Capacitating relatives of incapacitated patients
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - January 9, 2021 Category: Anesthesiology Tags: Editorial Source Type: research

Book Review - Essentials of Pediatric Neuroanesthesia
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Book review Source Type: research

Reply to: video laryngoscopy during airway management in COVID-19 patients
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Video laryngoscopy during airway management in COVID-19 patients: practical relevance of a recent EJA Christmas issue article
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Intra-operative goal-directed therapy and postoperative acute kidney injury in high-risk patients undergoing major gastrointestinal surgery
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Goal-directed therapy and development of acute kidney injury
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: the effect of a combination of lidocaine and magnesium sulphate on postoperative pain
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

The effect of a combination of lidocaine and magnesium sulphate on postoperative pain
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: postoperative nausea and vomiting: The role of the serotonin transporter 5-HTTLPR polymorphism
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Postoperative nausea and vomiting: The role of the serotonin transporter 5-HTTLPR polymorphism
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: goal-directed haemodynamic therapy is in need of a new paradigm to survive
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Goal-directed haemodynamic therapy is in need of a new paradigm to survive
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: stressed volume and fluid responsiveness
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Stressed volume and fluid responsiveness
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: cognitive function after carotid endarterectomy
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Cognitive function after carotid endarterectomy
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: gastric emptying following tea with milk in pregnancy
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Gastric emptying following tea with milk in pregnancy
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Comparison of adequacy of anaesthesia monitoring with standard clinical practice monitoring during routine general anaesthesia: An international, multicentre, single-blinded randomised controlled trial
CONCLUSION In the current study, the guidance of total intravenous anaesthesia by Entropy and surgical pleth index in comparison with standard monitoring alone was not able to validate reduction of unwanted anaesthesia events. However, there was a reduction in the use of propofol, and shorter times for emergence and time spent in the postanaesthesia care unit. TRIAL REGISTRATION at ClinicalTrials.gov NCT01928875. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Anaesthesia Source Type: research

Ultrasound-guided supraclavicular vs. retroclavicular block of the brachial plexus: comparison of ipsilateral diaphragmatic function: A randomised clinical trial
BACKGROUND The ultrasound-guided retroclavicular block (RCB) is a recently described alternative approach to brachial plexus blockade at the level of the cords. Although more distal blockade of the brachial plexus is thought to be associated with a lower incidence of phrenic nerve block, the impact of RCB on ipsilateral diaphragmatic function has not been formally investigated. OBJECTIVE To compare the effects of supraclavicular and retroclavicular brachial plexus block on diaphragmatic function. SETTING A single tertiary hospital, study period from December 2017 to May 2019. DESIGN Double-blinded,...
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Anaesthesia Source Type: research

The effect of oral Δ-9-tetrahydrocannabinol on the minimal alveolar concentration of sevoflurane: A randomised, controlled, observer-blinded experimental study
CONCLUSION Gastric administration of THC 10 mg kg−1 significantly reduced the MAC of sevoflurane by 26%. TRIAL REGISTRATION Not applicable. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Anaesthesia Source Type: research

Effects on cerebral blood flow of position changes, hyperoxia, CO2 partial pressure variations and the Valsalva manoeuvre: A study in healthy volunteers
CONCLUSION CBF changes in response to cerebral vasoconstriction and vasodilatation were detected with rSO2 and transcranial Doppler in healthy volunteers during cardiac preload and in different body positions. Acute hypercapnia had a greater effect on recorded brain parameters than hypocapnia. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Anaesthesia Source Type: research

Prevention of atelectasis by continuous positive airway pressure in anaesthetised children: A randomised controlled study
BACKGROUND Continuous positive airway pressure (CPAP) prevents peri-operative atelectasis in adults, but its effect in children has not been quantified. OBJECTIVE The aim of this study was to evaluate the role of CPAP in preventing postinduction and postoperative atelectasis in children under general anaesthesia. DESIGN A randomised controlled study. SETTING Single-institution study, community hospital, Mar del Plata. Argentina. PATIENTS We studied 42 children, aged 6 months to 7 years, American Society of Anesthesiologists physical status class I, under standardised general anaesthesia. ...
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

Comparative effects of neurally adjusted ventilatory assist and variable pressure support on lung and diaphragmatic function in a model of acute respiratory distress syndrome: A randomised animal study
CONCLUSION Noisy PSV and NAVA did not reduce global lung injury compared with PCV but affected different biomarkers and attenuated diaphragmatic atrophy. NAVA increased the respiratory variability; however, NAVA yielded a similar SVA incidence as Noisy PSV. TRIAL REGISTRATION This trial was registered and approved by the Landesdirektion Dresden, Germany (AZ 24-9168.11-1/2012-2). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

