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Anaesthesia is the official journal of the Association of Anaesthetists and is international in scope and comprehensive in coverage. It publishes original, peer-reviewed articles on all aspects of general and regional anaesthesia, intensive care and pain therapy, including research on equipment.
Rapid Sequence podcasts offer an insight into our journal, publications, editors, reviewers, authors and readers. Each episode is short, concise and packed full of CPD for all your educational needs.
Rapid Sequence podcasts offer an insight into our journal, publications, editors, reviewers, authors and readers. Each episode is short, concise and packed full of CPD for all your educational needs.
74 Episodes
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Surgical decision-making after SARS-CoV-2 infection is influenced by the presence of comorbidity, infection severity and whether the surgical problem is time-sensitive.
This new paper utilised the OpenSAFELY database to look at practices and outcomes in England, and suggests that some patients can be safely operated within 2 weeks from infection. This podcast goes deeper into the associated issues and implications for clinicians, patients and hospitals.
Detailed contemporary knowledge of the characteristics of the surgical population, national anaesthetic workload, anaesthetic techniques and behaviours are essential to monitor productivity, inform policy and direct research themes. Every 3–4 years, the Royal College of Anaesthetists, as part of its National Audit Projects (NAP), performs a snapshot activity survey in all UK hospitals delivering anaesthesia, collecting patient-level encounter data from all cases under the care of an anaesthetist.
For this podcast, Tanya Selak speaks with the authors about their work and explores some of the trends from these new data.
Arguably the most important paper of 2023 so far and essential reading/listening for all!
This new paper from the AERATOR group examines the science around aerosol generation and awake tracheal intubation (ATI). Their study was performed on a single day during an ATI course on 12 anaesthetic trainees. They show that ATI without sedation generates high concentrations of respiratory aerosol. Professor Ross Hofmeyr talks to the authors about their study, its clinical implications and what the future holds for research in this area.
We caught up with Dr Fiona Kelly, lead author of a new guideline from the Association of Anaesthetists and the Difficult Airway Society on human factors in anaesthesia. The guideline and narrative review were published and launched live at the Winter Scientific Meeting in London today and there are several actions that we can all take today to impact patient care.
Time to place less reliance on individual and team excellence to deliver high-quality patient care? We think so. Both papers are free to access and worth reading in full for all.
Pre-operative anaemia is common in patients undergoing non-cardiac surgery and associated with an increased risk of blood transfusion, hospital length of stay and postoperative complications.
This podcast is all about a new secondary analysis of the PREVENTT study. We are delighted to be joined in Australia by three of the papers authors, Professor Toby Richards, Dr Anastazia Keegan and Professor Lachlan Miles.
The aim of their analysis was to determine whether specific iron deficiency phenotypes derived clinical benefits from intravenous iron before major abdominal surgery compared with placebo.
Today, we were joined by three authors (Dr Alopi Patel, Dr Michelle Kars and Prof Ed Mariano) of a new paper which is all about how to use social media to get published. This forms part of a new series of articles called Reviewer Recommendations, which is very much a ‘how to’ guide for authors and readers. Enjoy!
Today we will be discussing this new paper which describes and validates a new anaesthetic complexity score, which is is a clinician-designed, real-world tested model of case complexity in anaesthetics. It is inclusive of, but distinct from, patient and surgical risk.
The paper is of interest because of the methods used and also the potential implications for increasing efficiency and productivity in theatre. Joining us today we have authors Dr Elliott Ridgeon, Dr Katy Wilson and Dr Ahmed Elrefaey.
The Editors of Anaesthesia acknowledge the EDI problems we face in anaesthesia and medicine as a whole. Without taking action to address these problems, these issues will persist.
This newly published position statement is from the Editors of Anaesthesia, including the Editor-in-Chief.
For this podcast, the principal authors join Association of Anaesthetists CEO Nicky de Beer to discuss why and how the statement was written as well as its implications for the present and future.
