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Welcome to the November bulletin highlighting new evidence published on selected topics relating to Critical Care, Anaesthesia, Pain and Resuscitation. Journals such as – Lancet, BMJ, JAMA, NEJM and American Journal of Critical Care Medicine have been scanned to identify relevant articles. Articles from other journals as retrieved via searches on MEDLINE and EMBASE are also listed. This bulletin features evidence published in the previous 8 weeks. Full text articles can be accessed via your HEFT Athens ID.

Anaesthesia

The following sub-topics are covered:

  • Cell salvage in surgery (including obstetric surgery)
  • Anaesthesia and surgical outcomes (including epidurals, regional anaesthesia)
  • Anaesthesia and Immunomodulation
  • Anaesthesia and post operative confusion

Title: Intraoperative cell salvaged blood as part of a blood conservation strategy in Caesarean section: is fetal red cell contamination important?.

Citation: British Journal of Anaesthesia, September 2011, vol./is. 107/3(404-8), 0007-0912;1471-6771 (2011 Sep) Author(s): Ralph CJ, Sullivan I, Faulds J

Abstract: In this study, the authors attempted to quantify the risk of antibody formation from re-infusion of autologous blood after Caesarean section.

Full Text: Available in fulltext at EBSCO Host EJS Available in print at Solihull Staff Library

Title: Intraoperative cell salvage in obstetrics: Is it a real therapeutic option?

Citation: Transfusion, October 2011, vol./is. 51/10(2244-2256), 0041-1132;1537-2995 (October 2011)Author(s): Liumbruno G.M., Liumbruno C., Rafanelli D.

Abstract: The authors highlight that the role of cell salvage as a blood-saving measure in obstetrics is progressively acquiring relevance and conclude that , intraoperative cell salvage in obstetrics should be considered in patients at high risk for hemorrhage or in cases where allogeneic blood transfusion is difficult or impossible.

Title: The volume of returned red blood cells in a large blood salvage program: Where does it all go?

Citation: Transfusion, October 2011, vol./is. 51/10(2126-2132), 0041-1132;1537-2995 (October 2011)Author(s): Waters J.H., Dyga R.M., Waters J.F.R., Yazer M.H.

Abstract: The study analyzed the trends in the volume of returned RBCs by a blood salvage program across a 12-hospital regional health care system over a 5-year period.

Title: Blood cell salvage during cesarean delivery

Citation: International Journal of Gynecology and Obstetrics, November 2011, vol./is. 115/2(161-163), 0020-7292;1879-3479 (November 2011)Author(s): Sullivan J.V., Crouch M.E., Stocken G., Lindow S.W.

Abstract: The study reviews the use of blood cell salvage performed during caesarean delivery.

Title: A quality assurance programme for cell salvage in cardiac surgery

Citation: Anaesthesia, October 2011, vol./is. 66/10(901-906), 0003-2409;1365-2044 (October 2011)Author(s): Kelleher A., Davidson S., Gohil M., MacHin M., Kimberley P., Hall J., Banya W.

Abstract: At the same time as cell salvage was introduced into our institution for all patients undergoing cardiac surgery with cardiopulmonary bypass, the authors established a supporting programme of quality assurance to reassure clinicians regarding safety and efficacy.

Title: Intraoperative blood loss and component utilization in hand and upper extremity allotransplantation

Citation: Transfusion, September 2011, vol./is. 51/(184A), 0041-1132 (September 2011)Author(s): Raval J.S., Lang R.S., Lee W., Planinsic R.M., Kiss J.E.

Abstract: The studysought to characterize the IO blood losses and hematological data of patients during HUT to better predict the blood utilization needs of transplant teams at our medical center.

Title: Continuous cell saver circuits for non-cardiac surgery patients who refuse allogeneic transfusion

Citation: Transfusion, September 2011, vol./is. 51/(184A), 0041-1132 (September 2011)Author(s): Inman A., Wheeler K., Figueroa P.I., Bakdash S.

Abstract: The authors aim to provide a detailed information on continuous cell saver circuit utilization with respect to Jehovah’s witness patients.

Title: Development and validation of a generalizable model for predicting major transfusion during spine fusion surgery

Citation: Journal of Neurosurgical Anesthesiology, October 2011, vol./is. 23/4(416), 0898-4921 (October 2011)Author(s): Carabini L.M., Moreland N., Zeeni C., Gould R.W., Gupta D.K.

