Clinical hypnosis: implications in anaesthesia and perioperative care.

A randomised trial published in the British Journal of Anaesthesia describes hypnosis compared with general anaesthesia in 60 children undergoing superficial surgery. We describe a definition of clinical hypnosis; the goals and conduct of hypnotic communication; and its potential as both an adjunct and, in suitable cases, alternative to traditional pharmacological anaesthesia.

Suggestions in Hypnosis to Aid Pain Education (SHAPE) in People with Chronic Low-Back Pain: A Pilot Feasibility Randomized, Controlled Trial.

Chronic low back pain (CLBP) is a debilitating and burdensome condition, and new treatment strategies are needed. This study aimed to evaluate (1) the feasibility of undertaking a controlled clinical trial investigating a novel intervention for people with CLBP: hypnotically reinforced pain science education, and (2) the acceptability of the intervention as rated by participants. feasibility and intervention acceptability criteria were set.

Nocebo language in anaesthetic patient written information.

Recent evidence suggests that how anaesthesia information is presented may influence patient treatment outcomes. We conducted an observational study of anaesthetic-based patient information leaflets across NHS Trusts in England for their nocebo terms vs. therapeutic terms, and how adverse effects were presented.

Implications of nocebo in anaesthesia care.

Nocebo refers to non-pharmacological adverse effects of an intervention. Well-intended procedural warnings frequently function as a nocebo. Both nocebo and placebo are integral to the generation of 'real' treatment effects and their associated 'real' side-effects.

Satisfaction measures in pediatric anesthesia and perioperative care.

Patient satisfaction is routinely used to assess the quality of care in medicine. In the field of anesthesia, research has been primarily directed toward developing satisfaction measures in adults with little attention paid to the pediatric population. Satisfaction in pediatric anesthesia and perioperative care is poorly understood.

Invasive placebos in research on peripheral nerve blocks: a follow-up study.

Introduction: The Serious Harm and Morbidity "SHAM" grading system has previously been proposed to categorize the risks associated with the use of invasive placebos in peripheral nerve block research. SHAM grades range from 0 (no potential complications, eg, using standard analgesia techniques as a comparator) through to 4 (risk of major complications, eg, performing a sub-Tenon's block and injecting normal saline). A study in 2011 found that 52% of studies of peripheral nerve blocks had SHAM grades of 3 or more.

Antenatal education for childbirth: Labour and birth.

Introduction: This study aimed to identify the way information is described and presented by childbirth educators during antenatal classes for expectant parents, and analyse the language structures used when discussing labour and birth.

Methods: This cross-sectional study of antenatal education was conducted at a single tertiary referral centre for Maternity Care in Western Sydney, Australia. All childbirth educators (n=3) were recorded whilst providing information to parents during antenatal classes.

Subcutaneous fentanyl for labour analgesia: a retrospective case note review.

Background: In 2017, a South Australia Perinatal Practice Guideline was introduced state-wide for the use of subcutaneous fentanyl for labour analgesia as a replacement for intramuscular pethidine. We retrospectively reviewed the implementation of this practice change in our institution.

Methods: A retrospective review of maternal and neonatal case notes for the first 100 women administered subcutaneous fentanyl in labour at a single tertiary referral centre for maternity care, between February and June 2017.

Consent for spine surgery: an observational study.

Background: The tension between the ideal of informed consent and the reality of the process is under-investigated in spine surgery. Guidelines around consent imply a logical, plain-speaking process with a clear endpoint, agreement and signature yet surgeons' surveys and patient interviews suggest that surgeons' explanation is anecdotally variable and patient understanding remains poor. To obtain a more authentic reflection of practice, spine surgeons obtaining 'informed consent' for non-instrumented spine surgery were studied via video recording and risk/benefit discussions were analysed.

Techniques for preventing hypotension during spinal anaesthesia for caesarean section.

Background: Maternal hypotension is the most frequent complication of spinal anaesthesia for caesarean section. It can be associated with nausea or vomiting and may pose serious risks to the mother (unconsciousness, pulmonary aspiration) and baby (hypoxia, acidosis, neurological injury).

