By William Harrop-Griffiths, Richard Griffiths, Felicity Plaat
In line with the organization of Anaesthetists of serious Britain & Ireland's (AAGBI) carrying on with schooling lecture sequence, this clinically-oriented booklet covers the most recent advancements in learn and the scientific software of anesthesia and soreness control.
- Reviews most up-to-date advancements in learn and practice
- Clinically-oriented yet rooted in simple science
- Concise and informative articles on key topics
- Road-tested via CPD roadshows
- Designed in particular for carrying on with scientific education
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Additional resources for AAGBI Core Topics in Anaesthesia 2015
Therefore caution must be exercised when using these tables and, at best, they provide a rough guide. There is also evidence suggesting that the conventional practice of opioid rotation based on equi-analgesic tables may be an important factor in opioid-related deaths, particularly in chronic non-cancer pain patients. On the strength of this, a different approach to opioid rotation has been recommended for these patients. The current opioid is reduced by 10– 30% and the new opioid introduced at the dose used for an opioid-na¨ıve patient.
Focused echocardiography in this setting has the potential to guide pre-operative optimisation as well as intra-operative and postoperative management. Patients presenting with fractured neck of femur form a high-risk group. A recent study identified a 12% incidence of moderate to severe aortic stenosis in unselected fractured neck of femur patients. In England, the recently introduced ‘Best Practice Tariff’ for hip fracture patients introduced a financial penalty if there is a delay of >36 h from admission to surgery.
Given the large number of uncertainties, close communication between anaesthetists and cardiologists is highly desirable in the management of patients suffering or at risk of ACS. References 1. McGill HC Jr, McMahan CA, Zieske AW, et al. Association of coronary heart disease risk factors with microscopic qualities of coronary atherosclerosis in youth. Circulation 2000; 102: 374–379. 2. Aldrovandi A, Cademartiri F, Arduini D, et al. Computed tomography coronary angiography in patients with acute myocardial infarction without significant coronary stenosis.