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Direct vs. videolaryngoscopy for tracheal intubation Anaesthesia (IF 10.7) Pub Date : 2024-05-31 Camilla Strøm, Rasmus Winkel, Michael S. Kristensen
Cook [1], Ward [2] and associates advocate for the videolaryngoscope to be the primary tool for tracheal intubation, suggesting that the debate over video vs. direct laryngoscopy should be concluded. This has already occurred in many Danish anaesthetic departments. There are now anaesthetists who have never learned to use direct laryngoscopy and colleagues who have ceased training with it. This concerns
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Stylets, bougies and hyperangulated videolaryngoscopy Anaesthesia (IF 10.7) Pub Date : 2024-05-31 Tim M. Cook
I enjoyed the article by Eum et al. [1], but as a very regular user of hyperangulated videolaryngoscopy, I am surprised by the results. In my practice and teaching, I advocate use of a stylet rather than a bougie with a hyperangulated videolaryngoscope blade. My rationale being that the stylet makes (or should make) the tracheal tube the same shape as the videolaryngoscope blade, which facilitates
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Association between multimorbidity and postoperative mortality in patients undergoing major surgery: a prospective study in 29 countries across Europe Anaesthesia (IF 10.7) Pub Date : 2024-05-27
Multimorbidity poses a global challenge to healthcare delivery. This study aimed to describe the prevalence of multimorbidity, common disease combinations and outcomes in a contemporary cohort of patients undergoing major abdominal surgery.
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Embracing change: a collective call to address multimorbidity in surgical pathways Anaesthesia (IF 10.7) Pub Date : 2024-05-27 Sivesh K. Kamarajah, Aneel Bhangu, Shalini Ahuja, Jugdeep Dhesi, Joyce Yeung, Krishnarajah Nirantharakumar, Thomas Pinkney, Dion G. Morton
In 2023, Sir Chris Whitty, Chief Medical Officer for England, released a pivotal report highlighting the challenges posed by an ageing society, urging healthcare professionals to proactively respond to the rising rates of multimorbidity [1]. The World Health Organization has similarly emphasised the need for urgent solutions to adapt to the growing needs of the population with multimorbidity, affecting
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Hyperangulated vs. Macintosh videolaryngoscopy in adults with anticipated difficult airway management: a randomised controlled trial Anaesthesia (IF 10.7) Pub Date : 2024-05-25 Vera Köhl, Viktor A. Wünsch, Marie‐Claire Müller, Phillip B. Sasu, Thorsten Dohrmann, Tanja Peters, Josephine Tolkmitt, André Dankert, Linda Krause, Christian Zöllner, Martin Petzoldt
SummaryBackgroundIt is not certain whether the blade geometry of videolaryngoscopes, either a hyperangulated or Macintosh shape, affects glottic view, success rate and/or tracheal intubation time in patients with expected difficult airways. We hypothesised that using a hyperangulated videolaryngoscope blade would visualise a higher percentage of glottic opening compared with a Macintosh videolaryngoscope
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Redefining risk in peri‐operative frailty: towards routine frailty assessment and a whole pathway approach Anaesthesia (IF 10.7) Pub Date : 2024-05-22 Rose S. Penfold, Adam Hunt
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Impact of peri‐operative frailty and operative stress on post‐discharge mortality, readmission and days at home in Medicare beneficiaries Anaesthesia (IF 10.7) Pub Date : 2024-05-22 Chan Mi Park, Jessica J. Lie, Laiji Yang, Zara Cooper, Dae Hyun Kim
SummaryBackgroundUnderstanding how patients' frailty and the physiological stress of surgical procedures affect postoperative outcomes may inform risk stratification of older patients undergoing surgery. The objective of the study was to examine the association of peri‐operative frailty with mortality, 30‐day readmission and days at home after non‐cardiac surgical procedures of different physiological
