Complex neuropathic pain states
Publication date: Available online 6 September 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Rhian P. Lewis, Indre KriukelyteAbstractIn this article we discuss complex neuropathic pain states: diabetic peripheral neuropathic pain (DPNP), phantom limb pain (PLP), central post-stroke pain (CPSP), and complex regional pain syndrome (CRPS). Pain in these conditions can often be severe, significantly affect quality of life and be resistant to current treatment options. Multidisciplinary assessment and treatment is essential. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - September 8, 2019 Category: Anesthesiology Source Type: research

Pain management in palliative care: art or science
Publication date: Available online 6 September 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Brigid BassamAbstractPain management in palliative care is both an art and a science. Essential to good pain control is an understanding not only of the pathophysiology of the origin of the pain, but also the impact that the pain is having, as the palliative patient may have to live with the symptoms of disease for months or even years. Interventions can then be targeted and at various times, may include a range of pharmacological treatments, psychological or spiritual support and possibly the involvement of other...
Source: Anaesthesia and intensive care medicine - September 8, 2019 Category: Anesthesiology Source Type: research

Radiofrequency techniques in pain management
Publication date: Available online 6 September 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Victor Mendis, Ramy Mottaleb, Sahiba SethiAbstractRadiofrequency techniques are minimally invasive procedures used to provide prolonged pain relief compared to local anaesthetic blocks and forms part of a multidisciplinary approach in managing chronic pain. A generator produces a high-frequency current that passes from an electrode to an earthing plate. The electromagnetic field created around the tip of the electrode then has an effect on the surrounding nervous tissue resulting in pain relief. (Source: Anaesthes...
Source: Anaesthesia and intensive care medicine - September 8, 2019 Category: Anesthesiology Source Type: research

Percutaneous cervical cordotomy for cancer-related pain
Publication date: Available online 6 September 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Manish Gupta, Manohar L. SharmaAbstractThe anatomic rationale of cordotomy involves interruption of pain fibres in the spinothalamic tract. Cordotomy is indicated in cancer patients with limited life expectancy who have severe, unilateral pain. The goal in patients with limited life expectancy should be to improve the quality of survival, which includes improving the patient's ability to interact with others, and to reduce the amount of time spent in contact with healthcare providers. Analgesic optimization alone ...
Source: Anaesthesia and intensive care medicine - September 6, 2019 Category: Anesthesiology Source Type: research

Opioids in the management of persistent non-cancer pain
Publication date: Available online 6 September 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Shun Yamanaka, Lucy MillerAbstractOne in five Europeans suffers from persistent pain which, for the majority, is non-oncological in origin. Patients with persistent non-cancer pain (PNCP) are a heterogeneous group in whom there is significant biological, psychological and societal comorbidity. Recently, there has been a large increase in opioid prescribing for PNCP, despite its limited evidence base and adverse side effect profile, including opioid dependence. This review examines the effectiveness and safety of l...
Source: Anaesthesia and intensive care medicine - September 6, 2019 Category: Anesthesiology Source Type: research

Drugs affecting the autonomic nervous system
Publication date: Available online 6 September 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Matthew Charlton, Jonathan P. ThompsonAbstractThe autonomic nervous system (ANS) is a complex system of nervous and humoral mechanisms that modulates the function of the autonomous or visceral organs. Autonomic control of organs aims to maintain homoeostasis in health. Many drugs used in clinical practice can have either primary or secondary effects on the function of autonomic nervous system. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - September 6, 2019 Category: Anesthesiology Source Type: research

Obstetric haemorrhage
Publication date: Available online 29 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Rosanne Ching, Thomas Mount, Kirsty MacLennanAbstractObstetric 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 multidisciplinary team, improve perfor...
Source: Anaesthesia and intensive care medicine - August 30, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 26 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Vijayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 27, 2019 Category: Anesthesiology Source Type: research

Failed intubation in obstetrics
Publication date: Available online 26 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Rhys Clayton, Matthew DevlinAbstractFailed intubation in obstetrics remains a topical issue, a rare but potentially devastating complication of obstetric general anaesthesia. The 2015 guidelines produced following several years of collaborative work between the Difficult Airway Society (DAS) and Obstetric Anaesthetist's Association (OAA) remain the definitive text. While deaths from failed intubation have declined significantly over 30 years, the incidence of failed intubation remains fairly constant at 1:300, with ...
Source: Anaesthesia and intensive care medicine - August 27, 2019 Category: Anesthesiology Source Type: research

