Recovery characteristics of patients receiving either sugammadex or neostigmine and glycopyrrolate for reversal of neuromuscular block: a randomised controlled trial
In this study, we compared the recovery characteristics of sugammadex and neostigmine/glycopyrrolate following reversal of neuromuscular block. This was a single‐centre, randomised, blinded, parallel‐group clinical trial in women undergoing elective day‐surgical laparoscopic gynaecological surgery, with a standardised general anaesthesia regimen that included rocuronium. Neuromuscular block was reversed with either sugammadex 2 mg.kg−1 or neostigmine 40 μg.kg−1 and glycopyrrolate 400 μg. The primary outcome was the incidence of nausea and vomiting during the first six postoperative hours. Secondary ...
Source: Anaesthesia - December 7, 2017 Category: Anesthesiology Authors: M. J. Paech, R. Kaye, C. Baber, E. A. Nathan Tags: Original Article Source Type: research

Sugammadex advice for women of childbearing age
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: R. Williams, H. Bryant Tags: Correspondence Source Type: research

Moderate vs. deep neuromuscular blockade and monitoring
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: P. Raju, G. Rodney Tags: Correspondence Source Type: research

Coding for anaesthetic and peri ‐operative practice
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: A. Norton Tags: Correspondence Source Type: research

Patient emergence – statistical questions: a reply
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: J. H. Seo Tags: Correspondence Source Type: research

Patient emergence – statistical questions
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: G. Wong Tags: Correspondence Source Type: research

Medical gas cylinder expiry dates – a reply
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: M. Nathanson Tags: Correspondence Source Type: research

Medical gas cylinder expiry dates
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: A. B. Philip, M. O'Sullivan, S. Mannion Tags: Correspondence Source Type: research

Seeking and reporting apparent research misconduct: errors and integrity – a reply
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: J. A. Loadsman, T. J. McCulloch Tags: Correspondence Source Type: research

Seeking and reporting apparent research misconduct: errors and integrity
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: E. D. Kharasch, T. T. Houle Tags: Correspondence Source Type: research

A novel wheeze
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: E. Perritt, A. Dunlop Tags: Snippet Source Type: research

Accidental awareness during general anaesthesia – a narrative review
Summary Unintended accidental awareness during general anaesthesia represents failure of successful anaesthesia, and so has been the subject of numerous studies during the past decades. As return to consciousness is both difficult to describe and identify, the reported incidence rates vary widely. Similarly, a wide range of techniques have been employed to identify cases of accidental awareness. Studies which have used the isolated forearm technique to identify responsiveness to command during intended anaesthesia have shown remarkably high incidences of awareness. For example, the ConsCIOUS‐1 study showed an incidence o...
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: S. R. Tasbihgou, M. F. Vogels, A. R. Absalom Tags: Review Article Source Type: research

Strategies for the prevention of airway complications – a narrative review
Summary Despite being infrequent, complications of airway management remain an important contributor to morbidity and mortality during anaesthesia and care of the critically ill. Developments in the last three decades have made anaesthesia safer, and this has been mirrored in the equipment and techniques available for airway management. Modern technology including novel oxygenation modalities, widespread availability of capnography, second‐generation supraglottic airway devices and videolaryngoscopy provide the tools to make airway management safer still. However, technology will only take safety so far, and non‐techni...
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Authors: T. M. Cook Tags: Review Article Source Type: research

Issue Information – Editorial Board
(Source: Anaesthesia)
Source: Anaesthesia - December 5, 2017 Category: Anesthesiology Tags: Issue Information Source Type: research

Determination of the optimal programmed intermittent epidural bolus volume of bupivacaine 0.0625% with fentanyl 2 μg.ml−1 at a fixed interval of forty minutes: a biased coin up‐and‐down sequential allocation trial
Anaesthesia,Volume 73, Issue 4, Page 459-465, April 2018. (Source: Anaesthesia)
Source: Anaesthesia - December 2, 2017 Category: Anesthesiology Source Type: research

Postoperative outcomes following cardiac surgery in non ‐anaemic iron‐replete and iron‐deficient patients – an exploratory study
Anaesthesia,Volume 73, Issue 4, Page 450-458, April 2018. (Source: Anaesthesia)
Source: Anaesthesia - December 2, 2017 Category: Anesthesiology Source Type: research

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Anaesthesia,Volume 73, Issue 4, Page 459-465, April 2018. (Source: Anaesthesia)
Source: Anaesthesia - December 2, 2017 Category: Anesthesiology Source Type: research

