Pain after lower limb amputation Limb amputation results in profound physical, psychological and social effects for individuals with consequent societal and healthcare costs. In the UK, the commonest indications for lower limb…

📉 Mortality after major lower limb amputation remains high. Reported 30-day mortality was 8.4% for transfemoral amputation and 4.4% for transtibial amputation. Pain management is only one issue, but it is a critical one.
Read more in the #BJAEd: buff.ly/GbBq1Y5
#PerioperativeMedicine #Anaesthesia

Persistent air leak in the critically ill Persistent air leak (PAL) is an infrequent but challenging scenario in critical care and anaesthesia, most often arising as a complication of lung resection surgery. Patients with PAL are at high…

🤢 Nausea and vomiting during caesarean delivery are not trivial. Multimodal antiemetic prophylaxis, especially combination therapy, can reduce complications, improve comfort, and support smoother recovery.
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#PONV #ObstetricAnaesthesia #PerioperativeCare

Persistent air leak in the critically ill Persistent air leak (PAL) is an infrequent but challenging scenario in critical care and anaesthesia, most often arising as a complication of lung resection surgery. Patients with PAL are at high…

🔍 If the lung fails to re-expand after pleural drainage, don’t assume it is just ongoing leak. Consider:
🫁 trapped/non-expandable lung
📍 drain malposition or blockage
💥 a very large leak
Read more in the #BJAEd: www.bjaed.org/article/S205...

Management of phaeochromocytoma in pregnancy Phaeochromocytomas are neuroendocrine tumours of the adrenal medulla that secrete catecholamines, which, when released into the bloodstream, typically cause paroxysmal symptoms of headache,…

🩺 Modern management has transformed outcomes. Perioperative mortality for phaeochromocytoma resection has fallen from >25% historically to <1%, with morbidity around 5%, thanks to α-blockade and better haemodynamic control.
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#Anaesthesia #CriticalCare

🔪 Surgical technique matters for pain outcomes. Careful nerve handling, traction neurectomy, and avoidance of neuroma-prone nerve endings in scarred or pressure-bearing tissue may reduce symptomatic neuroma formation.
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#Surgery #PainPrevention

🥤 Nonparticulate carbohydrate loading before caesarean delivery may reduce insulin resistance, shorten time to colostrum expression, improve breastfeeding outcomes, and reduce neonatal hypoglycaemia.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#EnhancedRecovery #Obstetrics

Persistent air leak in the critically ill Persistent air leak (PAL) is an infrequent but challenging scenario in critical care and anaesthesia, most often arising as a complication of lung resection surgery. Patients with PAL are at high…

🚨 In massive air leak with failing gas exchange, rescue strategies may include lung/lobar isolation, endobronchial occlusion, surgery, or VV-ECMO. Sometimes the priority is buying time safely enough for healing.
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#ECMO #CriticalCare #ThoracicAnaesthesia

Management of phaeochromocytoma in pregnancy Phaeochromocytomas are neuroendocrine tumours of the adrenal medulla that secrete catecholamines, which, when released into the bloodstream, typically cause paroxysmal symptoms of headache,…

⚠️ Phaeochromocytoma should stay on the differential for hypertension in pregnancy. It classically presents with headache, palpitations, diaphoresis, hypertension, and tachycardia, but diagnosis is easy to miss.
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#Obstetrics #Anaesthesia #Hypertension

Anaesthesia for children with cervical spine anomalies Craniocervical anomalies in children are unusual but may occur in the context of a range of congenital and acquired disorders. Children with such disorders, not infrequently, require anaesthesia for…

🤝 In children with c-spine abnormalities, best care is multidisciplinary: neurosurgery, orthopaedics, anaesthesia, radiology, physiotherapy and often medical teams too.
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#Teamwork #Paediatrics #Anaesthesia

📊 NCEPOD highlighted suboptimal analgesia in this group: only 23% reported good pain control before surgery and 38% reported good pain control after surgery. Early pain team involvement is not optional.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#PatientSafety #PainTeams #PeriopCare

💧 In elective Caesarean delivery, prolonged fasting is not benign. Reducing fasting time can improve recovery, maternal satisfaction, and length of stay. “Sip til send” is a pragmatic approach increasingly used in obstetric practice.
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#ObstetricAnaesthesia

Persistent air leak in the critically ill Persistent air leak (PAL) is an infrequent but challenging scenario in critical care and anaesthesia, most often arising as a complication of lung resection surgery. Patients with PAL are at high…

🩺 Bronchoscopy can be pivotal in persistent air leak:
🔹 identify a bronchopleural fistula
🔹 localise the culprit segment with balloon occlusion
🔹 guide endobronchial valve placement
Read more in the #BJAEd: www.bjaed.org/article/S205...
#Bronchoscopy #ICU

Management of phaeochromocytoma in pregnancy Phaeochromocytomas are neuroendocrine tumours of the adrenal medulla that secrete catecholamines, which, when released into the bloodstream, typically cause paroxysmal symptoms of headache,…

📚 In pregnancy, most phaeochromocytomas are resected after delivery. Recent reviews suggest 70–77% undergo postpartum resection, with diagnosis often made at around 24–26 weeks’ gestation.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#ObstetricMedicine #PerioperativeCare #BJAEd

