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It's not easy being green: the continued lack of sustainable anaesthetic options Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Kaitlyn Kulesus, Casey Windrix, Huy Nhan
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Comparing performance of the McGrath™ videolaryngoscope with direct laryngoscopy for rapid sequence intubation Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Fu‐Shan Xue, Dan‐Feng Wang, Xiao‐Chun Zheng
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The science of climate change and the effect of anaesthetic gas emissions. Useful metrics for ethical decision making Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Alain Kalmar, An Teunkens, Steffen Rex
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Medication errors contributing to obstetric cardiac arrest in NAP7 Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Noha Tageldin, Kailash Bhatia
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Still a ‘boys’ club': a qualitative analysis of how gender affects a career in anaesthesia in Australia and Aotearoa New Zealand Anaesthesia (IF 10.7) Pub Date : 2024-04-17 J. C. Carter, N. Purcell, C. H. Stewart, G. C. Pearce, M. Balkin, K. J. Allen
SummaryGender inequity remains an issue in anaesthesia despite increasing numbers of women training and achieving fellowship in the speciality. Women are under‐represented in all areas of anaesthetic research, academia and leadership. The Gender Equity Subcommittee of the Australian and New Zealand College of Anaesthetists recently conducted a survey asking “Does gender still matter in the pursuit
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Comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Xiaocou Wang, Jing Qian, Dongzi Liu
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Associations between postoperative anaemia and unplanned readmission to hospital after major surgery: a retrospective cohort study† Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Timothy Makar, Margaret Hezkial, Mayank Vasudeva, Dominic Walpole, John Xie, Chris Zi‐Fan Zhao, Bobby Ou Yang, Saranya Ramesh, Tom Larsen, Stephane Heritier, Toby Richards, Lachlan F. Miles
SummaryBackgroundAnaemia following major surgery may be associated with unplanned readmission to hospital. However, the severity‐response relationship between the degree of anaemia at discharge and the risk of unplanned readmission is poorly defined. We aimed to describe the severity‐response relationship between haemoglobin concentration at the time of discharge and the risk of unplanned readmission
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Optimising peri‐operative anaphylaxis management: end‐tidal carbon dioxide monitoring and adrenaline titration Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Hsin‐Yu Yang, Pei‐Yi Hung, Ming‐Hui Hung
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Artificial intelligence in obstetric anaesthesia: an unlikely player? Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Cian Hurley, Rosemarie Kearsley
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On the ethics of removing Entonox® from labour ward: beyond carbon dioxide equivalents and seeking justice for patients and the planet Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Sarah Hudson, Nadia Muspratt‐Tucker, Søren Kudsk‐Iversen
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Efficiency of CONTRAfluran™ in reducing sevoflurane pollution from maintenance anaesthesia in minimal flow end‐tidal control mode for laparoscopic surgery Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Harold Mulier, Michel M. R. F Struys, Hugo Vereecke, Steffen Rex, An Teunkens, Alain F. Kalmar
SummaryBackgroundRecommendations exist that aim to mitigate the substantial ecological impact of anaesthesia. One option is to use anaesthetic gas capturing technology at anaesthesia workstation exhausts to harvest and recycle volatile agents. However, the efficiency of such technology is mainly unverified in vivo.MethodsThe efficiency of CONTRAfluran™ in capturing sevoflurane from an anaesthesia workstation
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Reframing the gender equity discussion in anaesthesiology: adopting best practices to promote physician retention and belonging Anaesthesia (IF 10.7) Pub Date : 2024-04-06 Julie K. Silver, Lauren D. Feld, Varina R. Clark Onwunyi
