Title stringlengths 11 422 | Abstract stringlengths 130 3.94k |
|---|---|
Career choices for anaesthesia: National surveys of graduates of 1974-2002 from UK medical schools | Background. Knowledge about UK doctors' career intentions and pathways is essential for understanding future workforce requirements. The aim of this study was to report career choices for and career progression in anaesthesia in the UK. Methods. Postal questionnaire surveys were undertaken of qualifiers from all UK med... |
Consequences of running more operating theatres than anaesthetists to staff them: A stochastic simulation study | Background. Numerous hospitals implement a ratio of one anaesthetist supervising non-medically-qualified anaesthetist practitioners in two or more operating theatres. However, the risk of requiring anaesthetists simultaneously in several theatres due to concurrent critical periods has not been evaluated. It was examine... |
Item analysis for the written test of Taiwanese board certification examination in anaesthesiology using the Rasch model | Background. On the written test of board certification examination for anaesthesiology, the probability of a question being answered correctly is subject to two main factors, item difficulty and examinee ability. Thus, item analysis can provide insight into the appropriateness of a particular test, given the ability of... |
Detection of awareness in surgical patients with EEG-based indices - Bispectral index and patient state index | Background. Patient state index (PSI) and bispectral index (BIS) are values derived from the EEG, which can measure the hypnotic component of anaesthesia. We measured the ability of PSI and BIS to distinguish consciousness from unconsciousness during induction and emergence from anaesthesia and a period of awareness in... |
Patient Experiences with the Preoperative Assessment Clinic (PEPAC): Validation of an instrument to measure patient experiences | Background. Presently, no comprehensive and validated questionnaire to measure patient experiences of the preoperative assessment clinic (PAC) is available. We developed and validated the Patient Experiences with the Preoperative Assessment Clinic (PEPAC) questionnaire, which can be used for quantitative measurements o... |
Challenge of improving postoperative pain management: Case studies of three acute pain services in the UK National Health Service | Background. Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. Methods.... |
Reliability of the American Society of Anesthesiologists physical status scale in clinical practice | Background. Previous studies, which relied on hypothetical cases and chart reviews, have questioned the inter-rater reliability of the ASA physical status (ASA-PS) scale. We therefore conducted a retrospective cohort study to evaluate its inter-rater reliability and validity in clinical practice. Methods. The cohort in... |
Efficacy of high-fidelity simulation debriefing on the performance of practicing anaesthetists in simulated scenarios | Background. Research into adverse events in hospitalized patients suggests that a significant number are preventable. The purpose of this randomized, controlled study was to determine if simulation-based debriefing improved performance of practicing anaesthetists managing high-fidelity simulation scenarios. Methods. Th... |
Implementation of outpatient preoperative evaluation clinics: Facilitating and limiting factors | Background. Several studies have shown that outpatient preoperative evaluation by anaesthetists increases quality of care and is cost-effective. The aim of this study was to gain insight into the factors that positively or negatively influence the implementation of outpatient preoperative evaluation clinics (OPE clinic... |
Use of an anaesthesia workstation barrier device to decrease contamination in a simulated operating room | Background. Strategies to achieve reductions in perioperative infections have focused on hand hygiene among anaesthestists but have been of limited efficacy. We performed a study in a simulated operating room to determine whether a barrier covering the anaesthesia workstation during induction and intubation might reduc... |
Corresponding minimum alveolar concentrations of isoflurane and isoflurane/nitrous oxide have divergent effects on thalamic nociceptive signalling | Background. Suppression of nociceptive signalling in the thalamus is considered to contribute significantly to the anaesthetic state. Assuming additivity of anaesthetic mixtures, our study assessed the effects of corresponding minimum alveolar concentrations (MACs) of isoflurane and isoflurane/nitrous oxide on thalamic... |
Comparison of Alaris AEP index and bispectral index during propofol-remifentanil anaesthesia | Background. The Alaris AEP monitor™ (Alaris, UK, version 1.4) is the first commercially available auditory evoked potential (AEP) monitor designed to estimate the depth of anaesthesia. It generates an 'Alaris AEP index' (AAI), which is a dimensionless number scaled from 100 (awake) to 0. This study was designed to comp... |
