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Bacterial contamination and greenhouse gas emissions: A randomised study of reuse versus single-use of infusion-set components for intravenous anaesthesia. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-17 Snorri Laxdal Karlsson,Jon Edman-Wallér,Magni Vidar Gudmundsson,Peter Bentzer,Per Werner Moller
BACKGROUND Reusing anaesthesia infusion-set components may reduce the climate impact from plastic waste and discarded medications. Infusion-set contents can be shielded from patient contact by single use of an infusion line fitted with dual antireflux valves, preventing retrograde entry of microorganisms, and eliminating the risk for patient-to-patient cross-contamination. However, infusion-set contamination
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A survey and analysis of peri-operative quality indicators promoted by National Societies of Anaesthesiologists in Europe: The EQUIP project. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-12 Johannes Wacker,Guy Haller,Jan F A Hendrickx,Martin Ponschab
BACKGROUND To capture preventable peri-operative patient harm and guide improvement initiatives, many quality indicators (QIs) have been developed. Several National Anaesthesiologist Societies (NAS) in Europe have implemented quality indicators. To date, the definitions, validity and dissemination of such quality indicators, and their comparability with validated published indicators are unknown. OBJECTIVES
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Effect of remimazolam on intra-operative hypotension: Systematic review and meta-analysis of randomised controlled trials. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-12 Ting-Yu He,Rui-Peng Zhong,Wei-Bo Zhong,Gui-Ming Huang,Xiao-Cheng Liu
BACKGROUND Hypotension is common during anaesthesia. Increasing number of studies have reported that remimazolam may be associated with lower incidence of intra-operative hypotension compared with other anaesthetics. However, the results remain controversial. OBJECTIVE This study aimed to evaluate the influence of remimazolam on intra-operative hypotension and its related outcomes (hypoxaemia, bradycardia
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Mean arterial pressure versus cardiac index for haemodynamic management and myocardial injury after hepatopancreatic surgery: A randomised controlled trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-12 Taner Abdullah,Hürü Ceren Gökduman,İşbara Alp Enişte,İlyas Kudaş,Achmet Ali,Erdem Kınacı,İlgin Özden,Funda Gümüş Özcan
BACKGROUND Myocardial injury after noncardiac surgery (MINS) frequently complicates the peri-operative period and is associated with increased mortality. OBJECTIVES We hypothesised that cardiac index (CI) based haemodynamic management reduces peri-operative high-sensitive troponin-T (hsTnT) elevation and MINS incidence in patients undergoing hepatic/pancreatic surgery compared to mean arterial pressure
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Pre-operative triAge proCedure to streaMline elective surgicAl patieNts (PACMAN) improves efficiency by selecting patients eligible for phone consultation: A retrospective cohort study. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-10 Manuela Di Biase,Babette van der Zwaard,Fenne Aarts,Barbe Pieters
BACKGROUND Pre-operative screening is a high volume task consuming time and resource. Streamlining patient flow by gathering information in advance reduces costs, optimises resources and diminishes patient burden whilst maintaining safety of care. OBJECTIVE To evaluate whether 'Pre-operative triAge proCedure to streaMline elective surgicAl patieNts' (PACMAN) is able to improve pre-operative screening
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Water conservation in the OR: keep it simple. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-11 Sebastian Schulz-Stübner
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Positive impact of a nurse consultation on retention of information by outpatient after anaesthesia consultation: A randomised study. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-11 Vincent Compère,Etienne Allard,Quentin Robert,Thomas Clavier,Emmanuel Besnier,Julien Kallout,Jean Selim
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Is the 'loss of resistance' technique with hydrodissection during fascial plane blocks feasible? Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-11 Baththirange Malaka Munasinghe
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Planetary health: A great opportunity for anaesthesiologists. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-11 Anne Hübner,Andrea Nakoinz,Christian M Schulz
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Comparison of a videolaryngoscope with a 3D-printed angled blade and a direct laryngoscope with a Macintosh blade for rapid sequence tracheal intubation: An observational study. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-06 Andréa Jorge E Silva,Nubia Verçosa,Marco A C de Resende,Ismar L Cavalcanti
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Lung-protective ventilation and postoperative pulmonary complications during pulmonary resection in children: A prospective, single-centre, randomised controlled trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-06 Change Zhu,Mazhong Zhang,Saiji Zhang,Rufang Zhang,Rong Wei
