Anaesthesia reports最新文献

{"title":"Development of a survey evaluating patient Concerns Over Peri-operative Events (COPE).","authors":"A J Gardner, T Potter, P Greig, G Radcliffe, J E O'Carroll, K El-Boghdadly","doi":"10.1002/anr3.70098","DOIUrl":"10.1002/anr3.70098","url":null,"abstract":"<p><p>Anxiety frequently burdens patients before surgery, potentially leading to poorer recovery. However, standard assessment tools typically quantify the intensity of this distress without understanding its root cause. This often leaves clinicians unaware of the specific fears driving a patient's anxiety. We aimed to address this deficit by developing and validating a questionnaire designed to identify individual pre-operative concerns. An iterative development process resulted in a 14-item questionnaire: Concerns Over Peri-operative Events (COPE). We conducted a prospective evaluation of 52 patients having elective surgery, measuring the questionnaire's performance against the Amsterdam Pre-operative Anxiety and Information Scale. The questionnaire performed well on metrics of validity, reliability and acceptability. Severe pain was the most reported concern. The median (IQR [range]) total COPE score was 30 (22-44 [14-63]). There was a positive correlation between the Amsterdam Pre-operative Anxiety and Information Scale and COPE scores. A classification model to predict Amsterdam Pre-operative Anxiety and Information Scale-positive status demonstrated excellent discrimination with an area under the curve of 0.86. An optimal COPE score of ≥ 34 demonstrated 88% sensitivity and 81% specificity. While future research should focus on generalisability, this novel questionnaire of patient concerns facilitates the identification of specific drivers of pre-operative anxiety. By bridging the gap between clinicians' assumptions and patient experience, the COPE questionnaire may facilitate targeted therapies and improve informed consent.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":"e70098"},"PeriodicalIF":1.1,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13537895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidural blood patch for persistent cerebrospinal fluid leak after epidural catheter removal in an infant.","authors":"P Sae-Yup, A Wongwaikijphaisant","doi":"10.1002/anr3.70102","DOIUrl":"10.1002/anr3.70102","url":null,"abstract":"<p><p>Persistent fluid leakage following epidural catheter removal is rare in infants and may indicate cerebrospinal fluid leakage, with poorly described clinical manifestations. We report a case of a 10-month-old infant who developed persistent fluid leakage from the epidural insertion site and position-dependent changes in consciousness after the removal of a thoracic epidural catheter following right hepatectomy. Brain computed tomography excluded acute intracranial pathology, and the clinical course suggested intracranial hypotension secondary to suspected cerebrospinal fluid leakage. Bed rest, pressure dressings and intravenous fluids were unsuccessful in improving the leakage or the neurological symptoms. An epidural blood patch was performed by injecting 2.5 ml (0.31 ml.kg^-1) of autologous venous blood into the epidural space. No further leakage was observed from the epidural insertion site and the patient's neurological status rapidly returned to baseline. This case highlights the diagnostic challenges of suspected intracranial hypotension in infants and describes the clinical course following the performance of an epidural blood patch.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":"e70102"},"PeriodicalIF":1.1,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148867995","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unexpected intra-operative detection of a central venous catheter tip within the coronary venous system during coronary artery bypass grafting.","authors":"Alfred Ibrahimi, Diana Dhimitri, Saimir Kuci, Marsela Goga, Arber Aliu","doi":"10.1002/anr3.70101","DOIUrl":"10.1002/anr3.70101","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":"e70101"},"PeriodicalIF":1.1,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13527406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microbiological evaluation of a viscoelastic tracheal tube cuff in an in vitro aspiration model: a preliminary observational study","authors":"C. Palacios Clar,&nbsp;P. A. Bravo Fernández,&nbsp;N. Hernando Parreño,&nbsp;J. J. Artazkoz del Toro,&nbsp;M. D. Hernandez,&nbsp;R. Martinez-Ruiz","doi":"10.1002/anr3.70099","DOIUrl":"https://doi.org/10.1002/anr3.70099","url":null,"abstract":"<div>\u0000 \u0000 <p>Ventilator-associated pneumonia is the most common intensive care unit-acquired infection, driven by microaspiration of colonised secretions past the tracheal tube cuff. We performed a preliminary in vitro comparison of three tracheal tubes: a standard cylindrical cuff (Rusch^®, Teleflex Incorporated, PA, USA), a tapered cuff with subglottic suction (Shiley^®, Medtronic, MN, USA) and a novel self-expanding viscoelastic cuff (V-Cuff^®, Tianjin Medis Medical Device Co., Tianjin, China); using silicone artificial tracheas inoculated with <i>Staphylococcus aureus</i> (0.5 McFarland; approximately 1.5 × 10⁸ colony-forming units (CFU).ml⁻¹). This was an exploratory single-observation study (n = 1 per device). Over three 1-hourly instillations of 20 ml, the V-Cuff^® produced no fluid leakage or bacterial passage (0 ml; 0 CFU), versus 57.2 ml (&gt; 10⁸ CFU.ml⁻¹) for the Rusch^® and 4.96 ml (approximately 10⁶ CFU.ml⁻¹) for the Shiley^®. The V-Cuff^® also maintained a complete seal during high-volume challenges simulating vomiting (300 ml) and massive flooding (2500 ml). These hypothesis-generating findings support controlled investigation of the V-Cuff^® as a strategy for preventing microaspiration.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moisture ingress in a hospital medical air system secondary to dryer failure leading to service disruption","authors":"J. Summers,&nbsp;S. Lee,&nbsp;C. Rachbuch,&nbsp;B. El-Behesy,&nbsp;A. Ferlazzo,&nbsp;R. Rengasamy,&nbsp;Z. J. Lim","doi":"10.1002/anr3.70096","DOIUrl":"10.1002/anr3.70096","url":null,"abstract":"<p>Medical air is essential for the safe delivery of anaesthesia, critical care and emergency care. We report a hospital-wide medical air contamination event caused by failure of ageing desiccant dryers. Water was detected in the intensive care unit medical air outlets, before moisture contamination was confirmed within the medical air pipeline system and operating theatre pendants. This resulted in shutdown of the central medical air plant, suspension of non-urgent surgery, surgical bypass and a 5-day disruption to normal hospital services. The principal clinical challenges were the loss of reliable medical air supplied via the pipeline system, potential moisture exposure of anaesthetic ventilators and other equipment, limited capacity to provide ventilatory support and initial inability to use available medical air cylinders with anaesthetic workstations because of pressure regulator incompatibility. Management required immediate cessation of use of the medical air pipeline system, use of alternative medical air supplies, liaison with the anaesthetic machine manufacturer, installation of a temporary dehydrator, moisture removal and compliance testing. This case highlights that visible water at a medical gas outlet is a serious infrastructure failure requiring urgent escalation and multidisciplinary management. The primary educational message is that medical air-drying systems require proactive maintenance, lifecycle replacement and continuous dew-point monitoring linked to hospital alarm systems. Secondary lessons include the importance of tested backup medical air plans, equipment-compatible regulators and staff education to recognise moisture ingress as a high-risk patient safety event.</p>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13459192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-guided brachial plexus block for retrieval of an entrapped radial artery catheter during primary percutaneous coronary intervention","authors":"S. Nagalingam,&nbsp;V. R. K. Kodali,&nbsp;K. K. G. Sambandham,&nbsp;R. B. Karthekeyan,&nbsp;M. Vakamudi","doi":"10.1002/anr3.70097","DOIUrl":"10.1002/anr3.70097","url":null,"abstract":"<div>\u0000 \u0000 <p>Transradial access is widely used for percutaneous coronary intervention because it reduces bleeding complications and speeds recovery. Severe radial artery spasm, however, can entrap catheters or sheaths, and forceful extraction may cause major vascular injury. This report describes the atraumatic removal of an entrapped radial artery sheath assited by ultrasound-guided supraclavicular brachial plexus block during primary percutaneous coronary intervention.