General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multi-centre observational study

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%)

Space-selective crystallization of glass induced by femtosecond laser irradiation

Transparent glasses imbedded with functional nanocrystals have attracted considerable interest and been studied widely in the past several decades, due to their applications in optical devices, such as optical amplifiers, nonlinear optical devices, optical storage, 3D displays, etc. Femtosecond (fs) laser irradiation induced crystallization of glass has been proved to be a powerful tool to realize the space-selective precipitation of various nanocrystals inside glasses. In this review, we highlight our recent research achievements on the fs laser induced precipitation of nanocrystals inside glasses, including nonlinear optical crystal, upconversion luminescence crystal, high refractive index crystal, and metal nanoparticles. These studies not only help to understand the interaction process between fs laser and glassy materials, but also have potential applications in the fabrication of micro-optical devices. © 2013 Elsevier B.V. All rights reserved