BACKGROUND Children are more susceptible to postoperative pulmonary complications (PPCs) due to their smaller functional residual capacity and higher closing volume; however, lung-protective ventilation (LPV) in children requiring one-lung ventilation (OLV) has been relatively underexplored. OBJECTIVES To evaluate the effects of LPV and driving pressure-guided ventilation on PPCs in children with OLV
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Diagnostic value of lung ultrasound, clinical examination, and colourflow Doppler compared with fiberoptic bronchoscopy to predict appropriate lung exclusion in thoracic surgery: A cohort study. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-09-03 Pierre-Henri Moury,Quentin Jegousso,Maxime Durost,Jérôme Nicolas,Pierre Albaladejo
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Influence of pairing in examiner leniency and stringency ('hawk-dove effect') in part II of the European Diploma of Anaesthesiology and Intensive Care: A cohort study. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-29 Stephen Sciberras,Markus Klimek,Bazil Ateleanu,Hugues Scipioni,Rodolphe Di Loreto,Joana Berger-Estilita
BACKGROUND The European Diploma of Anaesthesiology and Intensive Care (EDAIC) Part II examination is a supranational examination for anaesthesiologists. OBJECTIVES We explore the impact of examiner pairing on leniency and stringency, commonly referred to as the 'hawk-dove effect'. We investigate the potential variations in grading approaches, resulting from different examiner pairs and their implications
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Transcutaneous electrical nerve stimulation and catheter-related bladder discomfort following transurethral resection of bladder tumour: A randomised controlled trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-14 Jun-Young Park, Jihion Yu, Chan-Sik Kim, Ji-Won Baek, Taeho Mun, Young-Kug Kim
Catheter-related bladder discomfort (CRBD) is problematic in patients with a urinary catheter. Transcutaneous electrical nerve stimulation (TENS) is a non-invasive analgesic modality used to relieve various types of pain.
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Pain management after laparoscopic cholecystectomy: A systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-12 Camille Bourgeois, Lukasa Oyaert, Marc Van de Velde, Esther Pogatzki-Zahn, Stephan M Freys, Axel R Sauter, Girish P Joshi, Geertrui Dewinter
Laparoscopic cholecystectomy can be associated with significant postoperative pain that is difficult to treat. We aimed to evaluate the available literature and develop updated recommendations for optimal pain management after laparoscopic cholecystectomy. A systematic review was performed using the procedure-specific postoperative pain management (PROSPECT) methodology. Randomised controlled trials
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Reply to comments on 'Epidural analgesia versus oral morphine for postoperative pain management following video-assisted thoracic surgery'. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-07 Jimmy Højberg Holm,Claus Andersen,Palle Toft
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Comparing efficacy of epidural analgesia and oral morphine for postoperative pain control following video-assisted thoracic surgery. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-07 Yan Li,Fu-Shan Xue,Cheng-Wen Li
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Epidural analgesia versus oral morphine for postoperative pain management following video-assisted thoracic surgery. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-07 Maurizio Carravetta,Tommaso Lami,Sara Zaffaroni,Stefano Turi
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Disregarding the use of oral morphine is not justified yet. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-07 Antal Bede
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Can prefilled syringes help to improve patient safety? Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-07 Cordélia Salomez-Ihl,Claire Chapuis,Pierrick Bedouch,Pierre Albaladejo,Julien Picard
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Clinical guideline on reversal of direct oral anticoagulants in patients with life-threatening bleeding: use of a urine dipstick. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-07 Job Harenberg,Florian Langer,Jürgen Koscielny
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Enhancing anaesthetic care for the elderly: Propofol versus remimazolam for general anaesthesia. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-08-07 Tom G Hansen,Marc Van de Velde
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The degree of respiratory depression according to the effect-site concentration in remimazolam target-controlled infusion: A randomised controlled trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-30 Soo Jung Park, Sang Kee Min, Gyubin Choi, Ji Eun Kim, Ha Yeon Kim
Remimazolam is not only associated with a lower incidence of respiratory depression than propofol but also in itself has the risk of respiratory depression.
