Anaesthesia and climate change: time to wake up? A rapid qualitative appraisal exploring the views of anaesthetic practitioners regarding the transition to TIVA and the reduction of desflurane.

Background: The National Health Service (NHS) has pledged to reach carbon net-zero by 2040. In alignment with this goal, a London hospital's anaesthesia department is actively reducing desflurane use and transitioning towards total intravenous anaesthesia (TIVA) as a sustainable alternative, contributing to environmentally responsible practices within the healthcare sector.

Methods: We conducted a rapid qualitative appraisal through online interviews with 17 anaesthetic practitioners to explore their perspectives regarding this climate change mitigation strategy.

Anaesthesia and COVID-19: infection control.

The world is currently facing an unprecedented healthcare crisis caused by a pandemic novel beta coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pathogen is spread by human-to-human transmission via droplets exposure and contact transfer, causing mild symptoms in the majority of cases, but critical illness, bilateral viral pneumonia, and acute respiratory distress syndrome (ARDS) in a minority. Currently, controlling infection to prevent the spread of SARS-CoV-2 is the primary public healthcare intervention used.

Measuring quality of recovery-15 after day case surgery.

Background: 'Quality of recovery' scores are patient-reported outcome measures evaluating recovery after surgery and anaesthesia. However, they are not widely used in the clinical or research setting. The Quality of Recovery-15 (QoR-15) is a recently developed, psychometrically tested and validated questionnaire.

Development of an ultrasound phantom for spinal injections with 3-dimensional printing.

Background And Objectives: This report describes a method for producing anatomically detailed, low-cost ultrasound phantoms of the spine with 3-dimensional printing. An implementation that involves representing a portion of the lumbar spine and the ligamentum flavum with 2 different printing materials and the surrounding soft tissues with agar gel is presented.

Methods: A computed tomography image volume of a patient with normal spinal anatomy was segmented to isolate the spine.

Improving the Peri-operative care of Patients by instituting a 'Block Room' for Regional Anaesthesia.

Regional anaesthesia has multiple known benefits over general anaesthesia alone, but requires time and expertise for its application. This study aimed to decrease anaesthetic time and increase total surgical operative time by instituting a 'block room' where regional anaesthesia nerve blocks could be provided by expert anaesthetists in regular scheduled sessions. A baseline audit showed that 2 hours per day was spent on performing nerve blocks.

Postoperative visual loss following prone spinal surgery.

Postoperative visual loss is a rare but disastrous complication that has an estimated incidence of 0.01-1% after non-ocular surgery. We report a patient who underwent a prolonged spinal operation in the prone position and complained of blindness in one eye postoperatively.

Thirty percent of patients have moderate to severe pain 24 hr after ambulatory surgery: a survey of 5,703 patients.

Purpose: Postoperative pain is the commonest reason for delayed discharge and unanticipated hospital admission after ambulatory surgery. We investigated the severity of pain at 24 hr postoperatively and determined the most painful procedures. The need for further medical advice and clarity of postoperative analgesia instructions were also studied.

Pain management in ambulatory surgery.

Successful ambulatory surgery is dependent on analgesia that is effective, has minimal adverse effects, and can be safely managed by the patient at home after discharge. A number of studies have identified that the provision of effective postoperative analgesia is inadequate for a significant proportion of patients. The following discussion details the current available analgesic options for ambulatory surgery patients and the rationale for their use.