British journal of anaesthesia
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The year 2024 marks 70 years since graduation of the first candidates in revised examinations for Fellowship of the Faculty of Anaesthetists of the Royal College of Surgeons (FFARCS). Here we review the progress of specialisation and professionalisation of anaesthesia in the UK.
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Randomized Controlled Trial Multicenter Study
Cardiac index-guided therapy to maintain optimised postinduction cardiac index in high-risk patients having major open abdominal surgery: the multicentre randomised iPEGASUS trial.
It is unclear whether optimising intraoperative cardiac index can reduce postoperative complications. We tested the hypothesis that maintaining optimised postinduction cardiac index during and for the first 8 h after surgery reduces the incidence of a composite outcome of complications within 28 days after surgery compared with routine care in high-risk patients having elective major open abdominal surgery. ⋯ NCT03021525.
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Review
The educational impact of technology-enhanced learning in regional anaesthesia: a scoping review.
Effective training in regional anaesthesia (RA) is paramount to ensuring widespread competence. Technology-based learning has assisted other specialties in achieving more rapid procedural skill acquisition. If applicable to RA, technology-enhanced training has the potential to provide an effective learning experience and to overcome barriers to RA training. We review the current evidence base for use of innovative technologies in assisting learning of RA. ⋯ Technology-enhanced RA training can provide a positive and effective learning experience, with potential to reduce the steep learning curve associated with gaining RA proficiency. A combined approach to RA education, using both technological and traditional approaches, should be maintained as no single method has been shown to provide comprehensive RA training.
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Preclinical studies suggest that early exposure to anaesthesia alters the visual system in mice and non-human primates. We investigated whether exposure to general anaesthesia leads to visual attention processing changes in children, which could potentially impact essential life skills, including learning. ⋯ These findings suggest lasting effects of early-life exposure to general anaesthesia on visuospatial abilities. Further investigations of the mechanisms by which general anaesthesia could have delayed effects on how children perceive their visual environment are needed.
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Opioid misuse in the paediatric population is understudied. This study aimed to develop a machine learning classifier to differentiate between occasional and sustained opioid users among children and adolescents in outpatient settings. ⋯ Our model showed promising performance in predicting sustained opioid use among paediatric patients. The online risk prediction tool can facilitate compliance to such tools by clinicians. This study presents the potential of machine learning in identifying at-risk paediatric populations for sustained opioid use, potentially contributing to secondary prevention of opioid abuse.