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Out‐of‐hospital cardiac arrest: pathways for extracorporeal cardiopulmonary resuscitation in the United Kingdom Anaesthesia (IF 10.7) Pub Date : 2024-05-17 Benjamin Stretch, Ben Singer
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Multiple failed intubation attempts in patients with rapid sequence induction are a thing of the past: a reply Anaesthesia (IF 10.7) Pub Date : 2024-05-17 Marc Kriege, Oliver Kunitz, Christoph Jänig, Axel Schmutz
We appreciate the interest shown by Wang et al. [1] and Xue et al. [2] for our recently published trial [3] and are grateful for the opportunity to comment further on this important topic. Their comments concur with our own. Xue et al. pinpointed the higher incidence of difficult tracheal intubations in our trial. Rapid sequence anaesthesia induction and intubation (RSI) aims to reduce the incidence
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Artificial intelligence in peri‐operative prediction model research: are we there yet? Anaesthesia (IF 10.7) Pub Date : 2024-05-15 Akshay Shah, Paula Dhiman
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Time for new guidelines to focus specifically on cardiac arrest in the peri‐operative period? Anaesthesia (IF 10.7) Pub Date : 2024-05-15 Stephanie Harrison, Alan D. Ashworth
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It ain't what you do (it's the way that you do it): modulating the host response in sepsis Anaesthesia (IF 10.7) Pub Date : 2024-05-15 Jonathan E. Millar, Annemarie B. Docherty
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Glucagon‐like peptide‐1 receptor agonists: a narrative review of clinical pharmacology and implications for peri‐operative practice Anaesthesia (IF 10.7) Pub Date : 2024-05-14 David A. Milder, Tamara Y. Milder, Sophie S. Liang, Peter C.A. Kam
SummaryBackgroundGlucagon‐like peptide‐1 receptor agonists are used increasingly in the management of patients living with type 2 diabetes mellitus and obesity. In patients using glucagon‐like peptide‐1 receptor agonists, a key concern in the peri‐operative period is the increased risk of pulmonary aspiration due to delayed gastric emptying. This review provides an overview of the pharmacodynamic and
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The association of withholding or continuing angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers on acute kidney injury after non‐cardiac surgery Anaesthesia (IF 10.7) Pub Date : 2024-05-14 Jisun Choi, Dae Kyun Ryu, Seunghyeon Woo, Jeayoun Kim, Seungwon Lee, Boram Park, Kyeongman Jeon, MiHye Park
SummaryBackgroundWithholding or continuing angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers peri‐operatively in non‐cardiac surgery remains controversial as they may result in intra‐operative hypotension and postoperative organ damage.MethodsWe included patients prescribed angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers who underwent surgical procedures
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Optimising peri-operative anaphylaxis management: end-tidal carbon dioxide monitoring and adrenaline titration: a reply Anaesthesia (IF 10.7) Pub Date : 2024-05-10 Amy Dodd, Paul J. Turner, Jasmeet Soar, Louise Savic
We thank Yang et al. [1] for their interest in our article [2] and for highlighting the difficulties of diagnosing peri-operative anaphylaxis in real time. The principal aim of this algorithm is to prevent respiratory or cardiovascular deterioration, cardiac arrest and death by promoting early effective treatment, which includes the early use of intravenous adrenaline irrespective of diagnostic uncertainty
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Advanced life support interventions during intra-operative cardiac arrest among adults as reported to the 7th National Audit Project of the Royal College of Anaesthetists Anaesthesia (IF 10.7) Pub Date : 2024-05-10 Jerry P. Nolan, Richard A. Armstrong, Andrew D. Kane, Emira Kursumovic, Matthew T. Davies, Iain K. Moppett, Tim M. Cook, Jasmeet Soar
Few existing resuscitation guidelines include specific reference to intra-operative cardiac arrest, but its optimal treatment is likely to require some adaptation of standard protocols.
