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doi:10.1093/bja/aer410
ABSTRACTS
(The name of the author presenting the paper is shown in bold type. *Indicates non-member. All authors have certified that, where
appropriate, studies have been conducted with the approval of the relevant Human Ethics Committee or Animal Experimental
Review Committee.)
All presentations to the ARS will be verbal and will be allocated 8 min for presentation and 7 min for discussion. These abstracts are reproduced here and are printed in order of presentation to the Society.
Abstracts submitted for the Presidents Award for Undergraduate Research will be presented by poster; these abstracts are provided
separately.
Acknowledgements
This work was supported by the Westminster Medical School
Research Trust. A.R.F. was awarded a scholarship for 2009
2011 from FCT Portugal.
References
1 Moller JT, Cluitmans P, Rasmussen LS, et al. Lancet 1998; 351:
85761
2 Fidalgo AR, Cibelli M, White JP, et al. Neurosci Lett 2011; 498: 63 6
3 Fidalgo AR, Cibelli M, White JP, et al. Neurosci 2011; 190: 1949
Delayed cerebral ischaemia (DCI) is the main cause of morbidity and mortality after subarachnoid haemorrhage (SAH).
Vasoconstrictive
processes
have
been
considered
& The Author [2012]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved.
For Permissions, please email: journals.permissions@oup.com
BJA
60
Patient 3
Patient 4
50
Patient 6
in
40
30
20
SAH
3
4
5
6
7
8
No. of days post-coiling
10
Fig 1 CBF measured with ASL MRI in three patients after subarachnoid haemorrhage.
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Acknowledgements
Funded by BJA/RCoA via National Institute of Academic
Anaesthesia (NIAA); National Institute of Health Research
Biomedical Research Centre, Oxford (NIHR-BRC); Medical
Research Council.
References
1 Cahill J, Zhang JH. Stroke 2009; 40: S86 7
2 Dai W, Garcia D, de Bazelaire C, et al. Magn Reson Med 2008; 60:
1488 97
3 Buxton RB, Frank LR, Wong EC, et al. Magn Reson Med 1998; 40:
38396
4 Chappell MA, Groves AR, Whitcher B, et al. IEEE Sig Proc 2009; 45:
795809
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References
1 Farrant M, Nusser Z. Nat Rev Neurosci 2005; 6: 21529
2 Taylor PM, Thomas P, Gorrie GH, Connolly CN, Smart TG, Moss SJ.
J Neurosci 1999; 19: 6360 71
30 59 yr
60 yr
T12
44
10
L1
60
310
96
L2
14
111
53
L3
L4
L5
Acknowledgement
This study was supported by departmental funds and there
were no conflicts with other sources of funding.
References
1
2
3
4
Interobserver reproducibility of
measurements of the supraclavicular
ultrasound view of the brachial plexus
A. Kant*, T. Lawton*, L. Adams*, P. K. Gupta,
A. Vats and P. M. Hopkins
Academic Unit of Anaesthesia, Leeds General Infirmary, Leeds, UK
The performance of successful ultrasound-guided supraclavicular blocks currently relies upon appropriate twodimensional ultrasound visualization, accurate interpretation
of that image, and effective operator technique. Failure to do
so can result in harm (inadequate block, local anaesthetic
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0.79 cm
0.97 cm2
0.35 cm
0.33 cm2
0.18
0.12
0.83
0.24
Reference
1 Bhatia A, Lai J, Chan VW, Brull R. Anesth Analg 2010; 111: 817 9
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Intra/
extraneural
kPa
Block site
kPa
Intraneural
Interscalene
Extraneural
Median
Sciatic
A 1.0
0.8
Sensitivity
0.6
0.4
0.2
AUC 0.967 (95% Cl 0.9370.997)
0.0
0.0
0.2
References
1.0
0.8
0.6
0.4
0.2
AUC 0.925 (95% Cl 0.8780.971)
0.8
B 1.0
Sensitivity
1 Liu SS, YaDeau JT, Shaw PM, Wilfred S, Shetty T, Gordon M. Anaesthesia 2011; 66: 16874
2 Evans A, Whelehan P, Thomson K, et al. Breast Cancer Res 2010;
12: R104
0.6
0.4
1-specificity
0.0
0.0
0.2
0.4
0.6
1-specificity
0.8
1.0
Fig 2 ROC curves for (A) model generation and (B) test data sets.