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Tracheal intubation without neuromuscular blocking drugs: isn't it an illusion? Anaesthesia (IF 10.7) Pub Date : 2024-04-02 Nicolas Grillot, Antoine Roquilly
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Peri‐operative cardiac arrest in the older frail patient as reported to the 7th National Audit Project of the Royal College of Anaesthetists Anaesthesia (IF 10.7) Pub Date : 2024-04-01 I. K. Moppett, A. D. Kane, R. A. Armstrong, E. Kursumovic, J. Soar, T. M. Cook
SummaryFrailty increases peri‐operative risk, but details of its burden, clinical features and the risk of, and outcomes following, peri‐operative cardiac arrest are lacking. As a preplanned analysis of the 7th National Audit Project of the Royal College of Anaesthetists, we described the characteristics of older patients living with frailty undergoing anaesthesia and surgery, and those reported to
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The impact of musculoskeletal ill health on quality of life and function after critical care: a multicentre prospective cohort study Anaesthesia (IF 10.7) Pub Date : 2024-03-27 O. D. Gustafson, E. B. King, M. M. Schlussel, A. Arnold, C. Wade, P. S. Nicol, M. J. Rowland, H. Dawes, M. A. Williams
SummaryPhysical disability is a common component of post‐intensive care syndrome, but the importance of musculoskeletal health in this population is currently unknown. We aimed to determine the musculoskeletal health state of intensive care unit survivors and assess its relationship with health‐related quality of life; employment; and psychological and physical function. We conducted a multicentre
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Immunomodulatory drugs in sepsis: a systematic review and meta‐analysis Anaesthesia (IF 10.7) Pub Date : 2024-03-25 R. C. Robey, C. Logue, C. A. Caird, J. Hansel, T. P. Hellyer, J. Simpson, P. Dark, A. G. Mathioudakis, T. Felton
SummaryDysregulation of the host immune response has a central role in the pathophysiology of sepsis. There has been much interest in immunomodulatory drugs as potential therapeutic adjuncts in sepsis. We conducted a systematic review and meta‐analysis of randomised controlled trials evaluating the safety and clinical effectiveness of immunomodulatory drugs as adjuncts to standard care in the treatment
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Association between inflammation and post-intensive care syndrome: a systematic review Anaesthesia (IF 10.7) Pub Date : 2024-03-20 C. Docherty, C. Page, J. Wilson, P. Ross, K. Garrity, T. Quasim, M. Shaw, J. McPeake
Post-intensive care syndrome describes the physical, cognitive and emotional symptoms which persist following critical illness. At present there is limited understanding of the pathological mechanisms contributing to the development of post-intensive care syndrome. The aim of this systematic review was to synthesise current evidence exploring the association between inflammation and features of post-intensive
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Judgements of quality of care in NAP7: a clarification from the authors Anaesthesia (IF 10.7) Pub Date : 2024-03-22 Tim M. Cook, D. N. Lucas, Jasmeet Soar
It is a pleasure to see another editorial [1] accompanying the 7th National Audit Project (NAP7) paper regarding obstetric peri-operative cardiac arrest [2]. We would like to raise one point to correct a possible misinterpretation in the editorial and clarify what we laid out in the NAP7 methods and results [3, 4] regarding causes of cardiac arrest and inferences about quality of care. Dr Monks et al
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Dr Maldwyn (Mal) Morgan 1938–2023 Anaesthesia (IF 10.7) Pub Date : 2024-03-21 G. Hall
Anaesthesia in the UK has been fortunate because of the talented people who have contributed to the progress of the specialty. In the last 25 years of the 20th century, Mal Morgan was one of those talented people. However, it was the wide range of expertise that marked him out as exceptional, including education and training; research; editorship; authorship; and membership of national committees.
