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We’re Back

Thanks for the appeal, anaesthesiawest is now reactivated.

Low dose naloxone to relieve pain

From the “who would have guessed it” category come the idea of naloxone as an analgesic. There have been several previous studies (see below) showing that extremely low doses of naloxone appeared to have analgesic properties, but no real explanation of how this might be possible. The most recent interesting article is this one here, … Continue reading

Nitrous SAVES lives? Maybe, but the discussion is still open….

Following Paul Myles’ paper in Anesthesiology in 2007 – that demonstrated bad outcomes in patients anaesthetised with nitrous oxide (click here), “experts” clamoured to demand that we stop using the stuff in our clinical practice. Their opinions were enhanced by the ENIGMA trial, that claimed increased risk of myocardial infarction in patients receiving nitrous (click … Continue reading

Remote Ischaemic Preconditioning

Several years ago while in Galway I first came across the concept of remote ischaemic preconditioning (RIPC). This is the concept that subjecting one part of the body to a brief period of ischaemia (eg 3 cycles of 5 minutes of an arm tourniquet above systolic pressure, followed by 5 minute deflations) can protect the … Continue reading

Taking slow vent weans by the collar

Our ICUs are crowded by patients that are slow to liberate from mechanical ventilation. In North America, such patients are often transferred to long term mechanical ventilation facilities (LTAC) – where they are weaned to liberation. There are many strategies for weaning tracheostomised  patients from mechanical ventilation – a progressive reduction in pressure support, intermittent … Continue reading

The Obesity Paradox – Weight there’s more!

The media are constantly harping on about the obesity epidemic – “two in three of us are fat – this is going to lead to an explosion of obesity related morbidity – heart disease, cancer, cerebrovascular disease, crumbling joints etc.” It never seems to occur to the same talking heads on television and in print … Continue reading

The Toyota approach to anaesthesia- small continuous improvements: using placebo, IV cannulation, echo, blocks and compression devices

Toyota is famous for improving their cars through a process of continuous, small, incremental improvements, a technique known as Kaizen, or the Toyota way. In this way many small improvements, each inconsequential on their own, when added together produce significant results. I think this is a great model to use when looking at anaesthesia. Anaesthesia … Continue reading

Regional Anaesthesia Thursday Meetings Schedule Autumn 2012

26-Jul-12 TAP block Dr. J.Mc Donnell. 02-Aug-12 From TAP to Stellate Dr. Olivia Flinnerty. 09-Aug-12 Physiology of Pregnancy Dr. Aoife Quinn. 16-Aug-12 Failed block what to do? Epidural test dose Dr. Joye Coyne. 23-aug-12 LAST ? Dr. B. Kinirons. 30-Aug-12 Axillary brachial plexus block. ? Dr. J.Mc Donnell. 06-sep-12 Facet joint injections and medial branch … Continue reading

Tuesday morning meetings August

Tuesday 8 a.m. Meetings   Venue: ICU conference room   August 7th Introduction to hyperbaric Medicine Dr Noel Flynn   14th Interactive mini-quiz: the case continues Dr Leo Kevin   21st Obsetric anaesthesia J Costello   28th Morbidity and Mortality Department

July Tuesday educational sessions

Tuesday 8 a.m. Meetings July 2012 Venue: ICU conference room July 3rd Morbidity and Mortality Department 10th NCHD meeting 17th Introduction to the Labour ward Dr Joey Costello 24th Introduction to educational program and mini-quiz Dr Leo Kevin 31st The difficult airway Dr Brian Harte