British journal of anaesthesia
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Review Meta Analysis
Opioid-induced hyperalgesia in patients after surgery: a systematic review and a meta-analysis.
Intra-operative use of remifentanil may have a dose-response effect on inducing hyperalgesia and consequentially increasing post-operative pain.
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Randomized Controlled Trial
Volatile anaesthetics and positive pressure ventilation reduce left atrial performance: a transthoracic echocardiographic study in young healthy adults.
Animal and in vitro studies suggest that volatile anaesthetics affect left atrial (LA) performance. We hypothesized that human LA pump function and dimensions are altered by volatile anaesthetics in vivo. ⋯ NCT0024451.
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Randomized Controlled Trial
Transcutaneous electric acupoint stimulation reduces intra-operative remifentanil consumption and alleviates postoperative side-effects in patients undergoing sinusotomy: a prospective, randomized, placebo-controlled trial.
Although opioids are widely used as analgesics in general anaesthesia, they have unpleasant side-effects and can delay postoperative recovery. Acupuncture and related techniques are effective for acute and chronic pain, and reduces some side-effects. We assessed the effect of transcutaneous electric acupoint stimulation (TEAS) on intra-operative remifentanil consumption and the incidences of anaesthesia-related side-effects. ⋯ The trial was registered at clinicaltrials.gov (NCT01700855).
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Several different crystalloid solutions are available for i.v. fluid administration but there is little information about their specific advantages and disadvantages. ⋯ Different solutions have different effects on acid-base status, electrolyte levels, coagulation, renal, and hepatic function. Whether these differences have clinical consequences remains unclear.
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Randomized Controlled Trial
Improving team information sharing with a structured call-out in anaesthetic emergencies: a randomized controlled trial.
Sharing information with the team is critical in developing a shared mental model in an emergency, and fundamental to effective teamwork. We developed a structured call-out tool, encapsulated in the acronym 'SNAPPI': Stop; Notify; Assessment; Plan; Priorities; Invite ideas. We explored whether a video-based intervention could improve structured call-outs during simulated crises and if this would improve information sharing and medical management. ⋯ We developed a structured communication tool, SNAPPI, to improve information sharing between anaesthetists and their team, taught it using a video-based intervention, and provide initial evidence to support its value for improving communication in a crisis.