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Anaesthesia,Volume 73, Issue 4, Page 450-458, April 2018. (Source: Anaesthesia)
Source: Anaesthesia - December 2, 2017 Category: Anesthesiology Source Type: research

Determination of the optimal programmed intermittent epidural bolus volume of bupivacaine 0.0625% with fentanyl 2 μg.ml−1 at a fixed interval of forty minutes: a biased coin up‐and‐down sequential allocation trial
In conclusion, it is not possible to reduce the programmed intermittent epidural bolus volume from 10 ml, used in our current regimen, without compromising the quality of analgesia. Using this regimen, a high proportion of women will develop a sensory block above T6. (Source: Anaesthesia)
Source: Anaesthesia - December 2, 2017 Category: Anesthesiology Authors: P. Zakus, C. Arzola, R. Bittencourt, K. Downey, X. Y. Ye, J. C. Carvalho Tags: Original Article Source Type: research

Postoperative outcomes following cardiac surgery in non ‐anaemic iron‐replete and iron‐deficient patients – an exploratory study
Summary Iron deficiency anaemia is strongly associated with poor outcomes after cardiac surgery. However, pre‐operative non‐anaemic iron deficiency (a probable anaemia precursor) has not been comprehensively examined in patients undergoing cardiac surgery, despite biological plausibility and evidence from other patient populations of negative effect on outcome. This exploratory retrospective cohort study aimed to compare an iron‐deficient group of patients undergoing cardiac surgery with an iron‐replete group. Consecutive non‐anaemic patients undergoing elective coronary artery bypass grafting or single valve rep...
Source: Anaesthesia - December 1, 2017 Category: Anesthesiology Authors: L. F. Miles, S. A. Kunz, L. H. Na, S. Braat, K. Burbury, D. A. Story Tags: Original Article Source Type: research

Risk of epilepsy in surgical patients undergoing general or neuraxial anaesthesia
Summary Limited information is available on the risks of epilepsy after surgery in patients receiving general or neuraxial anaesthesia. Using Taiwan's National Health Insurance Research Database, we identified 1,478,977 patients aged ≥ 20 years who underwent surgery (required general or neuraxial anaesthesia with hospitalisation for more than one day) between 2004 and 2011. We selected 235,066 patients with general anaesthesia and 235,066 patients with neuraxial anaesthesia using a frequency‐matching procedure for age and sex. We did not study those with co‐existing epilepsy‐related risk factors. Th...
Source: Anaesthesia - November 27, 2017 Category: Anesthesiology Authors: H. C. Chang, C. C. Liao, C. C. Chang, S. Y. Huang, C. C. Yeh, C. J. Hu, Y. G. Cherng, T. L. Chen Tags: Original Article Source Type: research

A randomised controlled trial comparing high ‐flow nasal oxygen with standard management for conscious sedation during bronchoscopy
Summary Traditional conscious sedation for endobronchial ultrasound procedures places patients at risk of desaturation, and high‐flow nasal oxygen may reduce the risk. We designed a parallel‐group randomised controlled trial of high‐flow nasal oxygen at a flow rate of 30–70 l.min−1 via nasal cannulae, compared with standard oxygen therapy at 10 l.min−1 via a bite block in adults planned for conscious sedation for endobronchial ultrasound. The primary outcome was the proportion of patients experiencing desaturation (defined as SpO2
Source: Anaesthesia - November 24, 2017 Category: Anesthesiology Authors: N. Douglas, I. Ng, F. Nazeem, K. Lee, P. Mezzavia, R. Krieser, D. Steinfort, L. Irving, R. Segal Tags: Original Article Source Type: research

Volume responsiveness assessed by passive leg raising and a fluid challenge: a critical review focused on mean systemic filling pressure
Summary This review applied cardiovascular principles relevant to the physiology of venous return in interpreting studies on the utility of a passive leg‐raising manoeuvre to identify patients who do (responders) or do not respond to a subsequent intravenous volume challenge with an increase in cardiac output. Values for cardiac output, mean arterial and central venous pressure, and the calculated cardiovascular variables mean systemic filling pressure analogue, heart efficiency, cardiac power indexed by volume state and volume efficiency, before and after passive leg raising as well as before and after fluid volume chal...
Source: Anaesthesia - November 24, 2017 Category: Anesthesiology Authors: K. Cooke, R. Sharvill, S. Sondergaard, A. Aneman Tags: Original Article Source Type: research

Time to stop using uncuffed tracheal tubes in children?
(Source: Anaesthesia)
Source: Anaesthesia - November 23, 2017 Category: Anesthesiology Authors: C. R. Bailey Tags: Editorial Source Type: research

