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Efficacy of acupressure on quality of recovery after surgery: Randomised controlled trial
CONCLUSION Two days of postoperative acupressure therapy (up to six treatments) did not significantly improve patient QoR, postoperative nausea and vomiting, pain score or opioid consumption. Acupressure, however, was associated with improved patient satisfaction. TRIAL REGISTRATION ClinicalTrials.gov, identifier: NCT02762435. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 8, 2019 Category: Anesthesiology Tags: Postoperative nausea and vomiting Source Type: research

Acupressure and quality of recovery
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 8, 2019 Category: Anesthesiology Tags: Invited commentary Source Type: research

Protocolised personalised peri-operative haemodynamic management
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - July 8, 2019 Category: Anesthesiology Tags: Editorial Source Type: research

Variation in medicines on anaesthesia carts in operating rooms
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

A clinical pathway developed on the principles of lean management improves hospitalisation capacity in outpatient hand surgery: A retrospective study
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Mild to moderate degree of neck flexion improves sealing pressures without compromising ventilation with I-Gel in anaesthetised adults: A prospective observational study
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Comparison of the acromio-axillosuprasternal notch index with five anatomical indices for the prediction of difficult laryngoscopy and intubation
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

New device and technique for lung deflation in bronchial blocker
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Assessment of cerebral and renal autoregulation using near-infrared spectroscopy under normal, hypovolaemic and postfluid resuscitation conditions in a swine model: An observational study
CONCLUSION Renal oxygenation is more pressure-dependent than pressure-tolerant cerebral oxygenation, and autoregulation is not robust. Renal oxygenation decreased four-fold compared with cerebral oxygenation during hypovolaemia and two-fold during isovolaemic anaemia. Thus, paradoxical responses are part of normal autoregulatory function and beneficial for maintaining stable oxygenation. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Resuscitation Source Type: research

Initial end-tidal carbon dioxide as a predictive factor for return of spontaneous circulation in nonshockable out-of-hospital cardiac arrest patients: A retrospective observational study
CONCLUSION Patients with a nonshockable out-of-hospital cardiac arrest who presented with higher values of initial ETCO2 had an increased chance of sustained ROSC and survival. This finding could help decision making as regards continuation of resuscitation efforts. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Resuscitation Source Type: research

Necessity to depict difficult neck anatomy for training of cricothyroidotomy: A pilot study evaluating two surgical devices on a new hybrid training model
CONCLUSION Participants had difficulties in performing cricothyroidotomy in obese models, but various and difficult anatomical situations must be expected in airway management and therefore must be taught. A new hybrid model combining porcine and synthetic materials offers the necessary conditions for the next step in training of surgical airway procedures. TRIAL REGISTRATION The study was performed without human tissue or living animals, and was therefore exempted from ethical review by the University of Ulm Ethical Committee, Germany (Chairperson Prof Dr C. Lenk) on 9 August 2018. Hence a protocol number was not att...
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Airway management Source Type: research

Ultrasound as a new tool in the assessment of airway difficulties: An observational study
CONCLUSION The prospective observational study confirms the relationship between ultrasound assessment of the anterior soft tissues of the neck and difficult laryngoscopy and DMV. DSHB and the other distances extend the available evidence, not only for difficult laryngoscopy but also for DMV. TRIAL REGISTRATION Clinicaltrials.gov. identified NCT03592758. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Airway management Source Type: research

Effect of pretreatment with magnesium sulphate on the duration of intense and deep neuromuscular blockade with rocuronium: A randomised controlled trial
CONCLUSION Magnesium sulphate increased both the duration of intense NMB and the period of no response. The duration of deep NMB was similar in the magnesium sulphate group and saline group. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02989272. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Neuromuscular blocking agents Source Type: research

Efficacy of profound versus moderate neuromuscular blockade in enhancing postoperative recovery after laparoscopic donor nephrectomy: A randomised controlled trial
CONCLUSION Secondary analysis indicates that an adequately maintained profound neuromuscular block improves postoperative pain scores and quality of recovery. As the intention-to-treat analysis did not reveal a difference regarding the primary endpoint, future studies should pursue whether a thoroughly maintained profound NMB during laparoscopy improves relevant patient outcomes. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT02838134. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Neuromuscular blocking agents Source Type: research