Integration of academic and clinical performance-Based faculty compensation plans: A system and its impact on an anaesthesiology department | Background. The current economic environmentmakes it difficult foracademic institutions to maintain academic activities with necessary clinical coverage. Productivity-based faculty compensation is reported to improve clinical work output; however, the impact on academic productivity has not been fully described. Method... |
Influence of resident training on anaesthesia induction times | Background. The effect of resident training in anaesthesiology on operating room (OR) economics is an issue of debate. Comparisons of anaesthesia process times between residents and consultants might be systematically skewed by interactions of anaesthesia technique and patient factors. Methods. In this prospective, obs... |
Training and the European working time directive: A 7 year review of paediatric anaesthetic trainee caseload data | Background. The implementation of the European Working Time Directive (WTD) has reduced the hours worked by trainees in the UK to a maximum of 56 h per week. With a further and final reduction to 48 h per week scheduled for August 2009, there is concern amongst doctors about the impact on training and on patient care. ... |
Upper limb muscular activity and perceived workload during laryngoscopy: Comparison of Glidescope® and Macintosh laryngoscopy in manikin: An observational study | Background. The interaction between operators and their working environment during laryngoscopy is poorly understood. Numerous studies have focused on the forces applied to the patient's airway during laryngoscopy, but only a few authors have addressed operator muscle activity and workload. We tested whether different ... |
Investigation of trainee and specialist reactions to the mini-Clinical Evaluation Exercise in anaesthesia: Implications for implementation | Background. The mini-Clinical Evaluation Exercise (mini-CEX) is a workplace-based assessment which may be useful in anaesthesia training. However, its value depends on how supervisors use it with their trainees. This study analyses experience with the mini-CEX after its introduction into anaesthesia departments in our ... |
Comparison of the Glidescope®, the Pentax AWS®, and the Truview EVO2® with the Macintosh laryngoscope in experienced anaesthetists: A manikin study | Background. The Pentax Airwayscope®, the Glidescope®, and the Truview EVO2® constitute three novel laryngoscopes that facilitate visualization of the vocal cords without alignment of the oral, pharyngeal, and tracheal axes. We compared these devices with the Macintosh laryngoscope in a simulated easy and difficult lary... |
Predictive performance of computer-controlled infusion of remifentanil during propofol/remifentanil anaesthesia | Background. The predictive performance of the available pharmacokinetic parameter sets for remifentanil, when used for target-controlled infusion (TCI) during total i.v. anaesthesia, has not been determined in a clinical setting. We studied the predictive performance of five parameter sets of remifentanil when used for... |
Setting priorities for improving the preoperative assessment clinic: The patients' and the professionals' perspective | Background. The quality of the preoperative assessment clinic (PAC) is determined by many factors. Patients' experiences are important indicators, but often overlooked. We prepare to set priorities to improve the PAC by obtaining detailed patients' feedback on the quality of the PAC, and establishing the value patients... |
Supervision and responsibility: The Royal College of Anaesthetists National Audit | Background. The Royal College of Anaesthetists audited consultant supervision and responsibility in anaesthesia in the UK during 2003. Methods. Consultants (supervising) and non-consultants (supervised) were surveyed on their attitudes to supervision, experience of their own hospital system for supervision and of induc... |
Virtual reality-based simulator for training in regional anaesthesia | Background. The safe performance of regional anaesthesia (RA) requires theoretical knowledge and good manual skills. Virtual reality (VR)-based simulators may offer trainees a safe environment to learn and practice different techniques. However, currently available VR simulators do not consider individual anatomy, whic... |
Failure of simulation training to change residents' management of oesophageal intubation | Background. There are few scientific reports documenting the effects of simulation training on learning. Issues of scientific validity challenge investigators who measure such outcomes. We perceived a failure of residents to change their technical management of oesophageal intubation after simulation training and sough... |
Influence of transactive memory on perceived performance, job satisfaction and identification in anaesthesia teams | Background. There is an increasing awareness in the medical community that human factors are involved in effectiveness of anaesthesia teams. Communication and coordination between physicians and nurses seems to play a crucial role in maintaining a good level of performance under time pressure, particularly for anaesthe... |
