World Anaesthesia Day commemorates the first successful demonstration of ether anaesthesia on 16 October 1846, which took place at the Massachusetts General Hospital, home of the Harvard School of Medicine. This ranks as one of the most significant events in the history of medicine and the discovery made it possible for patients to obtain the benefits of surgical treatment without the pain associated with an operation. To celebrate, we’re highlighting a selection of British Journal of Anaesthesia podcasts to learn more about anaesthesia practices today.
Failed tracheal intubation in Obstetrics
Dr A. Quinn, from Leeds General Infirmary in the UK, lead author of a recent BJA paper on failed tracheal intubation in obstetric anaesthesia talks us through this important UK national prospective survey. Using the UK Obstetric Surveillance System (UKOSS) of data collection, Dr Quinn and colleagues confirm the expected incidence of failed tracheal intubation in obstetrics at one in 224, and that the incidence of failed intubations hasn’t decreased in the last 20 years, despite advances in airway techniques. Age, BMI, and a recorded Mallampati score were significant independent predictors of failed tracheal intubation. (January 2013 || Volume 110 – Issue 1 || 20 Minutes)
Long-term quality of sleep after remifentanil-based anaesthesia: a randomized controlled trial
Dr Rik Thomas talks with Dr Manuel Wenk (lead author) about the inspiration and background behind this unusual randomised controlled trial. Dr Wenk summarises what we already know about the effects of opioids on sleep, and why remifentanil may differ in this respect. Dr Wenk goes on to explain his unexpected findings and the potential long-term effects remifentanil may have on sleep quality after surgery. (February 2013 || Volume 110 – Issue 2 || 16 Minutes)
Human factors and patient safety in anaesthesia
The majority of morbidity and mortality due to anaesthesia is unfortunately caused by human error. In this podcast, Professors Alan Merry and Jennifer Weller gives us an introduction to human factors in anaesthesia, the types of errors that occur and strategies to prevent them. We explore communication failure within the operating theatre environment, the differences between a blame-free and just culture, and the anaesthetist’s role in promoting patient safety. (May 2013 || Volume 110 – Issue 5 || 32 Minutes)
NAP5 and the recent controversial guidance from NICE are putting commercial depth of anaesthesia monitors under intense scrutiny. How do they work? Does their use correlate with a reduced incidence of awareness? What is the neurobiological basis for the relationship between EEG activity and depth of anaesthesia? A group from Glasgow have developed a new type of DOA monitor that is a radical departure from the conventional number generation box. Dr John Glenn and Dr Bernd Porr explain how their electroencephalophone (EEP) harnesses the power of the human ear as the system’s signal processing unit. By transducing the EEG signal into a real time audible sound wave, the EEP produces a sound that can be used to distinguish between the anaesthetised and the awake patient. Drs Glenn and Porr discuss the potential advantages the EEP holds over traditional DOA monitors, future testing and research, and their open approach to development of this exciting new technology. (September 2013 || Volume 111 – Issue 3 || 32 Minutes)
Propofol use by non-anaesthetists in the Emergency Department
Opinions on the use of propofol by non-anaesthetists remain controversial and divided. In this podcast Dr Gavin Lloyd, an emergency physician from The Royal Devon and Exeter NHS Foundation Trust, gives his point of view and describes his experience developing a training program and governance framework for propofol use in the resus room. Dr Lloyd and Dr Thomas explore the relative risks and potential benefits of propofol use in the ED, discuss the results from the accompanying paper and look at the recently published College guidance for the sedation of adults in the ED. (October 2013 || Volume 111 – Issue 4 || 25 Minutes)
For more information, visit the dedicated BJA World Anaesthesia Day webpage for a selection of free articles.