Rapid Sequence

The need for safe, stable and sustainable resumption of planned surgery in an era of COVID‐19

Today we published a new editorial which outlines the principles laid out in the recently released document from the Royal College of Anaesthetists, the Association of Anaesthetists and the Faculty of Intensive Care Medicine on resumption of planned surgical services.

The resumption of planned healthcare in 2021 is both a necessity and an opportunity, but it will require co‐ordination at all levels and acknowledgement and planning that accommodates the physical and psychological needs of those who have worked throughout the pandemic in order to deliver the safe, stable and sustainable service that will be required in the years to come.

Authors Professor Tim Cook and Dr Tei Sheraton are joined by Dr Kariem El-Boghdadly to go through the many issues raised in the paper.

Malignant hyperthermia guideline from the Association of Anaesthetists

Malignant hyperthermia (MH) is a rare anaesthetic emergency. It has been estimated to occur in between 1:10,000 and 1:150,000 general anaesthetics, though there is much uncertainity about the precision of these estimates.

The Association of Anaesthetists has not previously published full MH guidelines. In the absence of any recent guidelines published in a peer reviewed journal, rather than simply updating the 2011 crisis management laminates, a Working Party was established to produce these formal comprehensive guidelines. Importantly, the scope of these guidelines is extended to include practical guidance for anaesthetists dealing with a case of suspected malignant hyperthermia once the acute reaction has been reversed.

With us today we have the lead author of the paper, Professor Phil Hopkins from the Malignant Hyperthermia Unit at St. James’ University Hospital and the University of Leeds. We are also delighted to be joined by Connor Philips, an award-winning television presenter, BBC radio presenter, writer and live event host whose broadcasting work includes sport, entertainment, current affairs, film, music, travel, comedy and property. Connor and several family members have been affected by MH, and his insights and experiences of this rare condition will be of interest to all.

Timing of surgery following SARS-CoV-2 infection

Today we will explore our exciting new publication that examines the timing of surgery after SARS-CoV-2 infection. 

With us today we have Joana Simoes, Dmitri Nepogodiev and Aneel Bhangu who are co-authors of the paper. They were interviewed by Ben Morton, who is an Editor of Anaesthesia. The authors are representatives from the NIHR Global Health Research Unit on Global Surgery, a collaborative team who authored this piece.

This multi-cente, multi-country prospective cohort study examined the risk of death after surgery following an episode of SARS-CoV-2 infection. We, at the journal, felt that the findings are highly clinically relevant and are extremely pleased that the team has agreed to this live broadcast to discuss their findings.

The importance of women’s health in peri‐operative care

“When we get it right for girls and women, everyone benefits." 

On #InternationalWomensDay2021 we were delighted to publish a special issue of 17 free to access articles all about the importance of women's health in peri-operative care. 

For this podcast, Seema Agarwal and Helen Laycock were joined by Ed Mullins and Alana Flexman to discuss some of the most important themes from the issue. 

The prevention of opioid‐related harm in adult surgical patients

With us today we have Dr Jane Quinlan from Oxford and Dr Nicholas Levy from Bury St. Edmunds, who are co-authors of a new international multidisciplinary consensus statement on the prevention of opioid‐related harm in adult surgical patients. Their aim was to provide balanced guidance on the safe peri‐operative use of opioids in adults.

The guidance should assist healthcare professionals and hospitals across the world to implement effective opioid stewardship practices that achieve a balance between the administration of sufficient opioid analgesia to facilitate recovery and restoration of function, while concurrently minimising the risk of opioid‐related harms.

This one is not just aimed at anaesthetists or doctors, but all healthcare professionals, patients and the public alike!

Mortality in patients admitted to intensive care with COVID‐19

Armstrong et al. conducted an initial systematic review and meta‐analysis of 24 observational studies published by 31 May 2020, which included 10,150 patients, finding that mortality was 41.6%, with evidence that this was decreasing as the pandemic progressed.

This new updated meta-analysis seems to show that any fall in mortality rate between June and September appears to have flattened or plateaued.

For this podcast, Mike Charlesworth speaks with authors Richard Armstrong and Tim Cook, as well as Danny Bryden, Rupert Pearse, Mandeep-Kaur Phull and Zudin Puthucheary. 

Direct reporting of awareness in maternity patients (DREAMY)

The direct reporting of awareness in maternity patients (DREAMY) study was a multicentre, prospective cohort study that aimed to establish the incidence, risk‐factors and sequelae of AAGA in obstetrics. A secondary study was embedded within it with the aim of describing general anaesthesia practice in obstetric patients in the UK.

We were joined live by authors Dr Peter Odor and Professor Nuala Lucas, as well as OAA President Dr Chris Elton. We discussed everything to do with these papers but also obstetric general anaesthesia more generally. 

Innovations in regional anaesthesia

This podcast is taken from the second live broadcast to support our 2021 regional anaesthesia supplement. The chairs, Laura Duggan and Ed Mariano, discuss innovations in regional anaesthesia with six more of our authors.

Fundamentals of regional anaesthesia

This podcast is taken from the first live broadcast to support our 2021 regional anaesthesia supplement. The chairs, Ki-Jinn Chin and Kariem El-Boghdadly, discuss the fundamentals of regional anaesthesia with six of our authors. 

COVID-19 vaccines: one step towards the beginning of the end of the global pandemic?

This month's podcast is taken from our first ever live broadcast with Professor Sir Jeremy Farrar (@JeremyFarrar) and Professor Tim Cook (@doctimcook). Mike Charlesworth (@Miko_Charleswor) and Louise Savic (@LouiseSavic) ask questions all about their new paper, which discusses everything to do with the COVID-19 vaccines. Enjoy!