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Patterns of opioid use after surgical discharge: a multicentre, prospective cohort study in 25 countries Anaesthesia (IF 10.7) Pub Date : 2024-05-09
Excessive opioid prescribing following surgery contributes to the growing opioid crisis. Prescribing practices are modifiable, yet data to guide appropriate prescription of opioids at surgical discharge remain sparse. This study aimed to evaluate factors associated with opioid consumption following discharge from surgery.
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Surgical closure of the neck following thyroid surgery: an important area of anatomy for the anaesthetist Anaesthesia (IF 10.7) Pub Date : 2024-05-11 Karen Collins, Benjamin Stretch, Rajeev Advani
We have been involved in the emergency management of life-threatening thyroid haematomas and followed the multidisciplinary consensus guidelines published in Anaesthesia, resulting in safe management of these patients [1]. We had expected to expose the Skin; Cut sutures; Open skin; Open muscles; and Pack the wound (SCOOP). However, on more than one occasion, surgical closure of the neck wound with
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Sarcopenia: it is time to attach more importance to this stealth killer in patients who are critically ill Anaesthesia (IF 10.7) Pub Date : 2024-05-08 Kunming Cheng, Cheng Li, Haiyang Wu
We read with great interest the recent article by Gustafson et al. [1]. The study evaluated the musculoskeletal health status of intensive care unit (ICU) survivors. Their findings suggested that, among 254 patients admitted to the ICU, 59% had musculoskeletal problems yet only 24% received physical therapy after discharge. Given the high incidence and risk of musculoskeletal disorders in patients
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A pilot project to test the feasibility of automated text messaging to collect multi‐day patient‐reported outcomes related to pain interference after total joint arthroplasty in veterans Anaesthesia (IF 10.7) Pub Date : 2024-05-08 Allison H. Dorogi, Oluwatobi O. Hunter, Daniel M. Gessner, Jody C. Leng, Alex Kou, Edward R. Mariano
Acute postoperative pain trajectories may differ between surgical procedures [1] and individuals who undergo the same procedure [2]. To date, clinical measurement of acute pain has been generally limited to pain intensity, which provides an inadequate assessment of recovery [3]. Despite recommendations to incorporate patient-reported outcomes into peri-operative pain assessment and management [3],
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Opioid analgesic exposure during the first trimester of pregnancy and the risk of major congenital malformations in infants: a systematic review and meta‐analysis† Anaesthesia (IF 10.7) Pub Date : 2024-05-08 Bianca Varney, Jonathan Brett, Helga Zoega, Malcolm B. Gillies, Madeline Powell, Brian T. Bateman, Antonia W. Shand, Sallie‐Anne Pearson, Alys Havard
SummaryBackgroundPrescribed opioid analgesics are frequently used to manage pain in pregnancy. However, the available literature regarding the teratogenic potential of opioid use during pregnancy has not been systematically summarised. This systematic review and meta‐analysis aimed to assess the quality of the evidence on these potential risks and calculate a pooled estimate of risk for any opioid
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Hospital‐level flow measurement to detect nitrous oxide leakage Anaesthesia (IF 10.7) Pub Date : 2024-05-03 Justin J. Skowno, H. Reza Kahlaee, Andrew J. Inglis, Darren McKinnon, Kathryn Asher
Nitrous oxide has a significant carbon footprint, and global initiatives are in progress to diminish its environmental impact in agriculture, industry and healthcare [1]. It is piped to locations in many healthcare environments, and in some hospitals, these systems can leak most of the gas they carry (75–95%) [1]. Leak detection traditionally relies on static pressure testing, a time-consuming and
