Anaesthesia and intensive care
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Anaesth Intensive Care · Nov 2020
Postoperative use of slow-release opioids: The impact of the Australian and New Zealand College of Anaesthetists/Faculty of Pain Medicine position statement on clinical practice.
Dose titration with immediate-release opioids is currently recommended for acute pain. The Australian and New Zealand College of Anaesthetists and the Faculty of Pain Medicine released a statement in March 2018 supporting their use in the treatment of opioid-naïve patients; however, the impact of this statement on clinical practice is currently unknown. This retrospective cohort study was conducted to compare opioid prescribing patterns before and after the release of the recommendations. ⋯ After adjusting for confounders, the odds of slow-release opioids being prescribed postoperatively and at discharge reduced by 86% and 88%, respectively (postoperative period: odds ratio 0.14, P < 0.05; discharge: odds ratio 0.12, P < 0.05). In addition, orthopaedic patients were more likely to receive slow-release opioids, consistent with existing literature. As the use of slow-release opioids has been associated with increased harm and protracted opioid use compared to immediate-release opioids, it is hoped that wider dissemination of these recommendations and a change in prescribing practice can be a step towards overcoming the opioid crisis.
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Anaesth Intensive Care · Nov 2020
Dr Himson Tamur Mulas, the first national specialist anaesthetist in Papua New Guinea.
Dr Himson Tamur Mulas was born on the Gazelle Peninsula of East New Britain, New Guinea, on 13 March 1934. After finishing his schooling, he was selected to go to Fiji to undertake a medical course at Fiji Central Medical School in 1953, returning to New Guinea in 1958. He successfully completed residency posts and after a period of training in anaesthesia in Port Moresby, was sent to the Alfred Hospital in Melbourne, Australia, in 1966-1967 to further his anaesthetic career. ⋯ He left public hospital anaesthetic practice in 1980. He is recognised as the first New Guinean to be a specialist anaesthetist. He died on 28 July 2000 aged 66 years.
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Anaesth Intensive Care · Nov 2020
Historical ArticleThe French Academy of Sciences: Deliberations related to the discovery of anaesthesia.
In the mid-19th century, the French Academy of Sciences was one of the oldest and most prominent scientific institutions in the world. Individuals seeking credit for the discovery of surgical anaesthesia contacted the French academy to achieve recognition from this prestigious body of scientists and to spread news of the discovery throughout continental Europe. The French Academy of Sciences was established under the reign of King Louis XIV in 1666 with the goal of supporting and advancing scientific research. ⋯ Since anaesthesia had already been tested in the United States and Great Britain, the main contributions of the French academy deliberations included refining administration techniques and documenting the effects of anaesthesia on animals and humans. Recognition of surgical anaesthesia by the French Academy of Sciences and the swift adoption of its use in surgical practice throughout the country lent credibility to this new discovery and enabled the discipline of surgery to progress. Nevertheless, the academy was not able to solve the initial problem for which they may have been contacted-the dispute about which individual deserved credit for the discovery of anaesthesia.
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Anaesth Intensive Care · Nov 2020
Historical ArticleDavid John Thomas and the first operation under etherisation in Melbourne.
The first patient etherised by David John Thomas was James Egan, an Irish bounty immigrant who lived on a pastoral lease about 120 km from Melbourne. Egan had injured his left hand and forearm in a shooting accident. ⋯ In September 1847, Thomas presented a paper on etherisation at a monthly meeting of the Port Phillip Medical Association-this is the earliest known presentation of a paper on etherisation in the Australian colonies. The original manuscript of Dr Thomas is now held by the Medical History Museum at the University of Melbourne.