Anaesthesia and Intensive Care最新文献

{"title":"A scoping review for published guidelines for use of ketamine in chronic non-cancer pain.","authors":"Meredith L M Daff, Sophie A Eblen, Andrew A Somogyi, Kathryn V Rough, Irina B Hollington","doi":"10.1177/0310057X261460082","DOIUrl":"https://doi.org/10.1177/0310057X261460082","url":null,"abstract":"<p><p>Off-label ketamine infusions are often used to manage chronic non-cancer pain (CNCP), including neuropathic pain, central sensitisation and opioid dose reduction. There are variable treatment regimens and routes of delivery based on clinical trials but there is the distinct lack of any clearly defined treatment guidelines. The goal of the scoping review was to determine whether there has been progress with the availability of published guidelines. Our inclusion criteria were publications that contained ketamine infusion, chronic pain and guidelines or protocols. We excluded publications that contained only acute pain, cancer pain or the paediatric population. A literature search was conducted on 10 May 2024 and included the medical scholarly literature databases MEDLINE and Embase and the evidence-based database Trip (formerly Turning Research into Practice; now Trip only; Trip Database Ltd, UK) Pro and limited to English language papers. Additional publications that were encountered during background reading were also included. A total of 42 publications were examined against the inclusion/exclusion criteria by the first three authors. The included full-text publications were then reviewed to determine whether they were considered a guideline. The three identified publications were then comparatively reviewed against the National Health and Medical Research Council standards for guidelines as a qualitative assessment, with 34-76% of standards met. This review found no published guidelines in Australia for use of ketamine in CNCP, despite ongoing clinical use. The authors' conclusion is that this is an area that should be addressed. Efficacy and adverse effects of off-label ketamine use should be able to be measured against an established guideline. Without a consistent and standard approach, the role of ketamine in this setting is unable to be thoroughly assessed. Such a guideline may be developed through expert consensus.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X261460082"},"PeriodicalIF":1.5,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148629075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid blowout with 'can't intubate, can't oxygenate' crisis: Supraglottic surgical airway rescue.","authors":"William T Birkett, Walston R Martis, Luke O'Halloran","doi":"10.1177/0310057X261462196","DOIUrl":"https://doi.org/10.1177/0310057X261462196","url":null,"abstract":"<p><p>We describe an out-of-theatre hypoxic cardiac arrest precipitated by spontaneous carotid blowout syndrome, resulting in massive haemorrhage with airway contamination and a 'can't intubate, can't oxygenate' crisis. Emergency front-of-neck access (eFONA) using a scalpel-bougie technique unintentionally traversed the thyrohyoid membrane; however, this fortuitously enabled effective oxygenation and return of spontaneous circulation. Ongoing oropharyngeal haemorrhage was stabilised with packing and haemostatic resuscitation prior to definitive endovascular repair of an internal carotid pseudoaneurysm. This case demonstrates that an unintended thyrohyoidotomy, although not recommended, may function as a viable eFONA route in extremis, and highlights that temporary packing should be considered as part of a multidisciplinary approach to the management of major airway bleeding.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"310057X261462196"},"PeriodicalIF":1.5,"publicationDate":"2026-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148590179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The use of communication applications among anaesthetists and other medical professionals in Australia: results of a national survey.","authors":"Emily H Jaarsma, Braden Rivers, Tristan Adams, Clayton Lam, Brigid Brown, Tim S Cheok, Hidde M Kroon, D-Yin Lin","doi":"10.1177/0310057X261427782","DOIUrl":"10.1177/0310057X261427782","url":null,"abstract":"<p><p>Communication applications offer healthcare professionals a simple, instantaneous and direct form of connection within a healthcare team. This cross-sectional survey aimed to examine current usage patterns among Australian medical practitioners and assess their understanding of data security and ethical considerations. Among 151 respondents, most of whom were anaesthetists (77%) practising in metropolitan centres (82%) across South Australia, Queensland, and New South Wales, the Apple iPhone was the most popular device type (77%) while WhatsApp was the preferred application for facilitating patient-based discussions (75%). Doctors sent an average of one to 10 patient-related messages per week, although junior doctors were significantly more likely to exceed this number. The majority (66%) of doctors felt comfortable sharing non-identifying patient information, in comparison to 32% who felt comfortable sharing identifying patient information. Participants demonstrated inconsistent understanding of consent and documentation requirements when transmitting patient data. These findings highlight the routine use of communication applications in Australian hospitals and emphasise the need for greater clinician education on privacy obligations and the development of clear, ethical guidelines for their use in healthcare.