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Intravenous lidocaine for postoperative analgesia management in paediatrics: A systematic review with meta-analysis of published studies. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-30 Pierre Pardessus, Maud Loiselle, Kelly Brouns, Anne-Laure Horlin, Beatrice Bruneau, Yara Maroun, Martin Lagarde, Maxime Deliere, Florence Julien-Marsollier, Souhayl Dahmani
The administration of intravenous lidocaine during the peri-operative period may improve pain management after paediatric surgery.
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Remimazolam vs. propofol for general anaesthesia in elderly patients: a meta-analysis with trial sequential analysis. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-29 Eduardo Maia Pereira, Vitor Ryuiti Moraes, Mariana Gaya da Costa, Tatiana Souza do Nascimento, Eric Slawka, Carlos Galhardo Júnior, Michel Mrf Struys
Elderly patients comprise an increasing proportion of patients undergoing surgery, and they require special attention due to age-related physiological changes. Propofol is the traditional agent for anaesthesia, and recently, remimazolam, a novel ultra-short-acting benzodiazepine, has emerged as an alternative to propofol in general anaesthesia.
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Ultrasound-guided transversalis fascia plane block or transversus abdominis plane block for recovery after caesarean section: A randomised clinical trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-23 Ahmet Pınarbaşı, Başak Altıparmak, Melike Korkmaz Toker, Fatih Pirinççi, Bakiye Uğur
Caesarean section is a widely performed surgical procedure that often results in moderate-to-severe postoperative pain. If left untreated, this pain can lead to short-term and long-term consequences. Transversalis fascia plane (TFP) block and transversus abdominis plane (TAP) block are among the regional anaesthesia techniques employed for managing pain after a caesarean section.
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Quality of recovery after major noncardiac surgery in a high-acuity postoperative unit: A prospective validation study to evaluate the QoR-15GE during advanced recovery room care. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-19 Lili Plümer,Eva Jung,Linda Krause,Marlene Fischer
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Relationship between intra-operative urine output and postoperative acute kidney injury in paediatric cardiac surgery: A retrospective cohort study. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-18 Dongyun Bie, Yinan Li, Hongbai Wang, Qiao Liu, Dou Dou, Yuan Jia, Su Yuan, Qi Li, Jianhui Wang, Fuxia Yan
Intra-operative urine output (UO) has been shown to predict postoperative acute kidney injury (AKI) in adults; however, its significance in children undergoing cardiac surgery remains unknown.
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Factors affecting adherence to recommendations on pre-operative cardiac testing: A cohort study. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-11 Alexandra Stroda, Tanja Sulot, Sebastian Roth, René M'Pembele, Eckhard Mauermann, Daniela Ionescu, Wojciech Szczeklik, Stefan De Hert, Miodrag Filipovic, Beatrice Beck Schimmer, Savino Spadaro, Purificación Matute, Sanem Cakar Turhan, Judith van Waes, Filipa Lagarto, Kassiani Theodoraki, Anil Gupta, Hans-Jörg Gillmann, Luca Guzzetti, Katarzyna Kotfis, Jan Larmann, Dan Corneci, Simon J Howell, Giovanna
Cardiac risk evaluation prior to noncardiac surgery is fundamental to tailor peri-operative management to patient's estimated risk. Data on the degree of adherence to guidelines in patients at cardiovascular risk in Europe and factors influencing adherence are underexplored.
