2017.
Anesthesiology
January 2017; Volume 126, Issue 1
This Month in: Anesthesiology
Anesthesiology January 2017, Vol.126, A1-A2.
Science, Medicine, and the Anesthesiologist
Anesthesiology January 2017, Vol.126, A19-A20.
Infographics in Anesthesiology
Perioperative Medication Management
Jonathan P. Wanderer; James P. Rathmell
Anesthesiology January 2017, Vol.126, A21.
Anesthesiology CME Program
Instructions for Obtaining Anesthesiology Continuing Medical Education (CME) Credit
Anesthesiology January 2017, Vol.126, A17.
Editorial Views
Preoperative Administration of Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor
Blockers: Do We Have Enough “VISION” to Stop It?
Martin J. London, M.D.
Anesthesiology January 2017, Vol.126, 1-3.
It’s About Time
Sachin Kheterpal, M.D., M.B.A.
Anesthesiology January 2017, Vol.126, 4-5.
Monkey in the Middle: Translational Studies of Pediatric Anesthetic Exposure
Mark G. Baxter, Ph.D.; Maria C. Alvarado, Ph.D.
Anesthesiology January 2017, Vol.126, 6-8. do
Vasopressin, Norepinephrine, and Vasodilatory Shock after Cardiac Surgery: Another “VASST”
Difference?
James A. Russell, A.B., M.D.
Anesthesiology January 2017, Vol.126, 9-11. do
Innovative Disruption in the World of Neuromuscular Blockade: What Is the “State of the Art?”
Mohamed Naguib, M.B., B.Ch., M.Sc., F.C.A.R.C.S.I., M.D.; Ken B. Johnson, M.D.
Anesthesiology January 2017, Vol.126, 12-15.
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Anesthesiology Reflections from the Wood Library-Museum
Richter’s Anchor Pain Expeller: Nondoctor Analgesia from “Doctoring” Chili, Black, and Guinea
Peppers
Anesthesiology January 2017, Vol.126, 15.
Perioperative Medicine Clinical Science
Withholding versus Continuing Angiotensin-converting Enzyme Inhibitors or Angiotensin II Receptor
Blockers before Noncardiac Surgery: An Analysis of the Vascular events In noncardiac Surg...
Pavel S. Roshanov, M.D., M.Sc.; Bram Rochwerg, M.D., M.Sc.; Ameen Patel, M.D.;
Anesthesiology January 2017, Vol.126, 16-27.
Mask Ventilation during Induction of General Anesthesia: Influences of Obstructive Sleep Apnea
Shin Sato, M.D.; Makoto Hasegawa, M.D.; Megumi Okuyama, M.D.; Junko Okazaki, M.D.
Anesthesiology January 2017, Vol.126, 28-38.
Anesthesiology Reflections from the Wood Library-Museum
Cocaine in the “Dental Delight” of the Doctors McKinley
Anesthesiology January 2017, Vol.126, 38.
Perioperative Medicine Clinical Science
Rapid Occurrence of Chronic Kidney Disease in Patients Experiencing Reversible Acute Kidney Injury
after Cardiac Surgery
David Legouis, M.D.; Pierre Galichon, M.D., Ph.D.; Aurélien Bataille, M.D.; Sylvie Chevret, M.D.
Anesthesiology January 2017, Vol.126, 39-46.
Relationship between Intraoperative Hypotension, Defined by Either Reduction from Baseline or
Absolute Thresholds, and Acute Kidney and Myocardial Injury after Noncardiac Surgery: A Retro...
Vafi Salmasi, M.D.; Kamal Maheshwari, M.D., M.P.H.; Dongsheng Yang, M.A.; Edward J.
Anesthesiology January 2017, Vol.126, 47-65.
Does Dexmedetomidine Have a Perineural Mechanism of Action When Used as an Adjuvant to
Ropivacaine?: A Paired, Blinded, Randomized Trial in Healthy Volunteers
Jakob H. Andersen, M.D.; Ulrik Grevstad, M.D., Ph.D.; Hanna Siegel, M.D.; Jørgen B. Dahl, M.D.,
Anesthesiology January 2017, Vol.126, 66-73. do
Perioperative Medicine Basic Science
Isoflurane Anesthesia Has Long-term Consequences on Motor and Behavioral Development in Infant
Rhesus Macaques
Kristine Coleman, Ph.D.; Nicola D. Robertson, M.S.; Gregory A. Dissen, Ph.D.; Martha D. Neuringer,
Anesthesiology January 2017, Vol.126, 74-84.
Critical Care Medicine Clinical Science
Vasopressin versus Norepinephrine in Patients with Vasoplegic Shock after Cardiac Surgery: The
VANCS Randomized Controlled Trial
Ludhmila Abrahao Hajjar, M.D., Ph.D.; Jean Louis Vincent, M.D., Ph.D.; Filomena Regina Barbosa
Anesthesiology January 2017, Vol.126, 85-93.
Pilot Study of Propofol-induced Slow Waves as a Pharmacologic Test for Brain Dysfunction after
Brain Injury
Jukka Kortelainen, M.D., Ph.D.; Eero Väyrynen, Ph.D.; Usko Huuskonen, M.D.; Jouko Laurila, M.D.,
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Anesthesiology January 2017, Vol.126, 94-103.
Extubation Failure in Brain-injured Patients: Risk Factors and Development of a Prediction Score in a
Preliminary Prospective Cohort Study
Thomas Godet, M.D., Ph.D.; Russell Chabanne, M.D.; Julien Marin, M.D.; Sophie Kauffmann, M.D.,
Anesthesiology January 2017, Vol.126, 104-114.
Activated Protein C Drives the Hyperfibrinolysis of Acute Traumatic Coagulopathy
Ross A. Davenport, Ph.D.; Maria Guerreiro, M.D.; Daniel Frith, Ph.D.; Claire Rourke, B.Sc.; Sean.
Anesthesiology January 2017, Vol.126, 115-127.
Critical Care Medicine Basic Science
Transient Receptor Potential Melastatin 2 Regulates Phagosome Maturation and Is Required for
Bacterial Clearance in Escherichia coli Sepsis
ZhanQin Zhang, M.Sc.; Ping Cui, M.Sc.; Kai Zhang, M.D.; QiXing Chen, Ph.D.; XiangMing Fang, M.D.
Anesthesiology January 2017, Vol.126, 128-139
Ivabradine Attenuates the Microcirculatory Derangements Evoked by Experimental Sepsis
Marcos L. Miranda, M.D., M.Sc.; Michelle M. Balarini, M.D., M.Sc.; Daniela S. Balthazar, B.Sc.;
Anesthesiology January 2017, Vol.126, 140-149
Pain Medicine Basic Science
Acquired Exchange Protein Directly Activated by Cyclic Adenosine Monophosphate Activity Induced
by p38 Mitogen-activated Protein Kinase in Primary Afferent Neurons Contributes to Sustaini...
Megumi Matsuda, M.D.; Kentaro Oh-hashi, Ph.D.; Isao Yokota, Ph.D., M.P.H.; Teiji Sawa, M.D., Ph.D.
Anesthesiology January 2017, Vol.126, 150-162.
Anesthesiology Reflections from the Wood Library-Museum
From “Hog Bean” to “Fowl Murder”: Liebig’s Henbane Advertising Card
Anesthesiology January 2017, Vol.126, 162.
