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1. Dedicated anticoagulation management protocols in fragility femoral fracture care – a source of significant variance and limited effectiveness in improving time to surgery: The hip and femoral fracture anticoagulation surgical timing evaluation (HASTE) study

Author

Smith, Matthew, Yoong, Andrel, Lim, Jun Wei, Yousef, Omar, McDonald, Stephen, Chileshe, Chinga, Ramus, Camilla, Clements, Christopher, Barrett, Liam, Rockall, Oliver, Geetala, Rahul, Islam, Saif Ul, Nasar, Ahmad, Almond, Kieran, Hassan, Ladan Fatima Yusuf, Shah, Sohan, Brand, Robert Bruce, Yawar, Bakhat, Gilmore, Catherine, McAuley, Daryl, Khan, Waleed, Subramanian, Padmanabhan, Ahluwalia, Aashish, Ozbek, Leyla, Awasthi, Prashant, Sheikh, Hassaan, Barkley, Sarah, Ardolino, Toni, Denning, Alexander, Thiruchandran, Gaj, Fraig, Hossam, Salim, Omar, Iqbal, Rabia, Guy, Stephen, Hogg, Jack, Bagshaw, Oliver, Asmar, Samir, Mitchell, Stephen, Quek, Fang, Fletcher, James, French, Jonathan, Graham, Selina, Sloper, Philip, Sadique, Hammad, Matera, Valentina, Sohail, Zain, Leong, Justin Wei, Issa, Fares, Greasley, Lauren, Marsden, Samuel, Parry, Lucy, Mannan, Syed, Zaheen, Humayoon, Moriarty, Peter, Manning, William, Morris, Timothy, Brockbanks, Carole, Ward, Peter, Pearce, Kim, McMenemy, Louise, Mahmoud, Mohamed, Kieffer, Will, Lal, Aayush, Collis, Justin, Chandrasekaran, Karthik, Foxall-Smith, Michael, Raad, Marjan, Kempshall, Peter, Cheuk, Jocelyn, Leckey, Sam, Gupta, Rishav, Engelke, Daniel, Kemp, Mark, Venkatesan, Aakaash, Hussain, Adnan, Simons, Michiel, Raghavendra, Ram Mohan, Rohra, Satish, Deo, Sunny, Vasarhelyi, Ferenc, Thelwall, Claire, Cullen, Krista, Al-Obaidi, Bilal, Fell, Adam, Thaumeen, Ahmad, Dadabhoy, Maria, Ali, Mira, Ijaz, Sameer, Lin, David, Khan, Basharat, Alsonbaty, Mohamed, Lebe, Moritz, Millan, Ravi Kant, Imam, Sam, Theobald, Emma, Cormack, Jonathan, Sharoff, Lokesh, Eardley, Will, Jeyapalan, Rathan, Alcock, Liam, Clayton, Julia, Bates, Natalie, Mahmoud, Yousif, Osborne, Alex, Ralhan, Shvaita, Carpenter, Catriona, Ahmad, Mahmood, Ravi, Sanjeev Musuvathy, Konbaz, Tarek, Lloyd, Thomas, Sheikh, Nomaan, Swealem, Ahmed, Soroya, Emma, Rayan, Faizal, Ward, Thomas, Vasireddy, Aswinkumar, Clarke, Ellisiv, Sikdar, Oishi, Smart, Yat Wing, Windley, Joseph, Ilagan, Belen, Brophy, Edel, Joseph, Sarah, Lowery, Kathryn, Jamjoom, Ammer, Ismayl, Ghiath, Aujla, Randeep, Sambhwani, Sharan, Ramasamy, Arul, Khalaf, Ahmed, Ponugoti, Nikhil, Teng, Wai Huang, Masud, Saqib, Otoibhili, Eghe, Clarkson, Martin, Nafea, Mohamed, Sarhan, Mohamed, Hanna, Shady, Kelly, Andrew, Curtis, Alex, Gourbault, Lysander, Tarhini, Mariam, Platt, Nicholas, Fleming, Thomas, Pemmaraju, Gopalakrishna, Choudri, Mohammed Junaid, Burahee, Abdus, Hassan, Labiba, Hamid, Laveeza, Loveday, David, Edres, Kareem, Schankat, Kerstin, Granger, Luke, Goodbun, Matthew, Parikh, Sunny, Johnson-Lynn, Sarah, Griffiths, Alexandra, Rai, Avinash, Chandler, Henry, Guiot, Luke, Appleyard, Thomas, Robinson, Karen, Fong, Angus, Watts, Anna, Stedman, Tobias, Walton, Victoria, Inman, Dominic, Liaw, Frank, Hadfield, James, McGovern, Julia, Baldock, Thomas, White, Jonathan, Seah, Matthew, Jacob, Neville, Ali, Zaid Haj, Goff, Thomas, Sanalla, Ahmed, Gomati, Ayoub, Nordin, Louise, Hassan, Eslam, Ramadan, Omar, Teoh, Kar Hao, Baskaran, Dinnish, Ngwayi, James, Abbakr, Lina, Blackmore, Noah, Mansukhani, Sameer, Guryel, Enis, Harper, Adam, Cashman, Emily, Brooker, Joanne, Pack, Louise, Regan, Nora, Wagner, Wilhelm, Selim, Amr, Archer, Debbie, McConaghie, Gregory, Patel, Ravi, Gibson, William, Pasapula, Chandra S, Youssef, Hesham, Aziz, Md Abdul, Subhash, Sadhin, Banaszkiewicz, Paul, Elzawahry, Ahmed, Neo, Chryssa, Wei, Nicholas, Bhaskaran, Arun, Sharma, Abhishek, Factor, Danielle, Shahin, Fatma, Shields, David, Ferreira, Catarina Dores Fernandes, Jeyakumar, Gowsikan, Liao, Quintin, Sinnerton, Robert, Ashwood, Neil, Sarhan, Islam, Ker, Andrew, Phelan, Sean, Paxton, James, McAuley, Joseph, Moulton, Lawrence, Mohamed, Ahmed, Dias, Ana, Ho, Beatrice, Francis, Daniel, Miller, Sarah, Phillips, Jon, Jones, Robin, Arthur, Calum, Oag, Erlend, Thutoetsile, Kamogelo, Bell, Katrina, Milne, Kirsty, Whitefield, Reiss, Patel, Kuntal, Singh, Abhimanyu, Morris, Geraint, Parkinson, Dawn, Patil, Amogh, Hamid, Hassan, Syam, Kevin, Singh, Rohit, Menon, Deepak, Crooks, Sophie, Borland, Steven, Rohman, Adam, Nicholson, Alys, Smith, Ben, Hafiz, Nauman, Kolhe, Shivam, Waites, Matthew, Piper, Dani, Westacott, David, Grimshaw, Jessica, Bott, Alasdair, Berry, Alexander, Battle, Joseph, Flannery, Oliver, Iyengar, Karthikeyan P, Thakur, Abdul Wadood, Yousef, Mina, Bansod, Vaibhav, El-nahas, Walaa, Dawe, Edward, Oladeji, Emmanuel, Federer, Simon, Trompeter, Alex, Pritchard, Anna, Shurovi, Badrun, Jordan, Chris, Little, Max, Sivaloganathan, Sivanshankar, Shaunak, Shalin, Watters, Hazel, Luck, Joshua, Zbaeda, Mohamed, Frasquet-Garcia, Antonio, Warner, Christian, Telford, Jeremy, Rooney, Joanna, Attwood, Joseph, Wilson, Faye, Panagiotopoulos, Andreas, Keane, Conal, Scott, Helen, Mazel, Rebecca, Maggs, Joanna, Skinner, Edward, McMunn, Finlay, Lau, Joshua, Ravikumar, Kasetti, Thakker, Dev, Gill, Moneet, McCarthy, Phillip, Fossey, Gavin, Shah, Sohaib, McAlinden, Gavan, McGoldrick, Peter, O'Brien, Scarlett, Patil, Sunit, Millington, Antonia, Umar, Hamza, Sehdev, Simran, Dyer-Hill, Thomas, Yu Kwan, Tsun, Tanagho, Andy, Hagnasir, Ahmed, White, Thomas, Bano, Christopher, Kissin, Eleanor, Ghani, Rafia, Thomas, Philip S W, McMullan, Mark, Walmsley, Matthew, Elgendy, Mohamed, Winstanley, Robert, Round, Joanne, Baxter, Mark, Thompson, Emett, Hogan, Kathryn, Youssef, Khaled, Fetouh, Sherif, Hopper, Graeme P, Simpson, Cameron, Warren, Craig, Waugh, Dominic, Nair, Gopikrishnan, Ballantyne, Andy, Blacklock, Calum, O'Connell, Ciara, Toland, Gemma, McIntyre, Joshua, Ross, Lauren, Badge, Ravindra, Loganathan, Deeraj, Turner, Ian, Ball, Matthew, Maqsood, Saad, Deierl, Krisztian, Beer, Alexander, Tan, Arthur Chen Wun, Mackinnon, Thomas, Gade, Venkat, Gill, James, Yu San, Kay, Archunan, Maheswaran Warren, Shaikh, Mariyam, Ugbah, Onyinye, Uwaoma, Sade, Pillai, Anand, Nath, Upamanyu, Rohan, Farhan-Alanie, M. M., Dixon, J., Irvine, S., Walker, R., and Eardley, W. G. P.