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148714721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In reply to ‘Evaluating the quality of expert-trained generative artificial intelligence when answering tracheostomy-related questions’","authors":"E. Johnstone,&nbsp;B. A. McGrath,&nbsp;A. Payton,&nbsp;B. Gorst,&nbsp;J. Abbas,&nbsp;M. Moran","doi":"10.1002/anr3.70094","DOIUrl":"10.1002/anr3.70094","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148610786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaphylaxis to propofol during cerebral aneurysm clipping","authors":"E. J. Phillips,&nbsp;R. Tran,&nbsp;A. Brahmbhatt","doi":"10.1002/anr3.70088","DOIUrl":"10.1002/anr3.70088","url":null,"abstract":"<div>\u0000 \u0000 <p>Anaphylaxis is a potentially life-threatening hypersensitivity reaction, most typically caused by neuromuscular blocking agents or antibiotics in the peri-operative setting. Propofol is the most common induction agent used during anaesthesia, and the occurrence of anaphylaxis is rare. This is a case report of suspected propofol anaphylaxis after induction of anaesthesia for cerebral aneurysm clipping surgery in a 51-year-old man who had previously been exposed to propofol. Recognition of the early signs of anaphylaxis, prompt management and follow-up allergy skin testing are crucial for confirming the diagnosis.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Addressing the gender confidence gap in anaesthesia training","authors":"R. Tully,&nbsp;E. Keane","doi":"10.1002/anr3.70095","DOIUrl":"10.1002/anr3.70095","url":null,"abstract":"","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148594803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning curves and demographic influence on skill acquisition of artificial intelligence-assisted videolaryngoscopy training with the LarynGuide™ system: A pilot simulation study","authors":"M. Sorbello,&nbsp;D. S. Paternò,&nbsp;E. C. Lo Giudice,&nbsp;A. Maniaci,&nbsp;F. Pappalardo,&nbsp;L. La Via","doi":"10.1002/anr3.70090","DOIUrl":"10.1002/anr3.70090","url":null,"abstract":"<div>\u0000 \u0000 <p>Videolaryngoscopy is increasingly important in airway management, but optimal training methods remain unclear. Artificial intelligence may enhance procedural skill acquisition through real-time feedback and guidance. This high-fidelity simulation pilot study characterised the learning curve of artificial intelligence-assisted videolaryngoscopy using the LarynGuide™ system in a mixed cohort of medical students, anaesthesia residents and qualified anaesthetists with limited or no prior experience of videolaryngoscopy. Ninety-nine healthcare practitioners (medical students, medical doctors, anaesthesia residents and specialists) performed 10 intubation attempts on a high-fidelity simulator with artificial intelligence-assisted real-time feedback. Optimal intubation was defined a priori as ≥90% probability of time to intubation &lt;30 s combined with a percentage of glottic opening &gt;90%. Tracheal intubation success, defined as completion of tracheal tube placement, irrespective of the number of laryngoscopy passes, was achieved in 951 of 990 attempts (96%), with mean (SD) time to intubation of 16 (13) s. At the group level, basic procedural competency (≥90% cumulative success rate, assessed using cumulative sum analysis) was reached at the fourth attempt. Success rates plateaued thereafter, time to intubation continued to fall until the seventh attempt, and the percentage of glottic opening continued to improve through the tenth attempt. Exploratory modelling estimated that more than 10 attempts would be required to reach a 90% probability of optimal intubation. Anaesthesia residents performed better than participants with no prior intubation experience: higher success rate (98% versus 93%, p = 0.003), better glottic visualisation (mean percentage of glottic opening 90% versus 78%, p &lt; 0.001) and shorter time to intubation (14 s versus 18 s, p = 0.021). Participants with prior video game experience reached optimal intubation thresholds four attempts earlier than non-gamers (p = 0.018). Outcomes were worse in the 60- to 70-year subgroup (n = 3, p &lt; 0.001), while the participants' sex had no influence. Satisfaction ratings were high, with ease of use reported as 9/10. Artificial intelligence-assisted videolaryngoscopy facilitated rapid acquisition of basic competency within four attempts in this pilot simulation cohort. Exploratory modelling suggests differences from historical benchmarks which warrant further investigation.</p>\u0000 </div>","PeriodicalId":72186,"journal":{"name":"Anaesthesia reports","volume":"14 2","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148551494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}