Anaesthesia and intensive care
-
Anaesth Intensive Care · Mar 2018
On Dr Dick Climie and Dr Jack Thomas, and the genesis of chemical-clinical pharmacology in Australian anaesthesia research.
Pharmacokinetic and pharmacodynamic research is regularly reported in most contemporary anaesthesia-oriented journals. This sub-specialty area of pharmacology grew rapidly from the 1960s as various essential concepts and tools-laboratory analysis of drug/metabolite concentrations in biofluids, physiological signal collection, and methods for analysing/presenting relevant pharmacokinetic and pharmacodynamic data-started coming together. For Australia, such research began in Sydney in the mid-1960s with collaboration between anaesthetist Dr C. ⋯ Between the mid-1970s and early-1980s, with additional anaesthetists, postgraduate research students and their academic supervisors participating, the projects focussed mainly on the pharmacokinetics and pharmacodynamics of neuromuscular blocking agents. This form of chemical-clinical-pharmacologically-based anaesthesia-oriented research that started in Sydney with the collaboration of Drs Climie and Thomas led to many challenging higher degree projects for pharmaceutical scientists, and access to unprecedented research capabilities for anaesthetists. Most significantly, it established a permanent place for multidisciplinary pharmacokinetic- and pharmacodynamic-based research within Australian academic departments of anaesthesia.
-
Anaesth Intensive Care · Mar 2018
Biography Historical ArticleJohn Snow's "On the Inhalation of the Vapour of Ether in Surgical Operations".
-
Anaesth Intensive Care · Mar 2018
Case ReportsPostoperative euglycaemic diabetic ketoacidosis associated with sodium-glucose cotransporter-2 inhibitors (gliflozins): a report of two cases and review of the literature.
Sodium-glucose cotransporter 2 inhibitor (SGLT2i)-associated euglycaemic diabetic ketoacidosis (euDKA) is a serious and increasingly recognised complication of treatment with this class of oral hypoglycaemic agents and can present a diagnostic challenge, resulting in delayed recognition, inappropriate treatment and potentially life-threatening acidosis. We present two cases of patients developing SGLT2i-associated euDKA in the early postoperative period. We support ceasing SGLT2i for 72 hours preoperatively and would suggest continuing to withhold the medication until oral intake is restored, and recommend a wider awareness of SGLT2i-associated diabetic ketoacidosis (DKA) amongst patients and their healthcare providers with an emphasis on checking ketone levels irrespective of blood glucose levels in the postoperative setting.