Published
2024
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2. The impact of anticoagulant medications on fragility femur fracture care: The hip and femoral fracture anticoagulation surgical timing evaluation (HASTE) study

Author

Smith, Matthew, Yoong, Andrel, Lim, Jun Wei, Yousef, Omar, McDonald, Stephen, Chileshe, Chinga, Ramus, Camilla, Clements, Christopher, Barrett, Liam, Rockall, Oliver, Geetala, Rahul, Islam, Saif Ul, Nasar, Ahmad, Almond, Kieran, Hassan, Ladan Fatima Yusuf, Shah, Sohan, Brand, Robert Bruce, Yawar, Bakhat, Gilmore, Catherine, McAuley, Daryl, Khan, Waleed, Subramanian, Padmanabhan, Ahluwalia, Aashish, Ozbek, Leyla, Awasthi, Prashant, Sheikh, Hassaan, Barkley, Sarah, Ardolino, Toni, Denning, Alexander, Thiruchandran, Gaj, Fraig, Hossam, Salim, Omar, Iqbal, Rabia, Guy, Stephen, Hogg, Jack, Bagshaw, Oliver, Asmar, Samir, Mitchell, Stephen, Quek, Fang, Fletcher, James, French, Jonathan, Graham, Selina, Sloper, Philip, Sadique, Hammad, Matera, Valentina, Sohail, Zain, Leong, Justin Wei, Issa, Fares, Greasley, Lauren, Marsden, Samuel, Parry, Lucy, Mannan, Syed, Zaheen, Humayoon, Moriarty, Peter, Manning, William, Morris, Timothy, Brockbanks, Carole, Ward, Peter, Pearce, Kim, McMenemy, Louise, Mahmoud, Mohamed, Kieffer, Will, Lal, Aayush, Collis, Justin, Chandrasekaran, Karthik, Foxall-Smith, Michael, Raad, Marjan, Kempshall, Peter, Cheuk, Jocelyn, Leckey, Sam, Gupta, Rishav, Engelke, Daniel, Kemp, Mark, Venkatesan, Aakaash, Hussain, Adnan, Simons, Michiel, Raghavendra, Ram Mohan, Rohra, Satish, Deo, Sunny, Vasarhelyi, Ferenc, Thelwall, Claire, Cullen, Krista, Al-Obaidi, Bilal, Fell, Adam, Thaumeen, Ahmad, Dadabhoy, Maria, Ali, Mira, Ijaz, Sameer, Lin, David, Khan, Basharat, Alsonbaty, Mohamed, Lebe, Moritz, Millan, Ravi Kant, Imam, Sam, Theobald, Emma, Cormack, Jonathan, Sharoff, Lokesh, Eаrdley, Will, Jeyapalan, Rathan, Alcock, Liam, Clayton, Julia, Bates, Natalie, Mahmoud, Yousif, Osborne, Alex, Ralhan, Shvaita, Carpenter, Catriona, Ahmad, Mahmood, Ravi, Sanjeev Musuvathy, Konbaz, Tarek, Lloyd, Thomas, Sheikh, Nomaan, Swealem, Ahmed, Soroya, Emma, Rayan, Faizal, Ward, Thomas, Vasireddy, Aswinkumar, Clarke, Ellisiv, Sikdar, Oishi, Smart, Yat Wing, Windley, Joseph, Ilagan, Belen, Brophy, Edel, Joseph, Sarah, Lowery, Kathryn, Jamjoom, Ammer, Ismayl, Ghiath, Aujla, Randeep, Sambhwani, Sharan, Ramasamy, Arul, Khalaf, Ahmed, Ponugoti, Nikhil, Teng, Wai Huang, Masud, Saqib, Otoibhili, Eghe, Clarkson, Martin, Nafea, Mohamed, Sarhan, Mohamed, Hanna, Shady, Kelly, Andrew, Curtis, Alex, Gourbault, Lysander, Tarhini, Mariam, Platt, Nicholas, Fleming, Thomas, Pemmaraju, Gopalakrishna, Choudri, Mohammed Junaid, Burahee, Abdus, Hassan, Labiba, Hamid, Laveeza, Loveday, David, Edres, Kareem, Schankat, Kerstin, Granger, Luke, Goodbun, Matthew, Parikh, Sunny, Johnson-Lynn, Sarah, Griffiths, Alexandra, Rai, Avinash, Chandler, Henry, Guiot, Luke, Appleyard, Thomas, Robinson, Karen, Fong, Angus, Watts, Anna, Stedman, Tobias, Walton, Victoria, Inman, Dominic, Liaw, Frank, Hadfield, James, McGovern, Julia, Baldock, Thomas, White, Jonathan, Seah, Matthew, Jacob, Neville, Ali, Zaid Haj, Goff, Thomas, Sanalla, Ahmed, Gomati, Ayoub, Nordin, Louise, Hassan, Eslam, Ramadan, Omar, Teoh, Kar Hao, Baskaran, Dinnish, Ngwayi, James, Abbakr, Lina, Blackmore, Noah, Mansukhani, Sameer, Guryel, Enis, Harper, Adam, Cashman, Emily, Brooker, Joanne, Pack, Louise, Regan, Nora, Wagner, Wilhelm, Selim, Amr, Archer, Debbie, McConaghie, Gregory, Patel, Ravi, Gibson, William, Pasapula, Chandra S, Youssef, Hesham, Aziz, Md Abdul, Subhash, Sadhin, Banaszkiewicz, Paul, Elzawahry, Ahmed, Neo, Chryssa, Wei, Nicholas, Bhaskaran, Arun, Sharma, Abhishek, Factor, Danielle, Shahin, Fatma, Shields, David, Ferreira, Catarina Dores Fernandes, Jeyakumar, Gowsikan, Liao, Quintin, Sinnerton, Robert, Ashwood, Neil, Sarhan, Islam, Ker, Andrew, Phelan, Sean, Paxton, James, McAuley, Joseph, Moulton, Lawrence, Mohamed, Ahmed, Dias, Ana, Ho, Beatrice, Francis, Daniel, Miller, Sarah, Phillips, Jon, Jones, Robin, Arthur, Calum, Oag, Erlend, Thutoetsile, Kamogelo, Bell, Katrina, Milne, Kirsty, Whitefield, Reiss, Patel, Kuntal, Singh, Abhimanyu, Morris, Geraint, Parkinson, Dawn, Patil, Amogh, Hamid, Hassan, Syam, Kevin, Singh, Rohit, Menon, Deepak, Crooks, Sophie, Borland, Steven, Rohman, Adam, Nicholson, Alys, Smith, Ben, Hafiz, Nauman, Kolhe, Shivam, Waites, Matthew, Piper, Dani, Westacott, David, Grimshaw, Jessica, Bott, Alasdair, Berry, Alexander, Battle, Joseph, Flannery, Oliver, Iyengar, Karthikeyan P, Thakur, Abdul Wadood, Yousef, Mina, Bansod, Vaibhav, El-nahas, Walaa, Dawe, Edward, Oladeji, Emmanuel, Federer, Simon, Trompeter, Alex, Pritchard, Anna, Shurovi, Badrun, Jordan, Chris, Little, Max, Sivaloganathan, Sivanshankar, Shaunak, Shalin, Watters, Hazel, Luck, Joshua, Zbaeda, Mohamed, Frasquet-Garcia, Antonio, Warner, Christian, Telford, Jeremy, Rooney, Joanna, Attwood, Joseph, Wilson, Faye, Panagiotopoulos, Andreas, Keane, Conal, Scott, Helen, Mazel, Rebecca, Maggs, Joanna, Skinner, Edward, McMunn, Finlay, Lau, Joshua, Ravikumar, Kasetti, Thakker, Dev, Gill, Moneet, McCarthy, Phillip, Fossey, Gavin, Shah, Sohaib, McAlinden, Gavan, McGoldrick, Peter, O'Brien, Scarlett, Patil, Sunit, Millington, Antonia, Umar, Hamza, Sehdev, Simran, Dyer-Hill, Thomas, Yu Kwan, Tsun, Tanagho, Andy, Hagnasir, Ahmed, White, Thomas, Bano, Christopher, Kissin, Eleanor, Ghani, Rafia, Thomas, Philip S W, McMullan, Mark, Walmsley, Matthew, Elgendy, Mohamed, Winstanley, Robert, Round, Joanne, Baxter, Mark, Thompson, Emett, Hogan, Kathryn, Youssef, Khaled, Fetouh, Sherif, Hopper, Graeme P, Simpson, Cameron, Warren, Craig, Waugh, Dominic, Nair, Gopikrishnan, Ballantyne, Andy, Blacklock, Calum, O'Connell, Ciara, Toland, Gemma, McIntyre, Joshua, Ross, Lauren, Badge, Ravindra, Loganathan, Deeraj, Turner, Ian, Ball, Matthew, Maqsood, Saad, Deierl, Krisztian, Beer, Alexander, Tan, Arthur Chen Wun, Mackinnon, Thomas, Gade, Venkat, Gill, James, Yu San, Kay, Archunan, Maheswaran Warren, Shaikh, Mariyam, Ugbah, Onyinye, Uwaoma, Sade, Pillai, Anand, Nath, Upamanyu, Rohan, Farhan-Alanie, M.M., Chinweze, R., Walker, R., and Eardley, W.G.P.

