Anaesthesia

Preserving sleep in paediatric peri-operative care

#AnSky #sleep

doi.org/10.1111/anae...

"While the study by Meewisse et al. is reassuring in that it suggests that minor procedures under anaesthesia may not drastically alter sleep–wake rhythms in children, we must not assume this applies to all paediatric surgical scenarios."

#AnSky #sleep

Reassessing the dose-onset relationship of remimazolam in children: a reply

#AnSky

On MRI scans, people with chronic pain often had patterns that were like the patterns seen in people with Alzheimer's disease: less grey brain tissue, weaker white brain tissue, and signs of older brain age in places such as the hippocampus.

#AnSky

doi.org/10.1111/anae...

Brain health in adults with chronic pain

For structural MRI studies, smaller grey matter volumes were found in the chronic pain group compared with healthy controls in most studies.

#AnSky

doi.org/10.1111/anae...

Adults with chronic pain exhibit widespread alterations in brain health compared with healthy controls.

Several observed features overlap with biomarkers of Alzheimer's disease and other forms of neurodegeneration.

#AnSky

doi.org/10.1111/anae...

Machine learning and the NHS pre-operative assessment

"Presenting subgroup-stratified performance and quantifying the warning flag system would enhance transparency, support safe adoption and broaden the impact on peri-operative services and health system planning."

#AnSky

doi.org/10.1111/anae...

Too often surgical programs are presented to anaesthesia as a fait accompli.
Anaesthesia then has to figure out the logistics on their own usually with no new resources.

Postop sore throat

Treatments that seemed to help reduce a sore throat included keeping the pressure in the airway tube/mask low. For breathing tubes, medicines such as ketamine, steroids or anti-inflammatory drugs (sprays, creams or through a drip) also helped.

#AnSky

doi.org/10.1111/anae...

Comparison of two peripheral regional analgesic techniques for primary elective total hip arthroplasty: a reply

#AnSky

To make a TAVI programme work, all team members require the following:
• high-level understanding of the procedure
• knowledge of what can and might go wrong and the complications which are avoidable
• proper governance processes
• expert clinical management

#AnSky

doi.org/10.1111/anae...

Interpreting the afternoon disadvantage: accounting for mediation, weighting and secular trends

#AnSky

doi.org/10.1111/anae...

The relationship between generative AI and predictive analytics underscores the possibility for individual patient data and dynamic risk prediction to enhance care quality.

eg. ‘tri-hybrid model’ - integrates AI; predictive analytics; and human intelligence

#AnSky #AI

doi.org/10.1111/anae...

When you're doing a block for lower limb surgery, should you prioritise function or analgesia?

#AnSky #RASky

doi.org/10.1111/anae...

Postoperative sore throat has an incidence of up to 62%.

The current literature lacks high-quality randomised controlled trials on treatments that prevent a complication that is of importance to patients and their recovery.

#AnSky #MedSky

doi.org/10.1111/anae...

What strategies can be used to reduce the incidence of post operative sore throat?

• Cuff pressure ≤ 30 cmH2O
• IV/topical corticosteroids
• Nebulised/topical ketamine
• Topical NSAIDs
• Smaller tube: 7.0 mm (male); 6.0 mm female
• Use a SAD instead

#AnSky #MedSky

doi.org/10.1111/anae...

Are large national observational studies (eg NAP, SNAP, POPPY and SONAR) including the wider determinants of health?

Promisingly, over time the number of PROGRESS-Plus characteristics recorded has increased.

#AnSky

doi.org/10.1111/anae...

What characteristics relevant to equity can identify which populations are at higher risk of adverse outcomes?

PROGRESS-Plus: Place of residence; Race/ethnicity/culture/language; Occupation; Gender/sex; Religion; Education; Socio-economic status; and Social capital.

#AnSky

People taking SGLT2 inhibitors:
• were less likely to die w/i 30 days
• had fewer heart problems, kidney injuries and cases of diabetic ketoacidosis

Benefits greater in:
• women
• people with obesity
• people with protein in their urine
• heart surgery.

#AnSky #MedSky

doi.org/10.1111/anae...

What can peri-operative rehabilitation to ⬇️ pulmonary complications in cardiac surgery look like?

• 6 sessions of inspiratory muscle training
• 33 sessions of active cycle of breathing techniques
• 12 sessions of early mobilisation during hospitalisation

#AnSky #MedSky

doi.org/10.1111/anae...

People with heart valve problems who need surgery often get lung problems after.

This study showed that a special program (learning about their condition, training the breathing muscles, breathing techniques and moving soon after surgery) helped ⬇️ lung problems.

#AnSky

doi.org/10.1111/anae...

There is no formal, internationally recognised definition of ‘high’ neuraxial blockade.

Symptoms:
• cardiovascular instability
• weakness of the upper limbs
• respiratory compromise
• collapse

#AnSky

doi.org/10.1111/anae...

High neuraxial block in obstetrics: are we only seeing the tip of the iceberg?

The presence of local anaesthetic in the epidural space makes the effect of subsequent intrathecal drug administration less predictable.

#AnSky #ObSky #PainSky

doi.org/10.1111/anae...

We LOVE hearing the voice of our patients and publishing the patient experience.

If you have a unique story, think about sending it through to us for consideration for publication.

#AnSky

doi.org/10.1111/anae...

Also, if you do TIVA, you don't actually need an anaesthetic machine, scavenging or CO2 reabsorption. You just need a vent.

Did you know that CA125 is well known to be elevated in ovarian cancer but can also be elevated in heart failure, particularly right-sided heart failure & heart failure with preserved ejection fraction?

@rgdavies70 @USW_Oxygen

#MedSky #AnSky #ICUSky

doi.org/10.1002/anr3...

Peri-operative rehabilitation in patients undergoing elective cardiac valve surgery: a randomised controlled trial

#AnSky #MedSky

doi.org/10.1111/anae...

Peri-operative rehabilitation reduced the incidence of postoperative pulmonary complications in patients having surgery for valvular heart disease.

#AnSky

doi.org/10.1111/anae...

Motor-sparing regional anaesthesia in lower-limb arthroplasty: balancing analgesia and function

#AnSky #RASky

doi.org/10.1111/anae...

@decarvalhocc.bsky.social @dr-amit-pawa.bsky.social @elboghdadly.bsky.social