General anaesthesia for operative obstetrics
Publication date: Available online 21 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Naomi Fleming, Rowena CockerhamAbstractGeneral anaesthesia in obstetrics is reducing with a reported use in only 4% of caesarean sections in 2017–2018. Obstetric surgery is often urgent, requiring effective team communication and a rapid, focused preoperative assessment. Physiological changes of pregnancy increase the incidence of aspiration, desaturation and failed intubation. In addition, the rapidly evolving circumstances add additional stress, impacting on performance. Hypotension from aortocaval comp...
Source: Anaesthesia and intensive care medicine - August 22, 2019 Category: Anesthesiology Source Type: research

Cardiac disease in pregnancy
Publication date: Available online 20 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Amanda Zacharzewski, Ross MacnabAbstractCardiac disease is a significant cause of maternal mortality. In the UK in the last maternal mortality report, it was the leading cause of indirect maternal deaths (2.39 deaths per 100,000 maternities). The overall rate of maternal mortality from cardiac disease has significantly increased over the last three decades, with this increase being mostly attributable to deaths from ischaemic heart disease, myocardial infarction and peripartum cardiomyopathy. Conditions such as pulm...
Source: Anaesthesia and intensive care medicine - August 21, 2019 Category: Anesthesiology Source Type: research

Tropical diseases and anaesthesia
Publication date: Available online 20 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Victoria Howell, Tom BashfordAbstractThe range of infectious diseases encountered while working overseas in resource limited settings varies enormously depending on where in the world one is working, although the majority of low and middle income countries lie within the tropics. Human immunodeficiency virus (HIV), tuberculosis (TB) and malaria are commonly encountered when working in tropical countries and may have an impact upon anaesthesia, either as a direct result of the condition or due to interaction with the...
Source: Anaesthesia and intensive care medicine - August 21, 2019 Category: Anesthesiology Source Type: research

Obstetric emergencies
This article describes some common obstetric emergencies with which the anaesthetist will become involved. It emphasizes management related to some deficiencies identified in the MBRRACE-UK report as well as highlighting a multidisciplinary approach throughout. Good communication between team members is paramount in all aspects of medical care, but this approach should be fostered routinely to ensure that rapid and appropriate decisions are made in a safe and timely manner. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 21, 2019 Category: Anesthesiology Source Type: research

Assessment of the fetus before and during labour
Publication date: Available online 21 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Harriet Lamb, Alexander HeazellAbstractPerinatal death or cerebral palsy are devastating events for families. In an attempt to prevent these pregnancy outcomes, fetal wellbeing is assessed during labour by a variety of means. In this review, the most common means to confirm fetal wellbeing, the rationale for their use and evidence of their efficacy are discussed. With respect to labour, the indications for continuous electronic fetal monitoring are presented, together with a guide to interpretation of cardiotocograp...
Source: Anaesthesia and intensive care medicine - August 21, 2019 Category: Anesthesiology Source Type: research

The ethics of pregnancy testing
Publication date: Available online 19 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Emma Sharkey, Siân GriffithsAbstractAnaesthesia, surgery and ionizing radiation may all prove harmful to an undetected pregnancy. Elective procedures should be deferred at least until the second trimester to reduce the risk of teratogenicity or spontaneous abortion. If surgery cannot be delayed, anaesthetic or surgical techniques can be modified, and the use of intraoperative ionizing radiation avoided where possible. Determination of pregnancy status is mandated by current national guidelines prior to any pro...
Source: Anaesthesia and intensive care medicine - August 20, 2019 Category: Anesthesiology Source Type: research

Human factors in obstetrics
Publication date: Available online 19 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Paul Young, Kirsty MaclennanAbstractThe importance of human factors is becoming increasingly recognized in the healthcare profession. Lack of situational awareness, poor communication and inadequate leadership compounded by unfamiliar teams in a rapidly deteriorating clinical situation put obstetric patients at particular risk. There is much to be learnt from other high-risk industries including aviation and the military. Increasing awareness and training in human factors and utilization of communication tools (such...
Source: Anaesthesia and intensive care medicine - August 20, 2019 Category: Anesthesiology Source Type: research

Obtaining consent for obstetric procedures
This article summarizes current guidelines in relation to consent that have been updated to reflect recent case law. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 20, 2019 Category: Anesthesiology Source Type: research

Post-dural puncture headache in the parturient
Publication date: Available online 20 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Amit R. Panigrahi, Cathy ArmstrongAbstractPost-dural puncture headache (PDPH) is a common and debilitating complication of central neuraxial blockade in the parturient. The obstetric population is at particular risk with up to 80% of women developing symptoms after accidental dural puncture during labour 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 ...
Source: Anaesthesia and intensive care medicine - August 20, 2019 Category: Anesthesiology Source Type: research

