Electrolyte disorders in  the critically ill
This article provides a review of and guide to the aetiology, analysis, and management of major electrolytes disorders in the critically ill. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

Maintenance of anaesthesia
Publication date: Available online 18 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Thomas E.F. Walton, James Palmer The maintenance phase of general anaesthesia begins immediately following induction of, and ends immediately prior to emergence from, a state of intended unrousable unconsciousness. Maintenance of anaesthesia requires the application of a wide range of knowledge and skills, demanding a solid grounding in basic science, practical abilities and team management. These factors are considered in this article. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

Macronutrients, minerals, vitamins and energy
Publication date: Available online 18 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Iain Campbell Carbohydrates have the general formula C n (H2O) n . Monosaccharides have between three and six carbon atoms and exist as chains or ring structures. As rings, they link with other monosaccharide rings. The major carbohydrate in humans is glucose, which is stored as glycogen: branching chains of glucose molecules. Fat (triglyceride), which makes up adipose tissue, consists of three fatty acids bonded to glycerol, but other lipids include phospholipids and steroids. Proteins are composed of chains...
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

Databases
Publication date: Available online 18 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): James Berrington A database is a structured collection of records or data that is stored in a computer so that it can be consulted by a program to answer queries. Records retrieved through queries become information that can be used to make decisions. A database consists of one or more tables containing records of values for fields that pertain to the attributes of the object being represented by the table. Relational databases contain multiple tables that are linked by means of key fields. A database managem...
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

Local anaesthetic agents
Publication date: Available online 18 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Malachy O. Columb, David Cegielski, Daniel Haley Local anaesthetics are weak bases and consist of a lipophilic aromatic ring, a link and a hydrophilic amine. The chemistry of the link classifies them as amides or esters. They act by blocking the sodium ionophore, especially in the activated state of the channel, and frequency dependence can be shown. The speed of onset is related to dose and proportion of drug in the unionized lipid-soluble form, which in turn is determined by the pK a and the ambient pH. Loc...
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

Protective mechanisms of the body
Publication date: Available online 18 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Iain Campbell The surface of the body and the openings of the various body cavities (respiratory tract, gastrointestinal tract, genitourinary 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. S...
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

Anaesthetic records
This article explores their multiple purposes and the guidelines for their content. It also discusses the practical means of documenting the events that take place during an anaesthetic episode and the benefits and drawbacks of automated electronic records. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

Intermediary metabolism
Publication date: Available online 18 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Iain Campbell Carbohydrate and fat form the immediate and long-term energy stores of the body. Protein constitutes the active (functional) cell mass and is also an energy source but, normally, a relatively minor one. All three macronutrients are interrelated. Proteins are synthesized from amino acids derived from ingested protein. Glucose and fat provide energy via adenosine triphosphate. The brain and red blood cells can only obtain their energy from glucose. Glucose is oxidized via the glycolytic and the tr...
Source: Anaesthesia and intensive care medicine - January 19, 2017 Category: Anesthesiology Source Type: research

The treatment of hypertension in pregnancy
Publication date: Available online 9 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Umbareen Siddiqi, Felicity Plaat Maternal deaths from complications of pregnancy; so-called ‘direct deaths’, including hypertensive disorders, are now less than from indirect causes, (medical conditions that may be exacerbated by pregnancy). The direct death rate in the UK has fallen significantly over the past 5 years. The death rate from hypertensive disorders is at its lowest ever: 0.25/100 × 103 maternities [95%CI 0.09–0.55]. In other words there is one death from hypertensive disor...
Source: Anaesthesia and intensive care medicine - January 10, 2017 Category: Anesthesiology Source Type: research

Principles of anaesthesia for term neonates
Publication date: Available online 9 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Kylie McGregor Anaesthesia for term neonates is associated with increased perioperative morbidity and mortality and as a result should be reserved for specialized paediatric centres. Neonatal systems are immature and are undergoing rapid growth and development. Neonates are uniquely different in how they respond to surgery, drugs and fluids and this response varies across the neonatal period. Many of the physiological differences in neonates are a reflection of their high metabolic rate, increase in oxygen dem...
Source: Anaesthesia and intensive care medicine - January 10, 2017 Category: Anesthesiology Source Type: research

Adaptation for life after birth: a review of neonatal physiology
This article combines well established and contemporary information to summarize a systems-based approach to traditional neonatal physiology. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - January 6, 2017 Category: Anesthesiology Source Type: research