Abstract: The aim of this study was to identify and validate independent predictors of the need for major transfusion in any spine fusion surgery of Z3 levels to assist with preoperative risk stratification.

Title: Immune cell populations decrease during craniotomy under general anesthesia.

Citation: Anesthesia & Analgesia, September 2011, vol./is. 113/3(572-7), 0003-2999;1526-7598 (2011 Sep) Author(s): Liu S, Wang B, Li S, Zhou Y, An L, Wang Y, Lv H, Zhang G, Fang F, Liu Z, Han R, Jiang T, Kang X

Abstract: The aim of the study was to investigate how the immune cell population changes during the anesthesia process in patients undergoing craniotomy surgery.

Full Text: Available in fulltext at Ovid

Title: Extending epidural analgesia for emergency Caesarean section: A meta-analysis

Citation: British Journal of Anaesthesia, November 2011, vol./is. 107/5(668-678), 0007-0912;1471-6771 (November 2011) Author(s): Hillyard S.G., Bate T.E., Corcoran T.B., Paech M.J., O'Sullivan G.

Abstract: The aim of this meta-analysis was to identify the best epidural solutions for emergency Caesarean section anaesthesia, with respect to rapid onset and low supplementation of intraoperative block. Full Text: Available in fulltext at EBSCO Host EJS

Available in print at Solihull Staff Library

Title: Prospective randomized observer-blinded study comparing the analgesic efficacy of ultrasound-guided rectus sheath block and local anaesthetic infiltration for umbilical hernia repair

Citation: British Journal of Anaesthesia, November 2011, vol./is. 107/5(790-795), 0007-0912;1471-6771 (November 2011) Author(s): Gurnaney H.G., Maxwell L.G., Kraemer F.W., Goebel T., Nance M.L., Ganesh A.

Abstract: The authors of this study undertook an observer-blinded, randomized, prospective, observational study to compare the efficacy of ultrasound-guided RSB and LAI in providing postoperative analgesia for umbilical hernia repair.

Full Text: Available in fulltext at EBSCO Host EJS Available in print at Solihull Staff Library

Title: General anaesthesia is associated with increased risk of surgical site infection after Caesarean delivery compared with neuraxial anaesthesia: A population-based study

Citation: British Journal of Anaesthesia, November 2011, vol./is. 107/5(757-761), 0007-0912;1471-6771 (November 2011) Author(s): Tsai P.-S., Hsu C.-S., Fan Y.-C., Huang C.-J.

Abstract: This study compared the odds ratio (OR) of surgical site infection (SSI) within 30 days after operation with general anaesthesia (GA) or neuraxial anaesthesia (NA) in Taiwanese women undergoing Caesarean delivery (CD).

Full Text: Available in fulltext at EBSCO Host EJS Available in print at Solihull Staff Library

Title: Combined spinal and epidural anaesthesia and maternal intrapartum temperature during vaginal delivery: A randomized clinical trial

Citation: British Journal of Anaesthesia, November 2011, vol./is. 107/5(762-768), 0007-0912;1471-6771 (November 2011) Author(s): De Orange F.A., Passini Jr. R., Amorim M.M.R., Almeida T., Barros A.

Abstract: The studydetermined the association between combined spinalepidural (CSE) anaesthesia and an increase in maternal intrapartum temperature and intrapartum fever. Full Text: Available in fulltext at EBSCO Host EJS Available in print at Solihull Staff Library

Title: Spinal anaesthesia and monitored conscious sedation for repair of infantile meningomyelocele

Citation: Child's Nervous System, November 2011, vol./is. 27/11(1985-1988), 0256-7040;1433-0350 (November 2011) Author(s): Idowu O.E., Oyeleke S.O.

Abstract: Objectives: The study monitored conscious sedation combined with spinal anaesthesia.

Title: General or local anesthesia for carotid endarterectomy-The "real-World" experience

Citation: Angiology, November 2011, vol./is. 62/8(609-613), 0003-3197;1940-1574 (November 2011) Author(s): Sideso E., Walton J., Handa A.

Abstract: The aim of this study was to assess the complication rates in patients undergoing CEA under general anesthesia (GA) or regional anesthesia (local anesthesia [LA]).