Evaluation of high patient simulator in assessment of performance of anaesthetists | Background. There is increasing emphasis on performance-based assessment of clinical competence. The High Fidelity Patient Simulator (HPS) may be useful for assessment of clinical practice in anaesthesia, but needs formal evaluation of validity, reliability, feasibility and effect on learning. We set out to assess the ... |
Teaching antiarrhythmic therapy and ECG in simulator-based interdisciplinary undergraduate medical education | Background. Third-year students in the Dresden Medical School Programme undergo a 6 week course 'Basics of Drug Therapy' in a problem-based learning curriculum. As part of this course a practical seminar about antiarrhythmic drugs and ECG was set up. This study was conducted to evaluate the use of a simulator in this c... |
Perioperative tobacco use interventions in Japan: A survey of thoracic surgeons and anaesthesiologists | Background. Tobacco use interventions in surgical patients who smoke could benefit both their short-term outcome and long-term health. Anaesthesiologists and surgeons can play key roles in delivering these interventions. This study determined the practices, attitudes, and beliefs of these physicians regarding tobacco u... |
Video-assisted instruction improves the success rate for tracheal intubation by novices | Background. Tracheal intubation via laryngoscopy is a fundamental skill, particularly for anaesthesiologists. However, teaching this skill is difficult since direct laryngoscopy allows only one individual to view the larynx during the procedure. The purpose of this study was to determine if video-assisted laryngoscopy ... |
Trainee anaesthetists understand their work in different ways: Implications for specialist education | Background. Traditionally, programmes for specialist education in anaesthesia and intensive care have been based on lists of attributes such as skills and knowledge. However, modern research in the science of teaching has shown that competence development is linked to changes in the way professionals understand their w... |
In-theatre training of anaesthetists in a teaching hospital: Has it changed over 10 years? | Background. We wished to ascertain in what way recent changes such as Modernising Medical Careers (MMC) and the implementation of the Working Time Directive (WTD) have affected clinical training and experience for anaesthetists in a teaching centre, in particular the provision of training in specialized fields of anaes... |
Motivational influences on anaesthetists' use of practice guidelines | Background. With the proliferation of practice guidelines in anaesthesia comes the possibility that anaesthetists may, during the course of their work, commit 'violations' (actions that are not intended to cause harm to patients, but that deviate from guidelines). These may have a long-term impact on patient safety, an... |
Making robust assessments of specialist trainees' workplace performance | Background. Workplace-based assessments should provide a reliable measure of trainee performance, but have met with mixed success. We proposed that using an entrustability scale, where supervisors scored trainees on the level of supervision required for the case would improve the utility of compulsory mini-clinical eva... |
Leadership of United States academic anesthesiology programs 2006: Chairperson characteristics and accomplishments | BACKGROUND/METHODS: We conducted an Internet-based survey of all current academic anesthesiology chairpersons to benchmark their characteristics and accomplishments, as well as to gain insights that might be useful to aspirant department chairs. RESULTS: The response rate was 55%; chairs were predominantly male (92%), ... |
Anticipation of the difficult airway: Preoperative airway assessment, an educational and quality improvement tool | BackgroundAssessment of the potentially difficult airway (DA) is a critical aspect of resident education. We investigated the impact of a new assessment form on airway prediction and management by anaesthesia residents. We hypothesized that residents would demonstrate improvement in evaluation of DAs over the study dur... |
Anaesthetic management and outcomes in patients with surgically corrected D-transposition of the great arteries undergoing non-cardiac surgery | BackgroundPatients with effective repair of D-transposition of the great arteries (D-TGA) increasingly present for non-cardiac surgery. These patients may be predisposed to heart failure, arrhythmias, and sudden death, especially after the atrial switch repair. This retrospective study was undertaken to review the care... |
Visual metaphors on anaesthesia monitors do not improve anaesthetists' performance in the operating theatre | BackgroundPrevious research using a metaphorical anaesthesia monitor, where dimensions of rectangles proportionally represent 30 patient variable values, showed improved performance in diagnosing adverse events compared with the standard monitor. Steady-state values were represented by a frame around each rectangle. We... |
Scholarly activity points: A new tool to evaluate resident scholarly productivity | BackgroundScholarly activity is an important aspect of a resident's educational experience; however, evaluation methods have remained underdeveloped despite the increased focus over the last decade. A new scoring system is proposed as a comprehensive evaluation tool.MethodsIn this scoring system, each scholarly activit... |