Climate change is a real and accelerating existential danger. Urgent action is required to halt its progression, and everyone can contribute. Pollution mitigation represents an important opportunity for much needed leadership from the health community, addressing a threat that will directly and seriously impact the health and well-being of current and future generations.
Inhalational anaesthetics are a significant contributor to healthcare-related greenhouse gas emissions and minimising their climate impact represents a meaningful and achievable intervention. A challenge exists in translating well-established knowledge about inhalational anaesthetic pollution into practical action.
This new guideline is designed to provide a platform that engages health professionals as an active learning community, and invites sharing of success stories and evolving solutions across varied global practice settings.
For this podcast, @GongGasGirl interviews @jessahegedus about how they did it and why it is important.
There is very limited evidence about the relative effectiveness of emergency surgery vs. non-emergency surgery strategies for patients with common acute conditions. This lack of evidence means that there is likely to be considerable practice variation in the NHS in England.
The ESORT study, which was published last night, aimed to compare the effectiveness of emergency surgery or not for five acute abdominal conditions.
Joining us this morning we have three authors of this excellent new paper, Professors Moonsinghe, Hinchliffe and Grieve.
This new guideline provides an update to the previously published consensus statement on SARS-CoV-2 infection, COVID-19 and timing of elective surgery to assist policymakers, administrative staff, clinicians and patients. It focuses on the omicron variant, which is now strongly dominant in many countries. However, the principles may also be of relevance to future variants.
To set the paper in its context, Rose Kearsley speaks with authors Scarlett McNally, Tim Cook and Kariem El-Boghdadly. Five thousand watched the broadcast, catch up with the audio recording here!
Joining us today we have the authors of a new paper reporting the effect of a text message intervention on burnout in trainee anaesthetists.
First we have Emily Larson who is a Senior Advisor at The Behavioural Insights Team. Emily has worked on reducing burnout and increasing wellbeing with physicians, educators and children. We also have Dr Alix Brazier who is also a Senior Advisor at The Behavioural Insights Team and currently leads BIT’s work applying behavioural insights to improve healthcare. Alix is also a PhD student at Imperial College, London, who also supported this research.
Finally, we have Dr Yihan Xu who is a research advisor at The Behavioural Insights Team and she designs and runs rapid online or field trials to inform and improve the delivery of government services in public health and education, for clients like the Department of Health and Social Care, the NHS, the Education Endowment Foundation, and the Ministry of Defence.
There were more applications for higher specialty training posts in anaesthesia in the UK starting in August 2021 than in previous years, with approximately two-thirds being unsuccessful.
This new national survey is all about recruitment to higher specialty training in anaesthesia in the UK during the COVID-19 pandemic. Joining Dr C Hughes was Dr C Holt, Dr J Subramaniam, Dr N Durrant and Dr S Edwardson. Their results suggest that junior anaesthetic doctors in the UK negatively perceived postgraduate training structures and changes to the postgraduate curriculum and experienced difficulties in securing higher training. This is a ‘must listen’ for all trainees and all those involved with training. Enjoy!
What better way to see in any new year than with a brand-new Anaesthesia Special Supplement! This year, it is all about the peri-operative and critical care management of the brain, which has been guest edited by Dr Jugdeep Dhesi and Professor Alana Flexman. Joining us also were journal Editors Professor Iain Moppett and Dr Matt Wiles. Topics include:
Chronic SDH
Peri-operative neurocognitive disorders
COVID-19-associated delirium
Mode of anaesthesia for mechanical thrombectomy
Status epilepticus
Cerebral oximetry
30 minutes of high quality CPD for all. Enjoy!
A recent coroner’s report in the UK concluded that a healthy patient died as a result of unrecognised oesophageal intubation. This did not seem to be the result of misinterpretation of a flat end-tidal carbon dioxide trace, but an apparent omission to check the capnograph after intubation and to perform clinical checks of tracheal tube position.
This podcast accompanies a new editorial from Pandit, Young and Davies which highlights the main lessons that can be learned from this tragic event.
Joining Professor Pandit we are delighted to have with us Professors Laura Duggan and Andrew Smith. The tread from Tanya Selak to accompany the podcast can also be found here.