Acute pain management in the neonate
Publication date: Available online 3 January 2017 Source:Anaesthesia & Intensive Care Medicine Author(s): Glyn Williams Acute pain management in the neonatal period remains a challenge for the clinician. Responses to pain and analgesic intervention are developmentally influenced and cannot be not directly extrapolated from the older child. Successful and safe intervention will minimize acute physiological and behavioural distress, reduce pain scores and potentially improve short- and long-term outcomes. This requires an understanding of the physiology and pharmacology in this age group alongside a multi-modal appr...
Source: Anaesthesia and intensive care medicine - January 4, 2017 Category: Anesthesiology Source Type: research

Resuscitation of the newborn
This article outlines the cascade of evidence-based interventions that include and follow on from airway support in those newborns requiring ongoing assistance. These comments are based around the International Liaison Committee of Resuscitation (ILCOR) 2010 and 2015 Consensus on Science statements and subsequent guideline reviews. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 31, 2016 Category: Anesthesiology Source Type: research

Neonatal pharmacology
Publication date: Available online 28 December 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Brian J. Anderson Neonatal anaesthesia dosing needs to be based on physiological characteristics of the newborn, pharmacokinetic knowledge, pharmacodynamic considerations and the adverse effects profile. Disease processes and treatments in this group are distinct from adults. Immaturity of enzyme, anatomical and physiological systems cause extensive variability of drug disposition and drug response in neonates. This is further compounded by pharmacogenomic influences. Postmenstrual age is a reasonable measur...
Source: Anaesthesia and intensive care medicine - December 29, 2016 Category: Anesthesiology Source Type: research

Anaesthesia for specialist surgery in infancy
Publication date: Available online 26 December 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Amanda Dalton, Graham Knottenbelt Specialist surgery in infancy provides unique and significant challenges for paediatric anaesthetists. Both common (inguinal hernias and hypertrophic pyloric stenosis) and less common conditions (tracheo-oesophageal fistula, congenital diaphragmatic hernia, exomphalos (omphalocele), gastroschisis and congenital lobar emphysema) require a sound understanding of the relevant pathology and the particular issues that may be encountered in order to safely anaesthetise these infan...
Source: Anaesthesia and intensive care medicine - December 27, 2016 Category: Anesthesiology Source Type: research

Special considerations in the premature and ex-premature infant
Publication date: Available online 26 December 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Geoff Frawley Ex-premature infants and children are a heterogenous population, ranging from healthy children born at 36 weeks' gestation to formerly extremely premature children with significant medical issues that affect anaesthetic care. Preterm birth is associated with perinatal mortality, neurological disability (including cerebral palsy), severe morbidity in the first weeks of life, prolonged hospital stay after birth, readmission to hospital in the first year of life and increased risk of chronic lung ...
Source: Anaesthesia and intensive care medicine - December 27, 2016 Category: Anesthesiology Source Type: research

Anaesthesia in the elderly
Publication date: Available online 1 December 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): David J. Chambers, Martin W.B. Allan Older people are undergoing increasingly complex surgery with much greater mortality and morbidity than the younger adult population. In this article, we discuss the physiological changes that take place in the older patient, and how these may affect anaesthetic technique. Perioperative risk in the elderly is discussed, with focus on emergency surgery and frailty. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - December 2, 2016 Category: Anesthesiology Source Type: research

Local anaesthesia for ocular surgery
Publication date: Available online 30 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Heather Rodgers, Rachael Craven Local anaesthesia is the technique of choice for a large number of ophthalmic procedures, including cataract surgery. For some procedures topical anaesthesia is sufficient; for more complex procedures a local anaesthetic block will be needed. Sharp needle techniques previously favoured, whilst still useful, have become less common than the cannula-based sub-Tenon’s block. This provides favourable operating conditions with a lower risk of complications. Patients should be...
Source: Anaesthesia and intensive care medicine - December 1, 2016 Category: Anesthesiology Source Type: research

Data, information, knowledge and wisdom
Publication date: Available online 30 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Paul Cooper The relationship between data, information, knowledge and wisdom is explained. The growth of the Internet is changing the traditional hierarchies of ‘experts’ and changing ways of disseminating information. In the growing area of knowledge management, the Internet is enabling new ways of collecting, organizing and disseminating knowledge. Data mining is the application of improved techniques of data organization and storage and analysis to large datasets and has led to the discovery o...
Source: Anaesthesia and intensive care medicine - December 1, 2016 Category: Anesthesiology Source Type: research

Anaphylaxis
Publication date: Available online 29 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Jessica Chapman, Abdul G. Lalkhen Anaphylaxis is a severe, life-threatening, generalized or systemic hypersensitivity reaction. The pathophysiology of anaphylaxis can be described as immunologic and non-immunologic. Classification can be based on the time course of the anaphylactic reaction which may be uniphasic, biphasic or protracted. There are many triggers for anaphylaxis; the most commonly identified are food, drugs and venom. Perioperative anaphylaxis is a serious complication reported in up to 1...
Source: Anaesthesia and intensive care medicine - November 30, 2016 Category: Anesthesiology Source Type: research

