Spinal-induced hypotension at caesarean section
Publication date: Available online 20 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Mohamed Elriedy, Rowena CockerhamAbstractSpinal anaesthesia is preferred for caesarean section, yet hypotension remains a significant problem and may adversely affect mother and baby. Understanding the physiological causes is essential to direct management. The international consensus of management includes vasopressors, intravenous fluids and avoidance of aorto-caval compression. Phenylephrine by infusion is now the vasopressor of choice. Low-dose spinal anaesthesia can reduce the incidence but risks inadequate anaes...
Source: Anaesthesia and intensive care medicine - June 20, 2019 Category: Anesthesiology Source Type: research

Non-neuraxial analgesia in labour
Publication date: Available online 18 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Catherine Robinson, Lorna A. HowieAbstractPain in labour is often described as one of the most severe pains experienced. Neuraxial techniques provide the most effective form of labour analgesia. However, not all women wish to have this or indeed want complete pain relief in labour. There are also subgroups of women in whom neuraxial techniques are contraindicated or attempted placement is unsuccessful. Therefore delivery units must be able to offer a range of non-neuraxial analgesia options for labour. (Source: Anaest...
Source: Anaesthesia and intensive care medicine - June 20, 2019 Category: Anesthesiology Source Type: research

Physiology of pregnancy
Publication date: Available online 17 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Andrew Mockridge, Kirsty MaclennanAbstractDuring pregnancy, maternal physiology undergoes continual adaptation. These often interlinked changes occur in all body systems and are affected by the hormonal influences of the placenta and the mechanical adaptations required to accommodate the developing fetus. These important physiological changes can potentially lead to decompensation in parturients with pre-existing co-morbidities. They may also unmask asymptomatic pre-pregnancy disease. A sound knowledge of the expected...
Source: Anaesthesia and intensive care medicine - June 19, 2019 Category: Anesthesiology Source Type: research

Neuraxial analgesia in labour – induction and maintenance
Publication date: Available online 17 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Brynmor A. Summers, Graeme G. FlettAbstractSince the introduction of epidurals for labour analgesia in 1946 it has become the gold standard on delivery units throughout the world. Controversy remains as to the effects of neuraxial block upon the fetus; however, it is now widely accepted that there are beneficial and not just detrimental effects. With the introduction of low-dose anaesthetic solutions the major cardiovascular effects and concerns with toxicity have become much less prominent and the lack of profound mo...
Source: Anaesthesia and intensive care medicine - June 19, 2019 Category: Anesthesiology Source Type: research

Antenatal anaesthetic assessment of high risk obstetric patients
Publication date: Available online 14 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Nosakhare A. Uwubamwen, Dipali VermaAbstractEarly identification and anaesthetic assessment of high-risk patients in pregnancy is important and best delivered through a formal assessment clinic. It provides the opportunity to provide information, agree management plans, and carry out necessary investigations and referrals to other specialists prior to labour and delivery. Clear referral criteria and lines of communication are necessary for an effective service. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 16, 2019 Category: Anesthesiology Source Type: research

Pre-eclampsia and the anaesthetist
Publication date: Available online 15 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Yogini Kalamkar, Kailash BhatiaAbstractPre-eclampsia is a multisystem disorder of pregnancy that forms an integral part of the spectrum known as hypertensive diseases of pregnancy, occurring after 20 weeks of gestation. Intracerebral haemorrhage, pulmonary, liver and renal dysfunction are recognized complications of pre-eclampsia that contribute to maternal morbidity and mortality. Measurement of specific maternal angiogenic factors such as placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1)...
Source: Anaesthesia and intensive care medicine - June 16, 2019 Category: Anesthesiology Source Type: research

Intrauterine fetal resuscitation
Publication date: Available online 15 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Hannah Kither, Suna MonaghanAbstractThe delivery of oxygen to the fetus is dependent on adequate maternal blood oxygen concentration, uterine blood supply, placental transfer and fetal gas transport. Any disturbance in these factors, singly or in combination, can result in progressive fetal hypoxia and acidosis. The term fetal distress is non-specific but is usually applied to certain characteristic features on electronic fetal monitoring, confirmed if possible by fetal blood sampling. The aim of intrauterine fetal re...
Source: Anaesthesia and intensive care medicine - June 16, 2019 Category: Anesthesiology Source Type: research