Decision ‐making in response to respiratory veno‐venous extracorporeal membrane oxygenation referrals: is current practice precise enough?
(Source: Anaesthesia)
Source: Anaesthesia - November 23, 2017 Category: Anesthesiology Authors: M. Charlesworth, A. D. Ashworth, J. M. Barker Tags: Editorial Source Type: research

Cuffed vs. uncuffed tracheal tubes in children: a randomised controlled trial comparing leak, tidal volume and complications
This study compared tidal volume and leakage around cuffed and uncuffed tracheal tubes in children who required standardised mechanical ventilation of their lungs in the operating theatre. Children (0–16 years) undergoing elective surgery requiring tracheal intubation were randomly assigned to receive either a cuffed or an uncuffed tracheal tube. Assessments were made at five different time‐points: during volume‐controlled ventilation 6 ml.kg−1, PEEP 5 cmH2O and during pressure‐controlled ventilation 10 cmH2O / PEEP 5 cmH2O. The pressure‐controlled ventilation measurement time‐points were: just before...
Source: Anaesthesia - November 23, 2017 Category: Anesthesiology Authors: N. A. Chambers, A. Ramgolam, D. Sommerfield, G. Zhang, T. Ledowski, M. Thurm, M. Lethbridge, M. Hegarty, B. S. von Ungern ‐Sternberg Tags: Original Article Source Type: research

Acceptance and transfer to a regional severe respiratory failure and veno ‐venous extracorporeal membrane oxygenation (ECMO) service: predictors and outcomes
Summary The use of extracorporeal membrane oxygenation for respiratory failure is high risk and resource intensive. In England, five centres provide this service and patients who are referred have four possible outcomes: declined transfer due to perceived futility; accepted in principle but remain at the referring centre with ongoing surveillance; retrieved using conventional ventilation; or retrieved on extracorporeal support. The decision‐making process leading to these outcomes has not previously been examined. We evaluated referrals to one centre and identified factors associated with each decision outcome. Five hund...
Source: Anaesthesia - November 23, 2017 Category: Anesthesiology Authors: S. A. Gillon, K. Rowland, M. Shankar ‐Hari, L. Camporota, G. W. Glover, D. L. A. Wyncoll, N. A. Barrett, N. Ioannou, C. I. S. Meadows Tags: Original Article Source Type: research

The effect of 6% hydroxyethyl starch (130/0.4) on acute kidney injury in paediatric cardiac surgery: a prospective, randomised trial
Summary We have evaluated the effect of a colloid solution on acute kidney injury in paediatric cardiac surgery. A total of 195 patients were ramdomly divided into an hydroxyethyl starch group and a control group. In the starch group, 6% hydroxyethyl starch 130/0.4 (Volulyte®) was used as the primary fluid for volume resuscitation but was limited to 30 ml.kg−1. In the control group, only crystalloid fluid was used during the peri‐operative period. The incidence of acute kidney injury, peri‐operative transfusion, clinical outcomes and laboratory data were compared. The incidence of acute kidney injury determin...
Source: Anaesthesia - November 18, 2017 Category: Anesthesiology Authors: H. ‐W. Oh, J.‐H. Lee, H.‐C. Kim, E.‐H. Kim, I.‐K. Song, H.‐S. Kim, J.‐T. Kim Tags: Original Article Source Type: research

Defining sepsis on the wards: results of a multi ‐centre point‐prevalence study comparing two sepsis definitions
Summary Our aim was to prospectively determine the predictive capabilities of SEPSIS‐1 and SEPSIS‐3 definitions in the emergency departments and general wards. Patients with National Early Warning Score (NEWS) of 3 or above and suspected or proven infection were enrolled over a 24‐h period in 13 Welsh hospitals. The primary outcome measure was mortality within 30 days. Out of the 5422 patients screened, 431 fulfilled inclusion criteria and 380 (88%) were recruited. Using the SEPSIS‐1 definition, 212 patients had sepsis. When using the SEPSIS‐3 definitions with Sequential Organ Failure Assessment (SOFA) score ≥...
Source: Anaesthesia - November 17, 2017 Category: Anesthesiology Authors: T. Szakmany, R. Pugh, M. Kopczynska, R. M. Lundin, B. Sharif, P. Morgan, G. Ellis, J. Abreu, S. Kulikouskaya, K. Bashir, L. Galloway, H. Al ‐Hassan, T. Grother, P. McNulty, S. T. Seal, A. Cains, M. Vreugdenhil, M. Abdimalik, N. Dennehey, G. Evans, J. Wh Tags: Original Article Source Type: research