Multivariable haemodynamic approach to predict the fluid challenge response: A multicentre cohort study
CONCLUSION In a selection of mixed ICU patients, a statistical model based on a multivariable analysis of the changes of PPV, CCE, arterial elastance and SAP-Pdic, with respect to baseline values, reliably predicts both the early and the late response to a standardised fluid challenge. TRIAL REGISTRATION ACTRN12617000076370. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Hemodynamics/circulation Source Type: research

Urinary neprilysin for early detection of acute kidney injury after cardiac surgery: A prospective observational study
CONCLUSION Urinary neprilysin has potential as a biomarker for the early detection of AKI after cardiac surgery and has comparable discriminatory power to recently studied AKI biomarkers. TRIAL REGISTRATION The trial was registered at ClinicalTrials.gov (NCT03854825, https://clinicaltrials.gov/ct2/show/NCT03854825). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Hemodynamics/circulation Source Type: research

Peri-operative oxygen consumption revisited: An observational study in elderly patients undergoing major abdominal surgery
CONCLUSION General anaesthesia reduced VO2 by approximately a third in elderly patients undergoing major abdominal surgery. Parallel changes of intra-operative VO2 and delivery were demonstrated while oxygen extraction was low. The relevance of these changes needs further assessment in relation to outcomes and haemodynamic interventions. TRIAL REGISTRATION Clinicaltrials.gov NCT 03355118. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Hemodynamics/circulation Source Type: research

Our project for the Journal(s)
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - December 5, 2020 Category: Anesthesiology Tags: Editorial Source Type: research

Analgesia, anaesthesia and pregnancy: a practical guide
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Book review Source Type: research

Postoperative pain therapy with hydromorphone; comparison of patient-controlled analgesia with target-controlled infusion and standard patient-controlled analgesia: A randomised controlled trial
CONCLUSION TCI-PCA was effective and well tolerated in acute postoperative pain management after cardiac surgery. Further studies are needed to evaluate this approach in clinical practice. TRIAL REGISTRATION EudraCT Number: 2013-002875-16, and ClinicalTrials.gov Identifier: NCT02035709. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Pain Source Type: research

Preoperative dexamethasone for pain relief after total knee arthroplasty: A randomised controlled trial
This study aimed to evaluate two different doses of dexamethasone for pain management and their side effects after total knee arthroplasty. DESIGN A prospective randomised, controlled trial. SETTING A tertiary teaching hospital in Hong Kong. PATIENTS One hundred and forty-six patients were randomly allocated to one of three study groups. INTERVENTIONS Before operation, patients in group D8, D16 and P received dexamethasone 8 mg, dexamethasone 16 mg and placebo (0.9% saline), respectively. MAIN OUTCOME MEASURES The primary outcome was postoperative pain score. Secondary outcomes were o...
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Pain Source Type: research

Effect of spontaneous breathing on atelectasis during induction of general anaesthesia in infants: A prospective randomised controlled trial
CONCLUSION Maintaining spontaneous ventilation during induction of general anaesthesia has a preventive effect against atelectasis in infants younger than 1 year of age, particularly in the dependent portions of the lungs. TRIAL REGISTRATION Clinicaltrials.gov (identifier: NCT03739697). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Pediatrics Source Type: research

Intranasal dexmedetomidine versus oral midazolam premedication to prevent emergence delirium in children undergoing strabismus surgery: A randomised controlled trial
BACKGROUND Dexmedetomidine is being used increasingly as a premedicant in the paediatric population. However, the effectiveness of pre-operative intranasal dexmedetomidine premedication, compared with oral midazolam, for emergence delirium is not well characterised. OBJECTIVE To identify the effectiveness of pre-operative intranasal dexmedetomidine for emergence delirium in the paediatric patient population following general anaesthesia. DESIGN A prospective, randomised, double-blind, parallel-group, placebo-controlled trial. SETTING Single university teaching hospital, from September 2013 to Augus...
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Pediatrics Source Type: research