Uterine physiology
Publication date: Available online 14 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Kamran Abbas, Suna D. Monaghan, Iain CampbellAbstractThe role of the uterus is to nurture the fetus until parturition. Functionally it consists of a lower cervix (which acts at different times as a passageway, a barrier and a reservoir) and an upper body in which the fetus develops. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 14, 2019 Category: Anesthesiology Source Type: research

Functions of the placenta
Publication date: Available online 14 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Leo Donnelly, Gillian CamplingAbstractThe placenta is an ephemeral materno-fetal organ with chorionic (fetal) villi bathed in maternal blood spaces, which allows restricted transfer of metabolites and drugs across specialized transfer areas. The placenta develops respiratory, nutritive and excretory functions while the fetal organs mature, and is also an important endocrine organ. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 14, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 14 June 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 14, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: June 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 6Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 24, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: June 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 6Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 24, 2019 Category: Anesthesiology Source Type: research

Peripheral and local anaesthetic techniques for paediatric surgery
This article discusses a general approach to peripheral nerve blocks in children, along with the benefits of a predominately ultrasound-based approach and the role of peripheral catheters. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 11, 2019 Category: Anesthesiology Source Type: research

Crystalloids, colloids, blood products and blood substitutes
Publication date: Available online 9 May 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Christopher Naisbitt, K.F.A. Mos, Roop KishenAbstractUnderstanding the physiology of fluid distribution in the human body is fundamental to good clinical practice in anaesthesia and intensive care. Intravenous fluid therapies have a range of clinical and metabolic consequences and they should be context and patient specific. Inadequate or excessive fluid treatment is harmful to patients. There are numerous trials, both historical and current, investigating best practice in fluid therapy. New paradigms and guidelines are...
Source: Anaesthesia and intensive care medicine - May 11, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 10 May 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 11, 2019 Category: Anesthesiology Source Type: research

Paediatric day-case surgery
This article discusses the role of preoperative assessment and the need to consider each case individually despite robust inclusion/exclusion criteria. Optimization of preoperative hydration, pain management and prevention of postoperative nausea and vomiting are highlighted as important factors to successful day-case surgery. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 8, 2019 Category: Anesthesiology Source Type: research

Principles of paediatric anaesthesia
This article provides an overview of the practical aspects of paediatric anaesthesia, with particular emphasis on airway and fluid management. Common dilemmas that may be encountered during preoperative assessment are highlighted, including the child with asthma, obstructive sleep apnoea and the particularly anxious child. In light of the findings of the fourth National Audit Project (NAP4), strategies for managing the child with the difficult airway are discussed. The rationale for the use of isotonic perioperative fluids is outlined, along with the management of intraoperative blood loss. The increasingly recognized prob...
Source: Anaesthesia and intensive care medicine - May 8, 2019 Category: Anesthesiology Source Type: research

Neuraxial anaesthesia in paediatrics
Publication date: Available online 7 May 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Ryan Marcelino, Amod Sawardekar, Santhanam SureshAbstractNeuraxial anaesthesia is a valuable aid in the practice of paediatric anaesthesia. Spinal and epidural blockade are used as either the sole anaesthetic or as an adjunct to general anaesthesia, and often confer significant postoperative analgesia. Caudal epidural anaesthesia is used extensively for lower abdominal, urological and orthopaedic procedures in the setting of outpatient surgery. Lumbar and thoracic epidural infusions via a catheter can provide analgesia ...
Source: Anaesthesia and intensive care medicine - May 8, 2019 Category: Anesthesiology Source Type: research

