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The prevalence of anatomical variations that can cause inadvertent dural puncture when performing caudal block in Koreans: a study using magnetic resonance imagingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The purpose of this study was to investigate the prevalence of the anatomical abnormalities that can induce inadvertent dural puncture when performing caudal block. The anatomy of the lumbo-sacral area was evaluated using magnetic resonance imaging. In 2462 of the 2669 patients imaged, the dural sac terminal was located between the upper half of the 1st sacral vertebra and the lower half of the 2nd sacral vertebra. In 22 cases (0.8%), the dural sac terminal and the spinal canal were located at or below the 3rd sacral vertebra, and these were cases of simple anatomical variations. As regards pathologic conditions, there was...
Source: Anaesthesia - November 18, 2009 Category: Anesthesiology Authors: J. Joo, J. Kim, J. Lee Source Type: journals

Appropriate laryngeal mask airway size for overweight and underweight childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, laryngeal mask airway sizing according to the manufacturer's weight-based recommendation is to be preferred in overweight children, but laryngeal mask airway size by an ideal weight estimated from the patient's age is a better choice in underweight children. (Source: Anaesthesia)
Source: Anaesthesia - November 17, 2009 Category: Anesthesiology Authors: H. J. Kim, M. J. Park, J. T. Kim, C. S. Kim, S. D. Kim, H. S. Kim Source Type: journals

Radiation exposure to anaesthetists during interventional radiology*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This prospective study determined the level of radiation exposure of anaesthetists during interventional radiological procedures performed in the endoscopic retrograde cholangiopancreatography suite and cardiac catheterisation laboratory and compared it with the current safety guidelines. Anaesthetists wore area-specific lithium fluoride thermo-luminescent dosimeter badges at standardised positions. A total of 1344 procedures were performed over a 6-month period. Anaesthetists were involved in 39/645 (6.0%) procedures associated with ionisation radiation in the endoscopic retrograde cholangiopancreatography suite and 86/69...
Source: Anaesthesia - November 17, 2009 Category: Anesthesiology Authors: S. Ismail, F. Khan, N. Sultan, M. Naqvi Source Type: journals

Epidural analgesia and breastfeeding: a randomised controlled trial of epidural techniques with and without fentanyl and a non-epidural comparison groupEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We compared breastfeeding initiation and duration in 1054 nulliaparae randomised to bupivacaine Control epidural, Combined Spinal Epidural or Low Dose Infusion and 351 matched non-epidural comparisons. Women were interviewed after delivery and completed a postal questionnaire at 12 months. Regression analysis determined factors which independently predicted breastfeeding initiation. Breastfeeding duration was subjected to Kaplan[ndash]Meier analysis. A similar proportion of women in each epidural group initiated breastfeeding. Women with no epidural did not report a higher initiation rate relative to epidural groups and th...
Source: Anaesthesia - November 13, 2009 Category: Anesthesiology Authors: M. J. A. Wilson, C. MacArthur, G. M. Cooper, D. Bick, P. A. S. Moore, A. Shennan Source Type: journals

Validation of a novel fibreoptic intubation trainerEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study supports the use of such a device in training and assessment although further studies will be required to determine whether the skills learned on the device can be transferred to the clinical environment. (Source: Anaesthesia)
Source: Anaesthesia - November 8, 2009 Category: Anesthesiology Authors: D. J. Williams, A. J. Byrne, O. Bodger Source Type: journals

Atomised lidocaine for airway topical anaesthesia in the morbidly obese: 1% compared with 2%*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Airway anaesthesia using atomised lidocaine for awake oral fibreoptic intubation in morbidly obese patients was evaluated using two doses of local anaesthetic. In this randomised, blinded prospective study, 40 ml of atomised 1% (n = 11) or 2% (n = 10) lidocaine was administered with high oxygen flow as carrier. Outcomes included time for intubation, patient tolerance to airway manipulation, haemodynamic parameters, the bronchoscopist's overall satisfaction, and serial serum lidocaine concentrations. Patients receiving lidocaine 1% had a longer mean (SD) time from the start of topicalisation to tracheal tube cuff inflation ...
Source: Anaesthesia - November 6, 2009 Category: Anesthesiology Authors: C. Woodruff, P. M. Wieczorek, T. Schricker, B. Vinet, S. B. Backman Source Type: journals

