Obstetric haemorrhage
Abstract: Obstetric haemorrhage remains a significant cause of maternal morbidity and mortality. It is the leading obstetric cause for admission to intensive care units.Knowledge of risk factors and early recognition of haemorrhage enables rapid activation of a coordinated multidisciplinary team response.Clear unit protocols for the management of massive haemorrhage that are reinforced by team drills help to increase awareness in the multi-disciplinary team, improve performance and thus can improve patient outcome.Pharmacological agents and surgical manoeuvres are reviewed in the article, as are blood conservation techniqu...
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Kirsty Maclennan, Rachael Croft Tags: Obstetric anesthesia Source Type: research

Peripartum and intrapartum assessment of the fetus
Abstract: Perinatal death or cerebral palsy are devastating outcomes of pregnancy for families. In an attempt to prevent these outcomes fetal wellbeing is assessed by a variety of means in the antenatal and intrapartum settings. In this review, the most common means to confirm fetal wellbeing, the rationale for their use and evidence of their efficacy in each of these settings are discussed. With respect to labour, the indications for continuous electronic fetal monitoring are presented, together with a guide to interpretation of cardiotocograph (CTG) or fetal blood samples (FBS). (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Alexander Heazell Tags: Obstetric anesthesia Source Type: research

Neurological complications in obstetric regional anaesthesia
Abstract: Neurological complications in the postnatal period can cause significant morbidity in a population that is previously fit and healthy. The majority of neurological complications are due to compressive neuropathy resulting from prolonged labour, poor patient positioning or mode of delivery. Such neuropathies usually resolve within a few months. In 2009 the National Anaesthesia Audit Project (NAP3) identified that 45% of all central neuraxial blocks (CNB) are performed for obstetric reasons. While the incidence of neurological damage due to CNB is low it can result in permanent harm. It is important to understand t...
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Allison C.L. Howells Tags: Obstetric anesthesia Source Type: research

Regional anaesthesia for caesarean section (and what to do when it fails)
Abstract: Regional anaesthesia is the technique of choice for caesarean sections, with single-shot spinal most commonly used. Preoperative assessment must be undertaken in all women, and informed consent is mandatory. Antacid premedication should be given to both elective and emergency cases. Maternal obesity is a risk factor for failed regional anaesthesia. Light-touch is the most reliable way of assessing the block, and the level should be documented prior to surgery. Inadequate block is a frequent cause of litigation, and all women should be offered general anaesthesia. Good communication with the parturient and the obs...
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Stephen Wiggans, Ramesh Ekambaram, Richard Cross Tags: Obstetric anesthesia Source Type: research

Consent in obstetric anaesthesia
Abstract: Consent to medical treatment is a vital process that should occur prior to any procedure or intervention in a competent adult. There are ethical and legal reasons for doctors to ensure that valid, adequate consent has been obtained from a patient. It is generally accepted that written consent is acceptable, however, discussions regarding consent should be clearly documented, including specific risks discussed. Labouring women may have to consent for procedures when in severe pain, under the influence of strong analgesics, or in a time-pressured situation. However, the parturient is presumed to be competent. A com...
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Rhys Clayton, Ross Clark Tags: Ethics Source Type: research

The ethics of pregnancy testing
Abstract: Ethical and clinical concerns remain around mandatory pregnancy testing for under 16-year-olds attending for elective procedures. Existing national recommendations state that pregnancy state must be established in all females of reproductive capability. However for this group this is considered discriminatory as they may have capacity and the right to informed consent. In addition the possibility of safeguarding issues, disclosed under-age sexual activity and a newly revealed pregnancy in the presence of parents and guardians as well as the undue harm in attempting to determine pregnancy status when a positive re...
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Andrew Heck, Ross Clark Tags: Ethics Source Type: research

Post-dural puncture headache in the parturient
Abstract: Post-dural puncture headache (PDPH) is one of the most common and debilitating complications of neuraxial blockade in the parturient. The obstetric population is at particular risk with up to 80% of women developing symptoms after inadvertent dural puncture during epidural insertion. PDPH typically develops 24–48 hours post-puncture and is classically described as an occipito-frontal headache with postural features. Diagnosis and assessment should include consideration of other potential causes of post-partum headache. At the time of inadvertent dural puncture (IDP) one may insert an intrathecal catheter, r...
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Cathy Armstrong Tags: CORE: Obstetrics anaesthesia Source Type: research

