Cardiothoracic anaesthesia services are provided for patients undergoing cardiac and thoracic procedures. To reflect current practice, these guidelines have been more clearly divided to identify areas of differing requirement. Anaesthetists in cardiac surgical services are now more frequently required to provide anaesthesia for invasive cardiology procedures.
Cardiac surgery may involve adult, paediatric and neonatal patients and includes...
Day surgery is the planned admission of a surgical patient for an elective or semi-elective procedure where the patient is admitted, undergoes surgery and is discharged on the same calendar day.2 If the patient remains in a hospital bed overnight on the day of their surgery they are classed as having undergone inpatient surgery. The term ‘23-hour stay’...
Inpatient pain services (IPS) consist of a multidisciplinary team including appropriately trained acute pain physicians and anaesthetists along with nurses specialised in pain management. Other allied health professionals such as applied psychologists, addiction medicine specialists, physiotherapists and pharmacists may also be part of the IPS team.
After the publication of the joint working party of the Royal College of...
Head and neck surgery includes a wide spectrum of surgical interventions, ranging from short daycase procedures to long and complex operations.1 The requirements for providing anaesthesia services for routine head and neck surgery, such as tonsillectomy, will be different to those required to provide anaesthesia for major or complex surgery. There should be recognition that routine head...
Vascular services are recognised as having a high priority in the UK. Publication of evidence that the outcome from abdominal aortic aneurysm (AAA) surgery was significantly worse in the UK than in comparable countries,1 and the 2005 NCEPOD Report ‘AAA a service in need of surgery’, led to a national Abdominal Aortic Aneurysm Quality Improvement Programme (AAAQIP)...
From their inception, IPS have provided acute post-surgical pain management to promote a balance of symptomatic relief and early restoration of function to improve patient experience and surgical outcomes. An ongoing and important role of the IPS is the consistent training and education of staff and students across the wider hospital trust. Other responsibilities continue to expand into...
‘Emergency’ within this chapter applies to anaesthesia that is given in immediate (within minutes of a decision to operate) or urgent (within hours of a decision to operate) procedures as classified by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).
The provision of emergency anaesthesia differs from elective anaesthesia in that it is required 24/7. The demands...
Head and neck surgery includes a wide spectrum of surgical interventions, ranging from short daycase procedures to long and complex operations.1 The requirements for providing anaesthesia services for routine head and neck surgery, such as tonsillectomy, will be different to those required to provide anaesthesia for major or complex surgery. There should be recognition that routine head and...
It is nearly two decades since it was widely reported that the outcome from abdominal aortic aneurysm (AAA) surgery was significantly worse in the UK than in comparable countries.1 The 2005 NCEPOD report Abdominal Aortic Aneurysm: A service in need of surgery2 subsequently led to a national Abdominal Aortic Aneurysm Quality Improvement Programme (AAAQIP) being introduced...
Regional anaesthesia (RA) is an important component of anaesthetic practice. It includes neuraxial and peripheral nerve block techniques which may be used for either perioperative anaesthesia or analgesia, as well as other non-surgical indications such as chronic pain and traumatic rib fractures. The practice of RA has changed significantly, particularly over the past three decades.1 The introduction of...