Don't quote me on this, but …
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: L. Scott Tags: Correspondence Source Type: research

An unusual failure of sevoflurane QuikFil PEN bottles
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: D. Walsh, S. Ó. Riain Tags: Correspondence Source Type: research

What is the real oximeter gap?
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: A. Gibbs, T. Bashford, I. H. Wilson Tags: Correspondence Source Type: research

Rescue oxygenation in small infants
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: V. M. Y. Yuen, C. H. P. Wong, S. S. C. Wong, G. T. C. Wong Tags: Correspondence Source Type: research

Recognising obstructive sleep apnoea in pregnancy – a survey of UK obstetric anaesthetists
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: A. Miskovic, M. Simpson, J. E. Dominguez, A. S. Bullough Tags: Correspondence Source Type: research

Trainee fatigue – time for a culture change? A reply
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: L. McClelland, J. Holland, J. P. Lomas, N. Redfern, E. Plunkett Tags: Correspondence Source Type: research

Trainee fatigue – time for a culture change?
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: S. Swinkels Tags: Correspondence Source Type: research

MTP block anatomy and paravertebral spread – a reply
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: I. Costache, F. W. Abdallah, A. Pawa Tags: Correspondence Source Type: research

MTP block and paravertebral spread
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: D. L. Hamilton, B. P. Manickam Tags: Correspondence Source Type: research

MTP block anatomy
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: A. Philip, V. Kaushik Tags: Correspondence Source Type: research

Neuromuscular monitoring and the cost of antagonism: when will we learn? A reply
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: C. R. Bailey Tags: Correspondence Source Type: research

The ‘cost’ of sugammadex
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: A. Maddock Tags: Correspondence Source Type: research

Neuromuscular monitoring and the cost of antagonism: when will we learn?
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: S. J. Brull, R. C. Prielipp Tags: Correspondence Source Type: research

Comparing times in clinical studies with a finite ending
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: S. W. Choi, D. M. H. Lam Tags: Statistically Speaking: methodological madness Source Type: research

Feng shui And Emotional Response in the Critical care Environment (FARCE) study
Summary The aim of this study was to investigate the relationship between nursing staff emotions and their surrounding environment, using the ancient system of feng shui. Two orientations of critical care bed spaces (wind and water groups, respectively) were mapped using a western bagua. Energy or ‘chi’ scores for nine emotions were calculated based on the positive or negative flow of chi in each of the two groups. During a two‐week period, nursing staff were allocated to work in a bed space in either the wind or water groups; nursing staff who were not allocated to a study bed space acted as a control group....
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Authors: R. Charles, S. Glover, K. Bauchm üller, D. Wood Tags: Original Article Source Type: research

Issue Information – Editorial Board
(Source: Anaesthesia)
Source: Anaesthesia - November 12, 2017 Category: Anesthesiology Tags: Issue Information Source Type: research

A systematic review of the incidence of and risk factors for postoperative atrial fibrillation following general surgery
Anaesthesia,Volume 73, Issue 4, Page 490-498, April 2018. (Source: Anaesthesia)
Source: Anaesthesia - November 4, 2017 Category: Anesthesiology Source Type: research

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Anaesthesia,Volume 73, Issue 4, Page 490-498, April 2018. (Source: Anaesthesia)
Source: Anaesthesia - November 4, 2017 Category: Anesthesiology Source Type: research

Evaluation of a novel waste anaesthetic gas scavenger device for use during recovery from anaesthesia
Summary Volatile anaesthetic agents are a potential occupational health hazard to theatre and recovery staff. Operating theatres and anaesthetic rooms are required to be equipped with scavenging systems, but recovery units often are not. We compared exhaled, spectrophotometric sevoflurane and desflurane concentrations 15 cm from the mouth (‘patient breathing zone’) and 91 cm laterally to the patient (‘nurse work zone’) in 120 patients after tracheal extubation who were consecutively allocated to either ISO‐Gard mask oxygen/scavenging or standard oxygen mask, 0 min, 10 min and 20 min after arrival ...
Source: Anaesthesia - November 2, 2017 Category: Anesthesiology Authors: R. Tallent, J. Corcoran, J. Sebastian Tags: Original Article Source Type: research

When rain stops play: a ‘Duckworth–Lewis method’ for surgical operating list productivity?
(Source: Anaesthesia)
Source: Anaesthesia - November 2, 2017 Category: Anesthesiology Authors: A. Tavare, J. J. Pandit Tags: Statistically Speaking Source Type: research