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Acknowledgement
This work was funded through an ARS Vacation Studentship
to R.O.I.
References
1 Carpenter D, Robinson RL, Quinnell RJ, et al. Br J Anaesth 2009;
103: 53848
2 Hopkins PM, Ellis FR, Halsall PJ, Stewart AD. Anesth Analg 1997; 84:
64856
Do malignant hyperthermia-susceptible
patients have higher baseline core body
temperature?
A. Vats, M. J. Rodway*, E. Watkins*, P. K. Gupta and
P. M. Hopkins
Malignant Hyperthermia Unit, Leeds Institute of Molecular
Medicine, University of Leeds, Leeds, UK
Table 4 Age, sex and temperature for MH-positive and MH-negative patients.
MH-positive
MH-negative
P-value
29.7, 5 75
26.5, 5 75
0.26
Sex (m:f)
29:36
35:30
0.38
0.013
0.41
0.028
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Acknowledgement
References
1 Lambert DG. Nat Rev Drug Discov 2008; 7: 694 710
2 Siddiqui S, Hollins F, Saha S, et al. Eur Respir J 2007; 30:
1043 56
3 DAgostino B, Orlotti D, Calo` G, et al. Am J Respir Cell Mol Biol 2010;
42: 2504
Success
Failure
pLMA
sLMA
68 (94%)
64 (89%)
4 (6%)
8 (11%)
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References
Acknowledgement
References
1 Tanaka K, Oda Y, Funao T, Takahashi R, Hamaoka N, Asada A.
Anesth Analg 2005; 100: 68796
2 De Kock M, Le Polain B, Henin D, Vandewalle F, Scholtes JL. Anesthesiology 1993; 79: 2829
3 Hanci V, Karakaya K, Yurtlu S, et al. Reg Anesth Pain Med 2009; 34:
5658
4 Okada H, Kurita T, Mochizuki T, Morita K, Sato S. Resuscitation 2007;
74: 53845
5 Snapir A, Posti J, Kentala E, et al. Anesthesiology 2006; 105:
90210
Patients with poor functional capacity secondary to comorbidity or physical de-conditioning may be at higher risk
of mortality after major surgery.1 We studied the outcomes
of patients whose functional capacity was characterized by
cardiopulmonary exercise testing (CPET) and of those who
were unable to perform the test.
All patients undergoing elective major colorectal surgery
at our Colorectal Specialist Unit undergo preoperative CPET
to assist in the planning of perioperative care. With ethics
committee approval, we followed the outcomes of 238
patients stratified into Fit (Group 1, n161), Unfit (Group
2, n62), and Very Unfit (Group 3, n15) on the basis of
their CPET results and a further 17 patients who were
unable to cycle a stationary bicycle at all or sufficiently
long to provide an interpretable result, Unable to CPET
Table 6 Mean (SD) ropivacaine dose, plasma concentration, and time to onset of cardiac adverse event. *P,0.05 compared with the control
group A, ANOVA
A
2.36 (0.34)
3.98 (0.17)*
3.44 (0.34)
0.59 (0.07)
3.36 (0.49)*
2.78 (0.43)
3.50 (0.40)*
847 (125)
1235 (124)*
1300 (209)*
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1433 (66)*
3.63 (0.57)*
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100
Per cent
90
80
Fitness
Group
1
2
3
4
70
60
0
100
200
300
Days from surgery
400
500
Fig 3 Kaplan Meier survival plot stratified by subgroup (P,0.001 log-rank test).