Published
2024
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6. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial

Author

Davidson, Andrew J, Disma, Nicola, de Graaff, Jurgen C, Withington, Davinia E, Dorris, Liam, Bell, Graham, Stargatt, Robyn, Bellinger, David C, Schuster, Tibor, Arnup, Sarah J, Hardy, Pollyanna, Hunt, Rodney W, Takagi, Michael J, Giribaldi, Gaia, Hartmann, Penelope L, Salvo, Ida, Morton, Neil S, von Ungern Sternberg, Britta S, Locatelli, Bruno Guido, Wilton, Niall, Lynn, Anne, Thomas, Joss J, Polaner, David, Bagshaw, Oliver, Szmuk, Peter, Absalom, Anthony R, Frawley, Geoff, Berde, Charles, Ormond, Gillian D, Marmor, Jacki, and McCann, Mary Ellen

Published
2016
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8. Anesthesia for Thoracic Surgery

Author

Bagshaw, Oliver, Cray, Steven, Parikh, Dakshesh H., editor, Crabbe, David C. G., editor, Auldist, Alexander W., editor, and Rothenberg, Steven S., editor

Published
2009
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9. Relationship between decrement time and recovery time in pediatric total intravenous anesthesia with propofol and remifentanil.

Author

Bagshaw, Oliver

Subjects
*INTRAVENOUS anesthesia, *PROPOFOL, *REMIFENTANIL, *STATISTICAL correlation, *MANN Whitney U Test
Abstract

Background: Propofol target‐controlled infusion is now used in many countries for the administration of total intravenous anesthesia (TIVA) and uses population pharmacokinetic data incorporated into the target‐controlled infusion pump to administer a dose which will achieve a target concentration selected by the practitioner. Modern target‐controlled infusion pumps can include an estimate of how long it will take for the plasma propofol concentration to fall to a value programmed into the pump, once the propofol infusion is stopped. This is known as decrement time. Many users consider decrement time to be equivalent to recovery time for the patient, despite the several assumptions that makes. Aim: To determine if the decrement time estimated by the target‐controlled infusion pumps at the end of anesthesia could be reliably used to predict recovery time for individual patients. Methods: Target‐controlled infusion pumps at Birmingham Children's Hospital are programmed with a propofol decrement concentration of 1.5 μg.mL−1. Patients for a variety of surgical procedures were anesthetised with propofol–remifentanil TIVA. Eye opening was used as a surrogate of recovery time. Data were analyzed using median absolute deviation, Mann–Whitney U test, and linear regression to see if there was any correlation with decrement time and recovery time, total dose of propofol administered, duration of anesthesia and patient age. Results: A total of 55 patients were audited. Median age was 7.2 years (range 0.9–15.9), and median weight was 26 kg (range 8.5–77). Median decrement time was 11.8 min (IQR 8.3–21), while median recovery time was 15 min (IQR 9–20). Recovery time was the same as decrement time in 2% of patients, less than in 40% of patients and more in 58% of patients. Two thirds of patients opened eyes at an estimated plasma propofol concentration between 1.2 and 1.8 μg.mL−1. The median absolute deviation for the difference between decrement time and recovery time was 5.7 min, from a median of 1 min. Analysis demonstrated there was no statistical correlation between decrement time to 1.5 μg.mL−1 and recovery time, age, total propofol dose administered, or duration of anesthesia, for individual patients. Conclusion: There was variation between decrement time to 1.5 μg.mL−1 and recovery time of over 5 min in nearly half of patients. Decrement time to 1.5 μg.mL−1 must be used with caution when trying to predict recovery time for individual patients following TIVA. [ABSTRACT FROM AUTHOR]

Published
2023
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16. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial

Author

Leerstoel Baar, Development and Treatment of Psychosocial Problems, Mccann, Mary Ellen, De Graaff, Jurgen C, Dorris, Liam, Disma, Nicola, Withington, Davinia, Bell, Graham, Grobler, Anneke, Stargatt, Robyn, Hunt, Rodney W, Sheppard, Suzette J, Marmor, Jacki, Giribaldi, Gaia, Bellinger, David, Hartmann, Penelope L, Hardy, Pollyanna, Frawley, Geoff, Izzo, Francesca, Von Ungern-sternberg, Britta, Lynn, Anne, Wilton, Niall, Mueller, Martin, Polaner, David M, Absalom, Anthony R, Szmuk, Peter, Morton, Neil S, Berde, Charles, Soriano, Sulpicio, Davidson, Andrew J, Arnup, Sarah, Lee, Katherine, Hunt, Rod W, Ormond, Gillian D, Takagi, Michael J, Taylor, Kaitlyn, Malarbi, Stephanie, Doyle, Melissa, Ragg, Philip, Costi, David, Wilton, Niall C, Knottenbelt, Graham, Furue, Koto, Gagnon, Hélène, Mameli, Leila, Pini Prato, Alessio, Mattioli, Girolamo, Wolfler, Andrea, Bova, Stefania M, Krachmalnicoff, Arianna, Guuva, Claudia, Van Der Werff, Desiree Bm, Van Gool, Jose Tdg, Van Loon, Kim, Kalkman, Cor J, Van Baar, Anneloes L, Hoekstra, Frouckje M, Volkers, Martin, Oostra, Martine, Pownall, Jaycee, Waldman, Jack, Hind, Ruth, Symonds, Joseph D, Bagshaw, Oliver, Sethna, Navil, Kovatsis, Pete, Cravero, Joseph, Ivanova, Iskra, Hunyady, Agnes, Verma, Shilpa, Polaner, David, Thomas, Joss, Haret, Denisa, Steiner, Jeffrey, Kravitz, Brian, Farrow-gillespie, Alan, Suresh, Santhanam, Hays, Stephen, Taenzer, Andreas, Maxwell, Lynne, Williams, Robert, Leerstoel Baar, Development and Treatment of Psychosocial Problems, Mccann, Mary Ellen, De Graaff, Jurgen C, Dorris, Liam, Disma, Nicola, Withington, Davinia, Bell, Graham, Grobler, Anneke, Stargatt, Robyn, Hunt, Rodney W, Sheppard, Suzette J, Marmor, Jacki, Giribaldi, Gaia, Bellinger, David, Hartmann, Penelope L, Hardy, Pollyanna, Frawley, Geoff, Izzo, Francesca, Von Ungern-sternberg, Britta, Lynn, Anne, Wilton, Niall, Mueller, Martin, Polaner, David M, Absalom, Anthony R, Szmuk, Peter, Morton, Neil S, Berde, Charles, Soriano, Sulpicio, Davidson, Andrew J, Arnup, Sarah, Lee, Katherine, Hunt, Rod W, Ormond, Gillian D, Takagi, Michael J, Taylor, Kaitlyn, Malarbi, Stephanie, Doyle, Melissa, Ragg, Philip, Costi, David, Wilton, Niall C, Knottenbelt, Graham, Furue, Koto, Gagnon, Hélène, Mameli, Leila, Pini Prato, Alessio, Mattioli, Girolamo, Wolfler, Andrea, Bova, Stefania M, Krachmalnicoff, Arianna, Guuva, Claudia, Van Der Werff, Desiree Bm, Van Gool, Jose Tdg, Van Loon, Kim, Kalkman, Cor J, Van Baar, Anneloes L, Hoekstra, Frouckje M, Volkers, Martin, Oostra, Martine, Pownall, Jaycee, Waldman, Jack, Hind, Ruth, Symonds, Joseph D, Bagshaw, Oliver, Sethna, Navil, Kovatsis, Pete, Cravero, Joseph, Ivanova, Iskra, Hunyady, Agnes, Verma, Shilpa, Polaner, David, Thomas, Joss, Haret, Denisa, Steiner, Jeffrey, Kravitz, Brian, Farrow-gillespie, Alan, Suresh, Santhanam, Hays, Stephen, Taenzer, Andreas, Maxwell, Lynne, and Williams, Robert