Deep neuromuscular blockade improves surgical conditions during gastric bypass surgery for morbid obesity: A randomised controlled trial
BACKGROUND There is a controversy in the literature whether deep compared with moderate neuromuscular block (NMB) improves surgical conditions for laparoscopic surgery. OBJECTIVES The primary outcome measure was to examine whether switching from moderate to deep NMB improves surgical conditions for laparoscopic surgery in the obese; secondary outcome measures were changes in intra-abdominal pressure, time required to perform the gastrojejunal anastomosis and peri-operative surgical complications. DESIGN A single-centre, randomised controlled study. Each patient was taken as their own control and examined twice: at ...
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Neuromuscular blocking agents Source Type: research

Resistance towards nondepolarising muscle relaxants: prolonged onset time: A systematic review
CONCLUSION A prolonged onset time should be suspected in patients with thermal injury and Duchenne's muscular dystrophy. Further, evidence supports a prolonged onset time in patients with infection, oculopharyngeal muscular dystrophy, congenital heart defects, kidney failure, liver cirrhosis treated with ulinastatin along with remifentanil or intravenous fluids administered prior to NDMR. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Neuromuscular blocking agents Source Type: research

Medical training in anaesthesiology: Updated European requirements
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - June 11, 2019 Category: Anesthesiology Tags: Editorial Source Type: research

Recent Advances in Anesthesiology
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Book review Source Type: research

Near-infrared spectroscopy: A measurement tool for ‘vegetables’?
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Near-infrared spectroscopy measures extinction of light by chromophores
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: ultrasound assessment of gastric emptying time after a standardised light breakfast in healthy children
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Ultrasound assessment of gastric emptying time after a standardised light breakfast in healthy children
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Thromboelastometry as a diagnostic tool in mild bleeding disorders: A prospective cohort study
CONCLUSION Our data did not support the use of thromboelastometry as a diagnostic tool in patients with MBD. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Coagulation Source Type: research

Modified ROTEM for the detection of rivaroxaban and apixaban anticoagulant activity in whole blood: A diagnostic test study
CONCLUSION Modified ROTEM may be applicable in emergency situations for the detection of FXa inhibitors in whole blood. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Coagulation Source Type: research

Efficacy of forced-air warming and warmed intravenous fluid for prevention of hypothermia and shivering during caesarean delivery under spinal anaesthesia: A randomised controlled trial
BACKGROUND Peri-operative hypothermia and shivering are frequent events in patients during caesarean delivery under spinal anaesthesia. OBJECTIVE We assessed the efficacy of combined pre-anaesthetic forced-air warming in combination with warmed intravenous fluid infusion for preventing hypothermia and shivering during caesarean delivery under spinal anaesthesia. DESIGN A randomised controlled study. SETTING A tertiary care teaching hospital from July 2017 to April 2018. PATIENTS A total of 50 pregnant women, American Society of Anaesthesiologists physical status 2, aged 20 to 45 years, scheduled for caesarean...
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research

Ultrasound-guided serratus plane block enhances pain relief and quality of recovery after breast cancer surgery: A randomised controlled trial
BACKGROUND Multimodal analgesia can improve postoperative pain and possibly accelerate functional recovery after surgery. Serratus plane block (SPB) is a novel, ultrasound-guided regional anaesthetic technique for complete analgesia of the anterolateral chest wall. But, the effect of SPB on the quality of recovery after breast cancer surgery has not been established. OBJECTIVE To test the hypothesis that pre-operative SPB would enhance the quality of recovery following breast cancer surgery. DESIGN A randomised, double-blind, parallel-group, placebo-controlled trial. SETTING Single university teaching hospital, ...
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research

Interscalene versus supraclavicular plexus block for the prevention of postoperative pain after shoulder surgery: A systematic review and meta-analysis
BACKGROUND Interscalene brachial plexus blockade is the most common regional anaesthesia technique for alleviating pain after shoulder surgery, but complications occur, including ipsilateral hemidiaphragmatic paresis, Horner's syndrome and hoarseness. The supraclavicular approach might be an effective alternative with fewer adverse effects. OBJECTIVES The aim of this study was to determine whether there is a difference in postoperative pain scores and morphine equivalents between interscalene and supraclavicular brachial plexus blocks. Secondary endpoints were serious adverse events. DESIGN A systematic review and ...
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research