Full Text: Available in fulltext at EBSCO Host

Title: Ultrasound-guided suprascapular nerve block for shoulder reduction and adhesive capsulitis in the ED

Citation: American Journal of Emergency Medicine, October 2011, vol./is. 29/8(963.e1-963.e3), 0735-6757;1532-8171 (October 2011) Author(s): Herring A.A., Stone M.B., Nagdev A.

Full Text: Available in fulltext at MD Consult; Note: You will need to register (free of charge) with MD Consult the first time you use it.

Title: The nerve stimulation technique versus the loss of resistance technique for the posterior approach to lumbar plexus block: A randomized, prospective, observer-blinded, pilot study

Citation: Minerva Anestesiologica, October 2011, vol./is. 77/10(959-963), 0375-9393 (October 2011) Author(s): Danelli G., Ghisi D., Bellinghieri F., Borghi B., Fanelli G., Chelly J.E.

Abstract: This prospective, randomized, observer-blinded, pilot study compares the effects of the nerve stimulation guidance technique (NS) with the loss of resistance technique (LOR) on readiness for surgery during the posterior approach to lumbar plexus block.

Title: Maternal cardiac output changes after crystalloid or colloid coload following spinal anesthesia for elective cesarean delivery: A randomized controlled trial

Citation: Anesthesia and Analgesia, October 2011, vol./is. 113/4(803-810), 0003-2999 (October 2011) Author(s): McDonald S., Fernando R., Ashpole K., Columb M.

Abstract: The study hypothesized that a colloid coload compared with a crystalloid coload would produce a larger sustained increase in CO and therefore reduce vasopressor requirements. Full Text: Available in fulltext at Ovid

Title: Does the baricity of bupivacaine influence intrathecal spread in the prolonged sitting position before elective cesarean delivery? A prospective randomized controlled study

Citation: Anesthesia and Analgesia, October 2011, vol./is. 113/4(811-817), 0003-2999 (October 2011) Author(s): Loubert C., Hallworth S., Fernando R., Columb M., Patel N., Sarang K., Sodhi V.

Abstract: The authorshypothesized that the delay between the spinal injection of the local anesthetic mixture and the adoption of the supine position with lateral tilt, may affect the intrathecal distribution of local anesthetic of different baricities such that hypobaric local anesthetic would lead to a higher sensory block level.

Full Text: Available in fulltext at Ovid

Title: A randomized study of the effectiveness of suprascapular nerve block in patient satisfaction and outcome after arthroscopic subacromial decompression

Citation: Arthroscopy - Journal of Arthroscopic and Related Surgery, October 2011, vol./is. 27/10(1323-1328), 0749-8063;1526-3231 (October 2011) Author(s): Jeske H.-C., Kralinger F., Wambacher M., Perwanger F., Schoepf R., Oberladstaetter J., Krappinger D., Dallapozza C., Hoffmann F.

Abstract: The purpose of this study was to evaluate the efficiency of the suprascapular nerve (SSN) block in pain reduction after arthroscopic subacromial decompression operations and its influence on patient satisfaction.

Title: The minimum effective anesthetic volume of 0.75% ropivacaine in ultrasound-guided interscalene brachial plexus block

Citation: Anesthesia and Analgesia, October 2011, vol./is. 113/4(951-955), 0003-2999 (October 2011) Author(s): Gautier P., Vandepitte C., Ramquet C., Decoopman M., Xu D., Hadzic A.

Abstract: In the current study, the authors investigated the minimal volume necessary to accomplish surgical anesthesia with interscalene brachial plexus block.

Full Text: Available in fulltext at Ovid

Title: Comparison of intratracheal and intravenous lidocaine effects on bucking, cough, and emergence time at the end of anesthesia

Citation: Pakistan Journal of Medical Sciences, October 2011, vol./is. 27/4(793-796), 1682-024X (October 2011)Author(s): Khezri M.-B., Jalili S., Asefzadeh S., Kayalha A.

Abstract:The aim of the study was to compare the effects of intratracheal and intravenous lidocaine on bucking, cough and emergence time at the end of anesthesia.

Title: Awake coronary artery bypass grafting under thoracic epidural anesthesia: Great impact on off-pump coronary revascularization and fast-track recovery

Citation: European Journal of Cardio-thoracic Surgery, October 2011, vol./is. 40/4(788-793), 1010-7940;1873-734X (October 2011)Author(s): Watanabe G., Tomita S., Yamaguchi S., Yashiki N.

