European journal of anaesthesiology
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Current regulations of anaesthesiology training programmes may affect gender equity, female representation and leadership. ⋯ European countries have a wide variety of regulations. On paper, numerous countries have various paid maternal, paternal and parental leave; however, it remains to be determined if such leave takes place in practice. The practical consequences of these regulations on female trainees during the child-rearing period need to be explored further.
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Randomized Controlled Trial
Programmed intermittent bolus infusion vs. continuous infusion for erector spinae plane block in video-assisted thoracoscopic surgery: A double-blinded randomised controlled trial.
The optimal form of administration for erector spinae plane block has not been established. ⋯ PIB for erector spinae plane block in video-assisted thoracic surgery resulted in a larger anaesthetised area and required a lower anaesthetic dose to maintain the analgesic effect. Therefore, it is more suitable for erector spinae plane block than continuous infusion.
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Recent data indicated a high incidence of inappropriate management of neuromuscular block, with a high rate of residual paralysis and relaxant-associated postoperative complications. These data are alarming in that the available neuromuscular monitoring, as well as myorelaxants and their antagonists basically allow well tolerated management of neuromuscular blockade. In this first European Society of Anaesthesiology and Intensive Care (ESAIC) guideline on peri-operative management of neuromuscular block, we aim to present aggregated and evidence-based recommendations to assist clinicians provide best medical care and ensure patient safety. ⋯ R7 We recommend using sugammadex to antagonise deep, moderate and shallow neuromuscular blockade induced by aminosteroidal agents (rocuronium, vecuronium) (1A). R8 We recommend advanced spontaneous recovery (i.e. TOF ratio >0.2) before starting neostigmine-based reversal and to continue quantitative monitoring of neuromuscular blockade until a TOF ratio of more than 0.9 has been attained. (1C).
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Anaesthesiologists and intensive care doctors have become progressively more mobile across Europe. The standardisation of training systems has been recommended by the European Union of Medical Specialist (UEMS) to facilitate the mutual recognition of professionals. ⋯ This survey highlighted the diversity in the training in anaesthesiology and intensive care medicine in Europe despite the recommendations advocated by the EBA-UEMS. The findings on the duration of training demonstrated that the target of 5 years has not been universally achieved yet with a substantial difference between EU and non-EU countries. The presented evidence suggests the need for initiatives dedicated to implement compliance with the advocated duration and competence requirements reported in the European Training Requirement for anaesthesiology and intensive care by UEMS.