How excellent anaesthetists perform in the operating theatre: A qualitative study on non-technical skills | BackgroundTeaching trainees to become competent professionals who can keep the complex system of anaesthesia safe is important. From a safety point of view, non-technical skills such as smooth cooperation and good communication deserve as much attention as theoretical knowledge and practical skills, which by tradition ... |
Resistance, reverse flow and opening pressure of unidirectional valves | Based on a new preliminary standard of the‘Comité Européen de Normalisation’, the following unidirectional valves were tested with regard to resistance, opening pressure, reverse flow and dislocation: the Dräger inspiratory and expiratory valves, the Engström inspiratory valve, the Ohmeda valve, the Siemens Ventilator ... |
Twenty years of collaboration between Belgium and Benin in training anesthesiologists for Africa | Belgium has been collaborating for 20 years with Abomey-Calavi University in Cotonou, Republic of Benin, to train anesthesiologists for Sub-Saharan, French-speaking African countries. With 123 graduates from 15 countries and 46 residents still in training, this program has succeeded in reversing the trend of a decreasi... |
Anaphylaxis during anaesthesia. Results of a two-year survey in France | Between January 1, 1997 and December 31, 1998, 467 patients were referred to one of the allergo-anaesthesia centres of the French GERAP (Groupe d'Etudes des Réactions Anaphylactoïdes Peranesthésiques) network and were diagnosed as having anaphylaxis during anaesthesia. Diagnosis was established on the basis of clinical... |
Blood concentrations of nitrous oxide in theatre personnel | Blood concentrations of nitrous oxide were measured in anaesthetists, surgeons and theatre nursus. Comparison of anaesthetists and surgeons working in the same theatre showed that in ENT surgeons concentrations were greater (p≪0.01), while in general surgeons they were smaller (P≪0.003). Blood concentrations of nitrous... |
Book reviews | Book reviewed in this article PRACTICAL ANESTHESIOLOGY J.F.ARTUSIO and V.D.B.MAZZIA ELDERLY PATIENTS, THEIR MEDICAL CARE BEFORE AND AFTER OPERATION KENNETH HAZELL DRUG ADDICTION LAWRENCE KOLB LOCAL ANALGESIA, ABDOMINAL SURGERY SIR ROBERT MACINTOSH and R.BRYCE‐SMITH Copyright © 1963, Wiley Blackwell. All rights reserved |
Book reviews | Book reviewed in this article: Anaesthesia at the district hospital M.B. Dobson. A tribute to Professor Sir Robert Macintosh for his 90th birthday Edited by W.D.A. Smith and G.M.C. Paterson. Clinical anatomy for anesthesiologists R.S. Snell and J. Katz. Anesthesiology report Vol. 1. No. 1. Edited by M.C. Rogers, R.C. W... |
Book reviews | Book reviews in this article: Energy metabolism in trauma. Ciba Foundation symposium Edits R. Porter and J. Knight. Progress in Anaesthesiology: proceedings of the Fourth World Congress of Anaesthesiologists Editors T. B. Boulton, R. Bryce‐Smith, M. K. Sykes, G. B. Gillet, A. L. Revell. The Respiratory Muscles: Mechani... |
Book reviews | Books review in this article: A laboratory basis for anesthesiology G. DAL SANTO. Pain relief and anaesthesia in childbirth P. BROWSRIDGE. Psychology, pain and anaesthesia Edited by H.B. GIBSOK. Copyright © 1994, Wiley Blackwell. All rights reserved |
Book Reviews | Books reviewed in this article: ESSAYS ON THE FIRST HUNDRED YEARS OF ANESTHESIA. Volume 2
W. STANLEY SYKES THE CONQUEST OF PAIN
RONALD WOOLMER CONE OF OBLIVION
L. J. LUDOVICI CLINICAL ELECTROENCEPHALOGRAPHY
L. G. KILOH and J. W. OSSELTON APPRAISAL OF CURRENT CONCEPTS IN ANESTHESIOLOGY
... |
The formulation and introduction of a 'can't intubate, can't ventilate' algorithm into clinical practice | Both the American Society of Anesthesiologists and the Difficult Airway Society of the United Kingdom have published guidelines for the management of unanticipated difficult intubation. Both algorithms end with the 'can't intubate, can't ventilate' scenario. This eventuality is rare within elective anaesthetic practice... |
Diagnostic accuracy of anaesthesiologists' prediction of difficult airway management in daily clinical practice: A cohort study of 188 064 patients registered in the Danish Anaesthesia Database | Both the American Society of Anesthesiologists and the UK NAP4 project recommend that an unspecified pre-operative airway assessment be made. However, the choice of assessment is ultimately at the discretion of the individual anaesthesiologist. We retrieved a cohort of 188 064 cases from the Danish Anaesthesia Database... |
Chlorhexidine cleaning of re-usable bougies | Bougies are susceptible to becoming contaminated before or during use. Chlorhexidine wipes may have a residual antibacterial effect, potentially minimising bacterial transmission after bougie use or storage. We evaluated the decontaminant and antibacterial effectiveness of 70% alcohol/2% chlorhexidine wipes in laborato... |