Published
2019

17. Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial

Author

McCann, Mary Ellen, primary, de Graaff, Jurgen C, additional, Dorris, Liam, additional, Disma, Nicola, additional, Withington, Davinia, additional, Bell, Graham, additional, Grobler, Anneke, additional, Stargatt, Robyn, additional, Hunt, Rodney W, additional, Sheppard, Suzette J, additional, Marmor, Jacki, additional, Giribaldi, Gaia, additional, Bellinger, David C, additional, Hartmann, Penelope L, additional, Hardy, Pollyanna, additional, Frawley, Geoff, additional, Izzo, Francesca, additional, von Ungern Sternberg, Britta S, additional, Lynn, Anne, additional, Wilton, Niall, additional, Mueller, Martin, additional, Polaner, David M, additional, Absalom, Anthony R, additional, Szmuk, Peter, additional, Morton, Neil, additional, Berde, Charles, additional, Soriano, Sulpicio, additional, Davidson, Andrew J, additional, Arnup, Sarah, additional, Lee, Katherine, additional, Hunt, Rod W, additional, Ormond, Gillian D, additional, Takagi, Michael J, additional, Taylor, Kaitlyn, additional, Malarbi, Stephanie, additional, Doyle, Melissa, additional, Ragg, Philip, additional, Costi, David, additional, von Ungern-Sternberg, Britta, additional, Wilton, Niall C, additional, Knottenbelt, Graham, additional, Furue, Koto, additional, Gagnon, Hélène, additional, Mameli, Leila, additional, Pini Prato, Alessio, additional, Mattioli, Girolamo, additional, Wolfler, Andrea, additional, Bova, Stefania M, additional, Krachmalnicoff, Arianna, additional, Guuva, Claudia, additional, van der Werff, Desiree BM, additional, van Gool, Jose TDG, additional, van Loon, Kim, additional, Kalkman, Cor J, additional, van Baar, Anneloes L, additional, Hoekstra, Frouckje M, additional, Volkers, Martin, additional, Oostra, Martine, additional, Morton, Neil S, additional, Pownall, Jaycee, additional, Waldman, Jack, additional, Hind, Ruth, additional, Symonds, Joseph D, additional, Bagshaw, Oliver, additional, McCann, Mary Ellen, additional, Sethna, Navil, additional, Kovatsis, Pete, additional, Cravero, Joseph, additional, Bellinger, David, additional, Ivanova, Iskra, additional, Hunyady, Agnes, additional, Verma, Shilpa, additional, Polaner, David, additional, Thomas, Joss, additional, Haret, Denisa, additional, Steiner, Jeffrey, additional, Kravitz, Brian, additional, Farrow-Gillespie, Alan, additional, Suresh, Santhanam, additional, Hays, Stephen, additional, Taenzer, Andreas, additional, Maxwell, Lynne, additional, and Williams, Robert, additional

Published
2019
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20. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy

Author

Davidson, Andrew, Disma, Nicole, De Graaff, Jurgen C., Withington, Davinia E., Dorris, Liam, Bell, Graham T., Stargatt, Robyn, Bellinger, David C., Schuster, Tibor, Arnup, Sarah, Hardy, Pollyanna, Hunt, Rod, Takagi, Michael, Giribaldi, Gaia, Hartmann, Penelope, Salvo, Ida, Morton, Neil Stuart, von Ungern-Sternberg, Britta S., Locatelli, Bruno Guido, Wilton, Niall C. T., Lynn, Anne Merie, Thomas, Joss John, Polaner, David M., Bagshaw, Oliver N. T., Szmuk, Peter, Absalom, Anthony R., Frawley, Geoff P., Berde, Charles B., Ormond, Gillian D., Marmor, Jacki, and McCann, Mary Ellen

Abstract

Background Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy has any effect on neurodevelopmental outcome. Here we report the secondary outcome of neurodevelopmental outcome at 2 years of age in the General Anaesthesia compared to Spinal anaesthesia (GAS) trial.Methods In this international assessor-masked randomised controlled equivalence trial, we recruited infants younger than 60 weeks postmenstrual age, born at greater than 26 weeks’ gestation, and who had inguinal herniorrhaphy, from 28 hospitals in Australia, Italy, the USA, the UK, Canada, the Netherlands, and New Zealand. Infants were randomly assigned (1:1) to receive either awake-regional anaesthesia or sevofl urane-based general anaesthesia. Web-based randomisation was done in blocks of two or four and stratified by site and gestational age at birth. Infants were excluded if they had existing risk factors for neurological injury. The primary outcome of the trial will be the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Full Scale Intelligence Quotient score at age 5 years. The secondary outcome, reported here, is the composite cognitive score of the Bayley Scales of Infant and Toddler Development III, assessed at 2 years. The analysis was as per protocol adjusted for gestational age at birth. A difference in means of five points (1/3 SD) was predefined as the clinical equivalence margin. This trial is registered with ANZCTR, number ACTRN12606000441516 and ClinicalTrials.gov, number NCT00756600.Findings Between Feb 9, 2007, and Jan 31, 2013, 363 infants were randomly assigned to receive awake-regional anaesthesia and 359 to general anaesthesia. Outcome data were available for 238 children in the awake-regional group and 294 in the general anaesthesia group. In the as-per-protocol analysis, the cognitive composite score (mean [SD]) was 98·6 (14·2) in the awake-regional group and 98·2 (14·7) in the general anaesthesia group. There was equivalence in mean between groups (awake-regional minus general anaesthesia 0·169, 95% CI –2·30 to 2·64). The median duration of anaesthesia in the general anaesthesia group was 54 min.Interpretation For this secondary outcome, we found no evidence that just less than 1 h of sevoflurane anaesthesia in infancy increases the risk of adverse neurodevelopmental outcome at 2 years of age compared with awake-regional anaesthesia.Funding Australia National Health and Medical Research Council (NHMRC), Health Technologies Assessment-National Institute for Health Research UK, National Institutes of Health, Food and Drug Administration, Australian and New Zealand College of Anaesthetists, Murdoch Childrens Research Institute, Canadian Institute of Health Research, Canadian Anesthesiologists’ Society, Pfizer Canada, Italian Ministry of Heath, Fonds NutsOhra, and UK Clinical Research Network (UKCRN).