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The science of climate change and the effect of anaesthetic gas emissions: a reply Anaesthesia (IF 10.7) Pub Date : 2024-05-03 Christopher Prabhakar, Rakesh V. Sondekoppam, Vivian H. Y. Ip
Physicians are not climate scientists and are not trained in the intricacies of how greenhouse gases affect climate change. Hence it is refreshing to read the thought-provoking review article by Slingo and Slingo on the impact of volatile anaesthetic gas emissions on climate change [1]. They have suggested that only desflurane will have full radiative effect on global warming due to its longer atmospheric
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Airway management in patients with suspected or confirmed cervical spine injury Anaesthesia (IF 10.7) Pub Date : 2024-05-03 Matthew D. Wiles, Helen A. Iliff, Katherine Brooks, Egidio J. Da Silva, Mike Donnellon, Adrian Gardner, Matthew Harris, Caroline Leech, Steve Mathieu, Paul Moor, Lara Prisco, Kate Rivett, Frances Tait, Kariem El‐Boghdadly
SummaryBackgroundThere are concerns that airway management in patients with suspected or confirmed cervical spine injury may exacerbate an existing neurological deficit, cause a new spinal cord injury or be hazardous due to precautions to avoid neurological injury. However, there are no evidence‐based guidelines for practicing clinicians to support safe and effective airway management in this setting
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Post‐intensive care syndrome: survival, but at what cost? Anaesthesia (IF 10.7) Pub Date : 2024-04-29 Caroline Sampson
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Incidence and impact of cardiovascular complications after major abdominal surgery Anaesthesia (IF 10.7) Pub Date : 2024-04-29 Rui‐Peng Zhong, Bing‐Cheng Zhao, Gui‐Ming Huang
The international, prospective cohort study (CArdiovaSCulAr outcomes after major abDominal surgEry, CASCADE) reported that postoperative cardiovascular complications, as defined by the Standardised Endpoints for Perioperative Medicine-Core Outcome Measures for Perioperative and Anaesthetic Care (StEP-COMPAC), occurred infrequently in patients undergoing major abdominal surgery (incidence 2.5%), but
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It's not easy being green: the continued lack of sustainable anaesthetic options Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Kaitlyn Kulesus, Casey Windrix, Huy Nhan
We congratulate Bernat et al. on their retrospective observational study that highlights the high carbon footprint of anaesthesia [1]. They hypothesised that the predominance of total intravenous anaesthesia (TIVA) would reduce the carbon footprint in affiliated French hospitals. The study demonstrates the need for standardised techniques to facilitate accurate measurement of anaesthetic greenhouse
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Comparing performance of the McGrath™ videolaryngoscope with direct laryngoscopy for rapid sequence intubation Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Fu‐Shan Xue, Dan‐Feng Wang, Xiao‐Chun Zheng
In the recent study by Kriege et al. [1], comparing performance of the McGrath™ videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre, 94 of 500 patients (19%) in the direct laryngoscopy group had a Cormack and Lehane grade view ≥ 3.; however, study participants had an expected normal airway, direct laryngoscopy was performed under sufficient neuromuscular
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The science of climate change and the effect of anaesthetic gas emissions. Useful metrics for ethical decision making Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Alain Kalmar, An Teunkens, Steffen Rex
We support the call by Slingo and Slingo for anaesthetists to adopt a sustainability framework informed by climate science, which urgently stresses the need to reduce our climate impact [1]. As rightly emphasised, the global warming potential (GWP) metric has faced criticism for overestimating the climate impact of short-lived climate pollutants and potentially leading opportunistic policymakers to