Safe sedation of children for diagnostic and therapeutic procedures
This article will discuss how sedation can be safely performed. The depth of sedation has been classified into minimal, moderate and deep according to the National Institute for Health and Care Excellence. Amongst others, benefits of sedation include increased parental and child satisfaction, increased cost ben- efits for the hospital and reduced adverse effects of general anaes- thesia such as emergence delirium and postoperative nausea and vomiting. Safe sedation can be used for a wide range of procedures, most commonly for CT and MRI. Others include removing drains, changing burns dressings, simple plastic surgery proce...
Source: Anaesthesia and intensive care medicine - May 5, 2019 Category: Anesthesiology Source Type: research

An update of systemic analgesics in children
Publication date: Available online 3 May 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Jennifer A. WrightAbstractEffective and safe pain management in children can be complex and challenging. It remains an important goal in order to minimize acute distress, behavioural changes, central sensitization and hyperalgesia. Neonates are particularly susceptible to long-term neurodevelopmental changes due to the neuroplasticity of their immature brains, and adequate analgesia may help ameliorate these changes. The focus of this review is to look at systemic analgesic options available for children, infants and ne...
Source: Anaesthesia and intensive care medicine - May 5, 2019 Category: Anesthesiology Source Type: research

Total intravenous anaesthesia in children: a practical guide
This article will discuss topics relevant to administration of TIVA in children – the potential benefits of TIVA, challenges and some clinical examples of its use. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 5, 2019 Category: Anesthesiology Source Type: research

Pain assessment in children
This article outlines the different tools available for pain assessment in infants and children (excluding neonates). (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 5, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: May 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 5Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 27, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: May 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 5Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 27, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for the ruptured aortic aneurysm
We present the key components of emergency anaesthesia for both OAR and EVAR and describe clinical dilemmas arising at preoperative and intraoperative stages. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - April 6, 2019 Category: Anesthesiology Source Type: research

Postoperative care and analgesia in vascular surgery
Publication date: Available online 5 April 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Shaun McMahon, Rachael L. BirdAbstractPatients undergoing major vascular surgery are high risk for myocardial infarction, renal failure, respiratory complications and death. Invasive procedures confer greater risk of complication, with patients undergoing open aortic surgery being at highest risk. Endovascular procedures are less invasive, yet not devoid of potentially serious complications. Reduction of myocardial oxygen demand is key: stabilizing cardiovascular parameters, maintaining normothermia, adequate volume r...
Source: Anaesthesia and intensive care medicine - April 6, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: April 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 4Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 30, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: April 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 4Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 30, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 28 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 29, 2019 Category: Anesthesiology Source Type: research

Risk modification and preoperative optimization of vascular patients
This article summarizes currently accepted best practice for risk modification and preoperative optimization prior to vascular surgery. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 23, 2019 Category: Anesthesiology Source Type: research

Neurological and humoral control of blood pressure
Publication date: Available online 21 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Soumitra K. Ghosh, Jaideep J. PanditAbstractThere is a relationship between arterial blood pressure, cardiac output and vascular resistance described mathematically, that helps us to understand short-term control of blood pressure in terms of a hydraulic system. Arterial baroreceptors are specialized sensors which mediate a rapid response to sudden changes in pressure through interaction with the autonomic nervous system. This in turn influences heart rate, inotropic state and vascular tone, altering distribution of ...
Source: Anaesthesia and intensive care medicine - March 22, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for endovascular aneurysm repair
Publication date: Available online 21 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): John Barrett, Sian JonesAbstractA patient with an abdominal aortic aneurysm can have surgical management through either an open or endovascular approach. The use of an endovascular approach has benefits for the patient by being a less invasive approach with initially lower mortality and morbidity and lower lengths of hospital stay, although longer term outcomes match open techniques. The endovascular technique requires more specialist equipment, including stents and imaging equipment. In the UK they are usually perfo...
Source: Anaesthesia and intensive care medicine - March 22, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for carotid surgery
Publication date: Available online 21 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Michael Stallard, Indran RajuAbstractCarotid endarterectomy (CEA) is a surgical procedure to prevent strokes in patients with atheromatous disease at the carotid bifurcation. The effectiveness of CEA has been established in large clinical trials. Patients should have surgery performed within 2 weeks from the onset of symptoms. This time frame presents challenges to the anaesthetist and surgeon in terms of risk stratification and optimization of patients. Optimization includes blood pressure control and use of antipla...
Source: Anaesthesia and intensive care medicine - March 22, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for open abdominal aortic surgery
Publication date: Available online 19 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Alastair Duncan, Adam PichelAbstractThe prevalence of abdominal aortic aneurysm (AAA) and the number of patients undergoing aneurysm repair is increasing. The UK has worked tirelessly to reduce its operative mortality rates for elective open AAA repair with the introduction of a quality improvement programme. Reducing death from ruptured aortic aneurysm has been the focus of the national screening programme. Despite the increased prevalence of disease and intervention, the popularity of open repair has diminished sin...
Source: Anaesthesia and intensive care medicine - March 20, 2019 Category: Anesthesiology Source Type: research