Functional recovery after knee arthroplasty with regional analgesia: A systematic review and meta-analysis of randomised controlled trials
CONCLUSION RA techniques compared with systemic analgesia have a beneficial impact on the LOS and the ROM achieved in the early postoperative period. Global function in the longer term after surgery seems unaffected by peri-operative RA. TRIAL REGISTRATION CRD42014013995. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research

Comparison of the clinical performance of i-gel and Ambu AuraGain in children: A randomised noninferiority clinical trial
BACKGROUND Supraglottic airway devices are commonly used in general anaesthesia in children. The AuraGain™ is a newly developed disposable second-generation supraglottic airway device with an inflatable cuff and a gastric port. OBJECTIVE To confirm our hypothesis that the oropharyngeal leak pressure (OLP) of the AuraGain would be noninferior to that of the i-gel in paediatric patients. DESIGN A single-blinded, randomised, noninferiority, clinical trial. SETTING Single-centre trial from January to March 2017. PATIENTS One hundred paediatric patients (American Society of Anesthesiologists’ physical ...
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Paediatric anaesthesia Source Type: research

Ultrasound assessment of gastric emptying time in preterm infants: A prospective observational study
BACKGROUND In paediatric anaesthesia, pre-operative fasting should be short to prevent discomfort, hunger, thirst and metabolic disorders. Current European guidelines recommend pre-operative fasting times of 4 h for breast milk and 6 h for formula milk in infants, whereas some national guidelines allow both until 4 h before anaesthesia. OBJECTIVE We evaluated the gastric emptying times of preterm infants after breast milk and formula milk, hypothesising that the mean gastric emptying time would be less than 4 h. DESIGN A prospective, observational, noninterventional cohort study. SETTING Neonatal ICU of ...
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Paediatric anaesthesia Source Type: research

Accuracy of oscillometric noninvasive blood pressure compared with intra-arterial blood pressure in infants and small children during neurosurgical procedures: An observational study
CONCLUSION Arterial pressure derived by the oscillometric device showed acceptable levels of agreement. However, during hypotension, a clinically relevant overestimation of arterial pressure occurred when measured by an upper arm cuff. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Paediatric anaesthesia Source Type: research

Incidence and risk factors for adverse events during monitored anaesthesia care for gastrointestinal endoscopy in children: A prospective observational study
BACKGROUND Better understanding of risk factors for adverse events during monitored anaesthesia care (MAC) for paediatric gastrointestinal endoscopy may improve outcome in children. OBJECTIVES To identify the prevalence and predictors of adverse events during MAC for paediatric endoscopy. DESIGN An observational study. SETTING Tertiary university hospital, single-centre cohort, from January 2010 to August 2016. PATIENTS The prospectively collected electronic anaesthetic records of 3435 children aged up to 16 years who underwent diagnostic gastrointestinal endoscopy under MAC were analysed retrospectively. Chi...
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Paediatric anaesthesia Source Type: research

The anaesthesiologist: The unsung hero of peri-operative intensive care
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - May 2, 2019 Category: Anesthesiology Tags: Editorial Source Type: research

Pediatric Anesthesia: A Problem-Based Learning Approach
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Book review Source Type: research

Myocardial injury in noncardiac surgery in Sweden: Study protocol for a multicentre, observational cohort study of patients undergoing elective, major abdominal surgery
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

A prospective observational study of effect-site targeted, patient-maintained propofol sedation for lower limb orthopaedic surgery performed under spinal anaesthesia
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Troponin before and after arteriovenous fistula surgery performed under loco-regional anaesthesia
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Collaboration is the future of emergency medicine in Europe
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Renal dysfunction during sevoflurane sedation in the ICU: A case report
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Reply to: foundation and clinical exigency of cerebral oximetry
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Foundation and clinical exigency of cerebral oximetry
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Correspondence Source Type: research

Is ‘anxiety sensitivity’ predictive of postoperative nausea and vomiting?: A prospective observational study
CONCLUSION In addition to the well established risk factors, anxiety sensitivity can help to predict the risk of PONV. It seems justifiable to add psychological factors such as anxiety sensitivity to PONV risk-scores. PONV prophylaxis should be considered when anxiety sensitivity is high. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01875120. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Postoperative nausea and vomiting Source Type: research

