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BMJ Open Nov 2019The effect of mode of anaesthesia in emergency surgery is uncertain. This scoping review will identify and summarise the evidence for local, regional or general... (Review)
Review
INTRODUCTION
The effect of mode of anaesthesia in emergency surgery is uncertain. This scoping review will identify and summarise the evidence for local, regional or general anaesthetic in adult patients undergoing emergency surgical procedures.
METHODS AND ANALYSIS
Scoping review methodology will be followed. The search will be run in EMBASE and Medline. Further articles will be identified from searching references in relevant studies. A descriptive analysis will be performed considering the following main outcomes; mortality, length of stay, intensive care unit (ICU) admission, postoperative pain and morbidity. Data on complications including acute coronary syndrome, stroke, thromboembolic events, delirium, acute kidney injury, respiratory tract infection, surgical site infection and study-specific additional outcomes will also be collected.
ETHICS AND DISSEMINATION
No ethics approval is required. The results will be used to inform a funding application for a clinical trial comparing local/regional anaesthetic with general anaesthetic. The study will be disseminated via peer-reviewed manuscript and conferences.
TRIAL REGISTRATION NUMBER
Results will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) Statement. There are currently no registries that accept scoping reviews.
Topics: Anesthesia; Clinical Protocols; Critical Care; Emergencies; Hospital Mortality; Humans; Length of Stay; Outcome Assessment, Health Care; Postoperative Complications; Surgical Procedures, Operative
PubMed: 31719079
DOI: 10.1136/bmjopen-2019-030817 -
Anaesthesia Jul 2022
Topics: Anesthesia; Anesthesiology; Checklist; Humans
PubMed: 35343589
DOI: 10.1111/anae.15724 -
Journal of the American Veterinary... May 2022
Topics: Animals; Anesthesia
PubMed: 35522582
DOI: 10.2460/javma.22.01.0049 -
Journal of the American Veterinary... Mar 2022
Topics: Animals; Anesthesia
PubMed: 35298407
DOI: 10.2460/javma.21.07.0327 -
Journal of the American Veterinary... Mar 2022
Topics: Anesthesia; Animals
PubMed: 35298405
DOI: 10.2460/javma.21.06.0306 -
Journal of the American Veterinary... Mar 2022
Topics: Animals; Anesthesia
PubMed: 35333750
DOI: 10.2460/javma.21.08.0398 -
Journal of the American Veterinary... Mar 2022
Topics: Anesthesia; Animals
PubMed: 34968191
DOI: 10.2460/javma.21.05.0255 -
Anaesthesia Mar 2022
Topics: Anesthesia; Anesthetics; Drug Administration Routes; Drug Compounding; Humans; Infusions, Intravenous
PubMed: 34396509
DOI: 10.1111/anae.15561 -
Anaesthesia Jan 2021Over the past two decades, regional anaesthesia and medical education as a whole have undergone a renaissance. Significant changes in our teaching methods and clinical... (Review)
Review
Over the past two decades, regional anaesthesia and medical education as a whole have undergone a renaissance. Significant changes in our teaching methods and clinical practice have been influenced by improvements in our theoretical understanding as well as by technological innovations. More recently, there has been a focus on using foundational education principles to teach regional anaesthesia, and the evidence on how to best teach and assess trainees is growing. This narrative review will discuss fundamentals and innovations in regional anaesthesia training. We present the fundamentals in regional anaesthesia training, specifically the current state of simulation-based education, deliberate practice and curriculum design based on competency-based progression. Moving into the future, we present the latest innovations in web-based learning, emerging technologies for teaching and assessment and new developments in alternate reality learning systems.
Topics: Anesthesia, Conduction; Anesthesiology; Clinical Competence; Competency-Based Education; Curriculum; Education, Medical, Graduate; Humans; Simulation Training
PubMed: 33426656
DOI: 10.1111/anae.15244 -
Anaesthesia Jan 2022Surgery and anaesthesia subject the brain to considerable stress in the peri-operative period. This may be caused by potentially neurotoxic anaesthetic drugs, impaired... (Review)
Review
Surgery and anaesthesia subject the brain to considerable stress in the peri-operative period. This may be caused by potentially neurotoxic anaesthetic drugs, impaired cerebral perfusion and reperfusion injury related to surgery or thromboembolic events. Patient monitoring using electroencephalogram and cerebral oximetry can assist in optimising depth of anaesthesia and assessment of cerebral metabolic activity. However, research findings have been contradictory as to whether these monitors can help ameliorate peri-operative neurocognitive complications. In this narrative review, we will discuss recent evidence in the use of electroencephalography and cerebral oximetry and the underlying scientific principles. It is important to appreciate the raw electroencephalographic changes under anaesthesia and those associated with ageing, in order to interpret depth of anaesthesia indices correctly. Cerebral oximetry is useful not only for the detection of cerebral desaturation but also to identify those patients who are particularly vulnerable to injury, for better risk stratification. An algorithm-based approach may be most effective in managing the episodes of cerebral desaturation.
Topics: Anesthesia; Brain; Cerebrovascular Circulation; Electroencephalography; Humans; Monitoring, Intraoperative; Oximetry; Perioperative Care; Postoperative Complications
PubMed: 35001382
DOI: 10.1111/anae.15616