Fluid loading therapy to prevent spinal hypotension in women undergoing elective caesarean section: Network meta-analysis, trial sequential analysis and meta-regression
BACKGROUND Fluid loading is one of the recognised measures to prevent hypotension due to spinal anaesthesia in women scheduled for a caesarean section. OBJECTIVE We aimed to evaluate the current evidence on fluid loading in the prevention of spinal anaesthesia-induced hypotension. DESIGN Systematic review and network meta-analysis with trial sequential analysis and meta-regression. DATA SOURCES Medline, Epub, Embase.com (Embase and Medline), Cochrane Central, Web of Science and Google Scholar were used. ELIGIBILITY CRITERIA Only randomised controlled trials were used. Patients included women...
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Obstetrics Source Type: research

European minimum standards for obstetric analgesia and anaesthesia departments: An experts’ consensus
An important variability of anaesthetic standards of care was discovered in the obstetric departments of many European Union countries. After discussing this issue in various meetings of the European Society of Anaesthesiology (ESA) board and its obstetric subcommittee, European Board of Anaesthesiology of the European Union of Medical Specialists (EBA-UEMS) executive members, ESA obstetric subcommittee members and European experts in obstetric anaesthesiology have participated in the elaboration of this document. This experts’ opinion is focused mainly on obstetric patients and safety concerns in terms of minimum st...
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Obstetrics Source Type: research

Differential lung ventilation assessed by electrical impedance tomography in ultrasound-guided anterior suprascapular nerve block vs. interscalene brachial plexus block: A patient and assessor-blind, randomised controlled trial
BACKGROUND Ultrasound-guided interscalene brachial plexus block (ISB) is used to control pain after shoulder surgery. Though effective, drawbacks include phrenic nerve block and motor block of the hand. The ultrasound-guided anterior approach to perform suprascapular nerve block (SSNB) may provide a good alternative. OBJECTIVE To compare lung ventilation and diaphragmatic activity on the operated side in ISB and SSNB. DESIGN Randomised, controlled patient-blinded and assessor-blinded trial. SETTING Outpatient surgical clinic with recruitment from June 2017 to January 2018. PATIENTS Fifty-fiv...
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Anaesthesia Source Type: research

Adverse respiratory events with sevoflurane compared with desflurane in ambulatory surgery: A systematic review and meta-analysis
CONCLUSION Despite recent reports that there is no significant difference in adverse respiratory events between desflurane and sevoflurane, a pooled analysis revealed that desflurane resulted in a higher rate than sevoflurane. Therefore, the consequences of desflurane should not be neglected and its airway irritant properties should be taken into account. TRIAL REGISTRATION PROSPERO (CRD42019147939). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Anaesthesia Source Type: research

State entropy and burst suppression ratio can show contradictory information: A retrospective study
CONCLUSIONS Our results illustrate contradictory state entropy and BSR indices that may be relevant for anaesthesia navigation. Longer-lasting episodes may lead to incorrect titration of the depth of the hypnotic component of anaesthesia. Hence, our results demonstrate the necessity to monitor and check the raw EEG or EEG parameters that are less processed than the commercially available indices to safely navigate anaesthesia. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Anaesthesia Source Type: research

Getting old
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - November 7, 2020 Category: Anesthesiology Tags: Editorial Source Type: research

Mechanical insufflation/exsufflation compared with standard of care in patients with pneumonia: A randomised controlled trial
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Usefulness of computer-assisted ECG analysis in the pre-operative evaluation of noncardiac surgery
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Correspondence Source Type: research

Cognitive decline after carotid endarterectomy: Systematic review and meta-analysis
The objective of this study was to determine pCD incidence and risk factors in CEA patients. DESIGN We performed a systematic review and meta-analysis of both randomised and nonrandomised trials following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. DATA SOURCES We searched Cochrane, PubMed/Medline and Embase databases from the date of database inception to 1 December 2018. ELIGIBILITY CRITERIA We selected longitudinal studies including CEA patients with both pre-operative and postoperative cognitive assessments. Primary outcome was pCD incidence, differentiating delayed neurocogn...
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Perioperative medicine Source Type: research

Frailty predicts 30-day mortality in intensive care patients: A prospective prediction study
BACKGROUND Frailty is a multidimensional syndrome characterised by a loss of reserve and an increased risk of adverse outcomes. OBJECTIVE To study the impact of frailty on mortality in unselected intensive care patients, and to compare its discriminatory ability to an established model for outcome prediction in intensive care. DESIGN A prospective study with a comparison of two prediction models. SETTING A tertiary mixed ICU, from January 2017 to June 2018. PATIENTS AND MAIN OUTCOME MEASURES Data on premorbid frailty (clinical frailty scale; CFS), severity of illness (the simplified acute physiology score, th...
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Perioperative medicine Source Type: research