Published
2016

21. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair : Data from the General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes

Author

Frawley, Geoff, Bell, Graham, Disma, Nicola, Withington, Davinia E, de Graaff, Jurgen C, Morton, Neil S, McCann, Mary Ellen, Arnup, Sarah J, Bagshaw, Oliver, Wolfler, Andrea, Bellinger, David, Davidson, Andrew J, Absalom, Anthony, and Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE)

Subjects
Male, Internationality, Apnea, Research Support, Non-U.S. Gov't, Infant, Newborn, Research Support, U.S. Gov't, P.H.S, Infant, Hernia, Inguinal, Anesthesia, General, Anesthesia, Spinal, Cohort Studies, Multicenter Study, Child Development, Treatment Outcome, Research Support, N.I.H., Extramural, Anesthesia, Conduction, Predictive Value of Tests, Randomized Controlled Trial, Journal Article, Humans, Female, Single-Blind Method, Comparative Study, Prospective Studies, Treatment Failure
Abstract

BACKGROUND: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia study compares neurodevelopmental outcomes after awake RA or GA in otherwise healthy infants. The aim of the study is to describe success and failure rates of RA and report factors associated with failure. METHODS: This was a nested cohort study within a prospective, randomized, controlled, observer-blind, equivalence trial. Seven hundred twenty-two infants 60 weeks or less postmenstrual age scheduled for herniorrhaphy under anesthesia were randomly assigned to receive RA (spinal, caudal epidural, or combined spinal caudal anesthetic) or GA with sevoflurane. The data of 339 infants, where spinal or combined spinal caudal anesthetic was attempted, were analyzed. Possible predictors of failure were assessed including patient factors, technique, experience of site and anesthetist, and type of local anesthetic. RESULTS: RA was sufficient for the completion of surgery in 83.2% of patients. Spinal anesthesia was successful in 86.9% of cases and combined spinal caudal anesthetic in 76.1%. Thirty-four patients required conversion to GA, and an additional 23 patients (6.8%) required brief sedation. Bloody tap on the first attempt at lumbar puncture was the only risk factor significantly associated with block failure (odds ratio = 2.46). CONCLUSIONS: The failure rate of spinal anesthesia was low. Variability in application of combined spinal caudal anesthetic limited attempts to compare the success of this technique to spinal alone.

Published
2015

22. Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial

Author

Davidson, Andrew J., Morton, Neil S., Arnup, Sarah J., De Graaff, Jurgen C., Disma, Nicola, Withington, Davinia E., Frawley, Geoff, Hunt, Rodney W., Hardy, Pollyanna, Khotcholava, Magda, Von Ungern Sternberg, Britta S., Wilton, Niall, Tuo, Pietro, Salvo, Ida, Ormond, Gillian, Stargatt, Robyn, Locatelli, Bruno Guido, McCann, Mary Ellen, Lee, Katherine, Sheppard, Suzette, Hartmann, Penelope, Ragg, Philip, Backstrom, Marie, Costi, David, Von Ungern-Sternberg, Britta S., Knottenbelt, Graham, Montobbio, Giovanni, Mameli, Leila, Giribaldi, Gaia, Prato, Alessio Pini, Mattioli, Girolamo, Wolfler, Andrea, Izzo, Francesca, Sonzogni, Valter, Van Gool, Jose T D G, Numan, Sandra C., Kalkman, Cor J., Hagenaars, J. H M, Absalom, Anthony R., Hoekstra, Frouckje M., Volkers, Martin J., Furue, Koto, Gaudreault, Josee, Berde, Charles, Soriano, Sulpicio, Young, Vanessa, Sethna, Navil, Kovatsis, Pete, Cravero, Joseph P., Bellinger, David, Marmor, Jacki, Lynn, Anne, Ivanova, Iskra, Hunyady, Agnes, Verma, Shilpa, Polaner, David, Thomas, Joss, Meuller, Martin, Haret, Denisa, Szmuk, Peter, Steiner, Jeffery, Kravitz, Brian, Suresh, Santhanam, Hays, Stephen R., Taenzer, Andreas H., Maxwell, Lynne G., Williams, Robert K., Bell, Graham T., Dorris, Liam, Adey, Claire, Bagshaw, Oliver, Chisakuta, Anthony, Eissa, Ayman, Stoddart, Peter, Davis, Annette, Myles, Paul, Wolf, Andy, McIntosh, Neil, Carlin, John, Leslie, Kate, De Lima, Jonathan, Hammer, Greg, Field, David, Gebski, Val, and Tibboel, Dick

Subjects
Male, Internationality, Spinal, Apnea, Research Support, U.S. Gov't, P.H.S, Child Development, Postoperative Complications, Research Support, N.I.H., Extramural, Risk Factors, Journal Article, Humans, Comparative Study, Anesthesia, Wakefulness, General, Anesthesia, General, Anesthesia, Spinal, Female, Follow-Up Studies, Infant, Infant, Newborn, Treatment Outcome, Anesthesiology and Pain Medicine, Research Support, Non-U.S. Gov't, Newborn, Multicenter Study, Randomized Controlled Trial
Abstract

Background: Postoperative apnea is a complication in young infants. Awake regional anesthesia (RA) may reduce the risk; however, the evidence is weak. The General Anesthesia compared to Spinal anesthesia study is a randomized, controlled trial designed to assess the influence of general anesthesia (GA) on neurodevelopment. A secondary aim is to compare rates of apnea after anesthesia. Methods: Infants aged 60 weeks or younger, postmenstrual age scheduled for inguinal herniorrhaphy, were randomized to RA or GA. Exclusion criteria included risk factors for adverse neurodevelopmental outcome and infants born less than 26 weeks gestation. The primary outcome of this analysis was any observed apnea up to 12 h postoperatively. Apnea assessment was unblinded. Results: Three hundred sixty-three patients were assigned to RA and 359 to GA. Overall, the incidence of apnea (0 to 12 h) was similar between arms (3% in RA and 4% in GA arms; odds ratio [OR], 0.63; 95% CI, 0.31 to 1.30, P = 0.2133); however, the incidence of early apnea (0 to 30 min) was lower in the RA arm (1 vs. 3%; OR, 0.20; 95% CI, 0.05 to 0.91; P = 0.0367). The incidence of late apnea (30 min to 12 h) was 2% in both RA and GA arms (OR, 1.17; 95% CI, 0.41 to 3.33; P = 0.7688). The strongest predictor of apnea was prematurity (OR, 21.87; 95% CI, 4.38 to 109.24), and 96% of infants with apnea were premature. Conclusions: RA in infants undergoing inguinal herniorrhaphy reduces apnea in the early postoperative period. Cardiorespiratory monitoring should be used for all ex-premature infants.

Published
2015

23. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial

Author

Development and Treatment of Psychosocial Problems, Davidson, Andrew J, Disma, Nicola, De Graaff, Jurgen C, Withington, Davinia E, Dorris, Liam, Bell, Graham, Stargatt, Robyn, Bellinger, David C, Schuster, Tibor, Arnup, Sarah J, Hardy, Pollyanna, Hunt, Rodney W, Takagi, Michael J, Giribaldi, Gaia, Hartmann, Penelope L, Salvo, Ida, Morton, Neil S, Von Ungern Sternberg, Britta S, Locatelli, Bruno Guido, Wilton, Niall, Lynn, Anne, Thomas, Joss J, Polaner, David, Bagshaw, Oliver, Szmuk, Peter, Absalom, Anthony R, Frawley, Geoff, Berde, Charles, Ormond, Gillian D, Marmor, Jacki, Mccann, Mary Ellen, Development and Treatment of Psychosocial Problems, Davidson, Andrew J, Disma, Nicola, De Graaff, Jurgen C, Withington, Davinia E, Dorris, Liam, Bell, Graham, Stargatt, Robyn, Bellinger, David C, Schuster, Tibor, Arnup, Sarah J, Hardy, Pollyanna, Hunt, Rodney W, Takagi, Michael J, Giribaldi, Gaia, Hartmann, Penelope L, Salvo, Ida, Morton, Neil S, Von Ungern Sternberg, Britta S, Locatelli, Bruno Guido, Wilton, Niall, Lynn, Anne, Thomas, Joss J, Polaner, David, Bagshaw, Oliver, Szmuk, Peter, Absalom, Anthony R, Frawley, Geoff, Berde, Charles, Ormond, Gillian D, Marmor, Jacki, and Mccann, Mary Ellen

Published
2016

24. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial.