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Medication errors contributing to obstetric cardiac arrest in NAP7 Anaesthesia (IF 10.7) Pub Date : 2024-04-23 Noha Tageldin, Kailash Bhatia
It is reassuring to see that obstetric patients are four times less likely to experience a cardiac arrest than patients having non-obstetric surgery [1]. Further, no cardiac arrests were attributed to failed tracheal intubation, aspiration, local anaesthetic systemic toxicity or remifentanil patient-controlled analgesia, suggesting significant safety improvements in these areas. Anaesthesia-related
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Still a ‘boys’ club': a qualitative analysis of how gender affects a career in anaesthesia in Australia and Aotearoa New Zealand Anaesthesia (IF 10.7) Pub Date : 2024-04-17 J. C. Carter, N. Purcell, C. H. Stewart, G. C. Pearce, M. Balkin, K. J. Allen
Gender inequity remains an issue in anaesthesia despite increasing numbers of women training and achieving fellowship in the speciality. Women are under-represented in all areas of anaesthetic research, academia and leadership. The Gender Equity Subcommittee of the Australian and New Zealand College of Anaesthetists recently conducted a survey asking “Does gender still matter in the pursuit of a career
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Comparison of the McGrath videolaryngoscope with direct laryngoscopy for rapid sequence intubation in the operating theatre Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Xiaocou Wang, Jing Qian, Dongzi Liu
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Associations between postoperative anaemia and unplanned readmission to hospital after major surgery: a retrospective cohort study† Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Timothy Makar, Margaret Hezkial, Mayank Vasudeva, Dominic Walpole, John Xie, Chris Zi‐Fan Zhao, Bobby Ou Yang, Saranya Ramesh, Tom Larsen, Stephane Heritier, Toby Richards, Lachlan F. Miles
SummaryBackgroundAnaemia following major surgery may be associated with unplanned readmission to hospital. However, the severity‐response relationship between the degree of anaemia at discharge and the risk of unplanned readmission is poorly defined. We aimed to describe the severity‐response relationship between haemoglobin concentration at the time of discharge and the risk of unplanned readmission
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Optimising peri‐operative anaphylaxis management: end‐tidal carbon dioxide monitoring and adrenaline titration Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Hsin‐Yu Yang, Pei‐Yi Hung, Ming‐Hui Hung
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Artificial intelligence in obstetric anaesthesia: an unlikely player? Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Cian Hurley, Rosemarie Kearsley
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On the ethics of removing Entonox® from labour ward: beyond carbon dioxide equivalents and seeking justice for patients and the planet Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Sarah Hudson, Nadia Muspratt‐Tucker, Søren Kudsk‐Iversen
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Efficiency of CONTRAfluran™ in reducing sevoflurane pollution from maintenance anaesthesia in minimal flow end‐tidal control mode for laparoscopic surgery Anaesthesia (IF 10.7) Pub Date : 2024-04-12 Harold Mulier, Michel M. R. F Struys, Hugo Vereecke, Steffen Rex, An Teunkens, Alain F. Kalmar
SummaryBackgroundRecommendations exist that aim to mitigate the substantial ecological impact of anaesthesia. One option is to use anaesthetic gas capturing technology at anaesthesia workstation exhausts to harvest and recycle volatile agents. However, the efficiency of such technology is mainly unverified in vivo.MethodsThe efficiency of CONTRAfluran™ in capturing sevoflurane from an anaesthesia workstation
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Reframing the gender equity discussion in anaesthesiology: adopting best practices to promote physician retention and belonging Anaesthesia (IF 10.7) Pub Date : 2024-04-06 Julie K. Silver, Lauren D. Feld, Varina R. Clark Onwunyi