Improvement in postoperative pain control by combined use of intravenous dexamethasone with intravenous dexmedetomidine after interscalene brachial plexus block for arthroscopic shoulder surgery: A randomised controlled trial
BACKGROUND Intravenous dexamethasone or dexmedetomidine is reported to prolong the duration of analgesia after single-shot interscalene brachial plexus block (ISBPB). However, the effect of co-administration of these agents on the duration of analgesia has not been evaluated. OBJECTIVES We evaluated the difference in time to first rescue analgesic request between patients receiving co-administered intravenous dexamethasone and dexmedetomidine and patients receiving intravenous dexamethasone alone after single-shot ISBPB for arthroscopic shoulder surgery. DESIGN A randomised controlled study. SETTING A single ter...
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Postoperative pain Source Type: research

Metamizole vs. ibuprofen at home after day case surgery: A double-blind randomised controlled noninferiority trial
CONCLUSION Paracetamol/metamizole and paracetamol/ibuprofen are equally effective in treatment of acute postoperative pain at home after ambulatory surgery with comparable patient satisfaction levels. TRIAL REGISTRATION European Union Clinical Trials Register 2015-003987-35. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Postoperative pain Source Type: research

Genetics and postsurgical neuropathic pain: An ancillary study of a multicentre survey
CONCLUSION This is the first genetic association study specifically investigating the occurrence of persistent postsurgical neuropathic pain. Its results help target future research to better understand the mechanisms of peripheral neuropathic pain. TRIAL REGISTRATION ClinicalTrials.gov (ref. NCT00812734). (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Postoperative pain Source Type: research

Comparison of pre-oxygenation using spontaneous breathing through face mask and high-flow nasal oxygen: A randomised controlled crossover study in healthy volunteers
BACKGROUND High-flow nasal oxygen (HFNO) therapy has been proposed for pre-oxygenation before intubation, but the end-tidal fraction of oxygen (ETO2) obtained remains unknown. OBJECTIVE(S) To compare the ETO2 following a 3 min pre-oxygenation with HFNO and face mask. SETTING Operating room in a primary university hospital. DESIGN A randomised crossover study. PARTICIPANTS Fifty healthy volunteers. INTERVENTIONS Participants were randomly pre-oxygenated through spontaneous breathing 100% oxygen in a face mask and with HFNO (mouth closed, heated and humidified gas flow at 60 l min–1). In the face...
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Ventilation Source Type: research

Flow-controlled ventilation during ear, nose and throat surgery: A prospective observational study
CONCLUSION FCV achieves adequate PetCO2 levels with minute volume and Δp in the normal range. Tritube's high flow resistance may increase the likelihood of tube dislocations if the patient coughs. Although further evaluation is necessary, FCV provides a new option for short-term mechanical ventilation. The successful operation of FCV with narrow-bore tubes contributes to the armamentarium for airway management. TRIAL REGISTRATION DRKS00013312 (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Ventilation Source Type: research

Intra-operative high inspired oxygen fraction does not increase the risk of postoperative respiratory complications: Alternating intervention clinical trial
CONCLUSION Intra-operative hyperoxia did not change the postoperative SpO2/FiO2 ratio or the risk for pulmonary complications. Clinicians should not refrain from using hyperoxia for fear of provoking respiratory complications. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT01777568. (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Ventilation Source Type: research

Intra-operative high inspired oxygen during open abdominal surgery and postoperative pulmonary complications: From physiology to individualised strategies
No abstract available (Source: European Journal of Anaesthesiology)
Source: European Journal of Anaesthesiology - April 4, 2019 Category: Anesthesiology Tags: Invited commentary Source Type: research

Central venous-to-arterial PCO2 difference, arteriovenous oxygen content and outcome after adult cardiac surgery with cardiopulmonary bypass: A prospective observational study
BACKGROUND Rapid identification and treatment of tissue hypoxia reaching anaerobiosis (dysoxia) may reduce organ failure and the occurrence of major postoperative complications (MPC) after cardiac surgery. The predictive ability of PCO2-based dysoxia biomarkers, central venous-to-arterial PCO2 difference (ΔPCO2) and ΔPCO2 to arteriovenous oxygen content difference ratio, is poorly studied in this setting. OBJECTIVES We evaluated the ability of PCO2-based tissue dysoxia biomarkers, blood lactate concentration and central venous oxygen saturation measured 2 h after admission to the ICU as predictors of MPC...
Source: European Journal of Anaesthesiology - March 7, 2019 Category: Anesthesiology Tags: Haemodynamics Source Type: research