Regional anaesthesia for caesarean section and what to do if it fails
Publication date: Available online 20 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Sophie A. Kimber CraigAbstractRegional anaesthetic techniques are the most frequently used type of anaesthetic used for caesarean deliveries. They have a better safety profile than general anaesthesia in the pregnant woman. The choice of whether to use a spinal, epidural or combined spinal–epidural technique will depend on patient and surgical factors. Particular care is required in those receiving therapeutic anticoagulation or with clotting abnormalities. Women should be provided with information regarding t...
Source: Anaesthesia and intensive care medicine - August 20, 2019 Category: Anesthesiology Source Type: research

Anaesthetic equipment in low and low-middle income countries
Publication date: Available online 17 August 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Claire E. Adams, Michael DobsonAbstractThere is a discrepancy between healthcare need and the ability to provide safe anaesthesia in low/low-middle income countries (LMICs). There is a shortage of medically trained anaesthetists. Most anaesthetics are provided by non-physician anaesthetists who may not have studied the core sciences underpinning anaesthesia, but are clinically very competent. Poor infrastructure is common, such as a shortage of piped medical gases and critical care beds. Safe anaesthesia depends on ...
Source: Anaesthesia and intensive care medicine - August 18, 2019 Category: Anesthesiology Source Type: research

Acute pain management and perioperative drugs used in low-resource settings
This article provides an understanding of the choice of anaesthetic and analgesic drugs used in a low-resourced setting with a focus on those used less commonly in a well-resourced setting. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 18, 2019 Category: Anesthesiology Source Type: research

Challenges in healthcare delivery in developing nations
This article describes challenges through reflection on personal experience in Zambia. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 18, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: August 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 8Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 1, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: August 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 8Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - August 1, 2019 Category: Anesthesiology Source Type: research

Self-assessment
Publication date: Available online 13 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Vijayanand Nadella (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 14, 2019 Category: Anesthesiology Source Type: research

Non-opioid analgesics
This article will aim to provide an overview of the pain pathway in relation to the therapeutic targets for providing analgesia, commonly used NAOs and their brief introduction. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 6, 2019 Category: Anesthesiology Source Type: research

Editorial Board
Publication date: July 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 7Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 5, 2019 Category: Anesthesiology Source Type: research

Contents
Publication date: July 2019Source: Anaesthesia & Intensive Care Medicine, Volume 20, Issue 7Author(s): (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 5, 2019 Category: Anesthesiology Source Type: research

Medicolegal and social implications of practising in pain medicine
Publication date: Available online 5 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Lorraine de GrayAbstractPain is the most common reason for patients to see a doctor. Low social support and unemployment are common in such patients. Pain is the third leading cause for absence from work. Patients frequently seek support from their multidisciplinary pain team for welfare support and staying in or returning to employment or education. Pain physicians perform a range of intervention procedures and need to have a clear grasp of the law of consent. They are also called on to give expert evidence in persona...
Source: Anaesthesia and intensive care medicine - July 5, 2019 Category: Anesthesiology Source Type: research

The use of atypical analgesics by intravenous infusion for acute pain: evidence base for lidocaine, ketamine and magnesium
Publication date: Available online 3 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): David Hutchins, Mark RockettAbstractAtypical analgesics include antiepileptics and other membrane stabilizers (lidocaine and mexilitine), antidepressants, alpha-2-noradrenergic agonists, N-methyl-d-aspartate (NMDA) antagonists, corticosteroids and cannabinoids. This review will focus on three drugs commonly infused as intravenous co-analgesics. We will review the theoretical mechanisms of action, efficacy and clinical effectiveness of lidocaine, ketamine and magnesium. The evidence base supporting their use has expande...
Source: Anaesthesia and intensive care medicine - July 4, 2019 Category: Anesthesiology Source Type: research

Assessment of acute and chronic pain
Publication date: Available online 4 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Tim McCormick, Claire FramptonAbstractAcute and chronic pain states overlap in chronology and pathophysiology but both can remain under-managed. Assessment aims to elucidate underlying diagnosis and/or pain generators that can then guide treatment strategies. Assessment should be repeated to assess efficacy of treatments and the presence of side effects. Self-report questionnaires are available to assist in diagnosis and monitoring of pain and its related dimensions but they do not replace a thorough assessment by an e...
Source: Anaesthesia and intensive care medicine - July 4, 2019 Category: Anesthesiology Source Type: research