Physiology of ageing
Publication date: Available online 26 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Victoria Scott-Warren, Simon Maguire 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...
Source: Anaesthesia and intensive care medicine - November 27, 2016 Category: Anesthesiology Source Type: research

Ocular anatomy and physiology relevant to anaesthesia
This article discusses anatomy of the orbit and eye, and includes rudimentary ocular physiology. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - November 27, 2016 Category: Anesthesiology Source Type: research

Pathophysiology of respiratory disease and its significance to anaesthesia
Publication date: Available online 26 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): S. Kimber Craig, Li Fang Significant changes occur in the respiratory physiology of healthy patients during anaesthesia. In patients with underlying respiratory pathology, these changes in respiratory physiology may lead to clinical problems during the conduct of anaesthesia and the perioperative period. An understanding of the disease processes that can affect the lungs and pleura allows the anaesthetist to account for the potential complications of these conditions and manage the anaesthetic accordingly. (...
Source: Anaesthesia and intensive care medicine - November 27, 2016 Category: Anesthesiology Source Type: research

Care of the eye during anaesthesia and intensive care
Publication date: Available online 26 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Anthony O'Driscoll, Emert White Perioperative eye injuries and blindness are rare but important complications of anaesthesia. The three causes of postoperative blindness are ischaemic optic neuropathy, central retinal artery thrombosis (these can exist in tandem and have been described as ischaemic oculopathies) and cortical blindness. This review aims to improve anaesthetists' knowledge of orbital anatomy, ocular physiology and the mechanisms of perioperative eye injuries to help reduce their occurrence. (S...
Source: Anaesthesia and intensive care medicine - November 27, 2016 Category: Anesthesiology Source Type: research

Critical incidents: the respiratory system
Publication date: Available online 26 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Edward T.C. Miles, Timothy M. Cook Respiratory complications are expensive, not just in terms of the overall litigation burden faced by anaesthetists but also, far more importantly, the mortality and morbidity burden faced by our patients. Critical incidents arising in the respiratory system can cause rapid deterioration if left unchecked: trauma to airway structures can be debilitating or even life-threatening; hypoxaemia may result in damage to other organ systems, most notably the brain. Each patient carr...
Source: Anaesthesia and intensive care medicine - November 27, 2016 Category: Anesthesiology Source Type: research

Anaesthesia for paediatric eye surgery
Publication date: Available online 27 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Ian D.M. Davies, Steven M. Sale Local anaesthesia is often the technique of choice for ophthalmic procedures performed on adults; however, general anaesthesia is usually required for procedures on children. The majority of paediatric patients are fit and healthy but there is a minority in whom the presenting eye complaint is related to a congenital disorder, which may have significant bearing on the conduct of anaesthesia. Management of the airway and presentation of a quiescent eye for surgery are key consi...
Source: Anaesthesia and intensive care medicine - November 27, 2016 Category: Anesthesiology Source Type: research

Eye signs in anaesthesia and intensive care medicine
Publication date: Available online 25 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Rahul Bajekal, Francoise Bari Eye signs are of limited value in assessing the level of sedation or general anaesthesia. Horner's syndrome is an important complication of excessively high neuraxial block. Eye opening is part of the Glasgow Coma Scale, and pupil size and reaction have important implications in the intensive care setting. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - November 25, 2016 Category: Anesthesiology Source Type: research

Tracheal intubation
Publication date: Available online 25 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Elizabeth B.M. Thomas, Susan Moss Tracheal intubation is the placement of a tube into the trachea. It provides the gold standard for airway protection ensuring the trachea and lungs are protected from the aspiration of stomach contents. The tube can be used for ventilation permitting oxygen delivery and the removal of carbon dioxide; it also has a role in delivering drugs. If the tracheal tube is misplaced and not recognized, then hypoxia will occur which may be fatal. Tracheal intubation was first recorded ...
Source: Anaesthesia and intensive care medicine - November 25, 2016 Category: Anesthesiology Source Type: research

General anaesthesia for ophthalmic surgery
Publication date: Available online 25 November 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Nicholas C.B. Pritchard Local anaesthesia for eye surgery is increasingly popular, but there will always be a need for general anaesthesia. Patients may refuse local anaesthesia, may be unable to keep still or lie flat for the duration of surgery or lack the mental facility to cooperate whilst awake. Young children and those with allergy to local anaesthetic also need general anaesthesia. Careful patient preparation is important before surgery. Glycaemic control in patients with diabetes, adjustments to warf...
Source: Anaesthesia and intensive care medicine - November 25, 2016 Category: Anesthesiology Source Type: research