Objectives: To assess the effects of prophylactic interventions for hypotension following spinal anaesthesia for caesarean section.

Little words BIG impact: Perioperative communication for children with burns.

Anaesthetists are key members of teams caring for burn-injured children in almost every aspect of their management. Their role can involve initial resuscitation, intensive care, analgesia, and anaesthesia for multiple procedures both acutely and subsequently for scar management. As key members of burns management teams, effective communication with patients and their families as well as other members of the burn care team is vital.

Perioperative transversus abdominis plane (TAP) blocks for analgesia after abdominal surgery.

At April 2020, this review has been withdrawn. It is correct at the date of publication, and previous versions can be accessed in the 'Other versions' tab on the Cochrane Library. We are aware of new studies to potentially change the conclusions, however the update did not meet the timelines and expectations of Cochrane and the PaPaS review group.

Fentanyl concentration in maternal and umbilical cord plasma following intranasal or subcutaneous administration in labour.

Background: The effect that the route of maternal fentanyl administration has on placental transfer of drug to the neonate is not well studied. Plasma concentration ratios are an indicator of fetal exposure, relative to the mother.

Methods: A cohort study (n=30) was conducted to measure fentanyl concentrations in maternal plasma, and arterial and venous cord blood, among women administered either intranasal or subcutaneous fentanyl for labour pain relief.

Combined spinal-epidural versus spinal anaesthesia for caesarean section.

Background: Single-shot spinal anaesthesia (SSS) and combined spinal-epidural (CSE) anaesthesia are both commonly used for caesarean section anaesthesia. Spinals offer technical simplicity and rapid onset of nerve blockade which can be associated with hypotension. CSE anaesthesia allows for more gradual onset and also prolongation of the anaesthesia through use of a catheter.

The Laurs of Hypnotic Communication and the "Lived in Imagination" Technique in Medical Practice.

This article describes two common hypnotic communication techniques that can be used in anesthesiology and more generally for a variety of medical applications. First, the LAURS (listening, acceptance, utilization, reframing, suggestion) hypnotic communication structure is detailed. This technique allows clinicians to rapidly build patient rapport and maximize the chance of a suggestion being realized.

Antenatal education for childbirth-epidural analgesia.

Unlabelled: The language structures used by antenatal educators have not been previously researched in the context of antenatal childbirth classes. Epidural analgesia for labour is a common, and a frequently asked about, component of antenatal education for parents in hospitals providing maternity care.

Aim Of The Study: We aimed to identify the way information is described and presented by childbirth educators to assess content and determine which language structures such as metaphor, suggestion, information and storytelling are utilized.

Epidural versus non-epidural or no analgesia for pain management in labour.

Background: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011.

"Experience Isn't Everything": How Emotion Affects the Relationship Between Experience and Cue Utilization.

Objective: This research examined whether negative and positive arousal emotions modify the relationship between experience level and cue utilization among anesthetists.

Background: The capacity of a practitioner to form precise associations between clusters of features (e.g.

Systematic review and consensus definitions for the Standardised Endpoints in Perioperative Medicine (StEP) initiative: patient comfort.

Background: Maximising patient comfort during and after surgery is a primary concern of anaesthetists and other perioperative clinicians, but objective measures of what constitutes patient comfort in the perioperative period remain poorly defined. The Standardised Endpoints in Perioperative Medicine initiative was established to derive a set of standardised endpoints for use in perioperative clinical trials.

Methods: We undertook a systematic review to identify measures of patient comfort used in the anaesthetic, surgical, and other perioperative literature.

Successful spinal anaesthesia in a patient with a Tarlov cyst.

Perineural (Tarlov) cysts are cerebrospinal fluid-containing perineural sacs that are usually located in the sacral spine. While often asymptomatic, they can cause progressive neurological symptoms including pain, paraesthesia and weakness. We present a case of a 24-year-old patient who had uneventful spinal anaesthesia at the L3-4 level for an elective caesarean section.