18,777 results match your criteria British journal of anaesthesia[Journal]


The effect of i-gel insertion on the accuracy of cricothyroid membrane identification in adult females: a prospective observational study.

Br J Anaesth 2019 Apr 12. Epub 2019 Apr 12.

Department of Anaesthesia, The Rotunda Hospital, Dublin, Ireland; Department of Anaesthesia, Mater Misericordiae Hospital, Dublin, Ireland; School of Medicine and Medical Science, University College Dublin, Dublin, Ireland.

Background: Identification of the cricothyroid membrane is frequently inaccurate in females because of less distinct anatomy compared with males. Supraglottic airway devices cause ventral displacement of the laryngeal structures. We investigated if this would impact on the accuracy of cricothyroid membrane identification using palpation. Read More

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http://dx.doi.org/10.1016/j.bja.2019.03.012DOI Listing

Ultrasound-guided lung sliding sign to confirm optimal depth of tracheal tube insertion in young children.

Br J Anaesth 2019 Apr 12. Epub 2019 Apr 12.

Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, Seoul, South Korea. Electronic address:

Background: The tip of the tracheal tube should lie at the mid-tracheal level after tracheal intubation in paediatric patients. Auscultation does not guarantee optimal positioning of the tracheal tube. We compared auscultation and the ultrasound-guided lung sliding sign to confirm optimal positioning of the tracheal tube in paediatric patients. Read More

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http://dx.doi.org/10.1016/j.bja.2019.03.020DOI Listing

Observed vs fitted results: look both ways! Comment on Br J Anaesth 2018; 121: 453-61.

Br J Anaesth 2019 Apr 12. Epub 2019 Apr 12.

Manchester, UK. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2019.03.015DOI Listing

Patterns of neuropsychological changes after general anaesthesia in young children: secondary analysis of the Mayo Anesthesia Safety in Kids study.

Br J Anaesth 2019 May;122(5):671-681

Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA. Electronic address:

Background: We hypothesised that exposure to multiple, but not single, procedures requiring general anaesthesia before age 3 yr is associated with a specific pattern of deficits in processing speed and fine motor skills.

Methods: A secondary analysis (using factor and cluster analyses) of data from the Mayo Anesthesia Safety in Kids study was conducted, in which unexposed, singly exposed, and multiply exposed children born in Olmsted County, MN, USA from 1994 to 2007 were sampled using a propensity-guided approach and underwent neuropsychological testing at ages 8-12 or 15-20 yr.

Results: In the factor analysis, the data were well fit to a five factor model. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.022DOI Listing

Try, try, and try again: personal reflections on the development of propofol.

Authors:
John B Glen

Br J Anaesth 2019 Apr 11. Epub 2019 Apr 11.

AstraZeneca, Knutsford, Cheshire, UK. Electronic address:

The prominent position that propofol occupies as an anaesthetic and sedative agent is very gratifying. It is a personal honour that my involvement for many years in the discovery, development, and introduction of propofol has been recognised with my selection to receive the prestigious 2018 Lasker-DeBakey Clinical Medical Research Award. It has been a privilege for me to work with so many highly skilled and enthusiastic anaesthetists, and I welcome the opportunity to present some personal reflections on my time as a veterinary anaesthetist, as a research biologist in the Anaesthetics Project Team at ICI Pharmaceuticals Division (which later became Zeneca, then merged with Astra to form AstraZeneca), and as a Clinical Scientist within the Medical Department. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00070912193022
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http://dx.doi.org/10.1016/j.bja.2019.02.031DOI Listing
April 2019
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Mayo Anesthesia Safety in Kids continued: two new studies and a potential redirection of the field.

Br J Anaesth 2019 Apr 11. Epub 2019 Apr 11.

Department of Anesthesiology, Columbia University College of Physicians and Surgeons and Mailman School of Public Health, New York, NY, USA.

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http://dx.doi.org/10.1016/j.bja.2019.03.011DOI Listing

Effects of low-dose intraoperative fentanyl on postoperative respiratory complication rate: a pre-specified, retrospective analysis.

Br J Anaesth 2019 Apr 11. Epub 2019 Apr 11.

Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA; Universitätsklinikum Essen, Essen, Germany. Electronic address:

Background: Fentanyl is one of the most frequently administered intraoperative drugs and may increase the risk of postoperative respiratory complications (PRCs).