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"364-374"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328923/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Resuscitation using a Swan-Ganz pacing catheter following refractory intraoperative asystole during open abdominal aortic aneurysm repair.","authors":"Mitchell K Petersen","doi":"10.1177/0310057X261427456","DOIUrl":"10.1177/0310057X261427456","url":null,"abstract":"<p><p>We report the case of a 75-year-old man who suffered an intraoperative asystolic cardiac arrest during elective open repair of an abdominal aortic aneurysm. Return of circulation was achieved following the initiation of temporary right ventricular pacing via a Swan-Ganz pacing catheter. The patient experienced a further episode of refractory asystole in the postoperative period, with subsequent insertion of a permanent pacemaker. This case highlights the role of a Swan-Ganz pacing catheter as a resuscitative measure in refractory intraoperative asystole during major non-cardiac surgery.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"381-384"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728077","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on Residual neuromuscular blockade following electroconvulsive therapy.","authors":"Charles H Kellner, Ethan O Bryson","doi":"10.1177/0310057X251408363","DOIUrl":"10.1177/0310057X251408363","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"405-406"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two needles, one haystack: Lessons from spinal tuberculosis mimicking lumbar epidural complication in a post-partum patient.","authors":"Adam Lipszyc, Ajit Sivasankaran","doi":"10.1177/0310057X251397159","DOIUrl":"10.1177/0310057X251397159","url":null,"abstract":"<p><p>While both considered rare in contemporary Australian anaesthetic practice, the symptoms of epidural complication can mimic those of spinal tuberculosis, as we outline here in this unusual case. A 33-year-old woman presented to hospital with new neurological deficits days after receiving a lumbar epidural for labour analgesia. A complication of epidural was initially suspected; however, spinal tuberculosis was found be the cause. This case demonstrates many of the challenges and unique requirements involved in providing neuraxial anaesthesia to the obstetric cohort, namely: consenting linguistically diverse patients, providing advice on discharge, and the role of anaesthetics in expediting time-critical investigations.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"385-389"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146027817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to 'Reducing plastic in single-use central line insertion packs: a mixed methods observational study'.","authors":"Ismail K Zazay, James R Burmeister","doi":"10.1177/0310057X261415904","DOIUrl":"10.1177/0310057X261415904","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"393"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148025299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to comment on: Residual neuromuscular blockade following electroconvulsive therapy.","authors":"Siaavash Maghami, Dale Currigan","doi":"10.1177/0310057X251408355","DOIUrl":"10.1177/0310057X251408355","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"407-408"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148248864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurological outcome of patients with a non-traumatic infratentorial cerebellar haematoma admitted to the intensive care unit.","authors":"Lionel Kerhuel, Magali Simony, Eimad Shotar, Sophie Menat, Bertrand Mathon, Anne-Laure Boch, Sophie Crozier, Lamine Abdennour, Eléonore Bayen, Vincent Degos, Alice Jacquens","doi":"10.1177/0310057X261420839","DOIUrl":"10.1177/0310057X261420839","url":null,"abstract":"<p><p>Non-traumatic infratentorial cerebellar haematomas can occur spontaneously or secondarily to a vascular malformation, leading to life-threatening conditions that can necessitate surgical or radiological interventions and admission to the Neurological Intensive Care Unit (NICU). We conducted a retrospective, single-centre observational study over a 17-year period (2005-2022) involving all adult patients admitted to the NICU of a French tertiary centre with a diagnosis of non-traumatic infratentorial cerebellar brain haematoma. Among the 88 patients (median age 58 (interquartile range (IQR) 48-67) years) included in the study, a vascular malformation was found in 36 patients (41%). Surgical evacuation of the haematoma or a radio-embolisation procedure was performed in 53 patients (60%) and 18 patients (20%) respectively. Median length of NICU stay was 26 (IQR 12-45) days, and prolonged ventilatory support (>21 days) was necessary in 35 patients (40%). In NICU survivors, awareness recovery occurred at a median of 3 (IQR 1-6) days after discontinuation of sedation. NICU mortality was 19% (<i>n</i> = 17), and 97% (<i>n</i> = 62) of the NICU survivors who were included in the three-month follow-up were alive, while 56% (<i>n</i> = 36) had a favourable neurological outcome (modified Rankin Scale (mRS) ⩽ 3). We found a significant association between an unfavourable neurological outcome (three-month mRS score > 3) and advanced age (<i>P</i> = 0.004), pre-existing antithrombotic therapy (<i>P</i> = 0.04), low Glasgow Coma Scale score on admission (<i>P</i> < 0.001), presence of a ventricular haemorrhage (<i>P</i> = 0.04), presence of brainstem compression (<i>P</i> < 0.001) and delay in awareness recovery (<i>P</i> = 0.005). Among patients with a cerebellar haematoma and impaired alertness, half will have a favourable outcome at three months. Further studies are needed to explore these results over time and at other centres.</p>","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"347-355"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147728155","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design and implementation of an emergency front-of-neck access cognitive aid at a tertiary metropolitan hospital.","authors":"David J Tsang, Michelle Horne, Brydie Clark, Chad W Oughton","doi":"10.1177/0310057X251397170","DOIUrl":"10.1177/0310057X251397170","url":null,"abstract":"","PeriodicalId":7746,"journal":{"name":"Anaesthesia and Intensive Care","volume":" ","pages":"400-402"},"PeriodicalIF":1.5,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146200107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}