Comparison of fibrescope guided intubation via the classic laryngeal mask airway and i-gel in a manikin*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We compared the classic laryngeal mask airway and i-gel as adjuncts to fibrescope guided intubation in a manikin. Two methods of intubation were compared with each device: the tracheal tube directly over the fibrescope; and the tracheal tube over an Aintree Intubation Catheter. Thirty-two anaesthetists took part in this randomised crossover study. Each anaesthetist performed two intubations with each method via each device. The mean (SD) time for the first intubation using the tracheal tube over the fibrescope was 43 (24) s with the classic laryngeal mask airway and 22 (9) s with the i-gel (95% CI for the difference 12[nda...
Source: Anaesthesia - November 6, 2009 Category: Anesthesiology Authors: L. de Lloyd, I. Hodzovic, S. Voisey, A. R. Wilkes, I. P. Latto Source Type: journals

Bispectral index during cardiopulmonary resuscitation: a poor indicator of recovery. Two very different casesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report two cases of massive intra-operative bleeding during lung transplantation requiring emergency cardiopulmonary bypass. In both cases the bispectral index dropped to 0, remained low for around 30 and 90 min respectively, and then returned to values consistent with a usual anaesthetic state (around 40). At the time bispectral monitoring provided some reassurance to the medical team about the adequacy of the resuscitation. However, this proved misleading since postoperative neurological recovery was favourable in one case but not in the other. (Source: Anaesthesia)
Source: Anaesthesia - November 5, 2009 Category: Anesthesiology Authors: V. Dumans-Nizard, S. Hamada, M. Fischler Source Type: journals

The effect of pre-emptive use of minimal dose fentanyl on fentanyl-induced coughingEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We performed a randomised, double-blind study to evaluate the effect of the pre-emptive use of minimal dose intravenous fentanyl (25 [mu]g) on the incidence of cough caused by a larger bolus of intravenous fentanyl. Six hundred patients were randomly assigned to one of three groups to receive either 0.5 ml saline 0.9% 1 min before administration of fentanyl 150 [mu]g (3 ml), or pre-emptive fentanyl 25 [mu]g (0.5 ml) 1 min before administration of fentanyl 125 [mu]g or 150 [mu]g. The incidence of fentanyl-induced cough was significantly lower in both pre-emptive groups (7 (3.5%) for 125 [mu]g fentanyl and 15 (7.5%) for 150 ...
Source: Anaesthesia - November 4, 2009 Category: Anesthesiology Authors: K.-C. Hung, C.-W. Chen, V. C.-H. Lin, H.-C. Weng, S.-W. Hsieh Source Type: journals

The impact of computerised physician order entry on prescribing practices in a cardiothoracic intensive care unit*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This prospective, time series, cross-sectional study was designed to compare the quality of handwritten vs computerised prescriptions in a tertiary 25-bedded cardiothoracic intensive care unit. A total of 14 721 prescriptions for 613 patients were analysed over three periods of investigation: 7 months before; and 5 and 12 months after implementation of a clinical information system with computerised physician order entry capability. Errors in prescribing were common. Only (53%) of handwritten charts analysed had all immediate administration drugs prescribed correctly. Errors included omission of route 81 (8.0%), date of pr...
Source: Anaesthesia - November 4, 2009 Category: Anesthesiology Authors: J. Ali, L. Barrow, A. Vuylsteke Source Type: journals

Monitoring of haemostasis in liver transplantation: comparison of laboratory based and point of care testsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
During orthotopic liver transplanatation haemostasis is often disturbed and coagulation monitoring is mandatory. We compared the results obtained by whole blood prothrombin time and activated partial thromboplastin time assays (Hemochron®) and thrombelastometry (ROTEM® 05) with laboratory coagulation assays (prothrombin time, activated partial prothrombin time, fibrinogen, and platelet count) in samples obtained during orthotopic liver transplantations. Determination of prothrombin time and activated partial prothrombin time using the Hemochron device showed good correlation with laboratory coagulation assays (r = 0.912,...
Source: Anaesthesia - November 4, 2009 Category: Anesthesiology Authors: F. Herbstreit, E. M. Winter, J. Peters, M. Hartmann Source Type: journals