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Comparison of intravenous versus perineural dexamethasone as a local anaesthetic adjunct for peripheral nerve blocks in the lower limb: A meta-analysis and systematic review. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-11 Neel Desai, Suji Pararajasingham, Desire Onwochei, Eric Albrecht
As a local anaesthetic adjunct, the systemic absorption of perineural dexamethasone in the lower limb could be restricted because of decreased vascularity when compared with the upper limb.
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 10: Surgery in the obese patient. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Juan Ignacio Arcelus,Isabelle Gouin-Thibault,Charles Marc Samama
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 13: Nonambulatory orthopaedic surgery. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Jean-Yves Jenny,Anne Godier,Catherine Heim,Sibylle Langenecker,Emmanuel Thienpont,John Eikelboom
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 11: Trauma. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Catherine Heim,Nicolas Bruder,Ross Davenport,Jacques Duranteau,Christine Gaarder
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 12: Urology. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Kari A O Tikkinen,Rufus Cartwright,Anders Gadegaard Jensen,Philippe D Violette
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 9: Surgery during pregnancy and the immediate postpartum period. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Marie En-Asseri,D Nuala Lucas,Jacky Nizard,Anne-Sophie Bouthors
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 3: Day surgery and fast-track surgery. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Christoffer Calov Jørgensen,Juan Llau,Jean-Yves Jenny,Pierre Albaladejo
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 8: Plastic surgery. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Guido Paolini,Guido Firmani,Michail Sorotos,Milomir Ninkovic,Fabio Santanelli di Pompeo
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 6: Neurosurgery. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Lidia Mora,John G Gaudet,Federico Bilotta,Nicolas Bruder
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 5: Mechanical prophylaxis. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Christian Fenger-Eriksen,Pieter Willem Kamphuisen,Peter Verhamme,Jean Yves Jenny
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 4: Prophylaxis in critical care patients. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Fanny Bounes,Raquel Ferrandis,Corinne Frere,Julie Helms,Juan V Llau
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Executive summary. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Charles Marc Samama,Arash Afshari,Lars Grønlykke,Mikkel Herold Madsen,Sebastian Wiberg,Carolina S Romero
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 1: Cardiovascular Surgery. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Aamer Ahmed,Andreas Koster,Marcus Lance,Milan Milojevic
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Chapter 2: Thoracic oncology surgical patients. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Yaron Shargall,Alessandro Brunelli
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European guidelines on peri-operative venous thromboembolism prophylaxis: first update.: Introductory chapter. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Carolina S Romero,Arash Afshari,Roberta Südy,Charles Marc Samama
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Progress in the prevention of hospital-acquired venous thromboembolism. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-10 Beverley J Hunt
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Diaphragm-sparing efficacy of subparaneural upper trunk block for arthroscopic shoulder surgery: A randomised controlled trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-04 Yumin Jo, Chahyun Oh, Woo-Yong Lee, Donggeun Lee, Suyeon Shin, Woosuk Chung, Chaeseong Lim, Sun Yeul Lee, Boohwi Hong
Inter-scalene block (ISB) is associated with an inevitable risk of hemi-diaphragmatic paresis (HDP). To reduce the risk of HDP, an upper trunk block (UTB) has been proposed at the brachial plexus division level.
