Melatonin limits paclitaxel-induced mitochondrial dysfunction in vitro and protects against paclitaxel-induced neuropathic pain in the rat

Acknowledgements Thank you to Professor Ahmet Hoke (Johns Hopkins, Baltimore, USA) for the gift of DRG cells; and to Professor Patrick M. Dougherty (MD Anderson Cancer Center, Texas, USA) for sharing his expertise in the rat model. Funding The study was funded by the Association of Anaesthetists of Great Britain and Ireland, the British Journal of Anaesthesia/Royal College of Anaesthetists and the Melville Trust.Peer reviewedPublisher PD

Failure of anaesthetic machine automated self-check to detect massive leak in ventilator bellows

Anaesthetic machines are designed to provide for a safe, non-hypoxic gas mixture delivered to the patient. For this reason, anaesthetic machines provide a number of features to ensure such safety. Still, a number of anaesthetic societies, including the Association of Anaesthetists of Great Britain and Ireland [1], the American Society of Anaesthesiologists [2] and the Canadian Society of Anaesthesiologists [3] recommend that anaesthetic machines should be checked prior to each list, and prior to each case.peer-reviewe

Recomendaciones para la práctica segura de la Anestesia Total Intravenosa II

Abstract All anaesthetists need to know the pharmacokinetic principles underpinning Total Intravenous Anaesthesia (TIVA) to be able to achieve and maintain an appropriate concentration of an intravenous anaesthetic or analgesic drug in the patient's plasma and brain. This is a consensus document produced by expert members by the Association of Anaesthetists and the Society for Intravenous Anaesthesia of Great Britain and Ireland. It is intended as a guideline for safe practice when TIVA is being used. Todos los anestesiólogos necesitan conocer los principios farmacocinéticos en los que se basa la Anestesia Total Intravenosa (TIVA) para poder alcanzar y mantener una concentración adecuada de un anestésico o analgésico intravenoso en el plasma y en el cerebro del paciente. Se trata de un documento de consenso para una práctica segura cuando se utiliza TIVA, que ha sido elaborado por miembros expertos de la “Association of Anaesthetists and the Society for Intravenous Anaesthesia of Great Britain and Ireland”

Pulse oximetry and oxygenation assessment in small animal practice

Oxygen is essential for the cellular respiration of all aerobic organisms so it is important that the amount of oxygen present within the circulation can be measured. In clinical veterinary practice, a non-invasive method of measuring oxygen saturation of arterial blood is necessary for the rapid, reliable assessment of a patient's oxygen status, whether anaesthetised or in the intensive care unit. Pulse oximetry is considered to be essential for the safe conduct of anaesthesia by the Association of Anaesthetists of Great Britain and Ireland, and the American Society of Anesthesiologists, because a failure to recognise hypoxaemia is a major cause of preventable death. This article describes how oxygen is carried within the blood and the basic technology behind the pulse oximeter, together with some of its pitfalls and limitations

Should the Glidescope video laryngoscope be used first line for all oral intubations or only in those with a difficult airway? A review of current literature

The purpose of this study was to review literature that looked into the efficacy of the Glidescope video laryngoscope versus the Macintosh laryngoscope in oral endotracheal intubations. We aimed to answer the question 'Should the Glidescope video laryngoscope laryngoscopes be used as first line intubation aids or only in the difficult airway?’ A systematic search of electronic databases was made. The inclusion criteria included: Glidescope, video laryngoscope, and Macintosh laryngoscope in human studies. The study aimed to compare first attempt success rate, glottic view and intubation time in papers dating between 2009 and 2017. Eleven trials with a total of 7,919 patients with both difficult and normal airways were included. The trials showed an improvement in first attempt success rate and glottic view with the Glidescope video laryngoscope especially in those with difficult airways. Overall time to intubate showed no significant differences between the Glidescope video laryngoscope and the Macintosh laryngoscope although it was identified that with increased training and experience with the Glidescope video laryngoscope, intubation time was reduced. Glidescope video laryngoscopes show advantages over the Macintosh laryngoscopes in obtaining better glottic views in those with difficult airways. However its use is not supported in all routine intubations

Intravenous postoperative fluid prescriptions for children: A survey of practice

<p>Abstract</p> <p>Background</p> <p>Postoperative deaths and neurological injury have resulted from hyponatraemia associated with the use of hypotonic saline solutions following surgery. We aimed to determine the rates and types of intravenous fluids being prescribed postoperatively for children in the UK.</p> <p>Methods</p> <p>A questionnaire was sent to members of the British Association of Paediatric Surgeons (BAPS) and Association of Paediatric Anaesthetists of Great Britain and Ireland (APAGBI) based at UK paediatric centres. Respondents were asked to prescribe postoperative fluids for scenarios involving children of different ages. The study period was between May 2006 and November 2006.</p> <p>Results</p> <p>The most frequently used solution was sodium chloride 0.45% with glucose 5% although one quarter of respondents still used sodium chloride 0.18% with glucose 4%. Isotonic fluids were used by 41% of anaesthetists and 9.8% of surgeons for the older child, but fewer for infants. Standard maintenance rates or greater were prescribed by over 80% of respondents.</p> <p>Conclusion</p> <p>Most doctors said they would prescribe hypotonic fluids at volumes equal to or greater than traditional maintenance rates at the time of the survey. A survey to describe practice since publication of National Patient Safety Agency (NPSA) recommendations is required.</p

History of British Intensive Care, c. 1950–c. 2000

Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Annotated and edited transcript of a Witness Seminar held on 16 June 2010. Introduction by Professor Sir Ian Gilmore, Royal Liverpool Hospital and University of Liverpool.Intensive care developed in the UK as a medical specialty as the result of some extraordinary circumstances and the involvement of some extraordinary people. In 1952, the polio epidemic in Copenhagen demonstrated that tracheostomy with intermittent positive pressure ventilation saved lives and those infected with tetanus (common in agricultural areas) soon benefited. War-time developments such as triage, monitoring, transfusion and teamwork, and different specialists such as respiratory physiologists, anaesthetists and manufacturers of respiratory equipment all improved emergency treatment. These advances were rapidly extended to the care of post-operative patients, particularly with developments in cardiac surgery. Dedicated units appeared in the early 1960s in Cambridge, London and Liverpool, and later specialist care units were created for prenatal, cardiac and dialysis patients. The importance of specialist nursing care led to the development of nurse training, education and the eventual appointment of nurse consultants in the NHS in 1999. The specialty of intensive care was granted Faculty status by the GMC in 2010. Introduced by Professor Sir Ian Gilmore, this transcript includes, inter alia, the development of cardiac catheters, monitoring equipment, data collection techniques and the rise of multidisciplinarity, national audit, and scoring systems

Patient anxiety and conscious surgery

The amount of surgery undertaken on the conscious patient is increasing. However, many patients are anxious and resistant to such surgery. Patients (n=214) were surveyed to determine their related apprehensions. Being awake, feeling or seeing the body cut open and experiencing pain all increased anxiety. The potential for insufficient information provision was also a source of concern. Formal management of intra-operative apprehension may help limit anxiety and expel apparent misapprehensions