All Articles

This article describes the Difficult Airway Society’s algorithm for dealing with situations where, intubation and mask ventilation are difficult or impossible‘Can’t intubate, can’t ventilate’ – December 1, 2009

Abdominal compartment syndrome (ACS) is a condition associated with significant morbidity and mortality. This article includes a case summary of a patient who developed ACS, after which the pathophysiology, diagnosis and management of this important condition are discussed.
Abdominal Compartment Syndrome – December 1, 2012

The aim of this article is to provide the reader with a basic understanding of the physiology and biochemistry of acid base balance and its disturbances. This subject is often made unnecessarily complex and most disturbances of acid base control can be understood with the application of a few key principles.Acid Base Balance (Update 13) – June 1, 2001

This overview is written to give a basic understanding of the blood gas and a step-wise approach to its interpretation. The section on physics is to give a more complete understanding but you can gloss over it and go straight to the clinical significance.
Acid Base Balance and Interpretation of Blood Gas Results (Update 16) – June 1, 2003

Disorders in acid-base balance are commonly found in critically ill patients. Clinicians responsible for these patients need a clear understanding of acid-base pathophysiology in order to provide effective treatment for these disorders. Acid-base Disorders in Critical Care (Update 28, 2012) – December 21, 2012

This review is for anaesthetists who specialise in intensive care, focusing on the first few days following injury to the cervical spine and the spinal cord. Acute cervical spine injuries in adults (Update 28, 2012) – December 21, 2012

The anaesthetist’s involvement will range from participating in the resuscitation of patients with polytrauma to the provision of safe anaesthesia to allow surgical treatment for cervical spine or other injuries. The importance of early immobilization is emphasised and strategies used to ‘clear’ the cervical spine are described.Acute Cervical Spine Injury – June 1, 2008

This article describes the causes, diagnosis and management of acute kidney injury (AKI). Many centres in the developing world do not have access to renal replacement therapy and the emphasis is on prompt recognition, treatment and prevention of worsening AKI.
Acute kidney injury (Update 28, 2012) – December 21, 2012

Successful management of this rare but potentially devastating disorder relies on early recognition. The hallmark of acute liver failure (ALF) is encephalopathy (ranging from a subtle alterations in consciousness level to coma) in the context of an acute, severe liver injury.Acute Liver Failure in ICU – June 1, 2007

Oxygen has been used in clinical practice for more than 200 years. It is probably the most widely prescribed medication in pre-hospital and hospital environments. If appropriately used it is life-saving and part of first-line treatment in many critical conditions. As with any drug, oxygen should be used when indicated, in appropriate dosage (concentration), and correctly administered for a planned duration.
Acute Oxygen Treatment – December 1, 2000

This article is a review of the current recommendations relating to this group of patients and outlines the approach to management of acute pain in the opioid tolerant patient by anaesthetists in the hospital setting.Acute pain management for opioid tolerant patients – October 28, 2011

ARDS is a process of hypoxaemic respiratory failure associated with non-cardiogenic pulmonary oedema. It is the result of diffuse inflammatory damage to the alveoli and pulmonary capillaries from a range of local or systemic insults. ARDS is often associated with multiple organ dysfunction and carries a high mortality and financial cost.
Acute Respiratory Distress Syndrome – June 1, 2007

Identify and treat the underlying cause
Ventilate at low tidal volume
Apply generous PEEP
Maintain a low hydrostatic pressure in the lungs (avoid fluid overload)
Consider the prone position in severe cases
Consider steroids in persistent ARDS
Acute respiratory distress syndrome (Update 28, 2012) – December 21, 2012

Anaesthesia for neurosurgical procedures requires understanding of the normal anatomy and physiology of the central nervous system and the likely changes that occur in response to the presence of space occupying lesions, trauma or infection.An Introduction to Anaesthesia for Neurosurgery – December 1, 2007

Caesarean section (LSCS) is one of the commonest operations performed in the developing world and is often carried out in difficult circumstances. As with any operation, the anaesthetist should first think about all the problems that may occur as it is always better to be prepared for trouble than to be taken by surprise.Anaesthesia for Caesarian Section – December 1, 1998

