A randomised controlled trial of propofol vs. thiopentone and desflurane for fatigue after laparoscopic cholecystectomy
Summary Fatigue may delay functional recovery after day surgery and may be more common after propofol anaesthesia. We randomly allocated 123 participants scheduled for ambulatory laparoscopic cholecystectomy to induction and maintenance of general anaesthesia with propofol or thiopentone and desflurane. Postoperative fatigue was unaffected by the allocated anaesthetic. The combined mean (SD) Identity‐Consequences Fatigue Scale of 34.3 (15.1) before surgery increased in the first postoperative week: to 60.4 (21.1) on day 1, p
Source: Anaesthesia - April 26, 2017 Category: Anesthesiology Authors: T. Nostdahl, O. M. Fredheim, T. Bernklev, T. S. Doksrod, R. M. Mohus, J. Raeder Tags: Original Article Source Type: research

The effective introduction of Lifebox pulse oximetry to Malawi
(Source: Anaesthesia)
Source: Anaesthesia - April 25, 2017 Category: Anesthesiology Authors: D. A. Scott, R. McDougall Tags: Editorial Source Type: research

Lifebox pulse oximeter implementation in Malawi: evaluation of educational outcomes and impact on oxygen desaturation episodes during anaesthesia
Summary Pulse oximetry is an essential monitor for safe anaesthesia but is often not available in low‐income countries. The aim of this study was to determine whether the introduction of pulse oximetry with training was feasible and could reduce the incidence of oxygen desaturation during anaesthesia in a low‐income country. Pulse oximeters were donated, with training, to 83 non‐physician anaesthetists in Malawi. Knowledge was tested immediately before and after training and at follow‐up. Providers were asked to record the lowest peripheral oxygen saturation (SpO2) for the first 100 cases anaesthetised after traini...
Source: Anaesthesia - April 24, 2017 Category: Anesthesiology Authors: V. Albert, S. Mndolo, E. M. Harrison, E. O'Sullivan, I. H. Wilson, I. A. Walker Tags: Original Article Source Type: research

A case series of vital signs ‐controlled, patient‐assisted intravenous analgesia (VPIA) using remifentanil for labour and delivery
Summary Intravenous remifentanil patient‐controlled analgesia can be used during labour as an alternative to epidural analgesia. Adverse effects of opioids, including hypoxia and bradycardia, may lead to maternal morbidity and mortality. We devised an interactive feedback system based on a clinical proportional algorithm, to continuously monitor for adverse effects to enhance safety and better titrate analgesia. This vital signs‐controlled, patient‐assisted intravenous analgesia with remifentanil used a prototype delivery system linked to a pulse oximeter that evaluated maternal oxygen saturation and heart rate conti...
Source: Anaesthesia - April 18, 2017 Category: Anesthesiology Authors: W. L. Leong, B. L. Sng, Q. Zhang, N. L. R. Han, R. Sultana, A. T. H. Sia Tags: Original Article Source Type: research

Pressure waveforms to assess epidural placement: is there a role on delivery suite?
(Source: Anaesthesia)
Source: Anaesthesia - April 17, 2017 Category: Anesthesiology Authors: R. A. McKendry, N. A. Muchatuta Tags: Editorial Source Type: research

Reliability of pressure waveform analysis to determine correct epidural needle placement in labouring women
Summary Pressure waveform analysis provides a reliable confirmatory adjunct to the loss‐of‐resistance technique to identify the epidural space during thoracic epidural anaesthesia, but its role remains controversial in lumbar epidural analgesia during labour. We performed an observational study in 100 labouring women of the sensitivity and specificity of waveform analysis to determine the correct location of the epidural needle. After obtaining loss‐of‐resistance, the anaesthetist injected 5 ml saline through the epidural needle (accounting for the volume already used in the loss‐of‐resistance). Sterile extensi...
Source: Anaesthesia - April 17, 2017 Category: Anesthesiology Authors: I. Al ‐Aamri, S. H. Derzi, A. Moore, M. F. Elgueta, M. Moustafa, T. Schricker, D. Q. Tran Tags: Original Article Source Type: research