Assessing the efficacy of HME filters at preventing contamination of breathing systems | Breathing system filters are intended to prevent cross-infection during anaesthesia. However, there is a lack of information on whether filters prevent contamination of the breathing system by the patient. We measured the contamination of 235 used filters of four different types obtained from operating theatres: two pl... |
The effect of ventilation system design on air contamination with halothane in operating theatres | By measuring the halothane concentrations in samples of air from three different operating theatres during routine operating lists the pattern of spread of the waste anaesthetic gases has been demonstrated. The results show that in all the theatres there was a spread of halothane from its point of escape from the anaes... |
The World Federation of Societies of Anaesthesiologists Minimum Capnometer Specifications 2021-A Guide for Health Care Decision Makers | Capnometry, the measurement of respiratory carbon dioxide, is regarded as a highly recommended safety technology in intubated and nonintubated sedated and/or anesthetized patients. Its utility includes confirmation of initial and ongoing placement of an airway device as well as in detecting gas exchange, bronchospasm, ... |
Cardiac anesthesia: Thirty years later-the second annual Arthur E. Weyman lecture | Cardiac anesthesiology has evolved spectacularly over the past 30 yr, changing from a practice focused on the anesthetic management of patients with cardiovascular diseases to a practice of cardiovascular medicine that contributes to the medical and surgical management of cardiovascular patients. The second Weyman lect... |
A survey on the intended purposes and perceived utility of preoperative cardiology consultations | Cardiology consultations are often requested by surgeons and anesthesiologists for patients with cardiovascular disease. There can be confusion, however, regarding both the reasons for a consultation and their effect on patient management. This study was designed to determine the attitudes of physicians toward preopera... |
Changing specialties: Do anesthesiologists differ from other physicians? | Career choices of physicians frequently change after senior year in medical school. Although previous studies have documented the magnitude of these changes, they contain no information concerning anesthesiologists. Changes in specialities of 1151 physicians, graduates from the same medical school, between the years 19... |
Caroline B. Palmer: Pioneer physician anesthetist and first chair of anesthesia at Stanford | Caroline B. Palmer was appointed as Chief of Anesthesia at Cooper Medical College (soon renamed as Stanford Medical School) in 1909. For the next 28 years, she was an innovative leader, a clinical researcher, and a strong advocate for recognition of anesthesiology as a medical specialty. To honor her accomplishments, t... |
Micropuncture needles combined with ultrasound guidance for unusual central venous cannulation: Desperate times call for desperate measures-A new trick for old anesthesiologists | Central vascular access can be a very challenging task in patients with skeletal deformities such as ankylosing spondylitis, kyphosis, and chin-on-chest deformity. The use of traditional methods of accessing the central venous circulation in these patients can require multiple attempts and may lead to significant compl... |
Influence of less than full-time or full-time on totality of training and subsequent consultant appointment in anaesthesia | Changes in medical training have increased the popularity of less than full-time training. However, there are no data on the impact on training time or consultant workforce. We reviewed a three-year cohort of trainees via the Royal College of Anaesthetist's training and recruitment databases. Eighty-eight (96%) less th... |
Litigation related to airway and respiratory complications of anaesthesia: An analysis of claims against the NHS in England 1995-2007 | Claims notified to the NHS Litigation Authority in England between 1995 and 2007 and filed under anaesthesia were analysed to explore patterns of injury and cost related to airway or respiratory events. Of 841 interpretable claims the final dataset contained 96 claims of dental damage, 67 airway-related claims and 24 r... |
Action guidance for addressing pollution from inhalational anaesthetics | Climate change is a real and accelerating existential danger. Urgent action is required to halt its progression, and everyone can contribute. Pollution mitigation represents an important opportunity for much needed leadership from the health community, addressing a threat that will directly and seriously impact the hea... |
The laryngeal mask airway in children: A fibreoptic assessment of positioning | Clinical and fibreoptic assessment of the positioning of the laryngeal mask airway was performed in 100 children. Clinical observation indicated a patent airway in 98% and severe airway obstruction in 2% of cases. Perfect positioning, as judged by fibreoptic laryngoscopy, was found in 49% and the epiglottis was within ... |
Development, Reporting, and Evaluation of Clinical Practice Guidelines | Clinical practice parameters have been published with greater frequency by professional societies and groups of experts. These publications run the gamut of practice standards, practice guidelines, consensus statements or practice advisories, position statements, and practice alerts. The definitions of these terms have... |