Therapeutic hypothermia and acute brain injury
This article will review the putative mechanisms of hypothermia-induced neuroprotection, the technical considerations for the clinician wishing to use TTM, and review the evidence for the clinical application of TTM after acute brain injury. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

The management of ischaemic stroke
Publication date: Available online 20 October 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Robin S. Howard Ischaemic stroke often leads devastating long-term neurological sequelae. There are five interventions that improve the outcome after a stroke: management within a stroke unit, intravenous thrombolysis, mechanical clot retrieval, aspirin within 48 hours, and decompressive hemicraniectomy for malignant middle cerebral artery (MCA) stroke. The benefits of intravenous thrombolysis up to 4.5 hours are now well established, but the recent development of clot retrieval has radically altered the acut...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Anaesthesia for interventional neuroradiology
Publication date: Available online 20 October 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Baljit S. Phull, Ian Appleby The volume and range of procedures undertaken by interventional neuroradiologists have significantly expanded in recent years. They are now treating many conditions previously considered untreatable or only amenable to open surgical techniques. To facilitate the close cooperation required between radiologists and anaesthetists necessary for the successful outcome of these complex and lengthy procedures, it is important for the anaesthetist to have an appreciation of the physiopath...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Applied cerebral physiology
This article reviews cerebral metabolism and cerebral blood flow and techniques by which both can be monitored. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Cerebrospinal fluid and its physiology
This article describes the anatomy and physiology of cerebrospinal fluid and the abnormalities that can result in hydrocephalus. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Preoperative evaluation of neurosurgical patients
This article focuses on the required preoperative preparation of neurosurgical patients. Intracranial and spinal surgery are associated with significant morbidity (23.6% and 11.2%, respectively), with overall 30-day mortality around 0.4–2.3% for intracranial surgery. Preoperative assessment must consider the surgical procedure being undertaken, pathology and its presentation, as well as patient-related factors that can be optimized prior to surgery. It also allows preoperative risk stratification and shared decision-making, informed consent and appropriate planning of perioperative care. Careful documentation of preo...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Prion diseases
Publication date: Available online 21 October 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Michelle Leemans The prion diseases, or transmissible spongiform encephalopathies (TSEs), are a group of neurodegenerative diseases. They are caused by an abnormal form of a naturally occurring cellular protein, known as prion protein. All prion diseases are fatal and without cure. Although all are rare, interest has increased over the last 20 years due to the appearance of a new prion disease called variant Creutzfeldt–Jakob disease. This disease is transmissible via medical devices and blood and there...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Hypothalamic and pituitary function
Publication date: Available online 22 October 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Iain Campbell The endocrine system consists of groups of cells (glands) that secrete messengers (hormones), which affect distant groups of cells (target organs). It controls mainly basal processes. Hormonal action may be on receptors in the target cell membrane (e.g. leading to alterations in membrane channel properties), in which case it is rapid, or it may affect gene function and thus protein synthesis, in which case the onset of action is relatively slow. Endocrine function is controlled via single and mu...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Anaesthesia for neurosurgery
Publication date: Available online 24 October 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Oliver Hambidge, Robert John Neuroanaesthesia is an expanding speciality that requires a good understanding of neurophysiology as well as the pathophysiology of raised intracranial pressure. Neuroanaesthetists need to ensure neurosurgical patients maintain an adequate cerebral perfusion pressure intraoperatively, while providing optimum operating conditions. To achieve this, a balanced anaesthetic technique preventing hypertensive surges and optimizing cerebral venous drainage by careful patient positioning i...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Pharmacological and pathological modulation of cerebral physiology
This article outlines the effect of anaesthesia on cerebral physiology and reviews the pathophysiology of traumatic brain injury and subarachnoid haemorrhage. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Ion channels, receptors, agonists and antagonists
This article describes the physiology of ion channels and the principal molecular mechanisms responsible for modulating their activity by commonly used drugs in anaesthesia and intensive care. The concept of efficient and selective transport of ions across ‘impermeable’ plasma membranes is introduced, together with the mechanisms influencing electrochemical signalling within cells. The classification and composition of voltage-gated ion channels are described in the context of their contribution to action potential generation in excitable cells. Drug–receptor interaction of the four main classes of recept...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