Education Images in Anesthesiology
Images in Anesthesiology: Mirror Image: A Patient with Situs Inversus Totalis
Kaitlin J. Herald, D.O.; Daniel A. Tolpin, M.D.
Anesthesiology January 2017, Vol.126, 163. doi:10.1097/ALN.0000000000001250
Intraoperative Transesophageal Echocardiography Alters Surgical Plan for Laser Lead Extraction
Sachin Bahadur, M.B.B.S., F.R.C.A.; Tyler L. Evans, D.O.; Vijay Patel, M.D.; Mary E. Arthur, M.D.,
Anesthesiology January 2017, Vol.126, 164.
Education Clinical Concepts and Commentary
Anesthesia for Ophthalmic Artery Chemosurgery
Jacques H. Scharoun, M.D.; Jung H. Han, M.D.; Y. Pierre Gobin, M.D.
Anesthesiology Reflections from the Wood Library-Museum
Byzantine Ivory Scene of the Biblical Sleep of Adam and the Creation of Eve
Anesthesiology January 2017, Vol.126, 172.
Education Review Article
Current Status of Neuromuscular Reversal and Monitoring: Challenges and Opportunities
Sorin J. Brull, M.D., F.C.A.R.C.S.I. (Hon); Aaron F. Kopman, M.D.
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Anesthesiology January 2017, Vol.126, 173-190.
Education Mind to Mind
Mom’s Boyfriend
Thomas Quigley, M.D.
Anesthesiology January 2017, Vol.126, 191.
First Listen, Then Connect
Christo Frangopoulos, M.D.
Anesthesiology January 2017, Vol.126, 192-193.
Who Is Really the Communicator of Adverse Outcomes—And When?
Jeffrey L. Kaufman, M.D.
Anesthesiology January 2017, Vol.126, 194.
In Reply
Bradley A. Fritz, M.D., M.S.C.I.; Michael S. Avidan, M.B.B.Ch., F.C.A.S.A.
Anesthesiology January 2017, Vol.126, 194-195.
Complexities of Bleeding During Spine Surgery: It’ll Take Your (Mechanical) Breath Away
Bhiken I. Naik, M.B.B.Ch.; Edward C. Nemergut, M.D.; Marcel E. Durieux, M.D., Ph.D.
Anesthesiology January 2017, Vol.126, 195.
In Reply
Woon-Seok Kang, M.D., Ph.D.; Tae-Hoon Kim, M.D.; Seong-Hyop Kim, M.D., Ph.D.
Anesthesiology January 2017, Vol.126, 196.
Announcements
Anesthesiology January 2017, Vol.126, 197.
British Journal of Anaesthesia
January 2017; Volume 118, Issue 1
In This Issue
Br. J. Anaesth. (2017) 118 (1): i6 doi:10.1093/bja/aew429
Extract
EDITORIALS
H. C. Hemmings, Jr.
A global vision for the British Journal of Anaesthesia
Br. J. Anaesth. (2017) 118 (1): 1-2
Extract
G. L. Ludbrook
Coordinated perioperative care—a high value proposition?
Br. J. Anaesth. (2017) 118 (1): 3-5
Extract
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K. Slim
The egg-and-chicken situation in postoperative enhanced recovery programmes
Br. J. Anaesth. (2017) 118 (1): 5-6
Extract
J. R. Sneyd
Making sense of propofol sedation for endoscopy
Br. J. Anaesth. (2017) 118 (1): 6-7
Extract
M. Lamperti
Tracheal visualization during tracheostomy: the dark side of the moon or just the moon and mars
Br. J. Anaesth. (2017) 118 (1): 8-10
Extract
REVIEW ARTICLES
S. Hajibandeh,
Editor's Choice: Effect of beta-blockers on perioperative outcomes in vascular and endovascular
surgery: a systematic review and meta-analysis
Br. J. Anaesth. (2017) 118 (1): 11-21
Abstract
V. Martinez,
Editor's Choice: Non-opioid analgesics in adults after major surgery: systematic review with
network meta-analysis of randomized trials
Br. J. Anaesth. (2017) 118 (1): 22-31
Abstract
J. A. Wahr,
Medication safety in the operating room: literature and expert-based recommendations
Br. J. Anaesth. (2017) 118 (1): 32-43
Abstract
J. P. van den Berg,
Pharmacokinetic and pharmacodynamic interactions in anaesthesia. A review of current
knowledge and how it can be used to optimize anaesthetic drug administration
Br. J. Anaesth. (2017) 118 (1): 44-57
Abstract
CARDIOVASCULAR
J. Renner,
Non-invasive assessment of fluid responsiveness using CNAP™ technology is interchangeable with
invasive arterial measurements during major open abdominal surgery
Br. J. Anaesth. (2017) 118 (1): 58-67
Abstract
C. J. C. Trepte,
Electrical impedance tomography for non-invasive assessment of stroke volume variation in health
and experimental lung injury
Br. J. Anaesth. (2017) 118 (1): 68-76
Abstract
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CLINICAL PRACTICE
R. Kruisselbrink,
Ultrasound assessment of gastric volume in severely obese individuals: a validation study
Br. J. Anaesth. (2017) 118 (1): 77-82
Abstract
J. N. Darvall,
Chewing gum for the treatment of postoperative nausea and vomiting: a pilot randomized
controlled trial
Br. J. Anaesth. (2017) 118 (1): 83-89
Abstract
Safety of sedation for gastrointestinal endoscopy in a group of university-affiliated hospitals: a
prospective cohort study
Br. J. Anaesth. (2017) 118 (1): 90-99 do
Abstract
M. Swart,
Using predicted 30 day mortality to plan postoperative colorectal surgery care: a cohort study
Br. J. Anaesth. (2017) 118 (1): 100-104
Abstract
N. N. Saied,
Effect of anaesthesia type on postoperative mortality and morbidities: a matched analysis of the
NSQIP database
Br. J. Anaesth. (2017) 118 (1): 105-111
Abstract
CRITICAL CARE
N. Arulkumaran
Association between day and time of admission to critical care and acute hospital outcome for
unplanned admissions to adult general critical care units: cohort study exploring the ‘weekend
effect’
Br. J. Anaesth. (2017) 118 (1): 112-122 first published online December 7, 2016
Abstract OPEN ACCESS
M. A. Gillies,
Intensive care utilization and outcomes after high-risk surgery in Scotland: a population-based
cohort study
Br. J. Anaesth. (2017) 118 (1): 123-131
Abstract
RESPIRATION AND THE AIRWAY
B. A. McGrath,
Assessment of scoring systems to describe the position of tracheostomy tubes within the airway –
the lunar study
Br. J. Anaesth. (2017) 118 (1): 132-138
Abstract
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CORRESPONDENCE
Fu-Shan Xue,
Assessing influence of thermal softened double-lumen endobronchial tube on postoperative
airway injury and morbidity: a call for methodology clarification
Br. J. Anaesth. (2017) 118 (1): 139-140
J.-H. Bahk and
Reply
Br. J. Anaesth. (2017) 118 (1): 140
Extract
Q. Ren,
Pre-warming the double-lumen endobronchial tubes to facilitate intubation in incubator
Br. J. Anaesth. (2017) 118 (1): 140-141
Extract
J.-H. Bahk
Reply
Br. J. Anaesth. (2017) 118 (1): 141:
Extract
V. Moen,
Strong ion and weak acid analysis in severe preeclampsia
Br. J. Anaesth. (2017) 118 (1): 141
Extract
BOOK REVIEWS
A. Taylor and
Preparing to Pass the FRCA. C. Whymark
Br. J. Anaesth. (2017) 118 (1): 143
Extract
K. O. Pryor
Basic Anesthesiology Examination Review. G. W. Williams and E. S. Williams
Br. J. Anaesth. (2017) 118 (1): 143-144
Extract
Current Opinion in Anaesthesiology
February 2017; Volume 30, Issue 1
Editorial introductions
Current Opinion in Anaesthesiology. 30(1):v-vii, February 2017.
