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Anaesthesia Jan 2022
Topics: Anesthesia; Critical Care; Humans; Nervous System Diseases; Patient Reported Outcome Measures
PubMed: 35001378
DOI: 10.1111/anae.15637 -
Anaesthesia Mar 2020
Topics: Anesthesia, Conduction; Anesthesiology; Humans; Nerve Block; Pain Management; Ultrasonography, Interventional
PubMed: 31268173
DOI: 10.1111/anae.14768 -
British Journal of Anaesthesia Jul 2014
Topics: Analgesia; Anesthesia; Humans; Neoplasms
PubMed: 25052940
DOI: 10.1093/bja/aeu261 -
BMJ (Clinical Research Ed.) Aug 1999
Review
Topics: Anesthesia; Anesthesia, Epidural; Anesthesia, Inhalation; Anesthesia, Intravenous; Anesthetics, Local; Humans; Laryngeal Masks; Laryngoscopes; Nausea; Vomiting
PubMed: 10463900
DOI: 10.1136/bmj.319.7209.557 -
British Journal of Anaesthesia Dec 2015Recent studies have linked the use of regional anaesthesia to improved outcomes. Epidemiological research on utilization, trends, and disparities in this field is... (Review)
Review
Recent studies have linked the use of regional anaesthesia to improved outcomes. Epidemiological research on utilization, trends, and disparities in this field is sparse; however, large nationally representative database constructs containing anaesthesia-related data, demographic information, and multiyear files are now available. Together with advances in research methodology and technology, these databases provide the foundation for epidemiological research in anaesthesia. We present an overview of selected studies that provide epidemiological data and describe current anaesthetic practice, trends, and disparities in orthopaedic surgery in particular. This literature suggests that that even among orthopaedic surgical procedures, which are highly amenable to regional anaesthetic techniques, neuraxial anaesthetics and peripheral nerve blocks are used in only a minority of procedures. Trend analyses show that peripheral nerve blocks are gaining in popularity, whereas use of neuraxial anaesthetics is remaining relatively unchanged or even declining over time. Finally, significant disparities and variability in anaesthetic care seem to exist based on demographic and health-care-related factors. With anaesthesia playing an increasingly important part in population-based health-care delivery and evidence indicating improved outcome with use of regional anaesthesia, more research in this area is needed. Furthermore, prevalent disparities and variabilities in anaesthesia practice need to be specified further and addressed in the future.
Topics: Anesthesia, Conduction; Health Services Research; Healthcare Disparities; Humans; Nerve Block; Orthopedic Procedures; Professional Practice
PubMed: 26658202
DOI: 10.1093/bja/aev381 -
PloS One 2016Awake craniotomy (AC) renders an expanded role in functional neurosurgery. Yet, evidence for optimal anaesthesia management remains limited. We aimed to summarise the... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Awake craniotomy (AC) renders an expanded role in functional neurosurgery. Yet, evidence for optimal anaesthesia management remains limited. We aimed to summarise the latest clinical evidence of AC anaesthesia management and explore the relationship of AC failures on the used anaesthesia techniques.
METHODS
Two authors performed independently a systematic search of English articles in PubMed and EMBASE database 1/2007-12/2015. Search included randomised controlled trials (RCTs), observational trials, and case reports (n>4 cases), which reported anaesthetic approach for AC and at least one of our pre-specified outcomes: intraoperative seizures, hypoxia, arterial hypertension, nausea and vomiting, neurological dysfunction, conversion into general anaesthesia and failure of AC. Random effects meta-analysis was used to estimate event rates for four outcomes. Relationship with anaesthesia technique was explored using logistic meta-regression, calculating the odds ratios (OR) and 95% confidence intervals [95%CI].