HLA-DR expression and differential trafficking of monocyte subsets following low to intermediate risk surgery*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Reduced HLA-DR expression on monocytes has been suggested as a predictive marker of immunosuppression following very high risk surgery, but there are few reports in lower risk surgery. In 32 patients undergoing low to intermediate risk surgery, blood samples were analysed by flow cytometry for HLA-DR expression and numbers in both CD14high and CD14lowCD16+ monocyte subsets. The numbers of CD14high monocytes increased at 24 h (mean (SD), 5.0 (2.2) vs 7.6 (3.9) × 105 cells.ml[minus]1; p < 0.01) while CD14lowCD16+ monocytes decreased (0.68 (0.36) vs 0.44 (0.36) × 105 cells.ml[minus]1; p < 0.01). HLA-DR expression was signif...
Source: Anaesthesia - November 4, 2009 Category: Anesthesiology Authors: J. M. Handy, A. J. Scott, A. M. Cross, P. Sinha, K. P. O'Dea, M. Takata Source Type: journals

An assessment of the validity of SOFA score based triage in H1N1 critically ill patients during an influenza pandemicEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Sequential Organ Failure Assessment (SOFA) score based triage of influenza A H1N1 critically ill patients has been proposed for surge capacity management as a guide for clinical decision making. We conducted a retrospective records review and SOFA scoring of critically ill patients with influenza A H1N1 in a mixed medical-surgical intensive care unit in an urban hospital. Eight critically ill patients with influenza A H1N1 were admitted to the intensive care unit. Their mean (range) age was 39 (26[ndash]52) years with a length of stay of 11 (3[ndash]17) days. All patients met SOFA score based triage admission criteria with...
Source: Anaesthesia - October 23, 2009 Category: Anesthesiology Authors: Z. Khan, J. Hulme, N. Sherwood Source Type: journals

Risk of pulmonary aspiration with laryngeal mask airway and tracheal tube: analysis on 65 712 procedures with positive pressure ventilationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We compared the risk of pulmonary aspiration in patients whose lungs were mechanically ventilated through a laryngeal mask airway (35 630 procedures) or tracheal tube (30 082 procedures). Three cases of pulmonary aspiration occurred with the laryngeal mask airway and seven with the tracheal tube. There were no deaths related to pulmonary aspiration. The incidence and outcome of pulmonary aspiration detected in this study were similar to those previously reported. The adjusted odds ratio (OR) for pulmonary aspiration with the laryngeal mask airway was 1.06 (95% CI 0.20[ndash]5.62). Unplanned surgery (OR 30.5, 95% CI 8.6[nda...
Source: Anaesthesia - October 22, 2009 Category: Anesthesiology Authors: A. Bernardini, G. Natalini Source Type: journals

Use of remifentanil as a sedative agent in critically ill adult patients: a meta-analysisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This meta-analysis examined the benefits of using remifentanil as a sedative agent in critically ill patients. A total of 11 randomised controlled trials, comparing remifentanil with another opioid or hypnotic agent in 1067 critically ill adult patients, were identified from the Cochrane controlled trials register and EMBASE and MEDLINE databases, and subjected to meta-analysis. Remifentanil was associated with a reduction in the time to tracheal extubation after cessation of sedation (weighted-mean-difference [minus]2.04 h (95% CI [minus]0.39 to [minus]3.69 h); p = 0.02). Remifentanil was, however, not associated with a s...
Source: Anaesthesia - October 22, 2009 Category: Anesthesiology Authors: J. A. Tan, K. M. Ho Source Type: journals

Profound hypocalcaemia in a patient being anticoagulated with citrate for continuous renal replacement therapyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report a case of severe systemic hypocalcaemia during continuous renal replacement therapy with citrate anticoagulation resulting from relentless sequestration of calcium due to undiagnosed evolving rhabdomyolysis. Although excessive systemic citrate accumulation can also cause hypocalcaemia, this complication was not observed in our patient. While an acceptable lower limit of ionised calcium remains unknown, severe rhabdomyolysis needs to be considered when a patient's ionised calcium levels are not responsive to standard calcium replacement therapy during continuous renal replacement therapy using citrate anticoagulat...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: D. J. R. Morgan, K. M. Ho Source Type: journals

Dental implant removal to facilitate suspension laryngoscopy and laser treatment of an obstructed airwayEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A 29-year-old patient presented with dysphonia, dysphagia and a progressive history of stridor over 6 weeks. His past medical history included childhood nasolabial rhabdomyosarcoma treated by surgery, chemotherapy and radiotherapy. This had resulted in marked abnormalities of the facial skeleton, limited neck extension and restricted mouth opening of 1 cm, in part due to dental implants. After careful discussion and planning within a multidisciplinary team, the airway was optimised by temporary removal of the dental implants. This enabled a suspension laryngoscope to be passed, permitting carbon dioxide laser treatment to ...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: H. Hume-Smith, A. Fowler, F. Vaz, P. Suaris Source Type: journals