Free Access
THORACIC ANESTHESIA
Edited by Paul M. Heerdt
Anesthesia for nonintubated video-assisted thoracic surgery
Sunaga, Hiroshi; Blasberg, Justin D.; Heerdt, Paul M.
16
Current Opinion in Anaesthesiology. 30(1):1-6, February 2017.
Abstract
Hemodynamic monitoring in thoracic surgical patients
Raphael, Jacob; Regali, Lindsay A.; Thiele, Robert H.
Current Opinion in Anaesthesiology. 30(1):7-16, February 2017.
Abstract
New trends in interventional pulmonology
Selzer, Angela Roberts; Murrell, Matthew; Shostak, Eugene
Current Opinion in Anaesthesiology. 30(1):17-22, February 2017.
Abstract
Lung regeneration: steps toward clinical implementation and use
Calle, Elizabeth A.; Leiby, Katherine L.; Raredon, MichaSam B.; More
Current Opinion in Anaesthesiology. 30(1):23-29, February 2017.
Abstract
Current trends in anesthesia for esophagectomy
Durkin, Chris; Schisler, Travis; Lohser, Jens
Current Opinion in Anaesthesiology. 30(1):30-35, February 2017.
Abstract
The endothelial glycocalyx and perioperative lung injury
Brettner, Florian; von Dossow, Vera; Chappell, Daniel
Current Opinion in Anaesthesiology. 30(1):36-41, February 2017.
Abstract
Single-lung ventilation and oxidative stress: a different perspective on a common practice
Heerdt, Paul M.; Stowe, David F.
Current Opinion in Anaesthesiology. 30(1):42-49, February 2017.
Abstract
Extracorporeal lung support
Salna, Michael; Bacchetta, Matthew
Current Opinion in Anaesthesiology. 30(1):50-57, February 2017.
Abstract
CARDIOVASCULAR ANESTHESIA
Edited by Alexander Zarbock
Cardiac surgery-associated acute kidney injury: much improved, but still long ways to go
Zarbock, Alexander
Current Opinion in Anaesthesiology. 30(1):58-59, February 2017.
Epidemiology and pathophysiology of cardiac surgery-associated acute kidney injury
Fuhrman, Dana Y.; Kellum, John A.
Current Opinion in Anaesthesiology. 30(1):60-65, February 2017.
Abstract
Diagnosis of cardiac surgery-associated acute kidney injury from functional to damage biomarkers
Vandenberghe, Wim; De Loor, Jorien; Hoste, Eric A.J.
17
Current Opinion in Anaesthesiology. 30(1):66-75, February 2017.
Abstract
Prevention of cardiac surgery-associated acute kidney injury
Meersch, Melanie; Zarbock, Alexander
Current Opinion in Anaesthesiology. 30(1):76-83, February 2017.
Abstract
Does fluid management affect the occurrence of acute kidney injury?
Mårtensson, Johan; Bellomo, Rinaldo
Current Opinion in Anaesthesiology. 30(1):84-91, February 2017.
Abstract
Therapy of acute kidney injury in the perioperative setting
Romagnoli, Stefano; Ricci, Zaccaria; Ronco, Claudio
Romagnoli, Stefano; Ricci, Zaccaria; Ronco, Claudio Less
Current Opinion in Anaesthesiology. 30(1):92-99, February 2017.
Abstract
Long-term consequences of acute kidney injury in the perioperative setting
Palant, Carlos E.; Amdur, Richard L.; Chawla, Lakhmir S.
Current Opinion in Anaesthesiology. 30(1):100-104, February 2017.
Abstract
Congenital heart surgery and acute kidney injury
Webb, Tennille N.; Goldstein, Stuart L.
Webb, Tennille N.; Goldstein, Stuart L. Less
Current Opinion in Anaesthesiology. 30(1):105-112, February 2017.
Abstract
Mortality and cost of acute and chronic kidney disease after cardiac surgery
Lysak, Nicholas; Bihorac, Azra; Hobson, Charles
Current Opinion in Anaesthesiology. 30(1):113-117, February 2017.
Abstract
MORBID OBESITY AND SLEEP APNEA
Edited by Frances Chung
An update on the various practical applications of the STOP-Bang questionnaire in anesthesia,
surgery, and perioperative medicine
Nagappa, Mahesh; Wong, Jean; Singh, Mandeep; More
Current Opinion in Anaesthesiology. 30(1):118-125, February 2017.
Abstract
Preoperative evaluation and preparation of the morbidly obese patient
Böhmer, Andreas B.; Wappler, Frank
Current Opinion in Anaesthesiology. 30(1):126-132, February 2017.
Abstract
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19
Current Awareness Database Articles
If you require any of the articles in full please email: [email protected]
Influence of Anaesthesia on Mobilisation Following Hip Fracture Surgery: An
Observational Study:
Author(s): Ahmed I.; Khan M.A.; Allgar V.
Source: Journal of Orthopaedics, Trauma and Rehabilitation; Jun 2017; vol. 22 ; p. 41-47
Publication Date: Jun 2017
Publication Type(s): Journal: Article
Abstract:Background Anaesthetic technique can influence mortality and morbidity following
hip fracture surgery. However, its influence on postoperative mobilisation is not clear. In
this study, we evaluated the influence of anaesthetic technique on postoperative
mobilisation. Methods In this prospective observational study, we included all consecutive
patients who underwent surgery for hip fracture between 1 January 2012 and 31 December
2013 at our institution. Any patients who died prior to mobilisation or who could not be
followed up after surgery were excluded. Data was collected on demographics, clinical
characteristics, anaesthesia technique and surgical factors, and date and time of admission,
operation, first mobilisation and discharge. Results Of the 1040 patients included in the
analysis, 264 received general anaesthesia only (Group GA), 322 received general
anaesthesia with regional anaesthesia (Group GARA), and 454 received central neuraxial
blockade anaesthesia with or without sedation (Group CNB). There was no significant
difference in age (p = 0.56), sex (p = 0.23), number of comorbidities (p = 0.06), residential
status (p = 0.18), time to surgery (p = 0.10) and length of hospital stay (p = 0.30) between
the three groups. There was a statistically significant difference in ASA grade (p = 0.01),
implant type used (p = 0.04), grade of operating surgeon (p = 0.02) and grade of
anaesthetist during surgery (p = 0.004) among the three groups. Patients in Group GARA
had a median time-to-first mobilisation of 23.8 hours after surgery, compared to 24.1 hours
in Group GA and 24.3 hours in Group CNB. This difference was not statistically significant
after controlling for confounding factors (p = 0.45). Conclusion Our results show that
anaesthetic technique does not influence time-to-first mobilisation after hip fracture
surgery. Copyright © 2016 HK Orthopaedic Association and HK Orthopaedic College
Database: EMBASE
Intubation success rates of prehospital rapid sequence induction of anaesthesia by
physicians versus paramedics.
