British journal of anaesthesia
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Preoperative fasting is the standard of care for patients undergoing a procedure under general anaesthesia. Despite the increased leniency of fasting guideline recommendations, prolonged preoperative fasting periods continue to disproportionally affect paediatric patients. This review maps existing interventions optimising paediatric fasting practices, to explore strategies that can be best applied in clinical practice. ⋯ A variety of interventions have been studied to optimise paediatric preoperative fasting duration. These interventions show potential in reducing preoperative fasting duration.
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Editorial Review
Helping clinicians debrief themselves: a simple how-to guide.
The operating theatre is a dynamic and challenging environment where effective teamwork is essential. Routine clinical debriefings, which involve brief reflections on collaboration to identify successes and areas for improvement, have proved to enhance teamwork, particularly in the operating theatre. However, barriers such as time constraints, conflicting priorities, and a lack of standardised debriefing processes hinder their regular use. Implementation of TALK©, a voluntary self-debriefing method, showed significant improvements in debriefing performance and integration of debriefing into routine practice, although long-term consistency remains a challenge.
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Multicenter Study Observational Study
Effect of perioperative blood transfusion on preoperative haemoglobin levels as a risk factor for long-term outcomes in patients undergoing major noncardiac surgery: a prospective multicentre observational study.
Preoperative anaemia and red blood cell (RBC) transfusions are associated with poorer clinical outcomes. It is unknown whether perioperative RBC transfusions mediate the relationship between preoperative haemoglobin levels and postoperative outcomes. ⋯ Preoperative haemoglobin levels were significantly associated with 1-yr MACCEs and all-cause mortality. This effect was not mediated by perioperative RBC transfusions. Further research is needed to confirm these findings.
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Observational Study
Environmental and economic impact of sustainable anaesthesia interventions: a single-centre retrospective observational study.
Anaesthesia contributes substantially to the environmental impact of healthcare. To reduce the ecological footprint of anaesthesia, a set of sustainability interventions was implemented in the University Hospital Zurich, Switzerland. This study evaluates the environmental and economic implications of these interventions. ⋯ Implementing sustainable anaesthesia interventions can significantly reduce the environmental impact and cost of anaesthesia.
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Plexus injury results in lifelong suffering from flaccid paralysis, sensory loss, and intractable pain. For this clinical problem, regenerative medicine concepts set high expectations. However, it is largely unknown how dorsal root ganglia (DRG) are affected by accidental deafferentation. ⋯ DRKS00017266.