Reference
1 Wilson RJT, Davies S, Yates D, Redman J, Stone M. Br J Anaesth
2010; 105: 297 303
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References
1 Drummond GB, Bates A, Mann J, Arvind DK. Br J Anaesth 2011;
107: 4629
2 Duckitt RW, Buxton-Thomas R, Walker J, et al. Br J Anaesth 2007;
98: 76974
3 Cuthbertson BH, Boroujerdi M, McKie L, Aucott L, Prescott G. Crit
Care Med 2007; 35: 402 9
4 Taenzer AH, Pyke JB, McGrath SP, Blike GT. Anesthesiology 2010;
112: 2827
References
1 Allen J. Physiol Meas 2007; 28: R139
2 Shelley KH, Murray WB, Chang D. J Clin Monit 1997; 13: 223 8
Filter
Filter
50
Filter
100
Rad-Digit
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Rad-Digit
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Duration 5/503
of
analgesia
P-value
,0.00001
Onset of
sensory
block
5/259
0.06
Onset of
motor
block
5/259
0.16
Recovery
motor
function
3/180
References
1 Thornton PC, Grant SA, Breslin DS. Int Anesthesiol Clin 2010: 48;
59 70
2 Jadad AR, Moore RA, Carroll D, et al. Control Clin Trials 1996: 17; 112
,0.0001
We have previously reported that intraoperative goaldirected fluid therapy, GDT, had no impact on clinical outcomes for 179 patients having major elective colorectal
surgery.1 We performed side-stream dark-field imaging of
the sublingual capillaries at specified perioperative time
points on 27 of these patients to investigate the effects of
GDT on microcirculatory blood flow.
Side-stream dark-field imaging was undertaken using a
microcamera (Microscan, Microvision, Amsterdam, The Netherlands) at three specified time points: T0 immediately
before anaesthesia, T1 immediately after surgery, and T6
12, between 6 and 12 h after operation. The first three
images suitable for study at each time point were analysed
according to consensus methodology2 using AVA 3.0 software (Microscan, Microvision).
Fifty-three patients were assessed for inclusion. Twentysix were excluded (15 refused, 7 no suitable investigator, 4
other reasons) and 27 randomized: 13 GDT and 14 control.
Six GDT and 8 control patients were excluded from analysis
due to poor video clip quality (Table 8).
This pilot work illustrates the difficulties involved acquiring
microvascular images of sufficient quality for studies in awake
patients. The results mirror the clinical outcomes of our previous
study;1 however, power is limited. These pilot data have been
Table 8 Perioperative microvascular flow indices, haemodynamic measurements and selected clinical outcomes. Data are presented as
medians. No significant difference between T1 or T6 12 and preoperative values by Mann Whitney U-Test
n
T1
T6 12
Microvascular flow
index
T0
T1
T6 12
End-op.
Intraop.
fluid
(ml kg21)
Length
of stay
(days)
Control
13.3
12.5
11.5
2.9
2.9
2.5
89
98
30.5
8.9
GDT
13.7
12.7
14.4
3.0
2.8
2.8
67
101
89.6
7.9
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Acknowledgement
Funded by AAGBI through the NIAA, and South West Regional Innovation Fund.
References
1 Challand C, Struthers R, Sneyd JR, et al. Br J Anaesth 2011, August
26 (epub ahead of print)
2 De Backer D, Hollenberg S, Boerma C, et al. Crit Care 2007; 11: R101
Reference
1 Miller RD, Ward TA, Shiboski SC, Cohen NH. Anesth Analg 2011; 112:
85863
2
Lab Hb - SpHb (g/dl)
4
4
9
(Lab Hb + SpHb)/2 g dl1
14
SDs
Table 9 Mean (SD) epidural pressures (mm Hg) measured at four time points in full-term parturient (n15) and non-pregnant women (n20)
during epidural block. *P,0.05
T0
T1
T2
T3
Pregnant
17.1 (2.0)
14.3 (0.6)
24.0 (1.0)
23.8 (1.2)
Non-pregnant
16.1 (3.1)
11.7 (1.0)*
20.5 (1.8)*
20.2 (1.7)*
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References
1 Igarashi T, Hirabayashi Y, Shimizu R, Saitoh K, Fukuda H, Suzuki H.
Anesthesiology 2000; 92: 16316
2 Messih MNA. Anaesthesia 1981; 36: 77582
3 Moon JY, Lee PB, Nahm FS, Kim YC, Choi JB. Anesthesiology 2010;
113: 66671
4 Shah JL. Br J Anaesth 1984; 56: 13737
5 Thomas PS, Gerson JI, Strong G. Reg Anesth 1992; 17: 212 5
References
1 Alkire MT, Miller J. Prog Brain Res 2005; 150: 22944
2 Martuzzi R, Ramani R, Qiu M, Rajeevan N, Constable RT. Neuroimage 2010; 49: 82334
3 Ying S-W, Goldstein PA. Mol Pain 2005; 1: 2
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