Methods: We performed a pre-specified analysis of 145 735 adult non-cardiac surgical cases under general anaesthesia. Using multivariable logistic regression, we evaluated the association of intraoperative fentanyl dose and PRCs within 3 days after surgery (defined as reintubation, respiratory failure, pneumonia, pulmonary oedema, or atelectasis). Read More

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http://dx.doi.org/10.1016/j.bja.2019.03.017DOI Listing

Optimising diagnostics in perioperative allergy.

Br J Anaesth 2019 Apr 11. Epub 2019 Apr 11.

Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital, Gentofte, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

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http://dx.doi.org/10.1016/j.bja.2019.03.010DOI Listing

Learning from death.

Br J Anaesth 2019 Apr 9. Epub 2019 Apr 9.

Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand; Department of Anaesthesia, Auckland City Hospital, Auckland, New Zealand. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2019.03.002DOI Listing

Opioids: refining the perioperative role of God's own medicine.

Br J Anaesth 2019 Apr 9. Epub 2019 Apr 9.

Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK; Department of Anaesthesia, Nottingham University Hospitals NHS Trust, Nottingham UK.

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http://dx.doi.org/10.1016/j.bja.2019.03.005DOI Listing

Creating a climate for speaking up.

Br J Anaesth 2019 Apr 8. Epub 2019 Apr 8.

Centre for Medical and Health Sciences Education, School of Medicine, University of Auckland, Auckland, New Zealand.

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http://dx.doi.org/10.1016/j.bja.2019.03.003DOI Listing

Assessing cross-reactivity to neuromuscular blocking agents by skin and basophil activation tests in patients with neuromuscular blocking agent anaphylaxis.

Br J Anaesth 2019 Apr 5. Epub 2019 Apr 5.

Department of Clinical Immunology and Allergy, Australia; Medicine (Immunology & Infectious Diseases), University of Sydney, Sydney, Australia; NSW Health Pathology, Sydney, Australia.

Background: Following diagnosis of neuromuscular blocking agent (NMBA) anaphylaxis, identifying safe alternatives for subsequent anaesthesia is critical. A patient with anaphylaxis to one NMBA can also have an allergic reaction to other NMBAs (cross-reactivity). Whilst drug provocation testing is standard for identifying or excluding allergy, there is significant risk. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00070912193016
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http://dx.doi.org/10.1016/j.bja.2019.03.001DOI Listing
April 2019
3 Reads

Mixed Mu-Nociceptin/Orphanin FQ opioid receptor agonists and the search for the analgesic holy grail.

Authors:
David G Lambert

Br J Anaesth 2019 Apr 5. Epub 2019 Apr 5.

Department of Cardiovascular Sciences, University of Leicester, Anaesthesia, Critical Care and Pain Management, Leicester Royal Infirmary, Leicester, UK. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2019.02.022DOI Listing

Heterogeneous effects of alveolar recruitment in acute respiratory distress syndrome: a machine learning reanalysis of the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial.

Br J Anaesth 2019 Apr 5. Epub 2019 Apr 5.

Research Institute, HCor-Hospital do Coração, São Paulo, Brazil.

Background: Despite a robust physiological rationale, recruitment manoeuvres with PEEP titration were associated with harm in the Alveolar Recruitment for Acute Respiratory Distress Syndrome Trial (ART). We sought to investigate the potential heterogeneity in treatment effects in patients enrolled in the ART, using a machine learning approach.

Methods: The primary outcome was hospital mortality. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00070912193018
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http://dx.doi.org/10.1016/j.bja.2019.02.026DOI Listing
April 2019
3 Reads

The relationship between intraoperative oliguria and acute kidney injury.

Br J Anaesth 2019 Apr 5. Epub 2019 Apr 5.

University of Cape Town, Department of Anaesthesia and Perioperative Medicine, Groote Schuur Hospital, Cape Town, South Africa.

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http://dx.doi.org/10.1016/j.bja.2019.03.008DOI Listing

Chlorhexidine allergy in the perioperative setting: a narrative review.

Br J Anaesth 2019 Apr 4. Epub 2019 Apr 4.

Danish Anaesthesia Allergy Centre, Allergy Clinic, Department of Dermatology and Allergy, Copenhagen University Hospital, Gentofte, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Chlorhexidine is an antiseptic with a broad spectrum of activity and a persistent effect on skin. Consequently, it has become an ubiquitous antiseptic in healthcare and the community. As use has become widespread, increasing numbers of cases of allergy have been reported in the literature, including cases of anaphylaxis to chlorhexidine gels used on mucous membranes, chlorhexidine-impregnated devices such as central venous catheters, chlorhexidine preparations used on wounds and broken skin, and cases after dental procedures. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.033DOI Listing
April 2019
5 Reads

Anti-platelet therapy and the anaesthesiologist: controversies and unresolved clinical dilemmas continue.