A Call to Action: A Specialty-Specific Course to Support the Next Generation of Clinician Scientists in Anesthesiology | Clinical production pressure is a significant problem for faculty of anesthesiology departments who seek to remain involved in research. Lack of protected time to dedicate to research and insufficient external funding add to this long-standing issue. Recent trends in funding to the departments of anesthesiology and the... |
Publications in Anesthesia Journals: Quality and clinical relevance | Clinicians performing evidence-based anesthesia rely on anesthesia journals for clinically relevant information. The objective of this study was to analyze the proportion of clinically relevant articles in five high impact anesthesia journals. We evaluated all articles published in Anesthesiologiy, Anesthesia & Analges... |
The use of cognitive aids during emergencies in anesthesia: A review of the literature | Cognitive aids are prompts designed to help users complete a task or series of tasks. They may take the form of posters, flowcharts, checklists, or even mnemonics. It has been suggested that the use of cognitive aids improves performance and patient outcomes during anesthetic emergencies; however, a systematic assessme... |
State of the clinical science of perioperative brain health: report from the American Society of Anesthesiologists Brain Health Initiative Summit 2018 | Cognitive recovery after anaesthesia and surgery is a concern for older adults, their families, and caregivers. Reports of patients who were ‘never the same’ prompted a scientific inquiry into the nature of what patients have experienced. In June 2018, the ASA Brain Health Initiative held a summit to discuss the state ... |
The relationship of cognitive, personality, and academic measures to anesthesiology resident clinical performance | Cognitive skills (including vigilance), personality factors, and standardized academic test performance may be associated with clinical competence in anesthesiology to varying degrees. Sixty-seven anesthesiology residents in training at one center between 1993 and 1995 were administered the modified Vigil (For Thought,... |
Nominal group technique: A method of decision‐making by committee | Committee‐work which involves decision‐making from a range of alternatives is frequently time‐consuming, inefficient, and frustrating. Nominal Group Technique is a structured method of group decision‐making which allows a rich generation of original ideas, balanced participation of all members of the group, and a rank‐... |
Customizable Curriculum to Enhance Resident Communication Skills | Communication remains challenging to teach and evaluate. We designed an online patient survey to assess anesthesia residents' communication skills from August 2014 to July 2015. In December 2014, we implemented a customized, simulation-based curriculum. We calculated an overall rating for each survey by averaging the r... |
An evidence-based approach to airway management: Is there a role for clinical practice guidelines? | Complications arising out of airway management represent an important cause of anaesthesia-associated morbidity and mortality. Anaesthetic practice itself can lead to preventable harm, a particular example being persistent attempts at direct laryngoscopy, that results in delay in employing alternative strategies (or de... |
Design and analysis of studies with binary-event composite endpoints: Guidelines for anesthesia research | Composite endpoints consisting of several binary events, such as distinct perioperative complications, are frequently chosen as the primary outcome in anesthesia studies (and in many other clinical specialties) because (1) no single outcome fully characterizes the disease or outcome of interest, and/or (2) individual o... |
Performance of computer-controlled infusion of propofol: An evaluation of five pharmacokinetic parameter sets | Computer-controlled infusion of propofol is used with increasing frequency for the induction and maintenance of anesthesia. The performance of computer- controlled infusion devices is highly dependent on how well the implemented pharmacokinetic parameter set matches the pharmacokinetics of the patient. This study exami... |
False individual patient data and zombie randomised controlled trials submitted to Anaesthesia | Concerned that studies contain false data, I analysed the baseline summary data of randomised controlled trials when they were submitted to Anaesthesia from February 2017 to March 2020. I categorised trials with false data as ‘zombie’ if I thought that the trial was fatally flawed. I analysed 526 submitted trials: 73 (... |
A trial comparing emergency front of neck airway performance in a novel obese-synthetic neck, meat-modified obese neck and conventional slim manikin | Conventional emergency front of neck airway training manikins mimic slim patients and are associated with unrealistic procedural ease. We have described previously a pork belly-modified manikin that more realistically simulated an obese patient's neck. In this study, we compared a novel obese-synthetic manikin (obese-s... |