Abstract: The ultimate goal of minimally invasive coronary artery bypass grafting (CABG) is day surgery. This study evaluated the potential of a new awake CABG protocol using only epidural anesthesia in realizing day surgery.

Title: Local anaesthesia for endovascular repair of infrarenal aortic aneurysms

Citation: European Journal of Vascular and Endovascular Surgery, October 2011, vol./is. 42/4(467-473), 1078-5884;1532-2165 (October 2011)Author(s): Geisbusch P., Katzen B.T., MacHado R., Benenati J.F., Pena C., Tsoukas A.I.

Abstract: The study aimed to analyse and report the results of a 'local anaesthesia first' approach in elective endovascular aneurysm repair (EVAR) patients.

Title: Transilluminated powered phlebectomy in an office setting: Procedural considerations and clinical outcomes

Citation: Journal of Endovascular Therapy, October 2011, vol./is. 18/5(734-738), 1526-6028;1545-1550 (October 2011)Author(s): Spitz G.

Abstract: To report a series of non-sedated patients treated with transilluminated powered phlebectomy (TIPP) under tumescent anesthesia in an office setting.

Title: Intraoperative epidural analgesia prevents the early proinflammatory response to surgical trauma. Results from a prospective randomized clinical trial of intraoperative epidural versus general analgesia

Citation: Annals of Surgical Oncology, October 2011, vol./is. 18/10(2722-2731), 1068-9265;1534-4681 (October 2011)Author(s): Moselli N.M., Baricocchi E., Ribero D., Sottile A., Suita L., Debernardi F.

Abstract: This study investigates the effect of intraoperative EA versus intravenous analgesia (IA) on the immune function.

Title: Time-dependent perioperative anesthetic management and outcomes of the first 100 consecutive cases of spring-assisted surgery for sagittal craniosynostosis

Citation: Paediatric Anaesthesia, October 2011, vol./is. 21/10(1015-1019), 1155-5645;1460-9592 (October 2011)Author(s): Ririe D.G., Smith T.E., Wood B.C., Glazier S.S., Couture D.E., Argenta L.C., David L.R.

Abstract: Background: The anesthetic risks and outcomes of the first 100 consecutive spring-assisted surgeries (SAS) for cranial expansion from a single institution are reported. The effect of number of procedures was also tested on hematocrit postoperative day 1 (POD1), anesthesia time, and surgery time of the first procedure.

Full Text: Available in fulltext at EBSCO Host

Title: Right thoracic paravertebral anaesthesia for percutaneous radiofrequency ablation of liver tumours

Citation: British Journal of Radiology, September 2011, vol./is. 84/1005(785-789), 0007-1285 (September 2011)Author(s): Cheung Ning M., Karmakar M.K.

Abstract: This prospective study evaluated the efficacy of a right thoracic paravertebral block (TPVB) for anaesthesia and analgesia during PRFA of liver tumours.

Title: Obstetric outcomes and maternal satisfaction in nulliparous women using patient-controlled epidural analgesia

Citation: American Journal of Obstetrics and Gynecology, September 2011, vol./is. 205/3(271.e1-271.e6), 0002-9378;1097-6868 (September 2011)Author(s): Haydon M.L., Larson D., Reed E., Shrivastava V.K., Preslicka C.W., Nageotte M.P.

Abstract: The purpose of this study was to compare obstetric outcomes and maternal satisfaction in nulliparous women in spontaneous labor who used patient-controlled epidural analgesia (PCEA) vs continuous epidural infusion (CEI).

Full Text: Available in fulltext at MD Consult; Note: You will need to register (free of charge) with MD Consult the first time you use it.

Title: Management of acquired cardiac disease in the obstetric patient

Citation: Seminars in Cardiothoracic and Vascular Anesthesia, September 2011, vol./is. 15/3(85-97), 1089-2532;1940-5596 (September 2011)Author(s): Wolff G.A., Weitzel N.S.

Abstract: This review systematically presents the pathophysiology, peripartum risk, and anesthetic management in the puerperium of specific acquired cardiac abnormalities including: valvular disease, pulmonary hypertension, cardiomyopathy, cardiac transplantation, ischemia, arrhythmias, and cardiac arrest. 2011 SAGE Publications.