Failed intubation in obstetrics
Abstract: Failed intubation in obstetric practice is rare, however it can have a devastating impact on the mother and fetus if not managed appropriately.Over the last 20 years there have been significant changes in anaesthetic management and training; in addition The European Working Time Directive has led to a reduction in junior doctors' hours. As a result, trainees now have less exposure to airway management, specifically endotracheal intubation.Acquiring skills in obstetric general anaesthesia is increasingly difficult as the majority of women will be suitable for regional anaesthesia.Training must be targeted at the d...
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Authors: Kate O. Brien, Clare Conlon Tags: CORE: Obstetrics anaesthesia Source Type: research

Editorial Board
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Source Type: research

Contents
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 30, 2013 Category: Anesthesiology Source Type: research

MCQs
Magnesium (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Henry G.W. Paw, Vijayanand Nadella Tags: Test yourself Source Type: research

Physiology of ageing
Abstract: The impact that ageing has on organisms is a complex interaction between the processes of ageing at a cellular, organ and integrated systems level, and the effects of environmental factors such as nutrition, infection and trauma. Recovery from an insult that triggers a pathological response is never complete. The incremental fall in possible performance is part of the progressive diversity in ‘physiology’ that is the true hallmark of ageing. In this article we will outline some of the physiological changes, particularly cardiorespiratory, associated with the ageing process that will be of relevance to...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Simon L. Maguire, Benjamin M.J. Slater Tags: Physiology Source Type: research

Protective mechanisms of the body
Abstract: The surface of the body and the openings of the various body cavities (respiratory tract, gastrointestinal tract, genito-urinary tract) are at potential risk from injury and from pathogenic bacteria. The surface of the skin is acidic and inhibits the growth of organisms. Non-pathogenic bacteria (commensals) compete with pathogens for space and nutrients and so inhibit their growth. The openings to the various body cavities are lined with mucous membrane which traps bacteria and other particles. Skin is also shed and mucous is expectorated, but both types of surface produce chemicals which are bactericidal. A seco...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Iain Campbell Tags: Physiology Source Type: research

Starvation, exercise, injury and obesity
This article describes how the body adapts metabolically to a decreased nutrient supply, increased energy demands and a surfeit of nutrient supply. Many patients are malnourished, have impaired exercise tolerance, become injured, or are obese. An understanding of the metabolic physiology of these conditions is therefore desirable. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Iain Campbell Tags: Physiology Source Type: research

Hormonal control of metabolism: regulation of plasma glucose
Abstract: The control of plasma glucose needs to be tightly monitored because hyperglycaemia and hypoglycaemia can lead to severe clinical problems, including death. In this article the major mechanism for the transport of glucose into and out of the blood and how that mechanism is used to monitor the circulating concentrations of glucose are discussed. A number of hormones regulate glucose in response to changes in plasma concentrations. Insulin promotes the removal of glucose and its conversion to glycogen. Glucagon, in response to falling glucose concentrations, increases the breakdown of glycogen and the release of glu...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Robert Yeo, Marina Sawdon Tags: Physiology Source Type: research

Homeostatic control mechanisms
Abstract: Although exact values for physiological or biochemical variables show inter-individual variation, it is important for each value to be kept within a narrow range that is compatible with health. Such homeostasis must be achieved in spite of tendencies for changes to be produced by an individual’s environment and lifestyle. Tight and rapid control requires the existence of specific mechanisms: negative-feedback loops. These mechanisms form the basis of physiology, and this article deals with what they are, how they work, and the problems that can arise with them, and how these problems are solved in humans. T...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Jim Waterhouse Tags: Physiology Source Type: research

Intrauterine fetal resuscitation
Abstract: The 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 resuscitation (IUFR) measures is to increase oxygen delivery to the placenta and umbilical blood flow in an attempt to reverse fetal hy...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Hannah Kither, Suna Monaghan Tags: Obstetric anaesthesia Source Type: research