Br J Anaesth 2019 Apr 4. Epub 2019 Apr 4.

Toronto, Canada. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2019.03.009DOI Listing

Evidence and efficacy: time to think beyond the traditional randomised controlled trial in patient safety studies.

Authors:
Craig S Webster

Br J Anaesth 2019 Apr 3. Epub 2019 Apr 3.

Department of Anaesthesiology and Centre for Medical and Health Sciences Education, University of Auckland, Auckland, New Zealand. Electronic address:

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http://dx.doi.org/10.1016/j.bja.2019.02.023DOI Listing

Integrating basophil activation tests into evaluation of perioperative anaphylaxis to neuromuscular blocking agents.

Br J Anaesth 2019 Apr 4. Epub 2019 Apr 4.

Department of Clinical Immunology and Allergy, Royal North Shore Hospital, Sydney, Australia; Medicine (Immunology & Infectious Diseases), University of Sydney, Sydney, Australia; Medicine (Immunology & Infectious Diseases), NSW Health Pathology, Sydney, Australia.

Background: Neuromuscular blocking agents (NMBAs) remain the leading cause of perioperative anaphylaxis in Australia. Standard evaluation comprises history, skin tests, and in vitro specific immunoglobulin E tests. Drug provocation tests to suspected NMBA culprits are associated with a significant risk. Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.024DOI Listing
April 2019
1 Read

Noninvasive cardiac output monitoring in a porcine model using the inspired sinewave technique: a proof-of-concept study.

Br J Anaesth 2019 Apr 4. Epub 2019 Apr 4.

Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK.

Background: Cardiac output (Q˙) monitoring can support the management of high-risk surgical patients, but the pulmonary artery catheterisation required by the current 'gold standard'-bolus thermodilution (Q˙)-has the potential to cause life-threatening complications. We present a novel noninvasive and fully automated method that uses the inspired sinewave technique to continuously monitor cardiac output (Q˙).

Methods: Over successive breaths the inspired nitrous oxide (NO) concentration was forced to oscillate sinusoidally with a fixed mean (4%), amplitude (3%), and period (60 s). Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.025DOI Listing
April 2019
3 Reads

Reduced perioperative blood loss in children undergoing craniosynostosis surgery using prolonged tranexamic acid infusion: a randomised trial.

Br J Anaesth 2019 Apr 2. Epub 2019 Apr 2.

Department of Anaesthesiology, Aarhus University Hospital, Denmark.

Background: Tranexamic acid (TXA) reduces intraoperative blood loss and transfusion during paediatric craniosynostosis surgery. Additional reduction of postoperative blood loss may further reduce exposure to allogeneic blood products. We studied the effect of combined intra- and postoperative TXA treatment on postoperative blood loss in children. Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.017DOI Listing

Identifying brain regions associated with the neuropathology of chronic low back pain: a resting-state amplitude of low-frequency fluctuation study.

Br J Anaesth 2019 Apr 1. Epub 2019 Apr 1.

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Department of Radiology, Martinos Center for Biomedical Imaging, Charlestown, MA, USA. Electronic address:

Background: Previous studies have found widespread pain processing alterations in the brain in chronic low back pain (cLBP) patients. We aimed to (1) identify brain regions showing altered amplitude of low-frequency fluctuations (ALFF) using MRI and use these regions to discriminate cLBP patients from healthy controls (HCs) and (2) identify brain regions that are sensitive to cLBP pain intensity changes.

Methods: We compared ALFF differences by MRI between cLBP subjects (90) and HCs (74), conducted a discriminative analysis to validate the results, and explored structural changes in key brain regions of cLBP. Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.021DOI Listing
April 2019
3 Reads

Targeted intracluster supraclavicular brachial plexus block: too close for comfort.

Br J Anaesth 2019 Mar 28. Epub 2019 Mar 28.

Department of Anesthesiology and Perioperative Medicine, University of Pittburgh, Pittsburgh, PA, USA.

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http://dx.doi.org/10.1016/j.bja.2019.02.020DOI Listing

Microdeletion in a FAAH pseudogene identified in a patient with high anandamide concentrations and pain insensitivity.

Br J Anaesth 2019 Mar 28. Epub 2019 Mar 28.

Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London, UK. Electronic address:

The study of rare families with inherited pain insensitivity can identify new human-validated analgesic drug targets. Here, a 66-yr-old female presented with nil requirement for postoperative analgesia after a normally painful orthopaedic hand surgery (trapeziectomy). Further investigations revealed a lifelong history of painless injuries, such as frequent cuts and burns, which were observed to heal quickly. Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.019DOI Listing
March 2019
1 Read

The receptor tyrosine kinase-like orphan receptor ROR2 modulates neuropathic pain via phosphorylation of N-methyl-D-aspartate receptor subunit GluN2B.

Br J Anaesth 2018 Oct 29. Epub 2018 Oct 29.

Department of Anesthesiology, First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. Electronic address:

Background: Neuropathic pain, a type of chronic pain as a result of direct central or peripheral nerve damage, is associated with significant quality of life and functional impairment. Its underlying mechanisms remain unclear. We investigated whether ROR2, a member of the receptor tyrosine kinase-like orphan receptor (ROR) family, participates in modulation of neuropathic pain. Read More

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http://dx.doi.org/10.1016/j.bja.2018.08.025DOI Listing
October 2018
2 Reads

Pain management decisions in emergency hospitals are predicted by brain activity during empathy and error monitoring.

Br J Anaesth 2019 Mar 22. Epub 2019 Mar 22.

Emergency Department, University Hospital of Lausanne (UHL), Lausanne, Switzerland.

Objective: Pain undertreatment, or oligoanalgesia, is frequent in the emergency department (ED), with major medical, ethical, and financial implications. Across different hospitals, healthcare providers have been reported to differ considerably in the ways in which they recognise and manage pain, with some prescribing analgesics far less frequently than others. However, factors that could explain this variability remain poorly understood. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.039DOI Listing

Time for accountability and change: institutional gaps in pain care during the opioid crisis.

Br J Anaesth 2019 Mar 18. Epub 2019 Mar 18.

Transitional Pain Service, Department of Anaesthesia and Pain Management, Toronto General Hospital, Toronto, ON, Canada; Department of Anaesthesia and Toronto Centre for the Study of Pain, University of Toronto, Toronto, ON, Canada.

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https://linkinghub.elsevier.com/retrieve/pii/S00070912193010
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http://dx.doi.org/10.1016/j.bja.2019.02.015DOI Listing
March 2019
5 Reads

Lung protective ventilation during pulmonary resection in children: a prospective, single-centre, randomised controlled trial.

Br J Anaesth 2019 May 8;122(5):692-701. Epub 2019 Mar 8.

Department of Anaesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Perioperative ventilatory strategies for lung protection in children are underexplored. This study evaluated the effects of lung protective ventilation (LPV) on postoperative clinical outcomes in children requiring one-lung ventilation (OLV) for pulmonary resection.

Methods: Children age ≤5 yr scheduled for video-assisted thoracoscopic lung lobectomy or segmentectomy were randomly assigned to LPV or control ventilation. Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.013DOI Listing
May 2019
1 Read

Elevated fibrinogen, von Willebrand factor, and Factor VIII confer resistance to dilutional coagulopathy and activated protein C in normal pregnant women.

Br J Anaesth 2019 Mar 18. Epub 2019 Mar 18.

Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA.

Background: Gestational changes in coagulation factor concentrations include elevations in fibrinogen, Factor VIII, and von Willebrand factor (vWF). We hypothesised that blood samples from term pregnant (TP) subjects are less prone to coagulation disturbances from haemodilution compared with those from non-pregnant (NP) females.

Methods: Blood samples were collected from 15 NP and 15 TP subjects. Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.012DOI Listing
March 2019
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Permeabilised skeletal muscle reveals mitochondrial deficiency in malignant hyperthermia-susceptible individuals.

Br J Anaesth 2019 May 20;122(5):613-621. Epub 2019 Mar 20.

Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.

Background: Individuals genetically susceptible to malignant hyperthermia (MH) exhibit hypermetabolic reactions when exposed to volatile anaesthetics. Mitochondrial dysfunction has previously been associated with the MH-susceptible (MHS) phenotype in animal models, but evidence of this in human MH is limited.

Methods: We used high resolution respirometry to compare oxygen consumption rates (oxygen flux) between permeabilised human MHS and MH-negative (MHN) skeletal muscle fibres with or without prior exposure to halothane. Read More

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http://dx.doi.org/10.1016/j.bja.2019.02.010DOI Listing

Noninvasive continuous detection of arterial hypotension during induction of anaesthesia using a photoplethysmographic signal: proof of concept.

Br J Anaesth 2019 May 11;122(5):605-612. Epub 2019 Mar 11.