Author

Davidson, AJ, von Ungern Sternberg, BS, Frawley, G, Disma, Nicola, de Graaff, Jurgen C, Withington, Davinia E, Dorris, Liam, Bell, Graham, Stargatt, Robyn, Bellinger, David C, Schuster, Tibor, Arnup, Sarah J, Hardy, Pollyanna, Hunt, Rodney W, Takagi, Michael J, Giribaldi, Gaia, Hartmann, Penelope L, Salvo, Ida, Morton, Neil S, Locatelli, Bruno Guido, Wilton, Niall, Lynn, Anne, Thomas, Joss J, Polaner, David, Bagshaw, Oliver, Szmuk, Peter, Absalom, Anthony R, Berde, Charles, Ormond, Gillian D, Marmor, Jacki, McCann, Mary Ellen, Davidson, AJ, von Ungern Sternberg, BS, Frawley, G, Disma, Nicola, de Graaff, Jurgen C, Withington, Davinia E, Dorris, Liam, Bell, Graham, Stargatt, Robyn, Bellinger, David C, Schuster, Tibor, Arnup, Sarah J, Hardy, Pollyanna, Hunt, Rodney W, Takagi, Michael J, Giribaldi, Gaia, Hartmann, Penelope L, Salvo, Ida, Morton, Neil S, Locatelli, Bruno Guido, Wilton, Niall, Lynn, Anne, Thomas, Joss J, Polaner, David, Bagshaw, Oliver, Szmuk, Peter, Absalom, Anthony R, Berde, Charles, Ormond, Gillian D, Marmor, Jacki, and McCann, Mary Ellen

Abstract

Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy has any effect on neurodevelopmental outcome. Here we report the secondary outcome of neurodevelopmental outcome at 2 years of age in the General Anaesthesia compared to Spinal anaesthesia (GAS) trial. In this international assessor-masked randomised controlled equivalence trial, we recruited infants younger than 60 weeks postmenstrual age, born at greater than 26 weeks' gestation, and who had inguinal herniorrhaphy, from 28 hospitals in Australia, Italy, the USA, the UK, Canada, the Netherlands, and New Zealand. Infants were randomly assigned (1:1) to receive either awake-regional anaesthesia or sevoflurane-based general anaesthesia. Web-based randomisation was done in blocks of two or four and stratified by site and gestational age at birth. Infants were excluded if they had existing risk factors for neurological injury. The primary outcome of the trial will be the Wechsler Preschool and Primary Scale of Intelligence Third Edition (WPPSI-III) Full Scale Intelligence Quotient score at age 5 years. The secondary outcome, reported here, is the composite cognitive score of the Bayley Scales of Infant and Toddler Development III, assessed at 2 years. The analysis was as per protocol adjusted for gestational age at birth. A difference in means of five points (1/3 SD) was predefined as the clinical equivalence margin. This trial is registered with ANZCTR, number ACTRN12606000441516 and ClinicalTrials.gov, number NCT00756600. Between Feb 9, 2007, and Jan 31, 2013, 363 infants were randomly assigned to receive awake-regional anaesthesia and 359 to general anaesthesia. Outcome data were available for 238 children in the awake-regional group and 294 in the general anaesthesia group. In the as

Published
2016

25. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial

Author

Medische staf Anesthesiologie, Brain, Davidson, Andrew J, Disma, Nicola, de Graaff, Jurgen C, Withington, Davinia E, Dorris, Liam, Bell, Graham, Stargatt, Robyn, Bellinger, David C, Schuster, Tibor, Arnup, Sarah J, Hardy, Pollyanna, Hunt, Rodney W, Takagi, Michael J, Giribaldi, Gaia, Hartmann, Penelope L, Salvo, Ida, Morton, Neil S, von Ungern Sternberg, Britta S, Locatelli, Bruno Guido, Wilton, Niall, Lynn, Anne, Thomas, Joss J, Polaner, David, Bagshaw, Oliver, Szmuk, Peter, Absalom, Anthony R, Frawley, Geoff, Berde, Charles, Ormond, Gillian D, Marmor, Jacki, McCann, Mary Ellen, GAS consortium, Medische staf Anesthesiologie, Brain, Davidson, Andrew J, Disma, Nicola, de Graaff, Jurgen C, Withington, Davinia E, Dorris, Liam, Bell, Graham, Stargatt, Robyn, Bellinger, David C, Schuster, Tibor, Arnup, Sarah J, Hardy, Pollyanna, Hunt, Rodney W, Takagi, Michael J, Giribaldi, Gaia, Hartmann, Penelope L, Salvo, Ida, Morton, Neil S, von Ungern Sternberg, Britta S, Locatelli, Bruno Guido, Wilton, Niall, Lynn, Anne, Thomas, Joss J, Polaner, David, Bagshaw, Oliver, Szmuk, Peter, Absalom, Anthony R, Frawley, Geoff, Berde, Charles, Ormond, Gillian D, Marmor, Jacki, McCann, Mary Ellen, and GAS consortium

Published
2016

27. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair: Data from the General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes.

Author

Davidson, AJ, Frawley, G, Bell, Graham, Disma, Nicola, Withington, Davinia E, de Graaff, Jurgen C, Morton, Neil S, McCann, Mary Ellen, Arnup, Sarah J, Bagshaw, Oliver, Wolfler, Andrea, Bellinger, David, Davidson, AJ, Frawley, G, Bell, Graham, Disma, Nicola, Withington, Davinia E, de Graaff, Jurgen C, Morton, Neil S, McCann, Mary Ellen, Arnup, Sarah J, Bagshaw, Oliver, Wolfler, Andrea, and Bellinger, David

Abstract

Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia study compares neurodevelopmental outcomes after awake RA or GA in otherwise healthy infants. The aim of the study is to describe success and failure rates of RA and report factors associated with failure. This was a nested cohort study within a prospective, randomized, controlled, observer-blind, equivalence trial. Seven hundred twenty-two infants 60 weeks or less postmenstrual age scheduled for herniorrhaphy under anesthesia were randomly assigned to receive RA (spinal, caudal epidural, or combined spinal caudal anesthetic) or GA with sevoflurane. The data of 339 infants, where spinal or combined spinal caudal anesthetic was attempted, were analyzed. Possible predictors of failure were assessed including patient factors, technique, experience of site and anesthetist, and type of local anesthetic. RA was sufficient for the completion of surgery in 83.2% of patients. Spinal anesthesia was successful in 86.9% of cases and combined spinal caudal anesthetic in 76.1%. Thirty-four patients required conversion to GA, and an additional 23 patients (6.8%) required brief sedation. Bloody tap on the first attempt at lumbar puncture was the only risk factor significantly associated with block failure (odds ratio = 2.46). The failure rate of spinal anesthesia was low. Variability in application of combined spinal caudal anesthetic limited attempts to compare the success of this technique to spinal alone.

Published
2015

28. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair: Data from the General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes

Author

Medische staf Anesthesiologie, Frawley, Geoff, Bell, Graham, Disma, Nicola, Withington, Davinia E, de Graaff, Jurgen C, Morton, Neil S, McCann, Mary Ellen, Arnup, Sarah J, Bagshaw, Oliver, Wolfler, Andrea, Bellinger, David, Davidson, Andrew J, General Anesthesia compared to Spinal anesthesia (GAS) Consortium, Medische staf Anesthesiologie, Frawley, Geoff, Bell, Graham, Disma, Nicola, Withington, Davinia E, de Graaff, Jurgen C, Morton, Neil S, McCann, Mary Ellen, Arnup, Sarah J, Bagshaw, Oliver, Wolfler, Andrea, Bellinger, David, Davidson, Andrew J, and General Anesthesia compared to Spinal anesthesia (GAS) Consortium

Published
2015

29. Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, a Randomized Controlled Trial