Parachute (or ‘helicopter’) research is the practice of conducting primary research within a host country and subsequently publishing findings with inadequate recognition of local researchers, staff and/or supporting infrastructure.
The aim is that these recommendations will be broadly applicable within academic publishing; of use to international researchers at the point of study or partnership conceptualisation; and increase awareness of this issue among the general readership of academic journals.
Joining our Associate Editor Sheila Myatra was Seye Abimbola, Refiloe Masekela, Angela Obasi and Ben Morton who are authors of the paper.
In the UK, the Getting It Right First Time (GIRFT) programme was established by the Department of Health and Social Care as an initiative to investigate variation in healthcare delivery and patient outcomes between hospital Trusts in England. Variation between Trusts is unwarranted unless justified by patient case-mix, patient preference, equivocal evidence of effectiveness of a particular patient management approach or intractable resource constraints.
This new paper used the Hospital Episodes Statistics (HES) database to investigate variation in the rates Trusts discharged children the same day after tonsillectomy and associations with adverse postoperative outcomes. They found evidence that outcomes for day-case and overnight stay tonsillectomy are similar and conclude the majority of specialist and non-specialist Trusts should increase day-case surgery rates.
Joining the authors today was our chair Tanya Selak who is an Associate Editor as well as Ruth Tyrrell from GIRFT.
Robust evidence is needed to enable clinicians and policymakers to minimise VTE risk in patients with SARS-CoV-2 infection. Ideally, such evidence would stratify the risk of VTE against both the duration of time between infection and surgery and presence or absence of symptoms. This study aimed to determine the VTE rate in patients with SARS-CoV-2 infection, stratified by current or prior infection.
The authors found that SARS-CoV-2 infection was independently associated with an increased incidence of postoperative VTE in patients with peri-operative and recent SARS-CoV-2 infection. In patients with pre-operative SARS-CoV-2, ongoing symptoms were associated with an increased rate of postoperative VTE, irrespective of how long before surgery the diagnosis was made.
For this live podcast, Anaesthesia Editor Ed Mariano was joined by Elizabeth Li, Joana Simoes and Francesco Pata from the authorship group. They discuss the main findings, strengths, limitations, clinical applications and much more! Enjoy!
This international prospective cohort study analysed data on > 96k patients from > 1500 hospitals in > 100 countries. They found that the overall postoperative pulmonary complication rate for all patients was 2.0%, which alone is useful to know. Perhaps more strikingly, and following adjustment for various measured confounders, patients who isolated had a 20% increased risk of postoperative pulmonary complications. The risk climbed to 31% more in those isolating ≥ 8 days, which is still shorter than current periods recommended in England for certain patient groups.
The question is, can these new data be used to update guidelines and clinical practice, resulting in at once improved safety, outcomes, efficiency and patient experience?
Joining us today we have Joana Simoes, Elizabeth Li and Aneel Bhangu from the authorship group.
The WHO has developed a list of aerosol-generating procedures that healthcare organisations throughout the world have used as a framework for development of their guidelines. Supraglottic airways are used in the majority of the approximately 2.7 million general anaesthetics performed in the UK each year. In a UK survey in October 2020, 40% of responding hospitals reported that supraglottic airway removal, even in low COVID-19 risk pathways, is restricted exclusively to the operating theatre (rather than being performed in a recovery area), indicating the presence of policies that assume it is an aerosol-generating procedure. However, uncertainty remains as to whether insertion or removal of a supraglottic airway generates aerosols.
Given the uncertain balance of potential risks and benefits associated with the protective strategies put in place to limit airborne viral transmission, this new paper from Shrimpton et al. aimed to directly assess airborne particle emission during insertion and removal of supraglottic airways. They used real-time measures of aerosol generation with an optical particle sizer in a working operating theatre environment and compared the measured levels with reference to those generated by a volitional cough and the patient’s own breathing.
Joining two of the authors was our fellow, Craig Lyons as well as Laura Duggan who is an Editor of Anaesthesia.
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