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Wiley Online Library : Anaesthesia
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Standards for hip fracture anaesthesia

8. February 2017 - 9:00
Categories: From Anaesthesia

Issue Information – Editorial Board

8. February 2017 - 9:00
Categories: From Anaesthesia

Sugammadex and laryngospasm

8. February 2017 - 9:00
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Correction

8. February 2017 - 9:00
Categories: From Anaesthesia

Cricoid pressure: release – or adjust?

8. February 2017 - 9:00
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Phrenic nerve block for thoracic surgery

8. February 2017 - 9:00
Categories: From Anaesthesia

Metabolic oxygen requirements

8. February 2017 - 9:00
Categories: From Anaesthesia

Heart rate variability as a predictor of hypotension following spinal for elective caesarean section: a prospective observational study

30. January 2017 - 6:45
Summary

Post-spinal hypotension remains a common and clinically-important problem during caesarean section, and accurate pre-operative prediction of this complication might enhance clinical management. We conducted a prospective, single-centre, observational study of heart rate variability in 102 patients undergoing elective caesarean section in a South African regional hospital. We performed Holter recording for ≥ 5 min in the hour preceding spinal anaesthesia. The low-frequency/high-frequency ratio component of heart rate variability was compared, using a logistic regression model, with baseline heart rate and body mass index (BMI) as a predictor of hypotension (defined as systolic arterial pressure < 90 mmHg) occurring from the time of spinal insertion until 15 min after delivery of the baby. We also assessed clinically relevant cut-point estimations for low-frequency/high-frequency ratio. Low-frequency/high-frequency ratio predicted hypotension (p = 0.046; OR 1.478, 95% CI 1.008-1.014), with an optimal cut-point estimation of 2.0; this threshold predicted hypotension better than previously determined thresholds (p = 0.003; c-statistic 0.645). Baseline heart rate (p = 0.20; OR 1.022, 05% CI 0.988-1.057) and BMI (p = 0.60; OR 1.017, 95% CI 0.954-1.085) did not predict hypotension. Heart rate variability analysis is a potentially useful clinical tool for the prediction of hypotension. Future studies should consider a low-frequency/high-frequency ratio threshold of 2.0 for prospective validation.

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The application of three-dimensional printing technology in anaesthesia: a systematic review

27. January 2017 - 6:56
Summary

Three-dimensional printing has rapidly become an easily accessible, innovative and versatile technology, with a vast range of applications across a wide range of industries. There has been a recent emergence in the scientific literature relating to its potential application across a multitude of fields within medicine and surgery; however, its use within anaesthesia has yet to be formally explored. We undertook a systematic review using MEDLINE and EMBASE databases of three-dimensional printing in anaesthesia. We identified eight relevant articles. Due to the paucity of studies, we also completed a narrative review of the applications of three-dimensional printing pertinent to anaesthetic practice that our department are currently exploring, and suggest potential future uses for this technology relevant to our speciality.

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Determination of the median effective dose (ED50) of spinal chloroprocaine in labour analgesia

19. January 2017 - 11:35
Summary

The primary goal of this study was to determine the median effective dose (ED50) of spinal chloroprocaine for labour analgesia. Thirty-eight parturients requesting neuraxial analgesia were enrolled. Doses of 1% chloroprocaine were determined by the technique of up–down sequential allocation, with an initial dose of 20 mg and steps of 2 mg. The chloroprocaine spinal dose was given as the spinal component of a combined spinal-epidural, which was then supplemented with an epidural dose of 7.5 μg sufentanil in 7 ml saline. Effective analgesia was defined as a score ≤ 10 mm within 15 min on a 100-mm visual analogue pain scale. Using the isotonic regression estimator method, the ED50 of chloroprocaine for the spinal component of a combined spinal-epidural for labour was calculated to be median (95% CI) 12.0 (9.3–17.0) mg.

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