Anaesthesia for children with cervical spine anomalies Craniocervical anomalies in children are unusual but may occur in the context of a range of congenital and acquired disorders. Children with such disorders, not infrequently, require anaesthesia for…

⚠️ In trisomy 21, up to 30% of children have radiological evidence of atlantoaxial instability, though only a minority become symptomatic. Even asymptomatic patients may still be vulnerable to neurological injury from neck movement.
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#PaedsAnaesthesia #Airway

Pain after lower limb amputation Limb amputation results in profound physical, psychological and social effects for individuals with consequent societal and healthcare costs. In the UK, the commonest indications for lower limb…

🩺 A key perioperative message: pre-existing pain matters. Longer duration and greater intensity of pain before amputation are associated with more severe postoperative pain and higher risk of chronic pain after amputation.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#Pain #Anaesthesia

Persistent air leak in the critically ill Persistent air leak (PAL) is an infrequent but challenging scenario in critical care and anaesthesia, most often arising as a complication of lung resection surgery. Patients with PAL are at high…

🎥 Antenatal education is a core component of ERAC. It helps patients engage with care, supports shared decision-making, and improves experience. Educational videos may be especially effective for reducing maternal anxiety.
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#PatientEducation #Obstetrics

Persistent air leak in the critically ill Persistent air leak (PAL) is an infrequent but challenging scenario in critical care and anaesthesia, most often arising as a complication of lung resection surgery. Patients with PAL are at high…

⚠️ In persistent air leak, more suction is not always better. Excessive suction can increase flow across the defect and delay healing. Use the least suction necessary to maintain pleural apposition.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#RespiratoryMedicine #ChestDrain #ICU

Management of phaeochromocytoma in pregnancy Phaeochromocytomas are neuroendocrine tumours of the adrenal medulla that secrete catecholamines, which, when released into the bloodstream, typically cause paroxysmal symptoms of headache,…

🤰 Phaeochromocytoma in pregnancy is rare — estimated at 1 in 15,000 to 1 in 300,000 pregnancies — but the stakes are high, with reported maternal mortality of ~4–9% and fetal mortality of ~7–14%.
Read more in the #BJAEd: buff.ly/qADR2ZK
#ObstetricAnaesthesia #PerioperativeMedicine

Anaesthesia for children with cervical spine anomalies Craniocervical anomalies in children are unusual but may occur in the context of a range of congenital and acquired disorders. Children with such disorders, not infrequently, require anaesthesia for…

📚 A practical framework: most paediatric cervical spine/CVJ disorders can be understood through 3 mechanisms:
🔹 instability
🔹 deformity
🔹 compression
That biomechanical approach is often more useful than a rare syndrome label.
Read more in the #BJAEd: buff.ly/oAIGtKV
#Paediatrics

🦿 Lower limb amputation carries major personal and healthcare burden. In the UK in 2022, there were ~3500 major lower limb amputations, with median hospital stay 21 days and readmission rates >9%.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#Anaesthesia #PainMedicine #VascularSurgery

Enhanced recovery after Caesarean delivery. Part 1: preoperative and intraoperative considerations Caesarean delivery is the most performed inpatient surgical operation worldwide. Given that the number of Caesarean deliveries is predicted to increase globally, the enhancement and improvement of…

🤰 Caesarean delivery is now the most common inpatient surgical procedure worldwide. As rates rise globally, optimising maternal and neonatal outcomes becomes even more important.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#ObstetricAnaesthesia #PerioperativeMedicine #MedEd

😮 Airway difficulty is common in cervical anomalies, especially in mucopolysaccharidoses and skeletal dysplasias. Think large tongue, thickened airway tissues and limited neck movement.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#AirwayManagement #PaediatricAnaesthesia #DifficultAirway

🫁 Persistent air leak (PAL) is more than a bubbling chest drain. In critically ill patients it can severely affect oxygenation, ventilation, and lung expansion and may require bronchoscopy, surgery, or even ECMO.
Read more in the #BJAEd: www.bjaed.org/article/S205...
#CritCare #ICU #Anaesthesia

Read this new #BJAEd article by Carden & Zoumprouli for an overview of the management of aneurysmal subarachnoid haemorrhage in critical care: www.bjaed.org/article/S205...

Oosterom-Eijmael and colleagues provide a great outline of cardiac surgery-associated acute kidney injury in this new #BJAEd article: www.bjaed.org/article/S205...

Migraine part 2: evidence-based acute and preventive treatment Migraine is a highly prevalent condition affecting 15% of the general population; it is three times more common in women (22%) than men (7%).1 Migraine is one of the most common symptoms presenting…

This new #BJAEd article by Khan and colleagues on acute and preventative treatment for migraine is now available to read online: www.bjaed.org/article/S205...

This great new #BJAEd article on management of aneurysmal subarachnoid haemorrhage is now available to read online: www.bjaed.org/article/S205...

Read this new #BJAEd article by Doleman & Hardman for a fantastic overview of systematic review and meta-analysis: www.bjaed.org/article/S205...

Read this fantastic new #BJAEd article by Summers & colleagues which describes the surgical considerations, anatomy, physiology and perioperative care of patients undergoing elective cervical spine surgery: www.bjaed.org/article/S205...

Don't miss this month’s excellent #BJAEd Editors’ choice article, in which Maghami & colleagues outline the key considerations for using peripheral nerve catheters for regional anaesthesia. www.bjaed.org/article/S205...