Long ‐term alterations in monocyte function after elective cardiac surgery
Summary Optimal immunological homoeostasis determines the long‐term recovery of patients in the postoperative period. The functional adaptability of monocytes plays a pivotal role in adjusting the host's response to an insult, immunostasis and long‐term health, and may help to determine successful recovery. We undertook a longitudinal analysis of the functional adaptability of monocytes in 20 patients undergoing heart surgery with cardiopulmonary bypass, as a model of severe stress. Using each patient's pre‐cardiopulmonary bypass data as a baseline, we investigated the characteristics of peripheral blood monocytes&rs...
Source: Anaesthesia - April 13, 2017 Category: Anesthesiology Authors: M. Zawadka, J. Wahome, H. Oszkiel, W. Y. Szeto, B. Cobb, K. Laudanski Tags: Original Article Source Type: research

Effect of prophylactic placement of internal iliac artery balloon catheters on outcomes of women with placenta accreta: an impact study
This study demonstrates that prophylactic balloon occlusion of the internal iliac arteries did not reduce intra‐operative haemorrhage or caesarean hysterectomy in women with placenta accreta undergoing caesarean section. In addition, it has a significant impact on the choice of anaesthetic technique. (Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: S. Feng, Z. Liao, H. Huang Tags: Original Article Source Type: research

Self ‐harm and poisoning data in rural Ugandan hospitals – a reply
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: M. Duenser Tags: Correspondence Source Type: research

Self ‐harm and poisoning data in rural Ugandan hospitals
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: E. Hulse Tags: Correspondence Source Type: research

Cerebral oxygenation and vascular resistance changes during cardiopulmonary bypass  – where is the proof? A reply
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: N. H. Sperna Weiland, M. W. Hollmann, R. V. Immink Tags: Correspondence Source Type: research

Cerebral oxygenation and vascular resistance changes during cardiopulmonary bypass – where is the proof?
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: H. P. Grocott Tags: Correspondence Source Type: research

Mock before you block – a reply
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: J. J. Pandit, J. Matthews, M. Pandit Tags: Correspondence Source Type: research

Mock before you block
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: J. M. Wight, L. Chrisman, I. Reed, G. S. K. Wong, A. Pawa Tags: Correspondence Source Type: research

Fascia iliaca block for hip replacement – adjuvants and ethics. A reply
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: R. Kearns, A. Macfarlane, J. Kinsella, K. Anderson Tags: Correspondence Source Type: research

Fascia iliaca block for hip replacement – adjuvants and ethics
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: M. Haque, T. Fregene Tags: Correspondence Source Type: research

Should blood glucose measurement be a standard of monitoring? A reply
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: M. Checketts Tags: Correspondence Source Type: research

Should blood glucose measurement be a standard of monitoring?
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: B. Peirce, N. Levy Tags: Correspondence Source Type: research

AAGBI Consent for Anaesthesia 2017 guidelines – a reply
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: S. M. Yentis Tags: Correspondence Source Type: research

AAGBI Consent guidelines 2017 – should the advice about 16 and 17‐year‐olds be amended?
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: H. Wellesley, S. Pownall Tags: Correspondence Source Type: research

An alternative to the best interests standard for consent in paediatrics
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: J. Ip Tags: Correspondence Source Type: research

Is the anaesthetic consent process now too onerous?
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: I. F. Russell Tags: Correspondence Source Type: research

Non ‐sticky sticky syringe labels
(Source: Anaesthesia)
Source: Anaesthesia - April 12, 2017 Category: Anesthesiology Authors: Q. Lo, F. Plaat Tags: Snippet Source Type: research

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

Should patients be advised not to drive for 4  days after isoflurane anaesthesia?
(Source: Anaesthesia)
Source: Anaesthesia - April 8, 2017 Category: Anesthesiology Authors: L. M. Powell, M. Molyneux Tags: Editorial Source Type: research

Diagnostic criteria for pre ‐operative anaemia–time to end sex discrimination
(Source: Anaesthesia)
Source: Anaesthesia - April 6, 2017 Category: Anesthesiology Authors: A. Butcher, T. Richards, S. J. Stanworh, A. A. Klein Tags: Editorial Source Type: research

Pain ‐related unscheduled contact with healthcare services after outpatient surgery
Summary This prospective, observational study explored the need for pain‐related unscheduled contact with healthcare services after outpatient surgery. We hypothesised that 10% of outpatients would have pain‐related unscheduled contact with healthcare services, and that the incidence would differ depending on the type of surgical procedure. In total, 905 patients who had undergone one of five common outpatient surgical procedures (knee or shoulder arthroscopy, surgical correction of hallux valgus, laparoscopic cholecystectomy or laparoscopic gynaecological procedures) completed an electronic questionnaire one week and ...
Source: Anaesthesia - April 1, 2017 Category: Anesthesiology Authors: L. D. Brix, K. T. Bj ørnholdt, T. M. Thillemann, L. Nikolajsen Tags: Original Article Source Type: research

