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BMJ summary of NPSA safety report on avoiding midazolam overdoseEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: BMJ Area: News This is the first in a series of BMJ summaries of recommendations to improve patients' safety, based on reports of safety concerns, incident analysis, and other evidence. The articles will highlight the risks of incidents that have the potential for serious harm and are not well known, and for which clear preventive actions are available. This summary is based on the safety report (rapid response report or RRR) from the NPSA in December 2008 on how to prevent overdose of midazolam. The RRR highlights evidence of harm and recommends key actions for staff. An accompanying article describes the process...
Source: NeLM - Anaesthesia - November 20, 2009 Category: Anesthesiology Source Type: organizations

Lidocaine Hydrochloride Injection BP 1% w/v/, 2% w/v - Revised SPCEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Revised SPC includes changes to: Section 4.2 (Posology and method of administration) Addition of children's age - "Single doses of Lidocaine (for anaesthesia other than spinal) should not exceed 4.5 mg/kg (or 200 mg) in adults or children 12 - 18 years of age." A further addition of: "Lidocaine by local infiltration for children under the age of 12 years should not exceed 3mg/kg, repeated not more often than every 4 hours." Section 4.3 (Contraindications) In ventricular arrhythmia: Sino-atrial disorders, all g...
Source: NeLM - Anaesthesia - November 19, 2009 Category: Anesthesiology Source Type: organizations

Launch of new sections for anaesthetics and critical care practitioners on MHRA websiteEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: MHRA Area: News The latest targeted healthcare professional group pages to be launched on the MHRA website are for anaesthetics care practitioners and for critical care practitioners. These pages aim to provide healthcare professionals with targeted information relevant to different specialities, and include guidance, safety alerts and links to educational material related to the safe use and management of medicines and medical devices. (Source: NeLM - Anaesthesia)
Source: NeLM - Anaesthesia - September 27, 2009 Category: Anesthesiology Source Type: organizations

Xylocaine (lidocaine) 1% and 2% with Adrenaline - Revised SPCEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.3 (contraindications) has been updated and now reads as follows: Hypersensitivity to local anaesthetics of the amide type, or to any of the excipients. Hypersensitivity to methyl and/or propyl parahydroxybenzoate (methyl-/propyl paraben), or to their metabolite para amino benzoic acid (PABA). Formulations of lidocaine containing parabens should be avoided in patients allergic to ester local anaesthetics or their metabolite PABA. The use of a vasoconstrictor is contra-indicated for anaesthesia of fingers, toes, tip of no...
Source: NeLM - Anaesthesia - September 19, 2009 Category: Anesthesiology Source Type: organizations

Neostigmine Methylsulphate Injection BP 2.5mg in 1ml (Hameln) - Revised SPCEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.3 (contraindications) has been updated. The use of neostigmine with depolarising muscle relaxants is contraindicated. The following statement has been added to section 4.4 (special warnings and precautions for use): Administration of anticholinesterase agents to patients with intestinal anastomoses may produce rupture of the anastomosis or leakage of intestinal contents. (Source: NeLM - Anaesthesia)
Source: NeLM - Anaesthesia - September 19, 2009 Category: Anesthesiology Source Type: organizations

Greater incidence of emergence agitation in children after sevoflurane anesthesia as compared with halothane: a meta-analysis of randomized controlled trialsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: DARE Area: Evidence > Drug Class Focused Reviews CRD Summary: This review assessed the incidence of emergence agitation in children anaesthetised with either sevoflurane or halothane. The authors concluded that sevoflurane exhibited a significantly greater incidence of emergence agitation. The authors' conclusions from this well-conducted review reflected the evidence presented and were likely to be reliable. CRD Commentary: The review addressed a clear question and consulted a wide range of sources for studies with clear inclusion criteria. The literature search was restricted to publications in English and the...
Source: NeLM - Anaesthesia - September 16, 2009 Category: Anesthesiology Source Type: organizations

Updated national IV monograph on propofol (Propofol-Lipuro 2%®)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: Medusa Area: News An updated IV monograph on propofol (Propofol-Lipuro 2%®) is now available from the NHS injectable medicines guide website (Medusa) at the link below (registration required for access). (Source: NeLM - Anaesthesia)
Source: NeLM - Anaesthesia - September 1, 2009 Category: Anesthesiology Source Type: organizations

New national IV monograph on propofol (Propofol-Lipuro 1%®)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: Medusa Area: News A new IV monograph on propofol (Propofol-Lipuro 1%®) is now available from the NHS injectable medicines guide website (Medusa) at the link below (registration required for access). (Source: NeLM - Anaesthesia)
Source: NeLM - Anaesthesia - September 1, 2009 Category: Anesthesiology Source Type: organizations

Local versus. general anaesthesia for carotid endarterectomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: Cochrane Library Area: Evidence > Disease Focused Reviews Background Carotid endarterectomy reduces the risk of stroke in people with recently symptomatic, severe carotid artery stenosis. However, there are significant perioperative risks which may be lessened by performing the operation under local rather than general anaesthetic. This is an update of a Cochrane Review first published in 1996, and previously updated in 2008. Objectives To assess the risks of endarterectomy under local compared with general anaesthetic. Search strategy We searched the Cochrane Stroke Group Trials Register (last searched ...
Source: NeLM - Anaesthesia - August 4, 2009 Category: Anesthesiology Source Type: organizations

Xylocaine (lidocaine / adrenaline) 1% and 2% with Adrenaline - Revised SPCEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes ??Section 4.3 (contraindications) now contains extra information regarding hypersensitivity to local anaesthetics of the amide type or to any of the excipients. Section 4.5 (interactions) also now includes information on drugs that reduce the clearance of lidocaine. (Source: NeLM - Anaesthesia)
Source: NeLM - Anaesthesia - July 22, 2009 Category: Anesthesiology Source Type: organizations

Etomidate or ketamine for emergency intubation?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
This study intended to compare outcomes between single doses of etomidate and ketamine in critically ill patients who required sedation for intubation. Participants ... (Source: NeLM - Anaesthesia)
Source: NeLM - Anaesthesia - June 30, 2009 Category: Anesthesiology Source Type: organizations

Hyoscine Injection BP 400mcg/ml - Revised SPCEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes ?Section 4.8 (undesirable effects) has been updated with the following side effects: dypsnoea, angiooedema, anaphalaxis and anaphalactic shock. (Source: NeLM - Anaesthesia)
Source: NeLM - Anaesthesia - June 20, 2009 Category: Anesthesiology Source Type: organizations

Ketalar (ketamine) Injection - Revised SPCEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Source: eMC (electronic Medicines Compendium) Area: Other Library Updates > SPC Changes Section 4.3 (contra-indications) has been updated and now reads: Ketalar is contra-indicated in persons in whom an elevation of blood pressure would constitute a serious hazard (see section 4.8 Undesirable effects). Ketamine hydrochloride is contraindicated in patients who have shown hypersensitivity to the drug or its components. Ketalar should not be used in patients with eclampsia or pre-eclampsia, severe coronary or myocardial disease, cerebrovascular accident or cerebral trauma. Section 4.4 (special warnings a...
Source: NeLM - Anaesthesia - June 20, 2009 Category: Anesthesiology Source Type: organizations