Predicting postoperative complications with the respiratory exchange ratio after high-risk noncardiac surgery: A prospective cohort study
BACKGROUND The respiratory exchange ratio (RER), defined as the ratio of CO2 production (VCO2) to O2 consumption (VO2), is reported to be a noninvasive marker of anaerobic metabolism. The intubated, ventilated patient's inspired and expired fractions of O2 and CO2 (FiO2, FeO2, FiCO2 and FeCO2) are monitored in the operating room and can be used to calculate RER. OBJECTIVE To investigating the ability of the RER to predict postoperative complications. DESIGN An observational, prospective study. SETTING Two French university hospitals between March 2017 and September 2018. PATIENTS A total of 110 patients under...
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

Pulmonary levels of biomarkers for inflammation and lung injury in protective versus conventional one-lung ventilation for oesophagectomy: A randomised clinical trial
CONCLUSION Intra-operative protective ventilation compared with conventional ventilation does not affect changes in pulmonary levels of biomarkers for inflammation and lung injury in patients undergoing one-lung ventilation for oesophagectomy. TRIAL REGISTRATION The ‘Low versus Conventional tidal volumes during one-lung ventilation for minimally invasive oesophagectomy trial’ (LoCo) was registered at the Netherlands Trial Register (study identifier NTR 4391). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

Effects of intra-operative positive end-expiratory pressure setting guided by oesophageal pressure measurement on oxygenation and respiratory mechanics during laparoscopic gynaecological surgery: A randomised controlled trial
BACKGROUND The creation of pneumoperitoneum during laparoscopic surgery can lead to adverse effects on the respiratory system. Positive end-expiratory pressure (PEEP) plays an important role in mechanical ventilation during laparoscopic surgery. OBJECTIVE To evaluate whether PEEP setting guided by oesophageal pressure (Poeso) measurement would affect oxygenation and respiratory mechanics during laparoscopic gynaecological surgery. DESIGN A randomised controlled study. SETTING A single-centre trial from March 2018 to June 2018. PATIENTS Forty-four adult patients undergoing laparoscopic gynaecological surgery w...
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

Effects of high-flow nasal oxygen during prolonged deep sedation on postprocedural atelectasis: A randomised controlled trial
CONCLUSION Our results suggested that HFNO ameliorates lung atelectasis after prolonged deep sedation in patients receiving CT-guided hepatic tumour radiofrequency ablation. TRIAL REGISTRATION Clinicaltrials.gov Identifier: NCT03019354. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

A nebulised antitumour necrosis factor receptor-1 domain antibody in patients at risk of postoperative lung injury: A randomised, placebo-controlled pilot study
BACKGROUND Tumour necrosis factor receptor 1 (TNFR1) signalling mediates the cell death and inflammatory effects of TNF-α. OBJECTIVE The current clinical trial investigated the effects of a nebulised TNFR1 antagonist (GSK2862277) on signs of lung injury in patients undergoing oesophagectomy. DESIGN Randomised double-blind (sponsor unblind), placebo-controlled, parallel group study. SETTING Eight secondary care centres, the United Kingdom between April 2015 and June 2017. PATIENTS Thirty-three patients undergoing elective transthoracic oesophagectomy. INTERVENTIONS Patients randomly received a single ...
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

Pulmonary function decline in immediate postoperative period is not necessarily related to residual neuromuscular block: An observational study
BACKGROUND Previous studies have reported an association between the use of neuromuscular blocking (NMB) agents and postoperative pulmonary complications. Postoperative pulmonary function is a key indicator for postoperative pulmonary complications. Several sites can be used to assess depth and recovery from NMB. OBJECTIVES To investigate postoperative pulmonary function change in relation to train-of-four measurements at the adductor pollicis and corrugator supercilii muscles, and anaesthesia-related variables in orthopaedic patients undergoing hip or knee arthroplasty. DESIGN Observational study. SETTING Unive...
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Ventilation Source Type: research

Infraglottic versus supraglottic jet-ventilation for endobronchial ultrasound-guided transbronchial needle aspiration: A randomised controlled trial
CONCLUSION EBUS-TBNA under general anaesthesia using a LMA with SHJV is equal to rigid bronchoscopy with superimposed high-frequency jet ventilation for the variables analysed. TRIAL REGISTRATION ISRCTN (ISRCTN58911367). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - October 9, 2020 Category: Anesthesiology Tags: Airway Source Type: research