Pre ‐operative haemoglobin levels and iron status in a large multicentre cohort of patients undergoing major elective surgery
Summary Pre‐operative anaemia in patients undergoing major surgical procedures has been linked to poor outcomes. Therefore, early detection and treatment of pre‐operative anaemia is recommended. However, to effectively implement a pre‐operative anaemia management protocol, an estimation of its prevalence and main causes is needed. We analysed data from 3342 patients (44.5% female) scheduled for either: elective orthopaedic surgery (n = 1286); cardiac surgery (n = 691); colorectal cancer resection (n = 735); radical prostatectomy (n = 362); gynaecological surgery (n = ...
Source: Anaesthesia - April 1, 2017 Category: Anesthesiology Authors: M. Mu ñoz, M. J. Laso‐Morales, S. Gómez‐Ramírez, M. Cadellas, M. J. Núñez‐Matas, J. A. García‐Erce Tags: Original Article Source Type: research

Disease coding for anaesthetic and peri ‐operative practice: an opportunity not to be missed
(Source: Anaesthesia)
Source: Anaesthesia - April 1, 2017 Category: Anesthesiology Authors: J. H. MacG. Palmer, M. R. J. Sury, T. M. Cook, J. J. Pandit Tags: Editorial Source Type: research

Accuracy, intra ‐ and inter‐rater reliability of three scoring systems for the glottic view at videolaryngoscopy
Summary An accurate and reproducible recording of laryngoscopic view at tracheal intubation is an important aspect of anaesthetic practice. Unlike direct laryngoscopy, in which the view achieved by the line of sight directly relates to the ease of intubating the trachea, videolaryngoscopy can create a situation in which the view is good, but intubation difficult or impossible. Communicating this to a subsequent anaesthetist is important. We compared three scoring systems: Cormack and Lehane; POGO (percentage of glottic opening); and the Fremantle score, as used by 74 critical care doctors rating 30 anonymised videos of vid...
Source: Anaesthesia - March 24, 2017 Category: Anesthesiology Authors: E. J. O'Loughlin, A. D. Swann, J. D. English, R. Ramadas Tags: Original Article Source Type: research

A pilot study of ultrasound evaluation of gastric emptying in patients with end ‐stage renal failure: a comparison with healthy controls
This study supports the use of bedside gastric ultrasound as a point‐of‐care test for patients with known risk factors for delayed gastric emptying. (Source: Anaesthesia)
Source: Anaesthesia - March 23, 2017 Category: Anesthesiology Authors: C. Chen, L. Liu, C. Y. Wang, S. ‐W. Choi, V. M. Yuen Tags: Original Article Source Type: research

Comparing two methods –agreeing to disagree?
(Source: Anaesthesia)
Source: Anaesthesia - March 23, 2017 Category: Anesthesiology Authors: S. W. Choi, D. M. H. Lam Tags: Statistically Speaking: methodological madness Source Type: research

Intra ‐oral ignition of monopolar diathermy during transnasal humidified rapid‐insufflation ventilatory exchange (THRIVE)
We present the case of unanticipated airway ignition during hard palate biopsy. Transnasal humidified rapid‐insufflation ventilatory exchange (THRIVE) and monopolar diathermy were utilised for the procedure, during which an arc arose from the diathermy tip to a titanium implant, causing a brief ignition on the monopolar diathermy grip. This case highlights the need for maintained awareness of fire risk when using diathermy in the presence of THRIVE during airway surgery. (Source: Anaesthesia)
Source: Anaesthesia - March 21, 2017 Category: Anesthesiology Authors: D. Onwochei, K. El ‐Boghdadly, R. Oakley, I. Ahmad Tags: Case Report Source Type: research

The use of enrichment to reduce statistically indeterminate or negative trials in critical care
(Source: Anaesthesia)
Source: Anaesthesia - March 20, 2017 Category: Anesthesiology Authors: M. Shankar ‐Hari, G. D. Rubenfeld Tags: Editorial Source Type: research