Litigation related to drug errors in anaesthesia: an analysis of claims against the NHS in England 1995–2007Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Ninety-three claims (total cost £4 915 450) filed under 'anaesthesia' in the NHS Litigation Authority database between 1995 and 2007, alleging patient harm directly by drug administration error or by an allergic reaction, were analysed. Alleged errors were categorised using systems employed by the National Coordinating Council for Medication Error Reporting and Prevention, the American Society of Anesthesiologists Closed Claims Project and the UK Health and Safety Executive. The severity of outcome in each claim was categorised using adapted National Patient Safety Agency definitions. Sixty-two claims involved alleged dru...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: J. Cranshaw, K. J. Gupta, T. M. Cook Source Type: journals

The Parker Flex-Tip™ tube for nasotracheal intubation: the influence on nasal mucosal traumaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We tested our hypothesis that use of the Parker Flex-Tip[trade] tracheal tube could reduce the incidence of nasal mucosal trauma during nasotracheal intubation when compared with a conventional tip tracheal tube. One hundred and two patients, who were scheduled for elective oral surgery in which nasotracheal intubation was indicated to optimise the surgical approach, were recruited into this study. Either a Flex-Tip tracheal tube or a conventional tip tracheal tube was chosen randomly for each nasotracheal intubation. The incidence of epistaxis using the Flex-Tip tracheal tube (6 (11.8%)) was significantly lower than that ...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: T. Sanuki, M. Hirokane, Y. Matsuda, S. Sugioka, J. Kotani Source Type: journals

The Scottish Audit of Surgical Mortality: a review of areas of concern related to anaesthesia over 10 yearsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The Scottish Audit of Surgical Mortality is a voluntary, peer reviewed, critical event analysis of patients who die under the care of consultant surgeons in acute hospitals in Scotland. The anaesthetic contribution to surgical mortality over a 10-year period from 1996 was reviewed. The total number of deaths was 44 230 or 1.5% of all admissions. Forty thousand, eight hundred and ninety-six deaths (92%) were audited. Deaths after elective surgery declined over 10 years. Over 80% of deaths followed emergency admission. The number of deaths where an anaesthetist was present was 16 981 or 0.6% of all admissions. Anaesthetic ar...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: H. J. McFarlane, N. van der Horst, L. Kerr, G. McPhillips, H. Burton Source Type: journals

Peri-operative management of a patient with hereditary angioedema undergoing laparoscopic cholecystectomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We describe the peri-operative care of a woman with hereditary angioedema undergoing laparoscopic cholecystectomy with emphasis on the role of anaesthetists as peri-operative physicians. (Source: Anaesthesia)
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: A. Spyridonidou, C. Iatrou, A. Alexoudis, T. Vogiatzaki, A. Polychronidis, C. Simopoulos Source Type: journals

Lipid resuscitation in a carnitine deficient child following intravascular migration of an epidural catheter*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
A child with cerebral palsy and carnitine deficiency developed ventricular arrhythmias with loss of cardiac output during elective surgery under general anaesthesia with concomitant epidural analgesia. Sinus rhythm was restored on administration of adrenaline, but hypotension persisted despite resuscitation. Bolus administration of 0.8 ml.kg[minus]1 (20 ml) lipid emulsion resulted in rapid improvement in cardiac output. Blood samples taken before and after the lipid bolus did not demonstrate toxic concentrations of bupivacaine. This case suggests that carnitine deficiency may increase susceptibility to bupivacaine cardioto...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: G. K. Wong, D. T. Joo, C. McDonnell Source Type: journals

Tracheal intubation in patients with rigid collar immobilisation of the cervical spine: a comparison of Airtraq® and LMA CTrach™ devices*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
The aim of this study was to evaluate the effectiveness of the Airtraq® and CTrach[trade] in lean patients with simulated cervical spine injury after application of a rigid cervical collar. Eighty-six consenting adult patients of ASA physical status 1 or 2, who required elective tracheal intubation were included in this study in a randomised manner. Anaesthesia was induced using 1 [mu]g.kg[minus]1 fentanyl, 3 mg.kg[minus]1 propofol and 0.6 mg.kg[minus]1 rocuronium, following which a rigid cervical collar was applied. Comparison was then made between tracheal intubation techniques using either the AirTraq or CTrach device....
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: Z. I. Arslan, T. Yildiz, Z. N. Baykara, M. Solak, K. Toker Source Type: journals