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Non‐steroidal anti‐inflammatory drugs in multimodal strategies: a potential double‐edged sword but still more research needed Anaesthesia (IF 10.7) Pub Date : 2024-03-19 J. Poeran, S. G. Memtsoudis
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Improving patient care and enhancing surgical efficiency: strategies to reduce same‐day surgical cancellations Anaesthesia (IF 10.7) Pub Date : 2024-03-16 A. A. Dixit, E. C. Sun
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How to write pilot and feasibility studies Anaesthesia (IF 10.7) Pub Date : 2024-03-16 M. Murali, M. Charlesworth
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Trainees in the independent healthcare sector: benefits for all Anaesthesia (IF 10.7) Pub Date : 2024-03-12 J. H. Lawson, R. E. Grimes, D. J. N. Wong
We read with interest the editorial by Fletcher and Barker highlighting the challenges in the independent sector [1]. The authors note that 6.2% of elective UK NHS cases are now delivered by the independent private hospital sector, and the number of such cases will possibly increase over time. They further highlight the difficulties of providing safe postoperative care due to an over-reliance on resident
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Rethinking paediatric peri‐operative cardiac arrest: proactive preparation and tailored training Anaesthesia (IF 10.7) Pub Date : 2024-03-11 E. Keane, M. Johnson, H. Laycock
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Volatile anaesthetics and net zero: a quantitative approach for spending money effectively Anaesthesia (IF 10.7) Pub Date : 2024-03-11 A. F. Kalmar, H. Mulier, S. Rex
We endorse the proposal to adopt a framework for cost-effective decision-making to optimise the use of limited economic resources [1]. Additionally, we fully support the notion of prioritising measures with the greatest and most efficient impact first, based on quantitative analysis. However, it is unclear to us how the reported 47 kg carbon dioxide equivalents (CO2e) for one bottle of sevoflurane
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From insight to action: addressing burnout among anaesthetic trainees in the UK Anaesthesia (IF 10.7) Pub Date : 2024-03-11 C. Senver, M. Kulshrestha
We write in response to the study on burnout and its determinants among anaesthesia care providers in Switzerland [1]. This is a challenge that resonates across borders, most notably within the NHS in the UK. The study, conducted across 22 anaesthesia departments, reveals a worrying prevalence of burnout. Notably, a staggering 65% of respondents reported work-related errors due to high workload or
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Association between pre‐operative depression and postoperative pain outcomes Anaesthesia (IF 10.7) Pub Date : 2024-03-06 K.‐C. Hung, H.‐L. Weng, I.‐W. Chen
We read with great interest the article by Lee et al. that found that pre-operative depression was associated with worse pain severity in both the early postoperative period (< 72 h) and later follow-up (> 6 months) [1]. However, the degree of improvement in the pain scores from before surgery to 1–2 years after surgery was similar between the depressed and non-depressed cohorts. Some methodological
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Epidemiology of tobacco smoking in patients undergoing elective vascular surgery in the UK Anaesthesia (IF 10.7) Pub Date : 2024-03-06 K. H. F. Wong, R. Mouton, R. J. Hinchliffe
Tobacco smoking has well-known deleterious effects on vascular disease progression and peri-operative outcomes [1]. Consequently, international guidelines and quality improvement programmes recommend smoking cessation as a central component of best medical therapy [2-4]. Smoking cessation interventions in the peri-operative period are effective, especially with a changing approach to targeted behavioural
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Can we already provide a conclusive assessment of the evidence for the use of nociception-guided anaesthesia? Anaesthesia (IF 10.7) Pub Date : 2024-03-05 H. Bornemann-Cimenti, K. Lang-Illievich, C. Klivinyi
We thank Dr Chen et al. for their comments on our article on the effect of nociception level-guided anaesthesia on pain levels and opioid consumption in the post-anaesthesia care unit [1, 2]. Based on our meta-analysis, they conducted a trial sequential analysis to draw even deeper insights from previous studies. They showed that the current literature is not sufficient to conclusively assess the evidence