Applied cardiovascular physiology
Publication date: Available online 19 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Carla Gould, Jon HopperAbstractMaintaining an equilibrium between oxygen supply and demand is a principal function of the cardiovascular system. In times of altered metabolic demand mechanisms exist to maintain the balance between supply and demand. Exercise, haemorrhage and pregnancy all lead to changes in oxygen demand and subsequently modification of cardiac output. During isotonic exercise, metabolic demands of muscle are greatly increased. Sympathetic stimulation and inhibition of the parasympathetic system lead...
Source: Anaesthesia and intensive care medicine - March 20, 2019 Category: Anesthesiology Source Type: research

Preoperative assessment of patients for major vascular surgery
Publication date: Available online 19 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): James W. Durrand, Gerard R. DanjouxAbstractEffective preoperative evaluation of patients prior to major vascular surgery remains a significant multidisciplinary challenge. Focussed preoperative evaluation targeted to organ systems can mitigate the combined effects of inherently high-risk surgical procedures undertaken in a patient population with well-recognized comorbidity. Careful history and examination, supported by appropriate investigations and specialist input, remains the cornerstone of this process, with ris...
Source: Anaesthesia and intensive care medicine - March 20, 2019 Category: Anesthesiology Source Type: research

Anaesthesia for vascular surgery on the extremities
Publication date: Available online 20 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Richard J. TelfordAbstractPeripheral arterial surgery is challenging, operations are frequently long and associated with insidious blood loss. Because of the high incidence of comorbidities these patients are a high-risk group with a high incidence of morbidity and mortality. They key to successful outcome is meticulous attention to detail by all those professions involved in their care. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 20, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 20 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Viyayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 20, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: March 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 3Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 15, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: March 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 3Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 15, 2019 Category: Anesthesiology Source Type: research

Insertion of a chest drain for pneumothorax
Publication date: Available online 15 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Bilal Kirmani, Joseph ZachariasAbstractThe insertion of a chest drain, either using the Seldinger technique or as a cut-down for a wide bore tube, is common and relatively straightforward. An appreciation of the anatomy, procedural technique and potential complications is important. The process is outlined here. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - March 15, 2019 Category: Anesthesiology Source Type: research

Complications of regional anaesthesia
Publication date: Available online 14 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Alasdair Taylor, Calum R.K. GrantAbstractComplications of regional anaesthesia can be divided into those specific to central neuraxial blockade, those specific to peripheral nerve blockade, and those that pertain to both. Fortunately, severe complications, namely spinal cord damage, vertebral cord haematoma and epidural abscess are rare. Here we have given an overview of these complications, with reference to incidences available following the 3rd National Audit Project of the Royal College of Anaesthetists. A thorou...
Source: Anaesthesia and intensive care medicine - March 14, 2019 Category: Anesthesiology Source Type: research

Lower limb nerve blocks
Publication date: Available online 14 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Calum R.K. GrantAbstractThe proliferation of ultrasound use is changing the approach to regional anaesthesia of the lower limb. Techniques are being developed that provide high-quality postoperative analgesia while minimizing associated motor block that may impair mobilization. Regional anaesthetic techniques also provide significant opioid-sparing benefits (e.g. less sedation, nausea and urinary retention) that are key principles of current enhanced recovery protocols. Ultrasound-guided nerve localization offers sev...
Source: Anaesthesia and intensive care medicine - March 14, 2019 Category: Anesthesiology Source Type: research