RESULTS
We have included forty-seven studies. Eighteen reported asleep-awake-asleep technique (SAS), twenty-seven monitored anaesthesia care (MAC), one reported both and one used the awake-awake-awake technique (AAA). Proportions of AC failures, intraoperative seizures, new neurological dysfunction and conversion into general anaesthesia (GA) were 2% [95%CI:1-3], 8% [95%CI:6-11], 17% [95%CI:12-23] and 2% [95%CI:2-3], respectively. Meta-regression of SAS and MAC technique did not reveal any relevant differences between outcomes explained by the technique, except for conversion into GA. Estimated OR comparing SAS to MAC for AC failures was 0.98 [95%CI:0.36-2.69], 1.01 [95%CI:0.52-1.88] for seizures, 1.66 [95%CI:1.35-3.70] for new neurological dysfunction and 2.17 [95%CI:1.22-3.85] for conversion into GA. The latter result has to be interpreted cautiously. It is based on one retrospective high-risk of bias study and significance was abolished in a sensitivity analysis of only prospectively conducted studies.
CONCLUSION
SAS and MAC techniques were feasible and safe, whereas data for AAA technique are limited. Large RCTs are required to prove superiority of one anaesthetic regime for AC.
Topics: Anesthesia; Craniotomy; Female; Humans; Male; Wakefulness
PubMed: 27228013
DOI: 10.1371/journal.pone.0156448 -
Anaesthesia Aug 2018
Topics: Anesthesia; Anesthesiology; Anesthetics; Biomedical Research; Clinical Trials as Topic; Humans; Observational Studies as Topic; Terminology as Topic
PubMed: 29280142
DOI: 10.1111/anae.14200 -
Anaesthesia Feb 1996
Topics: Anesthesia; Anesthesiology; Health Care Costs; Humans; United Kingdom; Workforce
PubMed: 8779361
DOI: 10.1111/j.1365-2044.1996.tb07693.x -
European Journal of Anaesthesiology Dec 2022Emergency caesarean sections are often very urgent, with limited time for informing and guiding parents. Is it preferable to leave the partner outside of the operating... (Review)
Review
BACKGROUND
Emergency caesarean sections are often very urgent, with limited time for informing and guiding parents. Is it preferable to leave the partner outside of the operating room, or let the partner accompany the mother?
OBJECTIVE
This review aimed to provide an overview of the available evidence regarding the presence of the partner in the operating room during emergency caesarean sections.
DESIGN
Scoping review.
DATA SOURCES
A systematic literature search was performed in PubMed, Embase, Cinahl and the Cochrane Library.
ELIGIBILITY CRITERIA
All published literature reporting on emergency caesarean sections in regional or general anaesthesia with the partner present in the operating room were eligible, no matter the design.
RESULTS
Twenty-four titles, published between 1984 and 2020, were included; 15 contained original clinical findings and 9 were letters/debates. Quality of evidence was assessed using the Mixed Methods Appraisal Tool and found to be very low/low (17 studies), moderate (6) or good (1). Studies originated from Europe (16 studies), USA/Canada (4), South America (2), Asia (1) and Africa (1). Content data were thematically summarised and were overall either in favour or against having the partner present. Staff seemed reluctant to let partners be present for caesarean sections under general anaesthesia; mothers and partners preferred the partners' presence. Under regional anaesthesia, parents also wished for the partners' presence and described the caesarean section under regional anaesthesia as a predominantly positive experience. Most staff had a favourable attitude towards letting the partner be present for caesarean sections under regional anaesthesia.
CONCLUSION
Limited evidence exists regarding the presence of the partner during emergency caesarean sections, but is of low quality. Most parents prefer having their partner present. Staff can be reluctant, especially when general anaesthesia is used.
Topics: Pregnancy; Female; Humans; Cesarean Section; Anesthesia, Obstetrical; Operating Rooms; Anesthesia, Conduction; Anesthesia, General
PubMed: 36239403
DOI: 10.1097/EJA.0000000000001761 -
British Journal of Anaesthesia Feb 2020
Topics: Analgesia; Anesthesia, Conduction; Anesthesia, Local; Anesthetists; Humans; Surgeons
PubMed: 31733806
DOI: 10.1016/j.bja.2019.10.008