Pre-eclampsia and the anaesthetist
Abstract: Pre-eclampsia is a multi-systemic hypertensive disorder occurring after 20 weeks of pregnancy with an incidence of 2–8% in the UK. It has been one of the leading causes of maternal mortality throughout the world. Intra-cerebral haemorrhage, pulmonary and liver dysfunction are the key complications of severe pre-eclampsia leading to a fatal outcome. Serial surveillance of both mother and the fetus antenatally, aggressive monitoring and management of the blood pressure, appropriate fluid balance, magnesium sulphate to prevent seizures and timely delivery of the baby remain the mainstays of its management. Neu...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Juliette Li Wan Po, Kailash Bhatia Tags: Obstetric anaesthesia Source Type: research

Managing hypotension during anaesthesia for caesarean section
Abstract: Hypotension is a significant problem during regional anaesthesia for caesarean section. This may be associated with both maternal and fetal morbidity. Risk factors should be identified. The technique of neuraxial blockade can be modified to reduce the incidence. Management techniques include left uterine displacement, mechanical leg compression, intravenous fluids and vasopressors. Novel alternative methods include transcutaneous electrical nerve stimulation (TENS) and 5HT3 antagonists. Neither pre-loading nor co-loading with intravenous fluid has been shown to be effective alone but must be combined with vasopre...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Amy Hobbs, Rowena Cockerham Tags: Obstetric anaesthesia Source Type: research

Analgesia in labour: induction and maintenance
Abstract: Since the introduction of epidurals for labour analgesia in 1946 they have 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 motor block associated with traditional dosing has resulted in greater maternal satisfaction, although not the mobile revolution which was o...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Graeme G. Flett Tags: Obstetric anaesthesia Source Type: research

Non-neuraxial analgesia in labour
Abstract: Pain in labour is often described as one of the most severe pains known. Neuraxial techniques provide the most effective form of labour analgesia. However, not all women wish to have a neuraxial technique or indeed want complete pain relief for 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: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Lorna A. Howie, Catherine Robinson Tags: Obstetric anaesthesia Source Type: research

Antenatal anaesthetic assessment of the obstetric patient
Abstract: Antenatal anaesthetic assessment clinics allow obstetric anaesthetists to identify patients with serious or potentially serious problems. It entails review of past medical records, performance of detailed history and examination, ordering of investigations and commencement of early intervention. It facilitates patient education and provides opportunities to discuss peripartum management plans with the patient, obstetrician and other specialists. Ideally all pregnant women should have anaesthetic assessment, but this is not feasible because of the prohibitive cost and additional resources required. (Source: Anaest...
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Authors: Preye Zuokumor Tags: Obstetric anaesthesia Source Type: research

Editorial Board
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Source Type: research

Contents
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 28, 2013 Category: Anesthesiology Source Type: research

MCQs
B lymphocytes are responsible for cell-mediated immunity (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Tags: Test yourself Source Type: research

Physiology of red and white blood cells
Abstract: Blood consists of formed elements (red blood cells, white blood cells and platelets) and plasma. Red blood cells (erythrocytes) account for 99.9% of cells. Their principal function is the transport of oxygen from the lungs to respiring tissues and carbon dioxide from tissues back to the lungs. This is achieved through the presence of haemoglobin, a conjugated metallo-protein. The affinity of haemoglobin for oxygen changes with a number of circumstances. At the partial pressure of oxygen (PO2) in the alveoli (13 kPa) the binding of each oxygen molecule increases the affinity of haemoglobin, so aiding uptake o...
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Authors: Nick Ashton Tags: Physiology Source Type: research

Crystalloids, colloids, blood, blood products and blood substitutes
Abstract: Understanding the physiology of fluid distribution within the human body is fundamental to the practice of anaesthetists and intensivists of all grades. There is a necessity to recognize the range of actions and consequences of the commonly infused intravenous fluids if safe patient care is to be provided. There are many historical and on-going trials surrounding fluid therapy and it is important for the physician to keep up to date with current guidelines.There is a continued drive to improve the safety of donor blood and prevent transfusion errors. Knowledge of how blood products are collected separated and sto...
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Authors: Hugo Buckley, Roop Kishen Tags: Clinical Anaesthesia Source Type: research

Neuraxial anaesthesia in paediatrics
Abstract: Neuraxial anaesthesia is a valuable tool in the practice of paediatric anaesthesia. Spinal and epidural blockade are used for a variety of surgical cases as the sole anaesthetic or as an adjunct to general anaesthesia, and 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 for chest and upper abdominal procedures. The potential complications associated with neuraxial anaesthesia can be minimized by pru...
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Authors: Amod Sawardekar, Dorota Szczodry, Santhanam Suresh Tags: Paediatric Anaesthesia Source Type: research