Systemic toxic effects of local anaesthetics
Publication date: Available online 13 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Heather N. Sheppard, Ravi AnandampillaiAbstractLocal anaesthetics are widely used in the provision of local/regional anaesthesia and the management of acute and chronic pain. Their mechanism of action temporarily inhibits voltage gated sodium channels in neuronal plasma membranes. Local anaesthetic systemic toxicity (LAST) is a serious yet largely preventable complication that can occur by any of the multiple routes of administration. LAST predominantly affects the central nervous and cardiovascular systems. Awarenes...
Source: Anaesthesia and intensive care medicine - March 14, 2019 Category: Anesthesiology Source Type: research

Practical aspects of ultrasound-guided regional anaesthesia
Publication date: Available online 8 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Pavan Kumar BC. Raju, Calum RK. GrantAbstractUltrasound-guided regional anaesthesia is increasingly popular, offering the user a number of advantages over alternative methods of nerve localization (neurostimulation or paraesthesia). These include a more accurate understanding of individual patient anatomy, identification of needle tip position and the ability to assess local anaesthetic spread in relation to a target nerve. An understanding of the basic principles and commonly used terminologies of ultrasound scanning...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Intravenous regional anaesthesia
Publication date: Available online 7 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Alastair J.M. Baird, Colin B. DonaldAbstractIntravenous regional anaesthesia, or Bier's block, is a useful and safe technique for anaesthetizing distal limbs for short surgical procedures. It is most commonly used for reduction of forearm fractures within the emergency department and can be a useful method of providing anaesthesia in patients who may be unsuitable for a general anaesthetic, or when skills or equipment for other forms of regional anaesthesia are unavailable. When performed as recommended it has a prove...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Nerve cell function and synaptic mechanisms
Publication date: Available online 7 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Allan FletcherAbstractNerve cells (neurones) are ‘excitable’ cells that can transduce a variety of stimuli into electrical signals, continuously sending information about the external and internal environment (in the form of sequences of action potentials) to the central nervous system (CNS). Interneurones in the CNS integrate this information and send signals along output (efferent) neurones to various parts of the body for the appropriate actions to be taken in response to environmental changes. Networks...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Peripheral nerve catheter techniques
Publication date: Available online 7 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Ayman H.M. MustafaAbstractPeripheral nerve catheters (PNC) or perineural catheters are used synonymously to describe placing a catheter in close proximity to nerve plexuses or individual nerves for the provision of continuous pain relief. The indications of PNCs extend beyond upper and lower extremity orthopaedic surgery to perioperative analgesia in patients undergoing a wide range of surgical procedures (e.g. abdominal, vascular, thoracic, breast and trauma surgeries). PNC use can facilitate early mobilization after...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Action potential: generation and propagation
Publication date: Available online 8 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Allan FletcherAbstractIn the normal resting state, the plasma membrane of nerve and muscle cells generates a transmembrane electrical potential difference – the intracellular surface of the membrane being approximately 70–80 mV negative to the extracellular surface. This is a result of markedly different concentrations of ions inside and outside the cell, together with different membrane permeabilities to different ions that permits K+ to flow down their concentration gradient from inside to outside t...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research

Upper limb nerve blocks
Publication date: Available online 8 March 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Pavan Kumar B.C. Raju, James S. BownessAbstractBrachial plexus blockade is used for a variety of upper limb surgical procedures. Ultrasound guidance is generally considered to be the gold-standard technique, although large-scale studies examining efficacy and complications of ultrasound-guided techniques compared with nerve stimulation are still needed. Interscalene block remains the approach of choice for shoulder surgery, although phrenic nerve blockade is common even using low volumes of local anaesthetic. Of the c...
Source: Anaesthesia and intensive care medicine - March 9, 2019 Category: Anesthesiology Source Type: research