Full Text: Available in fulltext at EBSCO Host

Title: Anesthetic considerations for nontransplant procedures in lung transplant patients

Citation: Journal of Clinical Anesthesia, September 2011, vol./is. 23/6(508-516), 0952-8180;1873-4529 (September 2011)Author(s): Feltracco P., Falasco G., Barbieri S., Milevoj M., Serra E., Ori C.

Abstract: Anesthesia and surgery following lung transplantation may be required for various diseases that may affect both systemic organs and the transplanted graft. When a patient with a lung transplant undergoes surgery, there is the potential for interference with lung function, depending on the type of intervention and its anatomical site. Accurate preoperative evaluation, an understanding of the physiology of the transplanted lung, proper airway instrumentation, individualized management of intraoperative ventilation, and fluid balance are essential for a positive perioperative outcome. 2011 Elsevier Inc.

Full Text: Available in fulltext at MD Consult; Note: You will need to register (free of charge) with MD Consult the first time you use it.

Title: Clinical application of the cardioprotective effects of volatile anaesthetics: CON - Total intravenous anaesthesia or not total intravenous anaesthesia to anaesthetise a cardiac patient?

Citation: European Journal of Anaesthesiology, September 2011, vol./is. 28/9(623-627), 0265-0215;1365-2346 (September 2011)Author(s): Van Rompaey N., Barvais L.

Title: Effect of carotid sinus nerve blockade on hemodynamic stability during carotid endarterectomy under local anesthesia.

Citation: Journal of Vascular Surgery, August 2011, vol./is. 54/2(386-93), 0741-5214;1097-6809 (2011 Aug)Author(s): Ajduk M, Tudoric I, Sarlija M, Pavic P, Oremus Z, Held R, Patrlj L

Abstract: To find out whether routine carotid sinus nerve blockade with lidocaine during carotid endarterectomy under local anesthesia results in perioperative changes in blood pressure and heart rate.Full Text: Available in fulltext at Ovid

Cardiac arrests/cardiopulmonary resuscitation (CPR)

The following sub-topics are covered:

  • Quality of CPR
  • Use of feedback devices
  • Leadership and team factors

Title: Impact of team leader background and leadership skills on performance in simulated cardiac arrest management

Citation: Anaesthesia, October 2011, vol./is. 66/10(959), 0003-2409 (October 2011)

Author(s): Yeung J., Davies R.P., Field R., Akhtar N., Gao F., Perkins G.D.

Abstract: This study aims to identify the relationship between leadership skills and characteristics and quality of CPR.

Title: Survival from in-hospital cardiac arrest in Auckland City Hospital

Citation: EMA - Emergency Medicine Australasia, October 2011, vol./is. 23/5(569-579), 1742-6731;1742-6723 (October 2011)Author(s): Jones P., Miles J., Mitchell N.

Abstract: The objective of this article is to describe in-hospital resuscitation outcomes and factors associated with survival at Auckland City Hospital, New Zealand.

Title: The consequences of noncompliance with guidelines for withholding or terminating resuscitation in traumatic cardiac arrest patients

Citation: Journal of Trauma - Injury, Infection and Critical Care, October 2011, vol./is. 71/4(997-1002), 0022-5282;1529-8809 (October 2011)Author(s): Mollberg N.M., Wise S.R., Berman K., Chowdhry S., Holevar M., Sullivan R., Vafa A.

Abstract: The purpose of this study is to demonstrate the consequences of violating the current published guidelines and whether EMS personnel were able to accurately identify patients in TCPA.

Title: Perceived stress and team performance during a simulated resuscitation

Citation: Intensive Care Medicine, September 2011, vol./is. 37/9(1473-1479), 0342-4642;1432-1238 (September 2011)Author(s): Hunziker S., Laschinger L., Portmann-Schwarz S., Semmer N.K., Tschan F., Marsch S.

Abstract: The aim of this study was to investigate whether mental stress and different perceived emotions have a negative impact on the performance of rescuers.

Critical Care

The following sub-topics are covered:

  • Sepsis – the use of statins, biomarker MMP9
  • Acute lung injury (ALI)/adult respiratory distress syndrome (ARDS)
  • Use of non invasive ventilation (NIV) in weaning
  • Ventilator associate pneumonia (including E.Coli)

Title: Noninvasive ventilation and weaning in patients with chronic hypercapnic respiratory failure: A randomized multicenter trial