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The science of climate change and the effect of anaesthetic gas emissions: a reply Anaesthesia (IF 10.7) Pub Date : 2024-03-01 J. M. Slingo, M. E. Slingo
Thank you for the opportunity to reply to Dr Grant's letter [1] regarding our article [2]. Dr Grant includes several serious misstatements and allegations. We will take the most important points in turn. “The interpretation is that [the volatiles' radiative forcing] is too tiny to matter and, therefore, can be ignored. However, I believe this is more an opinion than a fact and should be challenged
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The science of climate change and the effect of anaesthetic gas emissions Anaesthesia (IF 10.7) Pub Date : 2024-03-01 A. Grant
I must commend Slingo and Slingo for writing such an interesting and accessible article on the science of climate change [1]. While I will not question the hard scientific facts, I intend to question some of the conclusions. To evaluate the current warming impact of a given gas, they favour the use of radiative forcing, with units of Wm-2. The relevant figures are carbon dioxide 2.16, with the combined
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Intubation aids in hyperangulated videolaryngoscopy: essential components more than just adjuncts: a reply Anaesthesia (IF 10.7) Pub Date : 2024-02-29 D. Eum, H. J. Kim
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Remifentanil for tracheal intubation without neuromuscular blocking drugs in adult patients: a systematic review and meta‐analysis Anaesthesia (IF 10.7) Pub Date : 2024-02-26 L. Santos, H. Zheng, S. Singhal, M. Wong
SummaryThere is increasing interest in the use of short‐acting opioids such as remifentanil to facilitate tracheal intubation. The aim of this systematic review was to determine the efficacy and safety of remifentanil for tracheal intubation compared with neuromuscular blocking drugs in adult patients. We conducted a systematic search for randomised controlled trials evaluating remifentanil for tracheal
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Association of peri‐operative prescription of non‐steroidal anti‐inflammatory drugs with continued prescription of opioids after total knee arthroplasty: a retrospective claims‐based cohort study Anaesthesia (IF 10.7) Pub Date : 2024-02-22 N. Hussain, R. Brull, I. Gilron, T. E. Weaver, H. Shahzad, R. S. D'Souza, M. Abdel‐Rasoul, H. Clarke, C. J. L. McCartney, F. W. Abdallah
SummaryNon‐steroidal anti‐inflammatory drugs (NSAIDs) are one of the mainstays of multimodal pain management. While effective for acute pain control, recent pre‐clinical evidence has raised concerns regarding an association between NSAIDs and chronic pain and potential opioid use. Our objective was to explore the association between peri‐operative use of prescription NSAIDs and the need for continued
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Risk factors for complications after emergency surgery for paediatric appendicitis: a national prospective observational cohort study Anaesthesia (IF 10.7) Pub Date : 2024-02-22 L. A. Sogbodjor, C. Razavi, K. Williams, A. Selman, S. M. Pinto Pereira, M. Davenport, , S. R. Moonesinghe
Appendicectomy is a common procedure in children with a low risk of mortality, however, complication rates and risk factors are largely unknown. This study aimed to characterise the incidence and epidemiology of postoperative complications in children undergoing appendicectomy in the UK. This multicentre prospective observational cohort study, which included children aged 1–16 y who underwent surgery
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How to conduct and report guidelines and position, best practice and consensus statements Anaesthesia (IF 10.7) Pub Date : 2024-02-19 M. D. Wiles, K. El‐Boghdadly, E. R. Mariano
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Peri‐operative cardiac arrest in children as reported to the 7th National Audit Project of the Royal College of Anaesthetists Anaesthesia (IF 10.7) Pub Date : 2024-02-19 F. C. Oglesby, B. R. Scholefield, T. M. Cook, J. H. Smith, V. J. Pappachan, A. D. Kane, R. A. Armstrong, E. Kursumovic, J. Soar
SummaryThe 7th National Audit Project of the Royal College of Anaesthetists studied peri‐operative cardiac arrest. An activity survey estimated UK paediatric anaesthesia annual caseload as 390,000 cases, 14% of the UK total. Paediatric peri‐operative cardiac arrests accounted for 104 (12%) reports giving an incidence of 3 in 10,000 anaesthetics (95%CI 2.2–3.3 per 10,000). The incidence of peri‐operative
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Systematic development and validation of a predictive model for major postoperative complications in the Peri-operative Quality Improvement Project (PQIP) dataset Anaesthesia (IF 10.7) Pub Date : 2024-02-18 C. M. Oliver, D. Wagstaff, J. Bedford, S. R. Moonesinghe
