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Anaesthesia Techniques (anaesthesia + techniques)

Distribution by Scientific Domains
Medical Sciences100%

Selected Abstracts

The occurrence of intra-operative hypotension varies between hospitals: observational analysis of more than 147,000 anaesthesia

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2009
P. TAFFÉ
Background: Hypotension, a common intra-operative incident, bears an important potential for morbidity. It is most often manageable and sometimes preventable, which renders its study important. Therefore, we aimed at examining hospital variations in the occurrence of intra-operative hypotension and its predictors. As secondary endpoints, we determined to what extent hypotension relates to the risk of post-operative incidents and death. Methods: We used the Anaesthesia Databank Switzerland, built on routinely and prospectively collected data on all anaesthesias in 21 hospitals. The three outcomes were assessed using multi-level logistic regression models. Results: Among 147,573 anaesthesias, hypotension ranged from 0.6% to 5.2% in participating hospitals, and from 0.3% up to 12% in different surgical specialties. Most (73.4%) were minor single events. Age, ASA status, combined general and regional anaesthesia techniques, duration of surgery and hospitalization were significantly associated with hypotension. Although significantly associated, the emergency status of the surgery had a weaker effect. Hospitals' odds ratios for hypotension varied between 0.12 and 2.50 (P,0.001), even after adjusting for patient and anaesthesia factors, and for type of surgery. At least one post-operative incident occurred in 9.7% of the procedures, including 0.03% deaths. Intra-operative hypotension was associated with a higher risk of post-operative incidents and death. Conclusion: Wide variations remain in the occurrence of hypotension among hospitals after adjustment for risk factors. Although differential reporting from hospitals may exist, variations in anaesthesia techniques and blood pressure maintenance may also have contributed. Intra-operative hypotension is associated with morbidities and sometimes death, and constant vigilance must thus be advocated. [source]

Postoperative analgesia for shoulder surgery: a critical appraisal and review of current techniques

ANAESTHESIA, Issue 6 2010
M. J. Fredrickson
Summary Shoulder surgery is well recognised as having the potential to cause severe postoperative pain. The aim of this review is to assess critically the evidence relating to the effectiveness of regional anaesthesia techniques commonly used for postoperative analgesia following shoulder surgery. Subacromial/intra-articular local anaesthetic infiltration appears to perform only marginally better than placebo, and because the technique has been associated with catastrophic chondrolysis, it can no longer be recommended. All single injection nerve blocks are limited by a short effective duration. Suprascapular nerve block reduces postoperative pain and opioid consumption following arthroscopic surgery, but provides inferior analgesia compared with single injection interscalene block. Continuous interscalene block incorporating a basal local anaesthetic infusion and patient controlled boluses is the most effective analgesic technique following both major and minor shoulder surgery. However, interscalene nerve block is an invasive procedure with potentially serious complications and should therefore only be performed by practitioners with appropriate experience. [source]

Bier's block and regional anaesthesia techniques in hand surgery

ANZ JOURNAL OF SURGERY, Issue 12 2009
MB BS, MRCS., Zeeshan Ahmad BSc (Hons)
No abstract is available for this article. [source]

Limbal anaesthesia versus topical anaesthesia for clear corneal phacoemulsification

ACTA OPHTHALMOLOGICA, Issue 1 2006
Carlo Cagini
Abstract. Purpose:,To compare the safety and clinical efficacy provided by limbal anaesthesia with topical anaesthesia in cataract surgery. Methods:,A total of 117 consecutive patients undergoing routine cataract surgery were randomly assigned to receive limbal or topical anaesthesia. Limbal anaesthesia was administered with a cellulose ophthalmic sponge soaked in preservative-free lidocaine hydrochloride 4% applied to the temporal perilimbal area for 45 seconds immediately before surgery. For topical anaesthesia lidocaine 4% was instilled in each patient at 10-min intervals four times before surgery. We studied phaco time, perioperative pain, visual outcome and intraoperative complications. The level of intraoperative pain was scored on a scale of 1,10, where 1 = no pain and 10 = severe pain. Results:,55 patients (91.6%) in the topical group and 54 patients (94.7%) in the limbal group tolerated the procedure well, giving pain scores of 1,3, with no statistical difference. No patients in either group required supplemental anaesthesia and no intraoperative complications were recorded. No eyes had epithelial defects at the end of surgery or at postoperative check-ups. Conclusion:,Limbal anaesthesia in cataract surgery is safe and the two anaesthesia techniques do not present differences in the degree of analgesia achieved. [source]

Nasal fracture manipulation: a comparative study of general and local anaesthesia techniques

CLINICAL OTOLARYNGOLOGY, Issue 1 2005
Ligy Thomas
[source]

Reply to Thomas & Lee: Nasal fracture manipulation: a comparative study of general and local anaesthesia techniques

CLINICAL OTOLARYNGOLOGY, Issue 1 2005
Mark Courtney
[source]