Author(s): Phelps, Scot
Source: European journal of emergency medicine : official journal of the European Society
for Emergency Medicine; Feb 2017; vol. 24 (no. 1); p. 76-77
Publication Date: Feb 2017
Publication Type(s): Journal Article
Database: Medline
20
Brief isoflurane anaesthesia affects differential gene expression, gene ontology and gene
networks in rat brain.
Author(s): Lowes, Damon A; Galley, Helen F; Moura, Alessandro P S; Webster, Nigel R
Source: Behavioural brain research; Jan 2017; vol. 317 ; p. 453-460
Publication Date: Jan 2017
Publication Type(s): Journal Article
Abstract:Much is still unknown about the mechanisms of effects of even brief anaesthesia
on the brain and previous studies have simply compared differential expression profiles with
and without anaesthesia. We hypothesised that network analysis, in addition to the
traditional differential gene expression and ontology analysis, would enable identification of
the effects of anaesthesia on interactions between genes. Rats (n=10 per group) were
randomised to anaesthesia with isoflurane in oxygen or oxygen only for 15min, and 6h later
brains were removed. Differential gene expression and gene ontology analysis of microarray
data was performed. Standard clustering techniques and principal component analysis with
Bayesian rules were used along with social network analysis methods, to quantitatively
model and describe the gene networks. Anaesthesia had marked effects on genes in the
brain with differential regulation of 416 probe sets by at least 2 fold. Gene ontology analysis
showed 23 genes were functionally related to the anaesthesia and of these, 12 were
involved with neurotransmitter release, transport and secretion. Gene network analysis
revealed much greater connectivity in genes from brains from anaesthetised rats compared
to controls. Other importance measures were also altered after anaesthesia; median [range]
closeness centrality (shortest path) was lower in anaesthetized animals (0.07 [0-0.30]) than
controls (0.39 [0.30-0.53], p<0.0001) and betweenness centrality was higher (53.85 [32.5670.00]% compared to 5.93 [0-30.65]%, p<0.0001). Simply studying the actions of individual
components does not fully describe dynamic and complex systems. Network analysis allows
insight into the interactions between genes after anaesthesia and suggests future targets for
investigation.
Copyright © 2016 Elsevier B.V. All rights reserved.
Database: Medline
AAGBI: Safer pre-hospital anaesthesia 2017: Association of Anaesthetists of Great Britain
and Ireland.
Author(s): Lockey, D J; Crewdson, K; Davies, G; Jenkins, B; Klein, J; Laird, C; Mahoney, P F;
Nolan, J; Pountney, A; Shinde, S; Tighe, S; Russell, M Q; Price, J; Wright, C
Source: Anaesthesia; Jan 2017
Publication Date: Jan 2017
Publication Type(s): Letter
Abstract:Pre-hospital emergency anaesthesia with oral tracheal intubation is the technique
of choice for trauma patients who cannot maintain their airway or achieve adequate
ventilation. It should be carried out as soon as safely possible, and performed to the same
standards as in-hospital emergency anaesthesia. It should only be conducted within
organisations with comprehensive clinical governance arrangements. Techniques should be
straightforward, reproducible, as simple as possible and supported by the use of checklists.
Monitoring and equipment should meet in-hospital anaesthesia standards. Practitioners
need to be competent in the provision of in-hospital emergency anaesthesia and have
supervised pre-hospital experience before carrying out pre-hospital emergency anaesthesia.
Training programmes allowing the safe delivery of pre-hospital emergency anaesthesia by
non-physicians do not currently exist in the UK. Where pre-hospital emergency anaesthesia
21
skills are not available, oxygenation and ventilation should be maintained with the use of
second-generation supraglottic airways in patients without airway reflexes, or basic airway
manoeuvres and basic airway adjuncts in patients with intact airway reflexes. © 2017 The
Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of
Anaesthetists of Great Britain and Ireland.
Database: Medline
Duration of low-dose spinal anaesthesia for hip fracture surgery.
Author(s): White, S
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 127-128
Publication Date: Jan 2017
Publication Type(s): Letter
Database: Medline
Implications of the 2015 AAGBI recommendations for standards of monitoring during
anaesthesia and recovery.
Author(s): Checketts, M R; Jenkins, B; Pandit, J J
Source: Anaesthesia; Jan 2017; vol. 72
Publication Date: Jan 2017
Publication Type(s): Editorial
Database: Medline
What Anaesthesia is doing to combat scientific misconduct and investigate data
fabrication and falsification.
Author(s): Klein, A A
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 3-4
Publication Date: Jan 2017
Publication Type(s): Editorial
Database: Medline
An introduction to predictive modelling of drug concentration in anaesthesia monitors.
Author(s): DeCou, J; Johnson, K
Source: Anaesthesia; Jan 2017; vol. 72
Publication Date: Jan 2017
Publication Type(s): Journal Article Review
Abstract:A significant amount of anaesthetists' work involves the prediction of drug effects
and interactions to produce a smooth general anaesthetic that minimises drug side effects
and promotes rapid emergence. Successfully managing this process requires a basic
understanding of drug effects, experience and inevitably some guesswork, since it is difficult
(and in some cases impossible) to anticipate all relevant patient and surgical factors.
Although data are generally available to allow calculation of plasma drug and effect site
concentrations, this is often difficult to apply in complex clinical contexts, particularly when
multiple drug types are used. In recent years, manufacturers have developed and
incorporated into anaesthetic workstations technologies that use drug pharmacodynamic
and pharmacokinetic data to predict drug effects and interactions. Such systems can predict
the duration and effects of drugs during anaesthesia and assist the anaesthetist to
understand complex drug interactions. With this information available, different drug types,
doses and combinations may be tailored in a scientific way to maximise useful effects whilst
22
minimising overdose and side-effects, particularly in high-risk patients. Examples are used to
illustrate how such systems can be used in practice, and how drug effects and interactions
can be simulated to "rehearse" an anaesthetic before any drugs are actually administered.
At present only a small number of anaesthetic workstations use this technology, and as yet
they are not able to manage all drugs used in anaesthetic practice. However, such systems
have the potential to help anaesthetists manage the complexity of their work, and to
provide information on predicted drug effects in a way that is useful and relevant to both
experienced anaesthetists and trainees. © 2017 The Association of Anaesthetists of Great
Britain and Ireland.
Database: Medline
Performance of adjustable pressure-limiting (APL) valves in two different modern
anaesthesia machines.
Author(s): Thomas, J; Weiss, M; Schmidt, A R; Buehler, P K
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 28-34
Publication Date: Jan 2017
Publication Type(s): Journal Article
Abstract:The ability to gently ventilate a patient's lungs using a self-inflating bag requires a
properly working adjustable pressure-limiting (APL) valve. We compared the performance of
the APL valves of the GE Aisys CS2 and the Draeger Fabius anaesthetic machines during
closure and opening from 1-20 and from 20-1 cmH2 O, using standardised experimental
baby and adolescent patient lung models. Airway pressures and inspiratory tidal volumes
were measured using an ASL-5000 test lung and a GE Aisys CS2 near-patient spirometry
sensors. In both lung models, the GE Aisys CS2 APL valves demonstrated non-linear
behaviours for airway pressures and for inspiratory tidal volumes, with a sharp increase at
set APL pressure levels of 8-10 cmH2 O. With further closure of the GE Aisys CS2 APL valves
up to 20 cmH2 O, inspiratory tidal volumes decreased to ~50% of the highest values
measured. Airway pressures in the Draeger Fabius APL valves demonstrated a near linear
increase and decrease. Airway pressure values measured in the Draeger Fabius were never
higher than those set by the APL valves, whereas in the GE Aisys CS2 , they considerably
exceeded set pressures (by up to 27 cmH2 O). We conclude that the performance of the GE
Aisys CS2 APL valve does not allow safe bag-assisted ventilation of a patient's lungs.