Anosmia after general anaesthesia: a case reportEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We present the case of a 60-year-old female patient with a 3-month history of altered smell and taste immediately after recovery from general anaesthesia for a urological operation. The anaesthetic drugs used were fentanyl, propofol and sevoflurane. Clinical examination and a computed tomography brain scan did not reveal any pathology. Psychophysical testing showed anosmia and normal taste function. Imaging studies using single photon emission computed tomography of the brain were performed twice: as a baseline examination; and after odour stimulation with phenyl ethyl alcohol. Normal brain activity without reaction to odo...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: I. Konstantinidis, E. Tsakiropoulou, I. Iakovou, A. Douvantzi, S. Metaxas Source Type: journals

A comparison of the laryngeal mask airway with the facemask and oropharyngeal airway for manual ventilation by first responders in childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In adults, first responders to a cardiopulmonary arrest provide better ventilation using a laryngeal mask airway than a facemask. It is unclear if the same is true in children. We investigated this by comparing the ability of 36 paediatric ward nurses to ventilate the lungs of 99 anaesthetised children (a model for cardiopulmonary arrest) using a laryngeal mask airway and using a facemask with an oropharyngeal airway. Anteroposterior chest wall displacement was measured using an ultrasonic detector. Nurses achieved successful ventilation in 74 (75%) of cases with the laryngeal mask airway and 76 (77%) with facemask and oro...
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: A. E. Blevin, S. F. McDouall, J. A. Rechner, T. A. Saunders, V. S. Barber, J. D. Young, D. G. Mason Source Type: journals

Unrecognised dural puncture resulting in subdural hygroma and cortical vein thrombosisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Unrecognised dural punctures are difficult to diagnose early. Failure of recognition may lead to sinister consequences. A case of unrecognised dural puncture in a young female leading to the development of subdural hygroma and cortical vein thrombosis is presented. The dilemma in the diagnosis of headache in such patients along with the significance of follow-up of all, including attempted, epidurals is also discussed. (Source: Anaesthesia)
Source: Anaesthesia - October 21, 2009 Category: Anesthesiology Authors: A. Sinha, S. Petkov, D. Meldrum Source Type: journals

Naloxone-responsive acute dystonia and parkinsonism following general anaesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We report an acute, severe and generalised dystonic reaction in an otherwise healthy woman at emergence from general anaesthesia, dramatically reversed by the administration of naloxone, pointing to a potential role of the fentanyl and morphine that the patient had received. Recent literature on the mechanisms of abnormal movements induced by opioids are discussed. The severity of the reaction with usual doses of opioids, in a patient with no prior history of parkinsonism, led to further investigation that demonstrated the possibility of an enhanced susceptibility to opioids, involving a genetically determined abnormal fun...
Source: Anaesthesia - October 15, 2009 Category: Anesthesiology Authors: I. A. Iselin-Chaves, H. Grötzsch, M. Besson, P. R. Burkhard, G. L. Savoldelli Source Type: journals

The effect of intrathecal fentanyl on Cerebral State Index-guided sedation during spinal anaesthesia*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In conclusion, adding intrathecal fentanyl 25 [mu]g during spinal anaesthesia significantly reduced the dose of propofol required for sedation and prolonged the subsequent recovery time. (Source: Anaesthesia)
Source: Anaesthesia - October 13, 2009 Category: Anesthesiology Authors: J. Y. Kim, K. B. Kim, C. S. Shin, S. H. Ha, M. K. Kim, J. S. Lee Source Type: journals

A bench study of ventilation via two self-assembled jet devices and the Oxygen Flow Modulator in simulated upper airway obstructionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In managing an obstructed upper airway, an emergency transtracheal ventilation device needs to function as a bidirectional airway, allowing both insufflation of oxygen and egress of gas. The aim of the present study was to determine the capability of two self-assembled, three-way stopcock based jet devices and the Oxygen Flow Modulator to function as a bidirectional airway in conjunction with a small lumen catheter. For each device the effective pressures at the catheter's tip during the expiratory phase and the achievable minute volumes were determined in a laboratory set-up. Using the three-way stopcock based jet devices...
Source: Anaesthesia - October 12, 2009 Category: Anesthesiology Authors: A. E. W. Hamaekers, P. A. J. Borg, D. Enk Source Type: journals