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Tracheal intubation without neuromuscular blocking drugs: isn't it an illusion? Anaesthesia (IF 10.7) Pub Date : 2024-04-02 Nicolas Grillot, Antoine Roquilly
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Peri‐operative cardiac arrest in the older frail patient as reported to the 7th National Audit Project of the Royal College of Anaesthetists Anaesthesia (IF 10.7) Pub Date : 2024-04-01 I. K. Moppett, A. D. Kane, R. A. Armstrong, E. Kursumovic, J. Soar, T. M. Cook
SummaryFrailty increases peri‐operative risk, but details of its burden, clinical features and the risk of, and outcomes following, peri‐operative cardiac arrest are lacking. As a preplanned analysis of the 7th National Audit Project of the Royal College of Anaesthetists, we described the characteristics of older patients living with frailty undergoing anaesthesia and surgery, and those reported to
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The impact of musculoskeletal ill health on quality of life and function after critical care: a multicentre prospective cohort study Anaesthesia (IF 10.7) Pub Date : 2024-03-27 O. D. Gustafson, E. B. King, M. M. Schlussel, A. Arnold, C. Wade, P. S. Nicol, M. J. Rowland, H. Dawes, M. A. Williams
SummaryPhysical disability is a common component of post‐intensive care syndrome, but the importance of musculoskeletal health in this population is currently unknown. We aimed to determine the musculoskeletal health state of intensive care unit survivors and assess its relationship with health‐related quality of life; employment; and psychological and physical function. We conducted a multicentre
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Immunomodulatory drugs in sepsis: a systematic review and meta‐analysis Anaesthesia (IF 10.7) Pub Date : 2024-03-25 R. C. Robey, C. Logue, C. A. Caird, J. Hansel, T. P. Hellyer, J. Simpson, P. Dark, A. G. Mathioudakis, T. Felton
SummaryDysregulation of the host immune response has a central role in the pathophysiology of sepsis. There has been much interest in immunomodulatory drugs as potential therapeutic adjuncts in sepsis. We conducted a systematic review and meta‐analysis of randomised controlled trials evaluating the safety and clinical effectiveness of immunomodulatory drugs as adjuncts to standard care in the treatment
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Association between inflammation and post-intensive care syndrome: a systematic review Anaesthesia (IF 10.7) Pub Date : 2024-03-20 C. Docherty, C. Page, J. Wilson, P. Ross, K. Garrity, T. Quasim, M. Shaw, J. McPeake
Post-intensive care syndrome describes the physical, cognitive and emotional symptoms which persist following critical illness. At present there is limited understanding of the pathological mechanisms contributing to the development of post-intensive care syndrome. The aim of this systematic review was to synthesise current evidence exploring the association between inflammation and features of post-intensive
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Judgements of quality of care in NAP7: a clarification from the authors Anaesthesia (IF 10.7) Pub Date : 2024-03-22 Tim M. Cook, D. N. Lucas, Jasmeet Soar
It is a pleasure to see another editorial [1] accompanying the 7th National Audit Project (NAP7) paper regarding obstetric peri-operative cardiac arrest [2]. We would like to raise one point to correct a possible misinterpretation in the editorial and clarify what we laid out in the NAP7 methods and results [3, 4] regarding causes of cardiac arrest and inferences about quality of care. Dr Monks et al
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Dr Maldwyn (Mal) Morgan 1938–2023 Anaesthesia (IF 10.7) Pub Date : 2024-03-21 G. Hall
Anaesthesia in the UK has been fortunate because of the talented people who have contributed to the progress of the specialty. In the last 25 years of the 20th century, Mal Morgan was one of those talented people. However, it was the wide range of expertise that marked him out as exceptional, including education and training; research; editorship; authorship; and membership of national committees.