©
2016 The Association of Anaesthetists of Great Britain and Ireland.
Database: Medline
GE Healthcare response: performance of adjustable pressure limiting (APL) valves in two
different modern anaesthesia machines.
Author(s): McCormick, T
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 34-35
Publication Date: Jan 2017
Publication Type(s): Journal Article
Database: Medline
Clinical experience with desflurane for paediatric anaesthesia outside the operating room.
Author(s): Alonso, M; Builes, L; Morán, P; Ortega, A; Fernández, E; Reinoso-Barbero, F
Source: Revista espanola de anestesiologia y reanimacion; Jan 2017; vol. 64 (no. 1); p. 6-12
Publication Date: Jan 2017
23
Publication Type(s): Journal Article
Abstract:Desflurane has been used in paediatric patients for several surgical indications.
This article analyses the efficacy and safety of desflurane for diagnostic-therapeutic
procedures in remote areas far from operating room in a group of selected patients with no
known associated respiratory disease. A retrospective analysis was performed on 2,072
general anaesthesia procedures stored in a computer database, in which desflurane was
used in a Paediatric Pain Unit during the years 2013 and 2014. An analysis was also
performed using the patient demographics, type of procedure, anaesthetic technique, type
of airway management, patient cooperation, and incidence of anaesthetic complications.
The study included 876 patients, with a mean age of 8.8 years. The main procedures were
bone marrow aspirates (23%), lumbar punctures (20%), panendoscopies (15%), and
colonoscopies (5%). Induction was intravenous with propofol (26%) or inhalation with
sevoflurane in the remaining 74%. Maintenance consisted of remifentanil and desflurane at
mean end tidal concentrations of 6.2±2.1%. The airway was managed through a nasal
cannula or face mask in spontaneous ventilation. The effectiveness was 98%, and the
incidence of side effects was 15%, which included agitation (6%), headache (4%), nauseavomiting (3%), and laryngospasm (2%).
The maintenance with desflurane (at
concentrations close to the hypnotic-MAC in spontaneous ventilation) was effective, with a
rapid recovery, and with a low incidence of adverse effects. Copyright © 2016 Sociedad
Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier
España, S.L.U. All rights reserved.
Database: Medline
Regional or general anaesthesia for carotid endarterectomy.
Author(s): Stoneham, Mark D
Source: European journal of anaesthesiology; Jan 2017; vol. 34 (no. 1); p. 45-46
Publication Date: Jan 2017
Publication Type(s): Journal Article
Database: Medline
Reply to: regional or general anaesthesia for carotid endarterectomy.
Author(s): Unic-Stojanovic, Dragana
Source: European journal of anaesthesiology; Jan 2017; vol. 34 (no. 1); p. 46-47
Publication Date: Jan 2017
Publication Type(s): Journal Article
Database: Medline
Laboratory evaluation of a novel anaesthesia delivery device.
Author(s): Paul, A; Clark, J N; Salama, I E; Jenkins, B J; Goodwin, N; Wilkes, A R; Mahoney, P
F; Hall, J E
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 63-72
Publication Date: Jan 2017
Publication Type(s): Journal Article
Abstract:Here, we describe proof of concept of a novel method for delivering volatile
anaesthetics, where the liquid anaesthetic (sevoflurane or isoflurane) is formulated into an
emulsion that is contained in a compact, lightweight device through which carrier gas flows.
Release of anaesthetic is achieved by stirring of the formulation, allowing controlled and
24
responsive release of anaesthetic at a variety of fixed flow rates between 0.5 l.min-1 and 5
l.min-1 , with ventilated, non-ventilated and draw-over breathing systems. Anaesthetic
release was evaluated using target anaesthetic concentrations ranging from 0.5% v/v to 8%
v/v to mimic those typically required for induction and maintenance of anaesthesia, and
lower concentrations suitable for sedation. Under all conditions, output could be
maintained within 0.1% v/v of the intended setting, and the device could deliver a
controlled level of anaesthetic for at least 60 min, with compensation for different ambient
temperatures (10-30 °C) and carrier gas flow rates. This device offers a simple, inexpensive
method of delivering safe concentrations of volatile anaesthetics for a wide range of
applications.
© 2016 The Association of Anaesthetists of Great Britain and Ireland.
Database: Medline
A global vision for the British Journal of Anaesthesia.
Author(s): Hemmings, H C
Source: British journal of anaesthesia; Jan 2017; vol. 118 (no. 1); p. 1-2
Publication Date: Jan 2017
Publication Type(s): Editorial
Database: Medline
Abandoning first generation supraglottic airway devices in paediatric anaesthesia.
Author(s): Montague, J P; Halloran, C J
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 125-126
Publication Date: Jan 2017
Publication Type(s): Letter
Database: Medline
Local anaesthesia during endometrial ablation: a systematic review.
Author(s): Reinders, Ima; Geomini, Pmaj; Timmermans, A; de Lange, M E; Bongers, M Y
Source: BJOG : an international journal of obstetrics and gynaecology; Jan 2017; vol. 124
(no. 2); p. 190-199
Publication Date: Jan 2017
Publication Type(s): Journal Article Review
Abstract:Endometrial ablation has been widely implemented in the outpatient setting.
Many different protocols of local anaesthesia during endometrial ablation are used and
described. However, prospective studies to assess and evaluate these protocols appear to
be scarce.
To evaluate systematically the different local anaesthesia techniques in
relation to pain perception during endometrial ablation. Medline and Embase were
systematically searched and reference lists of selected articles were checked for missed
publications.
All types of studies reporting the performance of endometrial ablation
under local anaesthesia in ten or more women were included. Data about the procedure,
the protocol of local anaesthesia, the acceptability and side-effects were extracted.
Twenty-five studies, involving 2013 women, were included. Applied anaesthesia techniques
included intracervical, paracervical and intrauterine anaesthesia or a combination of these
techniques. Women who received a combination of either intra- or paracervical anaesthesia
and intrauterine injections reported significantly lower pain scores than those who received
no local anaesthesia or intra- or paracervical anaesthesia alone (P = 0.000), but the quality
of evidence is low. The acceptability of endometrial ablation under local anaesthesia was
25
high (77-94%). Endometrial ablation under local anaesthesia is a safe, feasible and
acceptable procedure. The combination of either intra- or paracervical anaesthesia with
intrauterine injections seems to be promising, but has to be investigated more thoroughly.
Systematic review of local anaesthesia techniques during endometrial ablation. © 2016
Royal College of Obstetricians and Gynaecologists.
Database: Medline
Training responsibly to improve global surgical and anaesthesia capacity through
institutional health partnerships: a case study.