A comparison of a flexometallic tracheal tube with the intubating laryngeal mask tracheal tube for nasotracheal fibreoptic intubation using the two-scope technique*Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We compared the incidence and site of impingement of a flexometallic tracheal tube with those of the re-usable intubating laryngeal mask (ILMA) tube in 60 anaesthetised patients undergoing nasotracheal fibreoptic intubation for oral surgery. A two-scope technique was used, observing the site of impingement with one scope whilst intubating with the other. The tubes were 6.0-mm in females and 6.5-mm in males. Impingement occurred with 10 (33%) flexometallic and 2 (7%) ILMA tubes (p < 0.032). In all but one case, the impingement was posterior to the right arytenoid cartilage. When impingement was observed, a single disempacti...
Source: Anaesthesia - October 9, 2009 Category: Anesthesiology Authors: M. R. Rai, S. H. Scott, A. G. Marfin, M. T. Popat, J. J. Pandit Source Type: journals

An audit of intensive care unit recyclable wasteEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
There is little known about recyclable intensive care unit waste. We tested the hypotheses that the intensive care unit produces a small proportion (< 10%) of hospital waste, that much waste (> 30%) is recyclable and that there is little (< 10%) cross-contamination of non-infectious with infectious waste. For seven consecutive days in an Australian 10-bedded intensive care unit, we prospectively sorted all waste. The total intensive care unit waste for the week was 540 kg, representing 5% of hospital waste. Of the 401 kg of intensive care unit general waste, recyclables were 230 kg (57%; 95% CI 53[ndash]61%), mainly plasti...
Source: Anaesthesia - October 4, 2009 Category: Anesthesiology Authors: F. McGain, D. Story, S. Hendel Source Type: journals

High frequency jet ventilation through a supraglottic airway device: a case series of patients undergoing extra-corporeal shock wave lithotripsyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In this study, a simple method using supraglottic jet ventilation through a laryngeal mask attached to a circle absorber anaesthetic breathing system is described. The technique avoids the need for dense neuromuscular blockade for laryngoscopy and the potential complications associated with sub-glottic instrumentation and sub-glottic jet ventilation. The technique was successfully employed in a series of patients undergoing lithotripsy under general anaesthesia as an outpatient procedure. (Source: Anaesthesia)
Source: Anaesthesia - August 27, 2009 Category: Anesthesiology Authors: D. J. Canty, S. S. Dhara Source Type: journals

AnnouncementsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Tags: Announcements Source Type: journals

ErratumEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Tags: Erratum Source Type: journals

Book reviewOperations without Pain: The Practice and Science of Anaesthesia in Victorian BritainEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: Oana Cole Tags: Book reviews Source Type: journals

Book reviewUltrasound Guidance for Nerve Blocks: Principles and Practical ImplementationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: Victoria Cooper Tags: Book reviews Source Type: journals

Respiratory InfectionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: T. Bewick Tags: Book reviews Source Type: journals

Core Topics in Mechanical VentilationEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: Chris Harber Tags: Book reviews Source Type: journals

A commentary on the effect of lipid emulsions on pathology testsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: J. Picard, W. Harrop-Griffiths Tags: Special Correspondence Source Type: journals

Gift of the glob – is it foolproof?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: P. Watt, D. Malik, L. Dyson Tags: Special Correspondence Source Type: journals

Hands free spray-as-you-goEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: E. A. Hall, N. Haslam, P. Evans Tags: Correspondence Source Type: journals

Unrecognised benefit of oesophageal doppler monitoringEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: R. Kennedy, T. Smith Tags: Correspondence Source Type: journals

A replyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: S. O'Neill Tags: Correspondence Source Type: journals

Unwanted accessories with laryngeal mask airwaysEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: A. Kitsberg, A. Manocha Tags: Correspondence Source Type: journals

Accuracy of hospital clocksEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: J. Watts, K. M. Ni, A. Rose Tags: Correspondence Source Type: journals

Occult spinal dysraphism: detection during ultrasound for epidural blockade in childrenEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Anaesthesia)
Source: Anaesthesia - August 2, 2009 Category: Anesthesiology Authors: J. E. Kim, J. Y. Hong, S. W. Han, H. J. Kil Tags: Correspondence Source Type: journals