Long ‐term outcomes and cost effectiveness of high‐dose dexamethasone for cardiac surgery: a randomised trial
Summary Prophylactic intra‐operative administration of dexamethasone may improve short‐term clinical outcomes in cardiac surgical patients. The purpose of this study was to evaluate long‐term clinical outcomes and cost effectiveness of dexamethasone versus placebo. Patients included in the multicentre, randomised, double‐blind, placebo‐controlled DExamethasone for Cardiac Surgery (DECS) trial were followed up for 12 months after their cardiac surgical procedure. In the DECS trial, patients received a single intra‐operative dose of dexamethasone 1 mg.kg−1 (n = 2239) or placebo (n = 2255). The effects on th...
Source: Anaesthesia - March 19, 2017 Category: Anesthesiology Authors: J. M. Dieleman, G. A. Wit, A. P. Nierich, P. M. Rosseel, J. M. Maaten, J. Hofland, J. C. Diephuis, F. Lange, C. Boer, R. E. Neslo, K. G. Moons, L. A. Herwerden, J. G. Tijssen, C. J. Kalkman, D. Dijk, Tags: Original Article Source Type: research

Evaluation of a flexible bronchoscope prototype designed for bronchoscopy during mechanical ventilation: a proof ‐of‐concept study
Summary Bronchoscopy during mechanical ventilation of patients' lungs significantly affects ventilation because of partial obstruction of the tracheal tube, and may thus be omitted in the most severely ill patients. It has not previously been possible to reduce the external diameter of the bronchoscope without reducing the diameter of the suction channel, thus reducing the suctioning capacity of the device. We believed that a better‐designed bronchoscope could improve the safety of bronchoscopy in patients whose lungs were ventilated. We designed a flexible bronchoscope prototype with a drumstick‐shaped head consisting...
Source: Anaesthesia - March 15, 2017 Category: Anesthesiology Authors: M. ‐A. Nay, A. Auvet, J. Mankikian, V. Herve, P.‐F. Dequin, A. Guillon Tags: Original Article Source Type: research

A prospective, randomised trial of pre ‐oxygenation strategies available in the pre‐hospital environment
Summary Pre‐oxygenation before tracheal intubation aims to increase safe apnoea duration by denitrogenation of the functional residual capacity of the lungs, and increasing oxygen stores at the onset of apnoea. Pre‐oxygenation options in the pre‐hospital environment are limited due to oxygen availability and equipment portability. The aim of this study was to evaluate the effectiveness of strategies available in this setting. This was a prospective, randomised, crossover study of 30 healthy volunteers who underwent 3‐min periods of pre‐oxygenation by tidal volume breathing with a non‐rebreather mask, a bag‐va...
Source: Anaesthesia - March 14, 2017 Category: Anesthesiology Authors: C. J. Groombridge, E. Ley, M. Miller, T. Konig Tags: Original Article Source Type: research

Confused and confounded by statistics
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: K. S. Lim Tags: Correspondence Source Type: research

Misinterpreting the p value
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: R. Price Tags: Correspondence Source Type: research

Did sugammadex cause, or reveal, laryngospasm? A reply
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: A. J. Dalton, G. Rodney, B. McGuire Tags: Correspondence Source Type: research

Standardising anaesthesia for hip fracture surgery
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: S. Sivasubramaniam Tags: Correspondence Source Type: research

Eligibility criteria in paravertebral block meta ‐analysis – a reply
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: M. Heesen Tags: Correspondence Source Type: research

Eligibility criteria in paravertebral block meta ‐analysis
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: F. W. Abdallah, J. B ørglum, G. van Geffen, A. Pawa, M. Greher, I. Costache, P.‐A Lonnqvist Tags: Correspondence Source Type: research

Difficult airway research options and ethical consensus – a reply
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: M. G. Irwin, P. A. Ward Tags: Correspondence Source Type: research

Difficult airway research options and ethical consensus
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: H. P. Grocott Tags: Correspondence Source Type: research

Flow ‐pressure characteristics of a GE Healthcare Aisys CS2 APL valve
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: J. Thomas, M. Weiss Tags: Correspondence Source Type: research

Flow ‐pressure characteristics of an Intersurgical adjustable pressure‐limiting valve
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: S. Spinney, K. A. Sprigge, T. Lawson Tags: Correspondence Source Type: research

Videolaryngoscopy or fibreoptic bronchoscopy for awake intubation of bariatric patients with predicted difficult airways – a randomised, controlled trial
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: A. Moore, A. el ‐Bahrawy, E. El‐Mouallem, R. Lattermann, R. Hatzakorzian, W. LiPishan, T. Schricker Tags: Correspondence Source Type: research

Efficacy, safety and the routine use of first generation SADs in paediatric practice
(Source: Anaesthesia)
Source: Anaesthesia - March 12, 2017 Category: Anesthesiology Authors: T. M. Cook, F. E. Kelly Tags: Correspondence Source Type: research

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