Complications are common following major surgery and are associated with increased use of healthcare resources, disability and mortality. Continued reliance on mortality estimates risks harming patients and health systems, but existing tools for predicting complications are unwieldy and inaccurate. We aimed to systematically construct an accurate pre-operative model for predicting major postoperative
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The effect of a bundle intervention for ambulatory otorhinolaryngology procedures on same-day case cancellation rate and associated costs Anaesthesia (IF 10.7) Pub Date : 2024-02-14 K. Wongtangman, P. Semczuk, J. Freda, R. V. Smith, V. Pushparaj, D. Beckham, B. Aasman, M. I. Rudolph, E. Salloum, M. Kiyatkin, P. Anand, F. A. Ganz-Lord, C. Himes, P. Fassbender, M. Eikermann
Cancellations within 24 h of planned elective surgical procedures reduce operating theatre efficiency, add unnecessary costs and negatively affect patient experience. We implemented a bundle intervention that aimed to reduce same-day case cancellations. This consisted of communication tools to improve patient engagement and new screening instruments (automated estimation of ASA physical status and
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Socio-economic disadvantage and utilisation of labour epidural analgesia in Scotland: a population-based study† Anaesthesia (IF 10.7) Pub Date : 2024-02-15 L. Halliday, M. Shaw, A. Kyzayeva, D. A. Lawlor, S. M. Nelson, R. J. Kearns
Socio-economic deprivation is associated with adverse maternal and childhood outcomes. Epidural analgesia, the gold standard for labour analgesia, may improve maternal well-being. We assessed the association of socio-economic status with utilisation of epidural analgesia and whether this differed when epidural analgesia was advisable for maternal safety. This was a population-based study of NHS data
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Ethnicity, socio-economic deprivation and postpartum outcomes following caesarean delivery: a multicentre cohort study Anaesthesia (IF 10.7) Pub Date : 2024-02-15 J. E. O'Carroll, L. Zucco, E. Warwick, G. Radcliffe, S.R. Moonesinghe, K. El-Boghdadly, N. Guo, B. Carvalho, P. Sultan
Disparities relating to postpartum recovery outcomes in different socio-economic and racial ethnic groups are underexplored. We conducted a planned analysis of a large prospective caesarean delivery cohort to explore the relationship between ethnicity, socio-economic status and postpartum recovery. Eligible patients were enrolled and baseline demographic, obstetric and medical history data were collected
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A comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre: a multicentre randomised controlled trial Anaesthesia (IF 10.7) Pub Date : 2024-02-12 M. Kriege, P. Lang, C. Lang, I. Schmidtmann, O. Kunitz, M. Roth, M. Strate, A. Schmutz, E. Vits, O. Balogh, C. Jänig
Aspiration of gastric contents is a recognised complication during all phases of anaesthesia. The risk of this event becomes more likely with repeated attempts at tracheal intubation. There is a lack of clinical data on the effectiveness of videolaryngoscopy relative to direct laryngoscopy rapid sequence intubation in the operating theatre. We hypothesised that the use of a videolaryngoscope during
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Society for Obesity and Bariatric Anaesthesia UK (SOBA UK) response to the 7th National Audit Project report Anaesthesia (IF 10.7) Pub Date : 2024-02-12 E. Warwick, A. Mckechnie
We read the 7th National Audit Project (NAP7) report [1] and NAP7 publications [2, 3] with interest. We would like to congratulate the authors on providing an up-to-date view on the current picture of anaesthesia in the UK, especially in the context of the COVID-19 pandemic and changing peri-operative population. We have read the chapter examining the trends and outcomes in patients living with obesity
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Dexmedetomidine for delirium in adults undergoing heart valve surgery Anaesthesia (IF 10.7) Pub Date : 2024-02-08 X.-C. Wang, F. Chen, T. Li
We read with interest the article by Wang et al. which concluded that an intra-operative dexmedetomidine infusion did not decrease the incidence of delirium during the first 7 postoperative days in patients undergoing cardiac surgery, but might impair renal function, compared with placebo [1]. Although extensive clinical evidence supports the notion that peri-operative dexmedetomidine administration