Department of Anaesthesiology and Critical Care, Lariboisière Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France; UMR-S942, Lariboisière Hospital, Paris, France; University of Paris Diderot, Paris, France; MEDISIM, Inria Paris-Saclay, Palaiseau, France.

Background: During general anaesthesia, intraoperative hypotension (IOH), defined as a mean arterial pressure (MAP) reduction of > 20%, is frequent and may lead to complications. Pulse oximetry is mandatory in the operating room, making the photoplethysmographic signal and parameters, such as relative dicrotic notch height (Dic) or perfusion index (PI), readily available. The purpose of this study was to investigate whether relative variations of Dic and PI could detect IOH during anaesthesia induction, and to follow their variations during vasopressor boluses. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.037DOI Listing

Surgical pleth index: prospective validation of the score to predict moderate-to-severe postoperative pain.

Br J Anaesth 2019 Mar 11. Epub 2019 Mar 11.

Armadale Health Services, Perth, Australia.

Background: Reported outcome benefits after surgical pleth index (SPI, GE Healthcare, Helsinki, Finland) guided anaesthesia are conflicting. One potential explanation may be the lack of evidence for the selection of meaningful SPI target values. A recently published trial found an SPI cut-off of 30 as a 'best-fit' to predict moderate-to-severe acute postoperative pain. Read More

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http://dx.doi.org/10.1016/j.bja.2018.10.066DOI Listing

Programmed intermittent epidural bolus technique for maintenance of labour analgesia: does it work for everyone?

Br J Anaesth 2019 Mar 14. Epub 2019 Mar 14.

Départment d'Anesthésie, Hôpital Antoine Béclère (Hôpitaux Universitaires Paris-Sud, AP-HP) & Université Paris-Sud, Clamart, France.

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http://dx.doi.org/10.1016/j.bja.2019.02.008DOI Listing

High inspired oxygen fraction impairs lung volume and ventilation heterogeneity in healthy children: a double-blind randomised controlled trial.

Br J Anaesth 2019 May 11;122(5):682-691. Epub 2019 Mar 11.

Department of Anaesthesiology, Pharmacology and Intensive Care, University Hospitals of Geneva, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland. Electronic address:

Background: Although a high inspired oxygen fraction (FiO) is commonly used in paediatric anaesthesia, the impact on postoperative lung function is unclear. We compared lung volume, ventilation heterogeneity, and respiratory mechanics in anaesthetised children randomised to receive low or high FiO intraoperatively.

Methods: In a double-blind randomised controlled trial, children scheduled for elective surgery were randomly assigned FiO 100% (n=29) or FiO 80% (n=29) during anaesthesia induction and emergence. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.036DOI Listing
May 2019
1 Read

Applied reflective practice in medicine and anaesthesiology.

Br J Anaesth 2019 05 20;122(5):536-541. Epub 2019 Mar 20.

Harvard Medical School, Boston, MA, USA; Center for Medical Simulation, Boston, MA, USA; Department of Anaesthesiology, Critical Care, and Pain Medicine, Boston Children's Hospital, Boston, MA, USA.

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http://dx.doi.org/10.1016/j.bja.2019.02.006DOI Listing

Corrigendum to 'Retrospective analysis of 30-day unplanned readmission after major abdominal surgery with reversal by sugammadex or neostigmine' (Br J Anaesth 2019; 122: 370-378).

Br J Anaesth 2019 05 22;122(5):704. Epub 2019 Feb 22.

Department of Biostatistics, Korea University College of Medicine, Seoul, Republic of Korea.

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http://dx.doi.org/10.1016/j.bja.2019.02.005DOI Listing
May 2019
4.853 Impact Factor

Use of simulation to improve management of perioperative anaphylaxis: a narrative review.

Br J Anaesth 2019 Mar 12. Epub 2019 Mar 12.

Department of Anaesthesia and Perioperative Medicine, Monash University, Melbourne, Australia; Department of Anaesthesia, Peninsula Health, Melbourne, Australia; Department of Medical Education, University of Melbourne, Melbourne, Australia.

Simulation-based education is often highlighted as a method to prepare health personnel to handle clinical emergencies through repeated training and the design of supports. As one of the most common clinical emergencies in anaesthesia, anaphylaxis is often included in simulation scenarios at both graduate and postgraduate levels. Case reviews of anaphylaxis management continue to identify deficiencies in clinical responses. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.035DOI Listing
March 2019
1 Read

Grief reactions and coping strategies of trainee doctors working in paediatric intensive care.