Author

Medische staf Anesthesiologie, Circulatory Health, Brain, Davidson, Andrew J., Morton, Neil S., Arnup, Sarah J., De Graaff, Jurgen C., Disma, Nicola, Withington, Davinia E., Frawley, Geoff, Hunt, Rodney W., Hardy, Pollyanna, Khotcholava, Magda, Von Ungern Sternberg, Britta S., Wilton, Niall, Tuo, Pietro, Salvo, Ida, Ormond, Gillian, Stargatt, Robyn, Locatelli, Bruno Guido, McCann, Mary Ellen, Lee, Katherine, Sheppard, Suzette, Hartmann, Penelope, Ragg, Philip, Backstrom, Marie, Costi, David, Von Ungern-Sternberg, Britta S., Knottenbelt, Graham, Montobbio, Giovanni, Mameli, Leila, Giribaldi, Gaia, Prato, Alessio Pini, Mattioli, Girolamo, Wolfler, Andrea, Izzo, Francesca, Sonzogni, Valter, Van Gool, Jose T D G, Numan, Sandra C., Kalkman, Cor J., Hagenaars, J. H M, Absalom, Anthony R., Hoekstra, Frouckje M., Volkers, Martin J., Furue, Koto, Gaudreault, Josee, Berde, Charles, Soriano, Sulpicio, Young, Vanessa, Sethna, Navil, Kovatsis, Pete, Cravero, Joseph P., Bellinger, David, Marmor, Jacki, Lynn, Anne, Ivanova, Iskra, Hunyady, Agnes, Verma, Shilpa, Polaner, David, Thomas, Joss, Meuller, Martin, Haret, Denisa, Szmuk, Peter, Steiner, Jeffery, Kravitz, Brian, Suresh, Santhanam, Hays, Stephen R., Taenzer, Andreas H., Maxwell, Lynne G., Williams, Robert K., Bell, Graham T., Dorris, Liam, Adey, Claire, Bagshaw, Oliver, Chisakuta, Anthony, Eissa, Ayman, Stoddart, Peter, Davis, Annette, Myles, Paul, Wolf, Andy, McIntosh, Neil, Carlin, John, Leslie, Kate, De Lima, Jonathan, Hammer, Greg, Field, David, Gebski, Val, Tibboel, Dick, Medische staf Anesthesiologie, Circulatory Health, Brain, Davidson, Andrew J., Morton, Neil S., Arnup, Sarah J., De Graaff, Jurgen C., Disma, Nicola, Withington, Davinia E., Frawley, Geoff, Hunt, Rodney W., Hardy, Pollyanna, Khotcholava, Magda, Von Ungern Sternberg, Britta S., Wilton, Niall, Tuo, Pietro, Salvo, Ida, Ormond, Gillian, Stargatt, Robyn, Locatelli, Bruno Guido, McCann, Mary Ellen, Lee, Katherine, Sheppard, Suzette, Hartmann, Penelope, Ragg, Philip, Backstrom, Marie, Costi, David, Von Ungern-Sternberg, Britta S., Knottenbelt, Graham, Montobbio, Giovanni, Mameli, Leila, Giribaldi, Gaia, Prato, Alessio Pini, Mattioli, Girolamo, Wolfler, Andrea, Izzo, Francesca, Sonzogni, Valter, Van Gool, Jose T D G, Numan, Sandra C., Kalkman, Cor J., Hagenaars, J. H M, Absalom, Anthony R., Hoekstra, Frouckje M., Volkers, Martin J., Furue, Koto, Gaudreault, Josee, Berde, Charles, Soriano, Sulpicio, Young, Vanessa, Sethna, Navil, Kovatsis, Pete, Cravero, Joseph P., Bellinger, David, Marmor, Jacki, Lynn, Anne, Ivanova, Iskra, Hunyady, Agnes, Verma, Shilpa, Polaner, David, Thomas, Joss, Meuller, Martin, Haret, Denisa, Szmuk, Peter, Steiner, Jeffery, Kravitz, Brian, Suresh, Santhanam, Hays, Stephen R., Taenzer, Andreas H., Maxwell, Lynne G., Williams, Robert K., Bell, Graham T., Dorris, Liam, Adey, Claire, Bagshaw, Oliver, Chisakuta, Anthony, Eissa, Ayman, Stoddart, Peter, Davis, Annette, Myles, Paul, Wolf, Andy, McIntosh, Neil, Carlin, John, Leslie, Kate, De Lima, Jonathan, Hammer, Greg, Field, David, Gebski, Val, and Tibboel, Dick

Published
2015

30. Anaesthetic Considerations in Paediatric Myasthenia Gravis

Author

Masters, Oliver William and Bagshaw, Oliver N.

Subjects
Article Subject
Abstract

Myasthenia gravis is of particular interest to anaesthetists because of the muscle groups affected, the pharmacology of the neuromuscular junction, and interaction of both the disease and treatment with many anaesthetic drugs. Anaesthetists may encounter children with myasthenia either to facilitate treatment options or to institute mechanical ventilation in the face of a crisis. This paper reviews the literature pertaining to the pathophysiology and applied pharmacology of the disease and explores the relationship between these and the anaesthetic management. In addition to illustrating the tried-and-tested techniques, some newer management options are explored.

Published
2011
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35. A case of acute papillary muscle rupture in a child with campylobacter enteritis and citrullinaemia.

Author

Rowlands, Helen E., Westrope, Claire, Hendriksz, Chris, Chakrapani, Anupam, Barron, David J., and Bagshaw, Oliver

Subjects
GASTROENTERITIS, GASTROINTESTINAL diseases, DIAGNOSIS, PROGNOSIS, MITRAL valve
Abstract

We report a case of acute papillary muscle rupture associated with intercurrent Campylobacter jejuni gastroenteritis in a child with a diagnosis of citrullinaemia, requiring urgent mitral valve replacement. [ABSTRACT FROM AUTHOR]

Published
2007
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36. Anaesthetic Considerations in Paediatric Myasthenia Gravis

Author

William Masters, Oliver and N. Bagshaw, Oliver

Abstract

Myasthenia gravis is of particular interest to anaesthetists because of the muscle groups affected, the pharmacology of the neuromuscular junction, and interaction of both the disease and treatment with many anaesthetic drugs. Anaesthetists may encounter children with myasthenia either to facilitate treatment options or to institute mechanical ventilation in the face of a crisis. This paper reviews the literature pertaining to the pathophysiology and applied pharmacology of the disease and explores the relationship between these and the anaesthetic management. In addition to illustrating the tried-and-tested techniques, some newer management options are explored.

Published
2011
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38. UK Foot and Ankle Thromboembolism (UK-FATE).

Author

Mangwani J, Houchen-Wolloff L, Malhotra K, Booth S, Smith A, Teece L, Mason LW, Shaikh R, Alfred W, Okhifun I, Cinar E, Bua N, Vemulapalli K, Acharya A, Gadd R, Money-Taylor J, Kantharaju R, Bhosale A, Bahri S, Broadbent R, Drummond I, Jones N, Shah S, Ravindrarjah T, Yasen Z, Singh K, Al-Habs R, Jeyaseelan L, Habbiba A, Walker T, Dewhurst M, Glasgow N, Eze D, Carter G, Rajan P, Patil V, Amer O, Malik K, Pavanerathan P, Mallick A, Seferiadis I, Currall V, Sadasivan P, Kumar S, Sanjani SR, Ciaccio M, Ayyaswamy B, Prasad P, Anand M, Sunilraj D, Lane S, Prathap S, Kankate R, Aktselis I, Davda K, Vijapur A, Tayyem M, Chau J, Azhar MS, Sturdee S, Hussain H, Sonde S, Luqman MQ, Farooq R, Wells G, Shenolikar A, Simons M, Hodgson P, Thomas R, Stevens S, Elhassan Y, Adeniyi A, Aspinall W, Joseph V, Day M, Tong A, Joyner C, Alzaranky M, Elhassan O, Chhantyal K, Arora A, Abiddin Z, Kucharski R, Ahmad I, Zeb J, Ishaq U, Thomas J, Jain K, Deol R, Faroug R, Johal K, Mordecai S, Argyropouos M, Chawla A, Ibrahim M, Pereira M, Barr L, Julies E, Hill F, Kapoor S, Bailey J, Mukhopadhyay I, Rana S, Tarig H, Qualaghassi M, Seewoonarian S, Rose B, Crate G, Abbott S, Fenner C, Geleit R, Yousaf S, Akram N, Al-Hubeshy Z, Patel B, Hussein M, Clark C, Giddie J, Dega R, Dasari K, Nandhara G, Kumar P, Gupta P, Poole H, Zace P, Alvi F, Jacob J, Reddy R, Sateesh V, Gledhill A, Craven J, Cichero M, Yates B, Newton A, Grice J, Fawcett N, Fraig H, Hamad F, Marsland D, Elliot R, Ghani Y, Chandrashekhar S, Millan RK, Clark A, Rahman K, Sykes M, Little Z, Saleem J, Jolly L, Jain A, Qadri A, Rymaruk S, Kulkarni A, Garabadi M, Akhtar M, Hossain M, Yunus S, Saleem M, Fong J, Islam A, Nusir B, Chapman J, Holmes D, Mamoowala N, Almond K, Wright C, Caruana E, Watson T, Allison G, Pillai A, Madhi I, Alsalihy M, Elamin K, Yip CR, Tew L, Dahiya R, Goff T, Bagshaw O, Slade H, Andrzejowski P, Gomati A, Drake C, Hind J, Morgan R, Khalaf A, Ditta A, Ramasamy A, McIntyre J, Blacklock C, Middleton S, Clayton R, Hrycaiczuk A, Thornhill C, Jeyakumar G, Vaithilingam D, Potter K, Jamal/Pete Chan B, Mohamed M, Fraser D, Elhalawany A, Beastall J, Cousins G, Nunag P, Loveday D, Bawa A, Gilmore R, Schankat K, Walls A, Corin N, Robinson P, Hepple S, Harries W, Riddick A, Winson I, Marsh L, Bashir MA, Saini J, Atkinson H, Limaye R, Johnson-Lynn S, Sethi M, Flanagan G, Uddin A, Reilly I, Martin R, Pujol-Nichol A, Carroll N, Boucher A, Alward M, Myint Y, Butler K, Kendal A, Bugeja M, Mooteeram J, Saedi F, Koc T, Morcos Z, Robertson G, Holmes N, Tribe H, Pearkes T, Soliman A, Prasanna A, Teoh K, Kamat S, Bajracharya A, Reeves J, Ngwayi M, Imtiaz G, Blackmore N, Lau B, Naik A, Tung E, Murhekar S, Ray R, Lyle S, Makwana N, Kaisi KA, Al-Musabi M, Dean M, Hughes A, Shuttlewood K, Welck M, Patel S, Sykes A, Thibbaiah MM, Hadi H, Haldar A, Ardakani AG, Jani P, Kutuzov V, Gibbons J, Trussler D, Hawley E, Akhtar S, Rajgor HD, Budair B, Prem H, Mckenzie J, Thurston D, O'Sullivan M, Elmajee M, Pond E, Zahra W, Heaver C, Igbagiri K, Gaukroger A, Solan M, Peacock C, Fan KS, Barton T, Robinson D, Graham S, Zeolla J, Everett S, Iqbal M, Gourbault L, Singh S, Tang C, Tarhini M, Khan S, Balasubramanian S, Lever C, Bansod V, Iyengar K, Wadood A, McMillan L, Toh E, Masunda S, Federer S, Ahmad F, Lashin A, Kaddah A, Oladeji E, Dawe E, Nolan C, El-Bayouk K, Dhukaram V, Chapman A, Beddard L, Thomas A, Garg V, Taylor H, Kelsall N, Roslee C, Akram N, Lowdon H, Kamel-Sherif A, Jones A, Best A, Zabaglo M, Sayani J, Kyaw O, Khin C, Ali R, Shaik Y, Hossain N, Valente L, Ajis A, Guha A, Pereira M, Ayoub A, Paraoan V, Hali N, Baird C, Kugan R, Abdallatif A, Blomfield M, Jackson G, Craven J, Malhotra A, Toner A, Render L, Ashley C, Limb R, Smith R, Hughes L, Matthews H, Shiers-Gelalis F, Ting J, Place S, Budgen A, Stanley J, and Jowett C