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Widening the gap: could residential ‘simulated altitude prehabilitation’ exacerbate health inequalities? Anaesthesia (IF 10.7) Pub Date : 2024-02-08 L. Morris, C. Shelton
We thank Brown et al. for their study on the physiological feasibility of using simulated altitude for prehabilitation [1]. Their work sheds light on an innovative approach that could potentially be integrated into pre-operative care. As highlighted in the paper by Brown et al., pre-operative anaemia and poor cardiorespiratory fitness are well-known contributors to increased peri-operative morbidity
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Association of nociception level index-guided intra-operative analgesia with postoperative pain outcomes: a trial sequential analysis Anaesthesia (IF 10.7) Pub Date : 2024-02-08 I.-W. Chen, W.-T. Wang, K.-C. Hung
We read with great interest the article by Bornemann-Cimenti et al. on the effect of nociception level index-guided intra-operative analgesia on early postoperative pain and opioid consumption [1]. The use of nociception level index monitoring resulted in statistically significant reductions in both self-reported postoperative pain scores (mean difference -0.46 on an 11-point scale) and opioid requirements
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Principles for management of hip fracture for older adults taking direct oral anticoagulants: an international consensus statement Anaesthesia (IF 10.7) Pub Date : 2024-02-06 R. J. Mitchell, S. Wijekulasuriya, A. Mayor, F. K. Borges, A. C. Tonelli, J. Ahn, H. Seymour
Hip fracture is a common serious injury among older adults, yet the management of hip fractures for patients taking direct oral anticoagulants remains inconsistent worldwide. Drawing from a synthesis of available evidence and expert opinion, best practice approaches for managing patients with a hip fracture and who are taking direct oral anticoagulants pre-operatively were considered by a working group
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Effect of anterior quadratus lumborum block on morphine consumption in minimally invasive colorectal surgery: a reply Anaesthesia (IF 10.7) Pub Date : 2024-02-06 S. Coppens, D. F. Hoogma, G. Dewinter, A. Wolthuis, S. Rex
O'Sullivan and Lavelle raise several issues regarding our multicentre trial [1] that are worth addressing. They express concerns about the control group, citing the Serious Harm and Morbidity scale on placebo-placed blocks. We did consider alternatives such as an assessor-blinded study design, but we believe that many extremely optimistic and positive assessor-blinded studies on fascial plane blocks
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NAP7 and airway management: as important as life and death Anaesthesia (IF 10.7) Pub Date : 2024-02-06 T. Cook, F. Oglesby, J. Soar
It is a pleasure to see several editorials accompanying the Anaesthesia publications relating to the 7th National Audit Project of the Royal College of Anaesthetists (NAP7), which studied peri-operative cardiac arrest. The latest of these is by Dr Ahmad and Professor El-Boghdadly [1] and relates to the publication exploring airway and breathing events leading to peri-operative cardiac arrest in NAP7
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Determining analgesic effect of a regional block after caesarean section under spinal anaesthesia with intrathecal morphine Anaesthesia (IF 10.7) Pub Date : 2024-02-02 F. S. Xue, C. W. Li, P. Dong
We read with interest the recent study by Baghirzada et al. [1], which determined the postoperative analgesic efficacy of adding the bilateral transversalis fascia plane block to a multimodal analgesia regime in women undergoing caesarean section under spinal anaesthesia with intrathecal opioids. They demonstrated that mean (SD) 24-h cumulative morphine milligram equivalent was significantly lower
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Intubation aids in hyperangulated videolaryngoscopy: essential components more than just adjuncts Anaesthesia (IF 10.7) Pub Date : 2024-02-02 J. Cafferkey, P. A. Ward
We read with interest the study by Eum et al. [1], which compares performance of airway adjuncts for facilitating tracheal intubation using hyperangulated videolaryngoscopy in patients with predicted difficulty. We welcome research in this area of airway management since hyperangulated videolaryngoscopy is generally a less familiar technique than Macintosh (standard geometry) videolaryngoscopy; however
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Impact of postoperative cardiovascular complications on 30-day mortality after major abdominal surgery: an international prospective cohort study Anaesthesia (IF 10.7) Pub Date : 2024-02-02