The role of regional anaesthesia in the management of acute pain
Publication date: Available online 4 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Philip Hassell, James StimpsonAbstractThe role of regional anaesthesia in anaesthetic practice has become essential to enhance acute pain control, minimize the use of systemic opioids and optimize the multidisciplinary approach to enhanced recovery programmes. They are used as powerful tools to enable ambulatory surgery in a wide variety of surgical specialties and reduce the transition from acute to chronic pain. Adjuncts to local anaesthetics can be used to prolong block time and target nociception specifically allow...
Source: Anaesthesia and intensive care medicine - July 4, 2019 Category: Anesthesiology Source Type: research

The genesis of chronic pain
Publication date: Available online 2 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Bharti Seth, Lorraine de GrayAbstractThe theories behind the evolution of the genesis of chronic pain are explored from a historical perspective. The major focus of the article explores the biomedical and the psychosocial factors that contribute to the genesis of chronic pain in particular how the physical and psychological interact together. Risk factors and pre-existing determinants are discussed. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - July 3, 2019 Category: Anesthesiology Source Type: research

Techniques of opioid administration
Publication date: Available online 2 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Christopher JG. Green, Somnath BagchiAbstractOpiates remain the mainstay of the management of severe pain in acute, chronic and palliative settings across all population ages. Pharmacological advancement allows alternative routes of drug delivery best suited to individual patients and their conditions, with improved efficacy and safety. The different approaches to administration vary in their convenience, both to staff and patients, which can translate to differences in prescription compliance. Furthermore, the choice ...
Source: Anaesthesia and intensive care medicine - July 3, 2019 Category: Anesthesiology Source Type: research

The role of physiotherapy in the management of chronic pain
Publication date: Available online 2 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Judith SemmonsAbstractThe role of physiotherapy in managing chronic pain is challenging. A multidisciplinary approach incorporating several specialities within the pain clinic is recommended. Treatment primarily focuses on the biopsychosocial model: part of the clinician's skill is to decide which part or parts of this biopsychosocial model influence the patient's pain. Key physiotherapy treatments are described: education, patient empowerment and promoting exercise and function. Patients often fear exercise as without...
Source: Anaesthesia and intensive care medicine - July 3, 2019 Category: Anesthesiology Source Type: research

Anatomy, physiology and pharmacology of pain
Publication date: Available online 3 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Michael J. HudspithAbstractPain is neither a mere sensation nor a simple warning of potential or actual bodily injury: rather it a complex emotional experience arising from integrated processing of nociceptive input subject to inhibitory and excitatory modulatory influences at multiple levels of the neuroaxis. Transmembrane protein ion-channels transduce mechanical, thermal and chemical tissue injury into electrophysiological signals that are transmitted to supraspinal structures via multiple synapses that exhibit neur...
Source: Anaesthesia and intensive care medicine - July 3, 2019 Category: Anesthesiology Source Type: research

The role of occupational therapy in enabling people with chronic pain to return to work or education
Publication date: Available online 3 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Wendy Hill, Michelle MacartneyAbstractOccupational therapy is based on the premise that there is an intrinsic relationship between occupations, health and wellbeing. Chronic pain restricts the performance of activities that individuals need to, want to and are expected to perform, including working or studying. Young people who have a chronic pain condition may be restricted in their participation with school or higher education which can result in them being disadvantaged regarding their future potential for employmen...
Source: Anaesthesia and intensive care medicine - July 3, 2019 Category: Anesthesiology Source Type: research

The neurobiology of chronic pain states
Publication date: Available online 3 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Anthony H. DickensonAbstractPlasticity enables alterations in transmission in nociceptive systems. It is this plasticity in the nervous system that can alter the linear relation between noxious stimuli and the perception of pain and is important in the switch from acute to chronic pain. In this way, a number of CNS mechanisms can alter neuronal activity, leading to abnormal ongoing and stimulus-evoked pains due to peripheral and central changes. Peripheral nerves can become sensitized, spinal cord neurons can be render...
Source: Anaesthesia and intensive care medicine - July 3, 2019 Category: Anesthesiology Source Type: research

Opioid mechanisms and opioid drugs
Publication date: Available online 3 July 2019Source: Anaesthesia & Intensive Care MedicineAuthor(s): Helen Laycock, Carston BantelAbstractOpioids are effective in acute and cancer pain management and have increasingly been prescribed in chronic non-cancer pain despite concerns regarding long-term use and lack of efficacy. Opioid actions are via G protein coupled receptors, the activation of which leads to a variety of physiological consequences including analgesia. Prescribing opioids requires careful consideration of individual drug pharmacokinetics and pharmacodynamics, their actions across different physiological s...
Source: Anaesthesia and intensive care medicine - July 3, 2019 Category: Anesthesiology Source Type: research

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