Correction of strabismus is the most commonly performed paediatric ophthalmic operation. Strabismus surgery is normally carried out under general anaesthetic (always so in children), although a local anaesthetic technique may occasionally be used in adults.Anaesthesia for Correction of Strabismus – December 1, 2003

Electro convulsive therapy (ECT) is the electrical induction of a grandmal seizure. It is an effective therapy used as part of the treatment of several psychiatric conditions including depression, mania, catatonic schizophrenia and other psychosis. A short general anaesthetic is usually given for the procedure.Anaesthesia for Electroconvulsive Therapy – June 1, 2003

Anaesthesia for emergency eye surgery can present special problems to the anaesthetist. This article discusses the specific problems of emergency anaesthesia for eye surgery. We try and answer the common questions concerning these patients and provide a practical guide.Anaesthesia for Emergency Eye Surgery – June 1, 2000

Surgery on the eye can be performed under either local or general anaesthesia. In the previous issue of Update techniques for local anaesthesia were described. In this article the principles of general anaesthesia for eye surgery are outlined.Anaesthesia for Eye Surgery – General Anaesthesia – June 1, 1998

Ophthalmic surgery can be performed under either regional or general anaesthesia. This article describes regional anaesthesia. In the article general anaesthesia will be discussed.Anaesthesia for Eye Surgery – Regional Techniques – June 1, 2003

Spinal anaesthesia is appropriate for shorter procedures, whereas general anaesthesia in combination with a regional technique is generally used for procedures over two hours. Ankle block and sciatic nerve block at the
knee provide effective perioperative analgesia and both are described in detail.
Anaesthesia for Foot and Ankle Surgery – June 1, 2008

This article describes the anaesthetic management of some of the commonly performed paediatric ENT procedures, including adenotonsillectomy, oesophagoscopy, and middle ear surgery.Anaesthesia for Paediatric ENT Surgery – June 1, 2008

Management of these high risk patients is addressed with an emphasis on reducing postoperative complicationsAnaesthesia for Patients with Cardiac Disease Undergoing Non-cardiac Surgery – June 1, 2002

One of the major risks posed by patients who have not been prepared for theatre is that they may not have an empty stomach. Aspiration pneumonitis is especially severe, and often fatal, if the gastric contents are markedly acidic (pH < 2.5). As little as 30mls will cause a severe reaction. When solid foodstuffs are aspirated complete obstruction of the airway may occur.Anaesthesia for the Patient with a Full Stomach – June 1, 1994

TURP is a cystoscopic procedure used to alleviate the symptoms of bladder outflow obstruction, usually caused by benign prostatic hypertrophy (BPH). BPH affects 50% of males at 60 years and 90% of 85-year-olds and so TURP is most commonly performed on elderly patients, a population group with a high incidence of cardiac, respiratory and renal disease. The mortality rate associated with TURP is 0.2-6%, with the commonest cause of death being myocardial infarction. Safe anaesthesia depends on the detection and optimisation of co-existing diseases, and on weighing up the relative risks and benefits of regional and general anaesthesia for each patient.Anaesthesia for TURP – June 1, 2003

In some places, by necessity, children undergo anaesthesia with inadequate facilities. Transport to another unit is frequently not an option and the following article describes a method to adapt the EMO system for use in children under 15kg. The technique requires anaesthesia training and should not be attempted by someone without the ability to intubate.Anaesthesia in Children using the EMO System – June 1, 1998

Modern hospital practice has seen the role of the anaesthesiogist expand beyond the operating theatre complex. While the operating theatres have experienced staff, adequate equipment and monitors, providing anaesthesia outside this complex is challenging and requires expertise and skill.Anaesthesia Outside the Operating Theatre – June 1, 2009

As a new trainee in anaesthesia one of the most important skills to acquire is anaesthetic decision making, in particular choosing the most suitable anaesthetic for a particular patient. We propose an algorithm that allows the novice trainee to conceptualise the process in a simple, logical and sequential way.Anaesthetic decision making – October 28, 2011

Anaesthetic novice decision support algorithm Download – Anaesthetic novice decision support algorithm (Update 2011) Rachel Rogers and Alastair HellewellAnaesthetic novice decision support algorithm – October 28, 2011

The ankle block is a safe and effective method for obtaining anaesthesia and analgesia of the foot for surgical procedures on bones and soft tissues.Ankle Blocks – June 1, 1999