Anaesthesia and intensive care
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An integrative review of the literature specific to leadership within the intensive care unit was planned to guide future research. Four databases were searched. Study selection was based on predetermined inclusion and exclusion criteria and a quality check was done. ⋯ Personal individual factors seem the biggest enablers and barriers to leadership within the intensive care unit. Training is considered to be a facilitator of leadership within the intensive care unit. This study highlights the current literature on leadership in intensive care medicine and provides a basis for future research on interventions to improve leadership in the intensive care unit.
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Anaesth Intensive Care · Jul 2020
A survey of neuraxial analgesic preferences in open and laparoscopic major abdominal surgery amongst anaesthetists in Australia and New Zealand.
Practising anaesthetists who are Fellows of the Australian and New Zealand College of Anaesthetists were surveyed with the objective of gaining insight into current analgesic preferences, with particular regard to neuraxial techniques, when managing patients having major open and laparoscopic abdominal surgery. Major abdominal surgery is common and effective analgesia is fundamental to optimal postoperative recovery. A multitude of analgesic options exist, with epidurals recommended in recent Enhanced Recovery After Surgery protocols. ⋯ Less than half of the respondents used epidural or spinal analgesia in open surgery (48% versus 49% of respondents, respectively). A minority (16%) of respondents use a neuraxial technique in major laparoscopic surgery, with a strong preference for intrathecal morphine (74%) when they choose to do so. Further investigation of the role of intrathecal analgesia is warranted given the shift towards laparoscopic major abdominal surgery, the perceived benefits of neuraxial techniques and the need for opioid-sparing analgesic strategies.