Author(s): Macpherson, Laura; Collins, Maggie
Source: Tropical doctor; Jan 2017; vol. 47 (no. 1); p. 73-77
Publication Date: Jan 2017
Publication Type(s): Journal Article Review
Abstract:Urgent investment in human resources for surgical and anaesthesia care is needed
globally. Responsible training and education is required to ensure healthcare providers are
confident and skilled in the delivery of this care in both the rural and the urban setting. The
Tropical Health and Education Trust (THET), a UK-based specialist global health organisation,
is working with health training institutions, health professionals, Ministries of Health and
Health Partnerships or 'links' between healthcare institutions in the UK and low- or middleincome country (LMIC) counterparts. These institutions may be hospitals, professional
associations or universities whose primary focus is delivery of health services or the training
and education of health workers. Since 2011, THET has been delivering the Health
Partnership Scheme (HPS), a UK government-funded programme that provides grants and
guidance to health partnerships and promotes the voluntary engagement of UK health
professionals overseas. To date, the £30 million Scheme has supported peer-to-peer
collaborations involving more than 200 UK and overseas hospitals, universities and
professional associations across 25 countries in Africa, Asia and the Middle East.
In this
paper, we focus on four partnerships that are undertaking training initiatives focused on
building capacity for surgery and anaesthesia. In order to do so, we discuss their role as a
responsible and effective approach to harnessing the expertise available in the UK in order
to increase surgical and anaesthesia capacity in LMICs. Specifically, how well they: (1)
respond to locally identified needs; (2) are appropriate to the local context and are of high
quality; and (3) have an overarching goal of making a sustainable contribution to the
development of the health workforce through education and training. The HPS has now
supported 24 training initiatives focused on building capacity for surgery and anaesthesia in
16 countries across sub-Saharan Africa, Asia and the Middle East. THET argues that these
initiatives are both responsible and effective. The four partnerships featured in this paper
have demonstrated not only their effectiveness in increasing health worker skills and
knowledge, but have done so across a variety of surgical and anaesthesia disciplines and
within different contexts. This wide reach and applicability of partnership initiatives adds
even greater value to their use as responsible training interventions. One challenge that has
faced these partnerships has been the capture of improvements to patient outcomes as a
result of improved practice. To counteract the problems of data collection, partnerships are
collecting anecdotal evidence of improvements at the patient outcome level.
The
interventions supported by THET have been able to demonstrate success in improving
health worker skills and knowledge, and albeit to a lesser extent, in improving patient
outcomes. The implementing partners are achieving these successes by training responsibly:
26
responding to locally identified need, implementing projects that are appropriate to the
local context and are of high quality, and establishing mechanisms that ensure selfsufficiency of the health worker training and education that is delivered. Greater investment
in responsible training initiatives such as these are required to address the significant lack of
access to appropriate and safe surgical and anaesthesia interventions when needed and the
growing burden of disease. © The Author(s) 2016.
Database: Medline
The role and limitations of EEG-based depth of anaesthesia monitoring in theatres and
intensive care.
Author(s): Hajat, Z; Ahmad, N; Andrzejowski, J
Source: Anaesthesia; Jan 2017; vol. 72
Publication Date: Jan 2017
Publication Type(s): Journal Article Review
Abstract:In this article we will look at some of the principles in processed EEG monitoring as
applied to bispectral index (BIS). We outline why BIS should be regarded as a 'memory'
monitor which in most circumstances reflects the depth of sedation or anaesthesia in
particular patients. Its limitation in paralysed and non-paralysed patients must be
understood in order for this monitor to be used safely. Finally, its emerging use in critical
care will be explored.
© 2017 The Association of Anaesthetists of Great Britain and
Ireland.
Database: Medline
Current practice in regional anaesthesia in South America: An online survey.
Author(s): Corvetto, M A; Carmona, J; Vásquez, M I; Salgueiro, C; Crostón, J; Sosa, R; Folle,
V; Altermatt, F R
Source: Revista espanola de anestesiologia y reanimacion; Jan 2017; vol. 64 (no. 1); p. 27-31
Publication Date: Jan 2017
Publication Type(s): Journal Article
Abstract:A survey was conducted in order to obtain a profile of the practice of regional
anesthesia in South America, and determine the limitations of its use.
After
institutional ethics committee approval, a link to an online questionnaire was sent by e-mail
to anaesthesiologists in Argentina, Bolivia, Chile, Colombia, Panamá, Paraguay, Perú, and
Uruguay. The questionnaire was processed anonymously. A total of 1,260 completed
questionnaires were received. The results showed that 97.6% of the anaesthesiologists that
responded used regional anaesthesia in clinical practice, 66.9% performed peripheral nerve
block (PNB) regularly, 21.6% used continuous PNB techniques, and 4.6% used stimulating
catheters. The primary source of training was residency programs. As regards PNB, the most
common performed were interscalene (52.3%), axillary (45.1%), femoral (43.2%), and ankle
block (43%). As regards the localisation technique employed, 16% used paraesthesia, 44.2%
used a peripheral nerve stimulator, and 18.1% ultrasound guidance.
Regional
anaesthesia and PNB are commonly used among South American anaesthesiologists.
Considering that each country has its own profile for use, this profile should guide training in
clinical practice, especially in residency programs. Copyright © 2016 Sociedad Española de
Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U.
All rights reserved.
Database: Medline
27
Ultra-low dose spinal anaesthesia for hip fracture surgery.
Author(s): Godai, K
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 126
Publication Date: Jan 2017
Publication Type(s): Letter
Database: Medline
Response surface modelling of the pharmacodynamic interaction between propofol and
remifentanil in patients undergoing anaesthesia.
Author(s): Choe, SangMin; Choi, Byung-Moon; Lee, Yong-Hun; Lee, Soo-Han; Lee, EunKyung; Kim, Ki-Seong; Noh, Gyu-Jeong
Source: Clinical and experimental pharmacology & physiology; Jan 2017; vol. 44 (no. 1); p.
30-40
Publication Date: Jan 2017
Publication Type(s): Journal Article
Abstract:This study describes the pharmacodynamic interaction between propofol and
remifentanil. Sixty patients who were scheduled for elective surgery under general
anaesthesia (30 males/30 females) were enrolled. Patients were randomly allocated to
receive one of 15 combinations of drug levels. Baseline electroencephalograms (EEGs) were
recorded for 5 minutes prior to administering the drugs. Patients received a targetcontrolled infusion at one of four predefined doses of propofol (high, 3 μg/mL; medium,
1.5 μg/mL; low, 0.5 μg/mL; or no drug) and of remifentanil (high, 6 or 8 ng/mL; medium,
4 ng/mL; low, 2 ng/mL; or no drug). The occurrence of muscle rigidity, apnoea, and loss of
consciousness (LOC) was monitored, and EEGs were recorded during the drug
administration phase. Electroencephalographic approximate entropy (ApEn) and temporal
linear mode complexity (TLMC) parameters at baseline and under steady state conditions
were calculated off-line. Response surfaces were developed to map the interaction between
propofol and remifentanil to the probability of occurrence for quantal responses (muscle
rigidity, apnoea, LOC) and ApEn and TLMC measurements. Model parameters were
estimated using non-linear mixed effects modelling. The response surface revealed infraadditive and synergistic effects for muscle rigidity and apnoea, respectively. The effects of
the combined drugs on LOC and EEG parameters (eg, ApEn and TLMC) were additive. The
C50 estimates of remifentanil (ng/mL) and propofol (μg/mL) were 9.11 and 130 000 for
muscle rigidity, 8.99 and 6.26 for apnoea, 13.9 and 3.04 for LOC, 23.4 and 10.4 for ApEn, and
14.8 and 6.51 for TLMC, respectively. The probability of occurrence for muscle rigidity
declined when propofol was combined with remifentanil.