Cardiovascular complications after major surgery are associated with increases in morbidity and mortality. There is confusion over definitions of cardiac injury or complications, and variability in the assessment and management of patients. This international prospective cohort study aimed to define the incidence and timing of these complications and to investigate their impact on 30-day all-cause
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Predicting time to asystole following withdrawal of life-sustaining treatment: a systematic review Anaesthesia (IF 10.7) Pub Date : 2024-02-01 C. Nicolson, A. Burke, D. Gardiner, D. Harvey, L. Munshi, M. Shaw, A. Tsanas, N. Lone, K. Puxty
The planned withdrawal of life-sustaining treatment is a common practice in the intensive care unit for patients where ongoing organ support is recognised to be futile. Predicting the time to asystole following withdrawal of life-sustaining treatment is crucial for setting expectations, resource utilisation and identifying patients suitable for organ donation after circulatory death. This systematic
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Handling injectable medications: mixing drugs Anaesthesia (IF 10.7) Pub Date : 2024-02-02 T. Murphy, P. Stewart, C. C. Nestor, M. G. Irwin
We read with great interest the recent guidelines on handling injectable medications [1]. We applaud the considerable effort the authors have made to cover a wide range of elements encompassing safe administration of anaesthesia. Mixing of injectable medications is a longstanding practice within anaesthesia but is not alluded to in this guideline. The practice of mixing the anaesthetic and analgesic
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Harm during airway management by anaesthetists: its absence in randomised controlled trials does not mean it does not exist Anaesthesia (IF 10.7) Pub Date : 2024-02-02 J. Hansel, T. M. Cook
We thank Dr Lyons for his continued interest in our review [1] and welcome the ongoing dialogue. Dr Lyons presents a post hoc sensitivity analysis and a granular breakdown of outcomes after failed tracheal intubation [2]. First, we agree that standardised outcome definitions in airway management research would minimise between-study variability. We called for this in our review [1] and can report that
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Anaesthetic efficacy and postinduction hypotension with remimazolam compared with propofol: a multicentre randomised controlled trial Anaesthesia (IF 10.7) Pub Date : 2024-01-14 J. Fechner, K. El-Boghdadly, D. R. Spahn, J. Motsch, M. M. R. F. Struys, O. Duranteau, M. T. Ganter, T. Richter, M. W. Hollmann, R. Rossaint, S. Bercker, S. Rex, B. Drexler, F. Schippers, A. Morley, H. Ihmsen, E. Kochs
Remimazolam, a short-acting benzodiazepine, may be used for induction and maintenance of total intravenous anaesthesia, but its role in the management of patients with multiple comorbidities remains unclear. In this phase 3 randomised controlled trial, we compared the anaesthetic efficacy and the incidence of postinduction hypotension during total intravenous anaesthesia with remimazolam vs. propofol
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Quantification of aerosol generation during positive pressure ventilation via a supraglottic airway with an intentional leak Anaesthesia (IF 10.7) Pub Date : 2024-01-13 A. J. Shrimpton, A. C. Quayle, D. L. Sleep, J. M. Brown, T. M. Cook
Supraglottic airway devices (SAD) are used in almost half of general anaesthetics within the UK, yet concern remains as to whether air leakage around these devices generates high concentrations of respiratory aerosol, posing a risk of airborne disease transmission to airway practitioners [1, 2]. To address this concern, we conducted a prospective aerosol monitoring study during positive pressure ventilation
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Cardiac arrest in obstetric patients receiving anaesthetic care: results from the 7th National Audit Project of the Royal College of Anaesthetists Anaesthesia (IF 10.7) Pub Date : 2024-01-12 D. N. Lucas, E. Kursumovic, T. M. Cook, A. D. Kane, R. A. Armstrong, F. Plaat, J. Soar
The 7th National Audit Project (NAP7) of the Royal College of Anaesthetists studied peri-operative cardiac arrest. Additional inclusion criteria for obstetric anaesthesia were: cardiac arrest associated with neuraxial block performed by an anaesthetist outside the operating theatre (labour epidural analgesia); and cardiac arrest associated with remifentanil patient-controlled analgesia. There were