The management of haemorrhagic stroke
Publication date: Available online 26 October 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Robin S. Howard Intracerebral haemorrhage (ICH) accounts for 8–13% of all strokes and results from a variety of disorders. ICH is more likely to result in death or major disability than ischaemic stroke or subarachnoid haemorrhage. Rapid imaging allows early diagnosis and characterization of the localization and severity of the haemorrhage. Patients with acute ICH should be managed in an intensive care unit. Treatment entails general supportive care, control of blood pressure (BP) and intracranial press...
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Clinical approach to comatose patients
Publication date: Available online 29 October 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Joanne Tan, Marco Fedi The nature of consciousness itself belongs within a group of ‘underdetermined questions’ to which we might not be able to find an answer. Similarly, we have a limited understanding of disorders of consciousness. In this brief article, we discuss a practical approach to the comatose patient and the importance of promptly identifying the cause to prevent permanent neurologic damage. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - October 29, 2016 Category: Anesthesiology Source Type: research

Neurosurgical techniques in the management of chronic pain
Publication date: Available online 28 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Paul Eldridge Neurosurgical treatments for pain can be classified into three categories: treatment of the cause, neuromodulation and neuroablative techniques in order of preference of application. In general, it is important to be able offer all treatments in a pluripotential context. All of these treatments are now delivered in a multidisciplinary context, with other adjunctive treatments including pain medicine, cognitive techniques and pain management programmes. There is increasing emphasis on outcome m...
Source: Anaesthesia and intensive care medicine - September 29, 2016 Category: Anesthesiology Source Type: research

Pharmacology in the management of chronic pain
Publication date: Available online 28 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Matthew Roe, Arun Sehgal Management of chronic pain should be achieved with a biopsychosocial approach and often requires multidisciplinary input. Pharmacological treatment can play an important role in the successful management of chronic pain. When planning a pharmacological strategy for chronic pain it is important to consider the nature and likely source of the pain. This review article will summarize common pharmacological options in current clinical use for the management of chronic pain. (Source: Ana...
Source: Anaesthesia and intensive care medicine - September 29, 2016 Category: Anesthesiology Source Type: research

Paediatric chronic pain
Publication date: Available online 27 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Paul M. Rolfe Chronic pain in childhood is common and if untreated may lead to significant pain-related disability, emotional disturbance and poor school attendance. These children and adolescents are often successfully managed outside of specialist paediatric pain management clinics in a wide range of clinical settings. However, some children require the expertise of a multidisciplinary pain management team in a dedicated paediatric centre. Following multidisciplinary assessment an individualized pain mana...
Source: Anaesthesia and intensive care medicine - September 28, 2016 Category: Anesthesiology Source Type: research

Implantable technology for pain management
Publication date: Available online 26 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Sanad Hadidi, G. Baranidharan Neuropathic pain is a well-recognized chronic pain condition. This can have a significant impact in patients' quality of life. Neuromodulation is defined by the International Neuromodulation Society as ‘the therapeutic alteration of activity in the central or peripheral nervous system either electrically or pharmacologically’. Electrical stimulation can be performed at the motor cortex, deep brain, spinal cord, dorsal root ganglion, peripheral nerve and peripheral n...
Source: Anaesthesia and intensive care medicine - September 27, 2016 Category: Anesthesiology Source Type: research

Management of pain in the terminally ill
Publication date: Available online 23 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Siobhan E. King, Joseph Paul Hawkins, Jonathan MJ. Valentine Pain management in the terminally ill can be complex and challenging necessitating a holistic approach. Multimodal analgesic strategies are usually employed to successfully manage pain and other symptoms. There are now a variety of opioid formulations available to treat moderate to severe pain. Neuropathic and cancer-induced bone pain can be difficult to treat, but newer drugs are available in addition to a number of established interventional pro...
Source: Anaesthesia and intensive care medicine - September 24, 2016 Category: Anesthesiology Source Type: research

Radiofrequency techniques in pain management
Publication date: Available online 23 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Victor Mendis, Ramy Mottaleb, Ming Fung Radiofrequency 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: Anaesthesia ...
Source: Anaesthesia and intensive care medicine - September 24, 2016 Category: Anesthesiology Source Type: research

Opioids in the management of persistent non-cancer pain
This article reviews the evidence for the effectiveness of long-term opioids in the management of PNCP, the current guidelines and the associated adverse affects. (Source: Anaesthesia and intensive care medicine)
Source: Anaesthesia and intensive care medicine - September 24, 2016 Category: Anesthesiology Source Type: research

Drugs affecting the autonomic nervous system
Publication date: Available online 23 September 2016 Source:Anaesthesia & Intensive Care Medicine Author(s): Matthew Charlton, Jonathan P. Thompson The 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 24, 2016 Category: Anesthesiology Source Type: research