© 2016 John Wiley & Sons
Australia, Ltd.
Database: Medline
AAGBI: Consent for anaesthesia 2017: Association of Anaesthetists of Great Britain and
Ireland.
Author(s): Yentis, S M; Hartle, A J; Barker, I R; Barker, P; Bogod, D G; Clutton-Brock, T H;
Ruck Keene, A; Leifer, S; Naughton, A; Plunkett, E
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 93-105
Publication Date: Jan 2017
Publication Type(s): Letter
28
Abstract:Previous guidelines on consent for anaesthesia were issued by the Association of
Anaesthetists of Great Britain and Ireland in 1999 and revised in 2006. The following
guidelines have been produced in response to the changing ethical and legal background
against which anaesthetists, and also intensivists and pain specialists, currently work, while
retaining the key principles of respect for patients' autonomy and the need to provide
adequate information. The main points of difference between the relevant legal frameworks
in England and Wales and Scotland, Northern Ireland and the Republic of Ireland are also
highlighted.
© 2016 The Authors. Anaesthesia published by John Wiley & Sons Ltd on
behalf of Association of Anaesthetists of Great Britain and Ireland.
Database: Medline
Oxygen supplementation before induction of general anaesthesia in horses.
Author(s): van Oostrom, H; Schaap, M W H; van Loon, J P A M
Source: Equine veterinary journal; Jan 2017; vol. 49 (no. 1); p. 130-132
Publication Date: Jan 2017
Publication Type(s): Journal Article
Abstract:Hypoventilation or apnoea, caused by the induction of general anaesthesia, may
cause hypoxaemia. Preoxygenation may lengthen the period before this happens. No
scientific studies are published on preoxygenation in equine anaesthesia.
To
determine whether supplementation of oxygen at a flow rate of 15 l/min for 3 min via a
nasal cannula before induction of general anaesthesia is effective in elevating the arterial
partial pressure of oxygen (PaO2 ) directly after induction. Randomised, prospective clinical
trial.
A total of 18 American Society of Anesthesiologists physical status 1 or 2 adult
horses undergoing elective anaesthesia were randomly allocated to one of 2 groups. The
first group (control) received no oxygen supplementation before induction of general
anaesthesia, whereas the second group (oxygen) did. All horses were anaesthetised with
intravenous detomidine, butorphanol, ketamine, midazolam and isoflurane. Directly after
induction (T = 0) and 30 min later (T = 30) an arterial blood sample was taken for blood gas
analysis. At T = 30 an estimate of intrapulmonary shunt fraction (Qs/Qt) was calculated. At T
= 0 arterial partial pressure of oxygen (PaO2 ) was significantly higher in the oxygen group
compared with the control group (11.0 ± 2.6 kPa vs. 7.4 ± 1.6 kPa; mean ± s.d., P = 0.005)
and at T = 30 differences were not statistically significant. Partial pressure of carbon dioxide
(PaCO2 ) and Qs/Qt did not differ between groups.
Supplementing oxygen by a nasal
cannula before induction of general anaesthesia in horses is feasible and does effectively
elevate the PaO2 immediately after induction. Future research is needed to determine
whether supplementation of oxygen before induction of general anaesthesia in horses will
affect outcomes. © 2015 EVJ Ltd.
Database: Medline
Effect of anaesthesia type on postoperative mortality and morbidities: a matched analysis
of the NSQIP database.
Author(s): Saied, N N; Helwani, M A; Weavind, L M; Shi, Y; Shotwell, M S; Pandharipande, P
P
Source: British journal of anaesthesia; Jan 2017; vol. 118 (no. 1); p. 105-111
Publication Date: Jan 2017
Publication Type(s): Journal Article
29
Abstract:The anaesthetic technique may influence clinical outcomes, but inherent
confounding and small effect sizes makes this challenging to study. We hypothesized that
regional anaesthesia (RA) is associated with higher survival and fewer postoperative organ
dysfunctions when compared with general anaesthesia (GA).
We matched surgical
procedures and type of anaesthesia using the US National Surgical Quality Improvement
database, in which 264,421 received GA and 64,119 received RA. Procedures were matched
according to Current Procedural Terminology (CPT) and ASA physical status classification.
Our primary outcome was 30-day postoperative mortality and secondary outcomes were
hospital length of stay, and postoperative organ system dysfunction. After matching,
multiple regression analysis was used to examine associations between anaesthetic type
and outcomes, adjusting for covariates. After matching and adjusting for covariates, type of
anaesthesia did not significantly impact 30-day mortality. RA was significantly associated
with increased likelihood of early discharge (HR 1.09; P< 0.001), 47% lower odds of
intraoperative complications, and 24% lower odds of respiratory complications. RA was also
associated with 16% lower odds of developing deep vein thrombosis and 15% lower odds of
developing any one postoperative complication (OR 0.85; P < 0.001). There was no evidence
of an effect of anaesthesia technique on postoperative MI, stroke, renal complications,
pulmonary embolism or peripheral nerve injury.
After adjusting for clinical and patient
characteristic confounders, RA was associated with significantly lower odds of several
postoperative complications, decreased hospital length of stay, but not mortality when
compared with GA. © The Author 2016. Published by Oxford University Press on behalf of
the British Journal of Anaesthesia. All rights reserved. For Permissions, please email:
[email protected].
Database: Medline
Correction to: The 'go-between' study: a simulation study comparing the 'Traffic Lights'
and 'SBAR' tools as a means of communication between anaesthetic staff (Anaesthesia,
(2016), 71, 7, (764-772), 10.1111/anae.13464)
Author(s): anonymous
Source: Anaesthesia; Jan 2017; vol. 72 (no. 1); p. 134
Publication Date: Jan 2017
Publication Type(s): Journal: Erratum
Abstract:Following a letter from Dr Wingfield published in this edition of the journal, the
authors of MacDougall-Davis et al. [1] would like to correct an error of transposition. In
Table 1, the talk times and their p values have been transposed with the exception of at the
top of the table ('all messages(') where the times, but not the p value were transposed. The
corrected Table 1 is below. The discussion of the (slightly surprising) finding that the Traffic
Light system led go-betweens to walk down the corridor faster is therefore wrong and the
following sentences require correction: "The Traffic Lights tool also significantly reduced
message delivery time by reducing the 'walk time'" This should read: "The Traffic Lights tool
also significantly reduced message delivery time by reducing the 'talk time'" This sentence
should be deleted: "Of interest, the time the go-between took to walk to deliver the
message was affected by the urgency of the message, but use of the Traffic Lights tool
significantly reduced this time, particularly for emergency messages" Should be replaced by:
"The Traffic Lights tool led to the time taken to articulate all types of message being reduced
by > 20 s." Reference 1. MacDougall-Davis SR, Kettley L, Cook TM. The 'go-between' study: a
simulation study comparing the 'Traffic Lights' and 'SBAR' tools as a means of
30
communication between anaesthetic staff. Anaesthesia 2016; 71: 764-72. Table 1
Concordance of urgency between message recipient assessment and Traffic Light category,
rating of clarity of message, accuracy of information transfer and times taken. Values are
number or median (IQR [range]).(Table presented.). Copyright © 2016 The Association of
Anaesthetists of Great Britain and Ireland.
