Anaesthesia and intensive care
-
Anaesth Intensive Care · Jan 2015
Anaesthesia priorities for Australian and New Zealand medical school curricula: a Delphi consensus of academic anaesthetists.
The role of anaesthetists has expanded and evolved to include critical care, perioperative and pain medicine and general clinical skills, as well as operating theatre-based clinical anaesthesia. Across Australia and New Zealand, these topics are taught to varying degrees, however no uniform curriculum or standardisation exists between universities. ⋯ A range of appropriate content has been defined, as well as details relating to duration, timing, teaching environment, faculty, feedback and assessment methods. Future enquiry to assess the efficacy of future and current teaching practices is needed to facilitate continued improvement.
-
Anaesth Intensive Care · Jan 2015
Randomized Controlled TrialEffect of different phenylephrine bolus doses for treatment of hypotension during spinal anaesthesia in patients undergoing elective caesarean section.
The efficacy of phenylephrine might be improved by giving doses higher than that traditionally used (100 µg). This study compared the effects of three initial bolus doses of intravenous phenylephrine; 100 µg (group P100), 125 µg (group P125) and 150 µg (group P150), for the treatment of post-spinal hypotension in patients undergoing elective caesarean delivery. If hypotension was not corrected by this dose, additional boluses of 25 µg were given every minute. ⋯ Although systolic blood pressure was higher at certain time-points after 150 µg phenylephrine, there were no statistically significant differences in the effectiveness of the first bolus of phenylephrine to treat hypotension (85%, 95% and 95% in groups P100, P125 and P150, respectively, P=0.215); the additional dose of phenylephrine after the first bolus (P=0.810); the number of additional boluses (P=0.318) or of hypotensive episodes (P=0.118). There were no significant differences in the number of patients developing reactive hypertension or bradycardia, in maternal side-effects or in neonatal outcomes. Although the study may have been underpowered, initial phenylephrine bolus doses of 100 µg, 125 µg and 150 µg did not significantly differ in efficacy to treat post-spinal hypotension in these patients.