Anesthesia Considerations and Infection Precautions for Trauma and Acute Care Cases During the COVID-19 Pandemic: Recommendations From a Task Force of the Chinese Society of Anesthesiology | Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread worldwide. During the ongoing COVID-19 epidemic, most hospitals have postponed elective surgeries. However, some emergency surgeries, especially for trauma patients, are inevitable. For patients with ... |
A prospective survey of intra-operative critical incidents in a teaching hospital in a developing country | Critical incident monitoring has the advantage of identifying a potential risk to the patient without it necessarily resulting in morbidity. An added advantage in developing countries is the low cost involved in introducing the programme. This paper analyses the incidents reported from the operating room suite in a tea... |
Definitions in obstetric anaesthesia: How should we measure anaesthetic workload and what is 'epidural rate'? | Crude delivery rate is used to calculate requirements for consultant anaesthetic sessions in the UK, but this calculation is arbitrary and ignores differences in case-mix between units. The term 'epidural rate' is commonly used to indicate regional anaesthetic activity but has never been defined. We challenge both thes... |
Anaesthesia - A sedentary specialty? Accelerometer assessment of the activity level of anaesthetists while at work | Current guidance recommends that all adults should take a minimum of 10 000 steps a day to remain healthy. We assessed the activity levels of 45 anaesthetists while at work, using accelerometers. These devices also allowed us to measure sitting, standing and walking time - features of the working day that are also like... |
A survey of undergraduate teaching in anaesthesia | Currently, no well accepted and clearly defined 'core' curriculum for undergraduate anaesthesia teaching exists. To address this deficiency we surveyed 73 university departments of anaesthesia and intensive care. Sixty-five replied from South-east Asia (12), Australasia (13), the UK and Ireland (28) and Canada (12). A ... |
A novel technique to determine an 'apparent ke0' value for use with the Marsh pharmacokinetic model for propofol | Debate continues over the most appropriate blood-brain equilibration rate constant (ke0) for use with the Marsh pharmacokinetic model for propofol. We aimed to define the optimal ke0 value. Sixty-four patients were sedated with incremental increases in effect-site target concentration of propofol while using six differ... |
Effects of the European working time directive on anaesthetic training in the United Kingdom | Decreases in the hours worked by trainee anaesthetists are being brought about by both the New Deal for Trainees and the European Working Time Directive. Anticipated improvements in health and safety achieved by a decrease in hours will be at the expense of training time if the amount of night-time work remains constan... |
Improving perioperative brain health: an expert consensus review of key actions for the perioperative care team | Delirium and postoperative neurocognitive disorder are the commonest perioperative complications in patients more than 65 yr of age. However, data suggest that we often fail to screen patients for preoperative cognitive impairment, to warn patients and families of risk, and to take preventive measures to reduce the inc... |
Physician well-being in practice | Despite a recent surge of interest in physician well-being, the discussion remains diffuse and often scattered. Lingering questions of what wellness entails, how it is personally applicable, and what can be done, remain pervasive. In this review, we focus on policy-level, institutional and personal factors that are bot... |
Trends in Authorship in Anesthesiology Journals | Despite increasing representation in medicine, women continue to be a minority in academic practice and leadership, especially in male-dominated fields like anesthesiology. Differences in compensation and participation in leadership may represent barriers to career advancement for women in anesthesiology. Key factors f... |
Labor costs incurred by anesthesiology groups because of operating rooms not being allocated and cases not being scheduled to maximize operating room efficiency | Determination of operating room (OR) block allocation and case scheduling is often not based on maximizing OR efficiency, but rather on tradition and surgeon convenience. As a result, anesthesiology groups often incur additional labor costs. When negotiating financial support, heads of anesthesiology departments are of... |
Theoretic significance of pH dependence of narcotics and narcotic antagonists in clinical anesthesia | Determination of the effect of pH and temperature on pK(a) partition, and drug distribution coefficients in a series of common narcotics and their antagonists has shown that within the range of blood pH (7.1 to 7.7) encountered in the practice of anesthesiology, marked differences of distribution of the drugs between a... |