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Non‐steroidal anti‐inflammatory drugs in multimodal strategies: a potential double‐edged sword but still more research needed Anaesthesia (IF 10.7) Pub Date : 2024-03-19 J. Poeran, S. G. Memtsoudis
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Improving patient care and enhancing surgical efficiency: strategies to reduce same‐day surgical cancellations Anaesthesia (IF 10.7) Pub Date : 2024-03-16 A. A. Dixit, E. C. Sun
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How to write pilot and feasibility studies Anaesthesia (IF 10.7) Pub Date : 2024-03-16 M. Murali, M. Charlesworth
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Trainees in the independent healthcare sector: benefits for all Anaesthesia (IF 10.7) Pub Date : 2024-03-12 J. H. Lawson, R. E. Grimes, D. J. N. Wong
We read with interest the editorial by Fletcher and Barker highlighting the challenges in the independent sector [1]. The authors note that 6.2% of elective UK NHS cases are now delivered by the independent private hospital sector, and the number of such cases will possibly increase over time. They further highlight the difficulties of providing safe postoperative care due to an over-reliance on resident
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Rethinking paediatric peri‐operative cardiac arrest: proactive preparation and tailored training Anaesthesia (IF 10.7) Pub Date : 2024-03-11 E. Keane, M. Johnson, H. Laycock
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Volatile anaesthetics and net zero: a quantitative approach for spending money effectively Anaesthesia (IF 10.7) Pub Date : 2024-03-10 A. F. Kalmar, H. Mulier, S. Rex
We endorse the proposal to adopt a framework for cost-effective decision-making to optimise the use of limited economic resources [1]. Additionally, we fully support the notion of prioritising measures with the greatest and most efficient impact first, based on quantitative analysis. However, it is unclear to us how the reported 47 kg carbon dioxide equivalents (CO2e) for one bottle of sevoflurane
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From insight to action: addressing burnout among anaesthetic trainees in the UK Anaesthesia (IF 10.7) Pub Date : 2024-03-10 C. Senver, M. Kulshrestha
We write in response to the study on burnout and its determinants among anaesthesia care providers in Switzerland [1]. This is a challenge that resonates across borders, most notably within the NHS in the UK. The study, conducted across 22 anaesthesia departments, reveals a worrying prevalence of burnout. Notably, a staggering 65% of respondents reported work-related errors due to high workload or
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Association between pre-operative depression and postoperative pain outcomes Anaesthesia (IF 10.7) Pub Date : 2024-03-05 K.-C. Hung, H.-L. Weng, I.-W. Chen
We read with great interest the article by Lee et al. that found that pre-operative depression was associated with worse pain severity in both the early postoperative period (< 72 h) and later follow-up (> 6 months) [1]. However, the degree of improvement in the pain scores from before surgery to 1–2 years after surgery was similar between the depressed and non-depressed cohorts. Some methodological
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Epidemiology of tobacco smoking in patients undergoing elective vascular surgery in the UK Anaesthesia (IF 10.7) Pub Date : 2024-03-05 K. H. F. Wong, R. Mouton, R. J. Hinchliffe
Tobacco smoking has well-known deleterious effects on vascular disease progression and peri-operative outcomes [1]. Consequently, international guidelines and quality improvement programmes recommend smoking cessation as a central component of best medical therapy [2-4]. Smoking cessation interventions in the peri-operative period are effective, especially with a changing approach to targeted behavioural
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Can we already provide a conclusive assessment of the evidence for the use of nociception-guided anaesthesia? Anaesthesia (IF 10.7) Pub Date : 2024-03-05 H. Bornemann-Cimenti, K. Lang-Illievich, C. Klivinyi
We thank Dr Chen et al. for their comments on our article on the effect of nociception level-guided anaesthesia on pain levels and opioid consumption in the post-anaesthesia care unit [1, 2]. Based on our meta-analysis, they conducted a trial sequential analysis to draw even deeper insights from previous studies. They showed that the current literature is not sufficient to conclusively assess the evidence
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The science of climate change and the effect of anaesthetic gas emissions: a reply Anaesthesia (IF 10.7) Pub Date : 2024-03-01 J. M. Slingo, M. E. Slingo
Thank you for the opportunity to reply to Dr Grant's letter [1] regarding our article [2]. Dr Grant includes several serious misstatements and allegations. We will take the most important points in turn. “The interpretation is that [the volatiles' radiative forcing] is too tiny to matter and, therefore, can be ignored. However, I believe this is more an opinion than a fact and should be challenged
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The science of climate change and the effect of anaesthetic gas emissions Anaesthesia (IF 10.7) Pub Date : 2024-03-01 A. Grant
I must commend Slingo and Slingo for writing such an interesting and accessible article on the science of climate change [1]. While I will not question the hard scientific facts, I intend to question some of the conclusions. To evaluate the current warming impact of a given gas, they favour the use of radiative forcing, with units of Wm-2. The relevant figures are carbon dioxide 2.16, with the combined