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Do virtual meetings increase agreement while developing guidelines?: A cross-sectional study among guideline authors. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-03 Carolina S Romero,Peter Kranke,Stefan De Hert,Idit Matot,Arash Afshari,
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Early supraglottic airway versus facemask ventilation before tracheal intubation to facilitate ventilation in high-risk patients: A prospective randomised trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-07-01 J Ross Renew,Eslam A Fouda,Dylan M Mordecai,Ashley N Huxhold,Ilana I Logvinov,Michael G Heckman,Klaus D Torp
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Neuromuscular blocking agent drug challenge: a literature review and protocol proposal with biological evaluation. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-25 Aurélie Gouel-Cheron, Catherine Neukirch, Sylvie Chollet-Martin, Arnaud Valent, Benoit Plaud, Dan Longrois, Pascale Nicaise-Roland, Philippe Montravers, Luc de Chaisemartin
Drug challenge is the gold standard for identifying causative agents of drug allergies. Although clinical guidelines have recently been published, they do not recommend neuromuscular blocking agent (NMBA) drug challenges. NMBA challenges are rendered difficult by the lack of homogeneity of routine allergy work-ups and the necessity of a specialised setting. Several scenarios support NMBA challenges
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Usefulness of a virtual reality educational program for reducing preoperative anxiety in children: A randomised, single-centre clinical trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-25 Adriana Carbó, Daniel Tresandí, Cristina Tril, Diego Fernández-Rodríguez, Enrique Carrero
Preoperative anxiety (PA) is common in children and has detrimental effects on surgical outcome. Strategies based on virtual reality (VR) have recently been introduced to address this problem.
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The role of supraglottic airway devices for caesarean section under general anaesthesia. A scoping literature review with a proposed algorithm for the appropriate use of supraglottic airway devices for caesarean sections. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-20 Urvi Sanganee, Karen Jansen, Nuala Lucas, Marc Van de Velde
This review aims to assess the published evidence on airway management with a supraglottic airway device (SGA) for general anaesthesia in patients requiring a caesarean section. Physiological changes during pregnancy can make airway management in parturients challenging. At the same time, pregnant patients are at risk of pulmonary aspiration due to hormonal and mechanical alterations. The standard
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Epidemiology of videolaryngoscopy use: Evidence from surveys and patient data. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-12 Massimo Muraccini,Chiara Sansovini,Vincenzo Russotto
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Importance of accounting for repeated measure designs when evaluating treatment effects at multiple postoperative days. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-12 Markus Huber,Patrick Y Wuethrich
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Number of anaesthesia residents in Spain: correction to publication by Berger-Estilita J, et al. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-12 Pablo Monedero
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Reply to: more on fasting hypoglycaemia in children. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-12 Martin Ingi Sigurdsson,Steinunn Snaebjornsdottir,Theodor Skuli Sigurdsson
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More on fasting hypoglycaemia in children. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-12 Justine Mullie-Leger,Damien Lemaire,Francis Veyckemans
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Conflicting guidelines: a commentary on the recent European Society for Emergency Medicine and European Society of Anaesthesiology and Intensive Care guidelines on temperature control after cardiac arrest. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-12 Lars W Andersen,Mathias J Holmberg,Jerry P Nolan,Jasmeet Soar,Asger Granfeldt
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Atmospheric particulate matter and hypoxaemia in Korean children receiving general anaesthesia: A retrospective analysis. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-12 Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Young-Eun Jang, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim, Eun-Hee Kim
The association between the concentration of atmospheric particulate matter on the day of surgery and the occurrence of intra-operative hypoxaemia in children receiving general anaesthesia is unclear.
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Reply to Andersen et al .: a commentary on the recent European Society for Emergency Medicine and the European Society of Anaesthesiology and Intensive Care guidelines on temperature control after cardiac arrest. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-07 Wilhelm Behringer,Bernd W Böttiger,Daniele G Biasucci,Athanasios Chalkias,Jim Connolly,Christoph Dodt,Abdo Khoury,Said Laribi,Robert Leach,Giuseppe Ristagno
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Effects of goal-directed analgesia using the analgesia nociception index in children undergoing surgery for moyamoya disease: A randomised controlled trial. Eur. J. Anaesthesiol. (IF 4.2) Pub Date : 2024-06-04 Jung-Bin Park, Pyoyoon Kang, Sang-Hwan Ji, Young-Eun Jang, Ji-Hyun Lee, Jin-Tae Kim, Hee-Soo Kim, Eun-Hee Kim
The potential benefits of Analgesia Nociception Index guided intra-operative analgesia on intra-operative opioid consumption remains to be demonstrated in paediatric anaesthesia.