Effective standards and regulatory tools for respiratory gas monitors and pulse oximeters: The role of the engineer and clinician | Developing safe and effective medical devices involves understanding the hazardous situations that can arise in clinical practice and implementing appropriate risk control measures. The hazardous situations may have their roots in the design or in the use of the device. Risk control measures may be engineering or clini... |
Analysis of a national difficult airway database | Difficult airway management continues to adversely affect patient care and clinical outcomes and is poorly predicted. Previous difficult airway management is the most accurate predictor of future difficulty. The Difficult Airway Society initiated a national airway database to allow clinicians to access details of previ... |
Difficult tracheal intubation in obstetrics | Difficult intubation has been classified into four grades, according to the view obtainable at laryngoscopy. Frequency analysis suggests that, in obstetrics, the main cause of trouble is grade 3, in which the epiglottis can be seen, but not the cords. This group is fairly rare so that a proportion of anaesthetists will... |
Laryngeal mask airway intracuff pressure estimation by digital palpation of the pilot balloon: A comparison of reusable and disposable masks | Digital palpation of the pilot balloon provides information about the intracuff pressure of tile laryngeal mask airway. The purpose of this in vitro, study was to evaluate this technique for the reusable and disposable laryngeal mask airway. Ten anaesthetists and 10 recovery-unit nurses estimated intracuff pressures fr... |
Retention of tracheal intubation skills by novice personnel: A comparison of the Airtraq® and Macintosh laryngoscopes | Direct laryngoscopic tracheal intubation is a potentially lifesaving manoeuvre, but it is a difficult skill to acquire and to maintain. These difficulties are exacerbated if the opportunities to utilise this skill are infrequent, and by the fact that the consequences of poorly performed intubation attempts may be sever... |
Learning and performance of tracheal intubation by novice personnel: A comparison of the Airtraq® and Mancintosh laryngoscope | Direct laryngoscopic tracheal intubation is taught to many healthcare professionals as it is a potentially lifesaving procedure. However, it is a difficult skill to acquire and maintain, and, of concern, the consequences of poorly performed intubation attempts are potentially serious. The Airtraq® Laryngoscope is a nov... |
A comparison of McGrath and Macintosh laryngoscopes in novice users: A manikin study | Direct laryngoscopy using the Macintosh laryngoscope is a difficult skill to acquire. Videolaryngoscopy is a widely accepted airway management technique that may be easier for novices to learn. We compared the McGrath® videolaryngoscope and Macintosh laryngoscope by studying the performance of 25 medical students with ... |
The medicolegal importance of enhancing timeliness of documentation when using an anesthesia information system and the response to automated feedback in an academic practice | Documentation should ideally occur in real time immediately after completion of a service. Although electronic records often do not print the time that documentation notes were entered on the medical record, automated anesthesia record keeping systems store an audit trail that time stamps events entered by all anesthes... |
Zebulon Mennell: A pioneer of neurosurgical anaesthesia | Dr Zebulon Mennell, the first anaesthetist to devote himself largely to anaesthesia for neurosurgery, was horn on 15 June 1876. He graduated at St Thomas's Hospital in London, where he was an anaesthetist. He was also an anaesthetist at the Royal National Hospital for Nervous Diseases, Queen Square, London, a post whic... |
A tribute to Dr. Paul A. J. Janssen: entrepreneur extraordinaire, innovative scientist, and significant contributor to anesthesiology. | Dr. Paul Janssen was the founder of Janssen Pharmaceutica and the developer of over 80 pharmaceutical compounds that proved useful in human, botanical, and veterinary medicine. He and his coworkers synthesized the fentanyl family of drugs, many other potent analgesics, droperidol, etomidate, and numerous other importan... |
Special article: T. H. Seldon (1905-1991). | Dr. Seldon was Editor of Anesthesia & Analgesia from 1954 to 1977. We examined how he led the effort to transform this journal into a clinically relevant and vital publication for the specialty. |
Drug metabolizing ability in operating theatre personnel | Drug metabolizing ability was determined in a group of anesthetists and other operating theatre personnel. Two indices were used: plasma antipyrine half life and plasma γ glutamyl transpeptidase activity (γ GPT). The plasma clearance of antipyrine (2.93 ± 0.79 l./hr mean ± SD) was significantly faster (21%) in the oper... |
Drug metabolizing ability in operating theatre personnel | Drug-metabolizing ability was determined in a group of anaesthetists and other operating theatre personnel. A slightly increased rate of plasma antipyrine clearance was observed in the subjects studied. The extent of the increase was considerably less than that brought about by hypnotic doses of barbiturates or by occu... |
Subsets and Splits
No community queries yet
The top public SQL queries from the community will appear here once available.