Anaesthetists Handbook - MEDICAL EDUCATION at University ...

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Gabapentin in acute pain• Fassoulaki et al. Multimodal analgesia with gabapentin and localanesthetics prevents acute and chronic pain after breast surgeryfor cancer. Anesth Analg 2005; 101:1427-32• Jesper et al. A randomized study of the effects of single-dosegabapentin versus placebo on postoperative pain and morphineconsumption after mastectomy. Anesthesiology 2002; 97(3):560-4• Pandey et al. Evaluation of the optimal preemptive dose ofgabapentin for postoperative pain relief after lumbar diskectomy:a randomized, double-blind, placebo-controlled study. Journal ofNeurosurgical Anesthesiology 2005; 17(2): 65-8• Rorarius et al. Gabapentin for the prevention of postoperativepain after vaginal hysterectomy. Pain 2004; 110(1): 175-81• Rowbotham. Gabapentin: a new drug for postoperative pain?British Journal of Anaesthesia 2006; 96(2):152-5176 Anaesthetists Handbook January 2010
Blood and blood productsBlood and blood productsBlood transfusion – indications[Dr Mark Porter, January 2006; appraised by Dr Keith Clayton, January 2010]Blood transfusion can bring benefit but also has significant risks andcomplications. Each unit of blood is a scarce resource. In cases ofsignificant expected or actual haemorrhage, arrange for haemoglobinmonitoring to be available using in-theatres testing with HemoCue orarterial blood gas analysis. Remember that there are significantdilutional and rebound effects on the measured haemoglobin level.Do not attempt to manage massive haemorrhage on your own.Discuss potential cases with a senior colleague and call for help if ithappens.In case of acute haemorrhage or when you expect cross-matchedblood to be exhausted: call for senior help, then telephone bloodbank to discuss the patient’s needs. There is emergency ‘O Rh(D)negative’ blood available. Group specific blood (‘red label blood’) willalways arrive more quickly than cross-matched blood.YOU MUST CHECK ALL BLOOD PRODUCTS AGAINST THEPATIENT’S IDENTITY.The identity is recorded on the patient’s armband. You should confirmthe armband information with the patient on admission to theatres ifpossible. Remember to identify the patient positively – ask them tostate their name, date of birth and address, rather than just asking,for example, “Are you Mr Fred Jones?”The following guidelines are appropriate to elective surgery. Theymay be appropriate to urgent surgery but you should considercarefully how the urgent situation could change appropriatemanagement.• Where possible, anaemia should be corrected prior to majorsurgery to reduce exposure to allogeneic transfusion.Anaesthetists Handbook January 2010 177
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Department of AnaesthesiaAnaestheti
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Document control for approved clini
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ContentsTrauma list anaesthetist (t
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ContentsStudy leave 81Junior doctor
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ContentsIndications for investigati
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ContentsRenal patients - clinical g
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Introduction and scope of guideline
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Introduction and scope of guideline
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Airway assessmentManaging difficult
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Managing difficult airways• Flexi
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Managing difficult airways• Manuj
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Resuscitation - advanced life suppo
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Resuscitation - advanced life suppo
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Duties of the on call anaesthetists
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Getting senior helpGetting senior h
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On call casesGetting senior helpYou
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Supervision for sick patientsGettin
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Calling the senior resident anaesth
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Perianaesthesia Care Unit (PACU)PAC
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PACUThe surgical team responsible f
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PACU6. Oxygen and intravenous thera
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Integration with the critical care
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Inter-hospital transfersInter-hospi
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Inter-hospital transfersConsultant
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Signing onAdministrative issuesYour
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Administrative issuesMobile phones
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Administrative issuesobstetrics, we
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Administrative issuesMain theatre r
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CLWrota processes• To complete ca
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Security rules:• Do not put confi
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Education and trainingthe Royal Col
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Education and trainingthe necessary
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Education and trainingarrive in the
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Education and traininginformation c
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Education and trainingexamination i
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Education and trainingAll consultan
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Presenting at seminars• Bring har
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Presenting at seminarsDOI advise yo
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Clinical adverse event reportingCli
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Clinical auditClinical audit[Apprai
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Clinical auditYour presentation sho
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Pain management and postoperative c
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Signs and symptomsAgitation, anxiet
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Epidural anaesthesia and analgesiaP
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Page 133 and 134: Assessment and treatment optionsEpi
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Page 143 and 144: Allergies and adverse drug reaction
Page 149 and 150: Awareness during anaesthesiaPrevent
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Page 153 and 154: Fractured neck of femurGuidelines f
Page 155 and 156: Management of patients with diabete
Page 157 and 158: Patients who take insulinManagement
Page 163 and 164: Preoperative assessment and investi
Page 167 and 168: Indications for investigationsFull
Page 171 and 172: SevofluraneSevoflurane[Dr Mark Port
Page 173 and 174: Sevofluranemust be considered on it
Page 175: Gabapentin in acute painSide-effect
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Page 181 and 182: Blood and blood productsCross match
Page 183 and 184: Blood and blood productsBlood Cool
Page 185 and 186: Blood and blood productsHaematology
Page 187 and 188: Blood and blood products25322 so th
Page 189 and 190: Blood and blood productsfactors, ha
Page 191 and 192: Day case anaesthesia6. Social crite
Page 193 and 194: ENT anaesthesiaENT anaesthesia{Dr C
Page 195 and 196: ENT anaesthesiaIntraoperative• In
Page 197 and 198: Miscellaneous issuesMiscellaneous i
Page 199 and 200: Miscellaneous issuesideally be cont
Page 201 and 202: Miscellaneous issuesinstruction man
Page 203 and 204: Miscellaneous issuesRemifentanilRem
Page 205 and 206: Miscellaneous issuesCentral neuraxi
Page 207 and 208: Miscellaneous issuesAnalgesia Fenta
Page 209 and 210: Miscellaneous issues• Diclofenac
Page 211 and 212: Miscellaneous issues• Associated
Page 213 and 214: Miscellaneous issues• Everyone wi
Page 215 and 216: Miscellaneous issues• If fasting
Page 217 and 218: Miscellaneous issueslabour ward ana
Page 219 and 220: Miscellaneous issuesThere is no cli
Page 221 and 222: Patient monitoring in and out of th
Page 223 and 224: Miscellaneous issuessuch as Hartman
Page 225 and 226: Miscellaneous issues• Abdominal a
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Miscellaneous issuesPrevention of p
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Miscellaneous issuesDifferent clini
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Recovery and patient handoverMiscel
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For afternoon list (pm)Diabetic Pat
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Miscellaneous issuestake part in th
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Miscellaneous issuesSee page 37 for
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Waiting list initiatives[Appraised
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Major Incident ProcedureStaff assem
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Major Incident Procedure• In coop
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Finding your way round theUniversit
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• Coffee room.• Quiet room (fiv
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Anaesthesia department lead clinici
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Trust organisational structureTrust
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Telephone numbersLabour ward……
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IndexIndexAabsence, 68adenotonsille
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Indexemergency department, 222emerg
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Indexmortality review, 93MRI scansa
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Indexstudy leave, 81applications, 6
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NotesAnaesthetists Handbook January
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NotesAnaesthetists Handbook January
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