British journal of anaesthesia
-
Editorial Comment
'If you don't take a temperature, you can't find a fever': relevance to continuous arterial pressure monitoring.
Intraoperative hypotension is common and is associated with adverse postoperative outcomes. A substantial fraction of all perioperative hypotension occurs shortly after induction of anaesthesia and before the procedure begins. ⋯ Continuous blood pressure monitoring might help reduce hypotension. There are now strong arguments that if an arterial line is indicated, it should be placed before induction of anaesthesia to obtain maximal benefit.
-
General anaesthesia in the neonatal period has detrimental effects on the developing mammalian brain. The impact of underlying inflammation on anaesthesia-induced developmental neurotoxicity remains largely unknown. ⋯ Systemic inflammation promotes developmental neurotoxicity by worsening anaesthesia-induced neuronal damage with sex-specific behavioural outcomes. This highlights the importance of studying anaesthesia-induced neurotoxicity in more clinically relevant settings.
-
Recent evidence, highlighted in this editorial, creates a strong argument for universal use of videolaryngoscopy in anaesthesia to improve efficiency and safety of tracheal intubation. In a recent study published in the British Journal of Anaesthesia, the authors implemented widespread (66%) use of videolaryngoscopy as first choice in one hospital and compared this with a control hospital, in which this was not implemented. ⋯ Locations outside the operating theatre might also benefit from universal laryngoscopy, but the evidence base is less robust, most notably in pre-hospital emergency medicine. The extent to which variation in results in different locations is attributable to different patient factors or organisational and operator factors is considered.