Peripheral and local anaesthetic techniques for paediatric surgery
This article discusses a general approach to PNBs in children. It covers a small selection of limb and trunk blocks, and discusses the benefit of ultrasound guidance. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Authors: Steve Roberts, Alasdair Howie Tags: Paediatric Anaesthesia Source Type: research

Systemic analgesics in children – update
Abstract: A multimodal analgesic approach is key to providing safe and effective analgesia in children. The use of age-appropriate pain scoring systems with regular monitoring and pain assessment is essential to guide treatment and to achieve optimal pain control, while ensuring safety and minimizing unwanted effects.Due to neuroplasticity of immature pain pathways, pain in early life has been shown to lead to heightened sensitivity to pain on future exposure. Effective pain control has therefore the dual benefit of good analgesic control during an episode of pain, as well as reducing the potential for longer term pain pat...
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Authors: Julie L. Hui, Elaine M. Wilson-Smith Tags: Paediatric Anaesthesia Source Type: research

Day surgery for children
This article summarizes the essential components needed to provide a high-quality paediatric day surgery service. It also highlights the importance of good preoperative assessment, which involves having rigorous inclusion and exclusion criteria, but also comprising some degree of flexibility allowing evaluation of children on an individual basis. Strategies to minimize postoperative pain and nausea and vomiting are also discussed, with emphasis being placed on the safe discharge of these children home. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Authors: Jamuna Navaratnarajah, Mark Thomas Tags: Paediatric Anaesthesia 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 - June 1, 2013 Category: Anesthesiology Authors: Katherine Brand, Naveen Canchi Tags: Paediatric Anaesthesia Source Type: research

The principles of paediatric anaesthesia
This article provides an overview of the practical aspects of paediatric anaesthesia, with particular emphasis on preoperative assessment and fasting guidelines, intraoperative airway and fluid management, and identification and management of those at risk of postoperative nausea and vomiting. Strategies for identifying and managing the anxious child are discussed as this is an increasingly challenging area for paediatric anaesthetists. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Authors: Judith A. Nolan Tags: Paediatric Anaesthesia Source Type: research

Editorial Board
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Source Type: research

Contents
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - June 1, 2013 Category: Anesthesiology Source Type: research

MCQs
Brachioradialis forms the lateral boundary of the fossa (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Tags: Test yourself Source Type: research

Applied cardiovascular physiology
Abstract: The cardiovascular responses to exercise, haemorrhage, a Valsalva manoeuvre, postural changes and exposure to microgravity are complex patterns made up of a number of common physiological ‘building blocks’. The main cardiovascular response to isotonic exercise is an increase in cardiac output to elevate oxygen delivery to exercising muscle. This is largely mediated via an increase in heart rate and facilitated by an increase in venous return. By contrast, in haemorrhage a reduced venous return leads to a reduction in cardiac output, a fall in arterial pulse pressure and unloading of the arterial baror...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Emrys Kirkman Tags: Physiology Source Type: research

Neurological and humoral control of blood pressure
Abstract: There is a relationship between arterial blood pressure, cardiac output and vascular resistance which can be described mathematically, and helps us to understand the short-term control of blood pressure in the terms of a hydraulic system. The sensors in this system are the arterial baroreceptors which mediate changes in the hydraulic system though control of the autonomic nervous system, which in turn influences heart rate, inotropy and vascular tone. Altering the distribution of blood between the arterial and venous systems compensates for acute changes in total blood volume. The total blood volume is controlled...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Peadar B. O'Donohoe, Jaideep J. Pandit Tags: Physiology Source Type: research

Anaesthesia for carotid surgery
Abstract: Carotid 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 timeframe presents a challenge to the anaesthetist and surgeon in risk stratifying and optimizing these high-risk patients for surgery. Optimization includes blood pressure (BP) control and use of antiplatelet and lipid-lowering therapy.CEA can be carried out under general anaesthesia (GA) or regional anaesthesia (RA) wit...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Indran Raju, Kenneth Fraser Tags: Vascular Anaesthesia Source Type: research