Database: EMBASE
Care of the eye during anaesthesia and intensive care
Author(s): O'Driscoll A.; White E.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 47-51
Publication Date: Jan 2017
Publication Type(s): Journal: Review
Abstract:Perioperative eye injuries and blindness are rare but important complications of
anaesthesia. The three causes of postoperative blindness are ischaemic optic neuropathy,
central retinal artery thrombosis (these can exist in tandem and have been described as
ischaemic oculopathies) and cortical blindness. This review aims to improve anaesthetists'
knowledge of orbital anatomy, ocular physiology and the mechanisms of perioperative eye
injuries to help reduce their occurrence. Copyright © 2016 Elsevier Ltd
Database: EMBASE
Anaesthesia for paediatric eye surgery
Author(s): Davies I.D.M.; Sale S.M.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 37-40
Publication Date: Jan 2017
Publication Type(s): Journal: Review
Abstract:Local anaesthesia is often the technique of choice for ophthalmic procedures
performed on adults; however, general anaesthesia is usually required for procedures on
children. The majority of paediatric patients are fit and healthy but there is a minority in
whom the presenting eye complaint is related to a congenital disorder, which may have
significant bearing on the conduct of anaesthesia. Management of the airway and
presentation of a quiescent eye for surgery are key considerations, while control of the
oculocardiac reflex and intraocular pressure (IOP) are important both intraoperatively and
postoperatively. IOP is affected by almost all aspects of general anaesthesia and should be
considered when choosing an anaesthetic technique. Ocular surgery is emetogenic and
without prophylaxis is associated with a high incidence of postoperative nausea and
vomiting which should be addressed to prevent problematic increase in intraocular
pressure. Most procedures are associated with mild to moderate postoperative pain and
can usually be managed with simple analgesia. Pain, but also the use of opioid analgesia, is a
risk factor for postoperative nausea and vomiting. Examination under anaesthesia,
intraocular surgery, correction of squint and emergency ophthalmic surgery each presents
its own challenge and all are discussed. Copyright © 2016 Elsevier Ltd
Database: EMBASE
Local anaesthesia for ocular surgery
Author(s): Rodgers H.; Craven R.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 41-43
Publication Date: Jan 2017
31
Publication Type(s): Journal: Review
Abstract:Local anaesthesia is the technique of choice for a large number of ophthalmic
procedures, including cataract surgery. For some procedures topical anaesthesia is
sufficient; for more complex procedures a local anaesthetic block will be needed. Sharp
needle techniques previously favoured, whilst still useful, have become less common than
the cannula-based sub-Tenon's block. This provides favourable operating conditions with a
lower risk of complications. Patients should be appropriately counselled regarding local
anaesthesia early in their perioperative journey; combined with suitable preoperative
assessment this provides high levels of patient satisfaction and limits interruptions to their
usual routine. Copyright © 2016
Database: EMBASE
General anaesthesia for ophthalmic surgery
Author(s): Pritchard N.C.B.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 33-36
Publication Date: Jan 2017
Publication Type(s): Journal: Review
Abstract:Local anaesthesia for eye surgery is increasingly popular, but there will always be a
need for general anaesthesia. Patients may refuse local anaesthesia, may be unable to keep
still or lie flat for the duration of surgery or lack the mental facility to cooperate whilst
awake. Young children and those with allergy to local anaesthetic also need general
anaesthesia. Careful patient preparation is important before surgery. Glycaemic control in
patients with diabetes, adjustments to warfarin or aspirin dosing, thromboembolic
prophylaxis and preoperative fasting need to be considered. Eye surgery alone is rarely a
true emergency, and surgery can usually wait until the patient's stomach is empty. Eye
pathology requiring surgery is a feature of many medical conditions and syndromes. Many
patients are elderly with ischaemic heart disease, hypertension, chronic obstructive
pulmonary disease and renal impairment, which must be assessed before general
anaesthesia. Systemic effects of ophthalmic medications, such as hypokalaemia caused by
acetazolamide should be considered. A wide range of general anaesthetic techniques are
suitable for eye surgery, but certain key points are relevant to specific operations. These
include the oculo-cardiac reflex in strabismus and retinal surgery, the use of intraocular gas
bubbles in vitreo-retinal operations, controlled hypotension in lacrimal, orbital and other
oculoplastic procedures, and the high incidence of nausea after strabismus surgery. Total
intravenous anaesthesia (TIVA) fulfils many of the requirements for the ideal anaesthetic
technique for ophthalmic surgery. Blood pressure, heart rate and intraocular pressure are
lowered. It is rapidly titratable and recovery is fast. Postoperative nausea is reduced and
TIVA works well in patients with renal and hepatic disease. Remifentanil infusion allows
nitrous oxide to be avoided and top-up doses of muscle relaxants to be minimized during
ventilation. For most ophthalmic surgery, postoperative pain is mild and non-steroidal antiinflammatory drugs work well. Intraoperative sub-Tenon's local anaesthetic is useful.
Copyright © 2016
Database: EMBASE
Ocular anatomy and physiology relevant to anaesthesia
Author(s): Presland A.; Price J.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 27-32
32
Publication Date: Jan 2017
Publication Type(s): Journal: Review
Abstract:The orbit contains many delicate and vulnerable structures, but with a solid
knowledge of the anatomy one can minimize the chance of complications and better
understand how regional blocks work. This article discusses anatomy of the orbit and eye,
and includes rudimentary ocular physiology. Copyright © 2016 Elsevier Ltd
Database: EMBASE
Pathophysiology of respiratory disease and its significance to anaesthesia
Author(s): Kimber Craig S.; Fang L.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 10-15
Publication Date: Jan 2017
Publication Type(s): Journal: Review
Abstract:Significant changes occur in the respiratory physiology of healthy patients during
anaesthesia. In patients with underlying respiratory pathology, these changes in respiratory
physiology may lead to clinical problems during the conduct of anaesthesia and the
perioperative period. An understanding of the disease processes that can affect the lungs
and pleura allows the anaesthetist to account for the potential complications of these
conditions and manage the anaesthetic accordingly. Copyright © 2016 Elsevier Ltd
Database: EMBASE
Anaesthesia in the elderly
Author(s): Chambers D.J.; Allan M.W.B.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 22-26
Publication Date: Jan 2017
Publication Type(s): Journal: Review
Abstract:Older people are undergoing increasingly complex surgery with much greater
mortality and morbidity than the younger adult population. In this article, we discuss the
physiological changes that take place in the older patient, and how these may affect
anaesthetic technique. Perioperative risk in the elderly is discussed, with focus on
emergency surgery and frailty. Copyright © 2016
Database: EMBASE
Eye signs in anaesthesia and intensive care medicine
Author(s): Bajekal R.; Bari F.
Source: Anaesthesia and Intensive Care Medicine; Jan 2017; vol. 18 (no. 1); p. 44-46
Publication Date: Jan 2017
Publication Type(s): Journal: Review
Abstract:Eye signs are of limited value in assessing the level of sedation or general
anaesthesia. Horner's syndrome is an important complication of excessively high neuraxial
block. Eye opening is part of the Glasgow Coma Scale, and pupil size and reaction have
important implications in the intensive care setting. Copyright © 2016 Elsevier Ltd
Database: EMBASE
33
Exercise: Systematic Reviews
There are 7 key steps that need to be taken when carrying out a Systematic Review. Can you
put them in order?
A. Quality assessment
B. Study selection
C. Synthesis
D. Data extraction
E. Define the question
F. Literature search
G. Writing up
For assistance with carrying out a systematic review search or a literature search,
please email [email protected].
34
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