Subjects
Humans, Male, Female, United Kingdom epidemiology, Middle Aged, Prospective Studies, Risk Factors, Adult, Incidence, Aged, Postoperative Complications epidemiology, Postoperative Complications prevention & control, Rupture surgery, Venous Thromboembolism prevention & control, Venous Thromboembolism epidemiology, Venous Thromboembolism etiology, Achilles Tendon injuries, Achilles Tendon surgery, Anticoagulants therapeutic use
Abstract

Aims: Venous thromboembolism (VTE) is a potential complication of foot and ankle surgery. There is a lack of agreement on contributing risk factors and chemical prophylaxis requirements. The primary outcome of this study was to analyze the 90-day incidence of symptomatic VTE and VTE-related mortality in patients undergoing foot and ankle surgery and Achilles tendon (TA) rupture. Secondary aims were to assess the variation in the provision of chemical prophylaxis and risk factors for VTE., Methods: This was a multicentre, prospective national collaborative audit with data collection over nine months for all patients undergoing foot and ankle surgery in an operating theatre or TA rupture treatment, within participating UK hospitals. The association between VTE and thromboprophylaxis was assessed with a univariable logistic regression model. A multivariable logistic regression model was used to identify key predictors for the risk of VTE., Results: A total of 13,569 patients were included from 68 sites. Overall, 11,363 patients were available for analysis: 44.79% were elective (n = 5,090), 42.16% were trauma excluding TA ruptures (n = 4,791), 3.50% were acute diabetic procedures (n = 398), 2.44% were TA ruptures undergoing surgery (n = 277), and 7.10% were TA ruptures treated nonoperatively (n = 807). In total, 11 chemical anticoagulants were recorded, with the most common agent being low-molecular-weight heparin (n = 6,303; 56.79%). A total of 32.71% received no chemical prophylaxis. There were 99 cases of VTE (incidence 0.87% (95% CI 0.71 to 1.06)). VTE-related mortality was 0.03% (95% CI 0.005 to 0.080). Univariable analysis showed that increased age and American Society of Anesthesiologists (ASA) grade had higher odds of VTE, as did having previous cancer, stroke, or history of VTE. On multivariable analysis, the strongest predictors for VTE were the type of foot and ankle procedure and ASA grade., Conclusion: The 90-day incidence of symptomatic VTE and mortality related to VTE is low in foot and ankle surgery and TA management. There was notable variability in the chemical prophylaxis used. The significant risk factors associated with 90-day symptomatic VTE were TA rupture and high ASA grade., Competing Interests: J. Mangwani reports support from the Leicester Hospitals Charity, related to this study. J. Mangwani reports payment or honoraria for lectures, presentations, educational events from Orthosolutions, and royalties from Meshworks, unrelated to this study. K. Malhotra reports payment or honoraria for lectures, presentations, speaker bureaus, manuscript writing or educational events from NewClip Technics, unrelated to this study. L. W. Mason reports royalties or licenses, consulting fees, and patents planned, issued or pending from Orthosolutions, unrelated to this study., (© 2024 The British Editorial Society of Bone & Joint Surgery.)

Published
2024
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39. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair: Data from the General Anesthesia Compared to Spinal Anesthesia Study--Comparing Apnea and Neurodevelopmental Outcomes.

Author

Frawley G, Bell G, Disma N, Withington DE, de Graaff JC, Morton NS, McCann ME, Arnup SJ, Bagshaw O, Wolfler A, Bellinger D, and Davidson AJ

Subjects
Anesthesia, Conduction adverse effects, Anesthesia, Conduction trends, Anesthesia, General trends, Anesthesia, Spinal trends, Apnea etiology, Cohort Studies, Female, Hernia, Inguinal diagnosis, Humans, Infant, Infant, Newborn, Internationality, Male, Predictive Value of Tests, Prospective Studies, Single-Blind Method, Treatment Failure, Treatment Outcome, Anesthesia, General adverse effects, Anesthesia, Spinal adverse effects, Apnea diagnosis, Child Development drug effects, Hernia, Inguinal surgery
Abstract

Background: Awake regional anesthesia (RA) is a viable alternative to general anesthesia (GA) for infants undergoing lower abdominal surgery. Benefits include lower incidence of postoperative apnea and avoidance of anesthetic agents that may increase neuroapoptosis and worsen neurocognitive outcomes. The General Anesthesia compared to Spinal anesthesia study compares neurodevelopmental outcomes after awake RA or GA in otherwise healthy infants. The aim of the study is to describe success and failure rates of RA and report factors associated with failure., Methods: This was a nested cohort study within a prospective, randomized, controlled, observer-blind, equivalence trial. Seven hundred twenty-two infants 60 weeks or less postmenstrual age scheduled for herniorrhaphy under anesthesia were randomly assigned to receive RA (spinal, caudal epidural, or combined spinal caudal anesthetic) or GA with sevoflurane. The data of 339 infants, where spinal or combined spinal caudal anesthetic was attempted, were analyzed. Possible predictors of failure were assessed including patient factors, technique, experience of site and anesthetist, and type of local anesthetic., Results: RA was sufficient for the completion of surgery in 83.2% of patients. Spinal anesthesia was successful in 86.9% of cases and combined spinal caudal anesthetic in 76.1%. Thirty-four patients required conversion to GA, and an additional 23 patients (6.8%) required brief sedation. Bloody tap on the first attempt at lumbar puncture was the only risk factor significantly associated with block failure (odds ratio = 2.46)., Conclusions: The failure rate of spinal anesthesia was low. Variability in application of combined spinal caudal anesthetic limited attempts to compare the success of this technique to spinal alone.

Published
2015
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