Br J Anaesth 2019 Mar 6. Epub 2019 Mar 6.

Department of Human Factors in Patient Safety, Royal College of Surgeons of Ireland, Dublin, Ireland.

Background: The death of a child can have significant emotional effects on doctors responsible for their care. Trainee doctors working in the paediatric intensive care unit (PICU) may be particularly vulnerable. The aim of this study was to examine the emotional impact of, and grief reactions to, a child's death in PICU trainee doctors, along with coping strategies they used. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.034DOI Listing

Ventilatory inefficiency adversely affects outcomes and longer-term survival after planned colorectal cancer surgery.

Br J Anaesth 2019 Mar 5. Epub 2019 Mar 5.

York Teaching Hospitals NHS Foundation Trust, York, UK.

Background: Impaired cardiorespiratory reserve is an accepted risk factor for patients having major surgery. Ventilatory inefficiency, defined by an elevated ratio of minute ventilation to carbon dioxide excretion (VE/VCO), and measured by cardiopulmonary exercise testing (CPET), is a pathophysiological characteristic of patients with cardiorespiratory disease. We set out to evaluate the prevalence of ventilatory inefficiency in a colorectal cancer surgical population, and its influence on surgical outcomes and long-term cancer survival. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.032DOI Listing

Molecular mechanisms and pathophysiology of perioperative hypersensitivity and anaphylaxis: a narrative review.

Br J Anaesth 2019 Mar 7. Epub 2019 Mar 7.

Anaesthetic Allergy Referral Centre of Western Australia, Department of Anaesthesia, Sir Charles Gairdner Hospital, Perth, Australia; Department of Pharmacology, University of Western Australia, Perth, Australia.

Perioperative hypersensitivity reactions (POH) constitute a clinical and diagnostic challenge, a consequence of heterogeneous clinical presentations, and multiple underlying pathomechanisms. POH do not necessarily involve an allergen-specific immune response with cross-linking of specific immunoglobulin E (sIgE) antibodies on mast cells and basophils. POH can also result from alternative specific and non-specific effector cell activation/degranulation such as complement-derived anaphylatoxins and off-target occupancy of mast cell, basophil, or both surface receptors. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S00070912193007
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http://dx.doi.org/10.1016/j.bja.2019.01.031DOI Listing
March 2019
5 Reads

Spinal GABA receptors for pain control: back to the future?

Br J Anaesth 2019 Mar 4. Epub 2019 Mar 4.

Department of Neurology, Danish Headache Center, Glostrup Research Institute, Glostrup, Denmark.

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http://dx.doi.org/10.1016/j.bja.2019.01.030DOI Listing

Critical airway management in the intensive care unit: homogeneity in practice?

Br J Anaesth 2019 05 4;122(5):533-536. Epub 2019 Mar 4.

Université de Strasbourg, Faculté de Médecine, France; Hôpitaux Universitaires de Strasbourg, Hôpital de Hautepierre, Service d'Anesthésie-Réanimation Chirurgicale, Strasbourg, France.

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http://dx.doi.org/10.1016/j.bja.2019.02.002DOI Listing

Corrigendum to 'Predictors of perioperative complications in paediatric cranial vault reconstruction surgery: a multicentre observational study from the Pediatric Craniofacial Collaborative Group' [Br J Anaesth 2019; 122: 215-223].

Br J Anaesth 2019 05 15;122(5):703. Epub 2019 Feb 15.

Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Anesthesiology and Critical Care, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.

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http://dx.doi.org/10.1016/j.bja.2019.02.001DOI Listing

Novel neurosteroid hypnotic blocks T-type calcium channel-dependent rebound burst firing and suppresses long-term potentiation in the rat subiculum.

Br J Anaesth 2019 May 28;122(5):643-651. Epub 2019 Feb 28.

Department of Anesthesiology, University of Colorado, School of Medicine, Aurora, CO, USA.

Background: Hypnotics and general anaesthetics impair memory by altering hippocampal synaptic plasticity. We recently reported on a neurosteroid analogue with potent hypnotic activity [(3β,5β,17β)-3-hydroxyandrostane-17-carbonitrile; 3β-OH], which does not cause developmental neurotoxicity in rat pups. Here, we investigated the effects of 3β-OH on neuronal excitability in the subiculum, the major output structure of the hippocampal formation, and synaptic plasticity at two key hippocampal synapses in juvenile rats. Read More

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http://dx.doi.org/10.1016/j.bja.2019.01.029DOI Listing