Anaesthesia for vascular emergencies
Abstract: Emergent vascular surgery is classified as being high risk and includes ruptured abdominal aneurysm repair, acute ischaemic limb revascularization and postoperative haematoma evacuation following carotid endarterectomy. These procedures are frequently performed out of normal working hours on patients who have significant comorbidities. A detailed pre-operative assessment and adequate preoptimization is usually precluded. As expected, associated morbidity and mortality rates are considerably higher than for the equivalent elective surgery. The anaesthetic technique employed should be carefully selected and applied...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Shayanti M. Ghosh, Iain J. McCullagh Tags: Vascular Anaesthesia Source Type: research

Anaesthesia for abdominal vascular surgery
Abstract: Although there are a number of abdominal pathologies requiring vascular surgical intervention, aortic aneurysmal disease is by far the most common and the focus of this article. The most obvious development in this area has been the implementation of a national screening programme for abdominal aortic aneurysm (AAA). Recent changes to try and improve elective mortality figures from around 8% for open repair have been essential to make the screening programme effective. Endovascular aneurysm repair (EVAR) is now the most common technique for elective management. Longer term risks and benefits of endovascular versu...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Peter J. Herring, Ben Rippin Tags: Vascular Anaesthesia Source Type: research

Postoperative care and analgesia in vascular surgery
Abstract: Patients undergoing major vascular surgery are at 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. Reduction of myocardial oxygen demand is key: stabilizing cardiovascular parameters, maintaining normothermia, adequate volume resuscitation and effective analgesia. Preoperative risk reduction strategies including aspirin, β-blockers and statin therapies are critical, and should be continued in the postoperative period. Maintaining a high index of ...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Rachael Bird, Ian Nesbitt Tags: Vascular Anaesthesia Source Type: research

Anaesthesia for vascular surgery on the extremities
Abstract: Peripheral 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 - May 1, 2013 Category: Anesthesiology Authors: Richard J. Telford Tags: Vascular Anaesthesia Source Type: research

Anaesthesia for interventional vascular radiology
This article will discuss the different procedures performed (excluding neurological and cardiological interventions) with a focus on EVAR, and the anaesthetic implications of them. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Gemma L. Woodward, Paul Warman Tags: Vascular Anaesthesia 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 - May 1, 2013 Category: Anesthesiology Authors: Ben A. Goodman, Gerard R. Danjoux Tags: Vascular Anaesthesia Source Type: research

Preoperative assessment of patients for vascular surgery
Abstract: Effective preoperative evaluation of patients undergoing major vascular surgery presents a significant multidisciplinary challenge. A focussed preoperative evaluation targeted to organ systems can help mitigate the combined effects of inherently high-risk surgical procedures undertaken in an increasingly comorbid patient population. Careful history and examination supported by appropriate investigations and specialist input remains the cornerstone of this process, with risk increasingly quantified by dedicated scoring systems. In addition, the role and evidence base for objective assessment of functional capacity...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: James W. Durrand, Gerard R. Danjoux Tags: Vascular Anaesthesia Source Type: research

The femoral triangle and superficial veins of the leg
Abstract: The femoral triangle is important in puncture and exposure of the femoral artery, block dissection of the groin lymph nodes and surgery of the great saphenous vein at its termination. The great (long) saphenous vein passes upwards from in front of the medial malleolus to a hand’s breadth behind the patella to pierce the deep fascia at the groin to enter the common femoral vein. The landmark for this is one finger’s breadth medial to the femoral pulse, which is located halfway between the anterior superior iliac spine and the pubic symphysis. The small (short) saphenous vein commences behind the latera...
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Harold Ellis Tags: Vascular Anaesthesia Source Type: research

The cervical plexus
Abstract: A knowledge of the cervical plexus and the posterior triangle of the neck is important when performing a cervical plexus block. This useful regional anaesthetic technique can be utilized in carotid, ear, nose and throat (ENT) and thyroid surgery. In this article we revise the relevant anatomy and clinical application. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Andrew Kordowicz, Marco L. Baroni, David C. Berridge Tags: Vascular Anaesthesia Source Type: research

Anatomy of the antecubital fossa
This article outlines the essential anatomy of this region and its clinical application. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Authors: Andrew Kordowicz, Marco L. Baroni, David C. Berridge Tags: Vascular Anaesthesia Source Type: research

Editorial Board
(Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - May 1, 2013 Category: Anesthesiology Source Type: research