SummaryCardiac output may be an important determinant of the induction dose of intravenous anaesthetic. Esmolol is known to reduce cardiac output, and we examined its effect on the propofol dose required for induction of anaesthesia. The size of the effect seen with esmolol was compared with midazolam co-induction. Sixty patients were randomly allocated to placebo (saline), esmolol (1mg.kg )1 bolus, followed by an infusion at 250 lg.kg) or midazolam (0.04 mg.kg )1 ) groups. Induction of anaesthesia commenced 3 min following the administration of the study drug, using a Diprifusor set to achieve plasma propofol concentrations of 10 lg.mlat 5 min. The primary end point used was the propofol dose per kg at loss of response to command. The mean (SD) propofol dose for each group was 2.38 (0.48) mg.kg )1 for placebo,

We have demonstrated that wearing extra-thin surgical gloves offers increased touch sensitivity. This may improve dexterity when carrying out delicate invasive procedures. Latex-free surgical gloves performed similar to standard latex gloves. Our findings should encourage more widespread glove use among anaesthetists.

The rat is the preferred model for toxicology studies, and it offers distinctive advantages over the mouse as a preclinical research model including larger sample size collection, lower rates of drug clearance, and relative ease of surgical manipulation. An immunodeficient rat would allow for larger tumor size development, prolonged dosing and drug efficacy studies, and preliminary toxicologic testing and pharmacokinetic/pharmacodynamic studies in the same model animal. Here, we created an immunodeficient rat with a functional deletion of the Recombination Activating Gene 2 () gene, using genetically modified spermatogonial stem cells (SSC). We targeted the gene in rat SSCs with TALENs and transplanted these-deficient SSCs into sterile recipients. Offspring were genotyped, and a founder with a 27 bp deletion mutation was identified and bred to homozygosity to produce the Sprague-Dawley - (SDR) knockout rat. We demonstrated that SDR rat lacks mature B and T cells. Furthermore, the SDR rat model was permissive to growth of human glioblastoma cell line subcutaneously resulting in successful growth of tumors. In addition, a human KRAS-mutant non-small cell lung cancer cell line (H358), a patient-derived high-grade serous ovarian cancer cell line (OV81), and a patient-derived recurrent endometrial cancer cell line (OV185) were transplanted subcutaneously to test the ability of the SDR rat to accommodate human xenografts from multiple tissue types. All human cancer cell lines showed efficient tumor uptake and growth kinetics indicating that the SDR rat is a viable host for a range of xenograft studies..

SummaryNurses assess patients pre-operatively using screening questionnaires and locally-developed protocols. Our objectives were to determine which questions might identify patients who should be seen by an anaesthetist before the day of surgery. A review of the literature and a preliminary questionnaire to establish questions to be tested was followed by a modified, two-round Delphi questionnaire to determine the level of agreement by anaesthetists. There was agreement for referring patients who gave a positive response to questions that query: restricted exercise tolerance; previous anaesthetic problems; family history of anaesthetic problem; pathology affecting neck movement; angina; arrhythmia; heart failure; asthma; epilepsy; insulin-dependent diabetes mellitus; liver disease and unspecified kidney disease. There was equivocal agreement on questions that report a myocardial infarction over one year ago, cerebrovascular accident, non insulin-dependent diabetes mellitus and thyroid disease. Nurses should use these criteria during pre-operative assessment to decide the timing of evaluation by an anaesthetist.Keywords Anaesthesia; pre-operative, assessment. The National Booked Admissions programme was launched in 1998 in the UK as part of the government's strategy for modernising the National Health Service (NHS). The booking system includes booking from general practice to outpatient clinics, or day-case surgery, and booking from within hospitals for day-case and inpatient admissions. During one visit to hospital, patients will be seen by the consultant and pre-assessed for treatment if necessary [1,2]. The NHS Modernisation Agency, through the National Pre-operative Assessment Project, continues to develop pre-operative assessment by nurses [3]. The Association of Anaesthetists of Great Britain and Ireland (AAGBI) recommends the provision of pre-operative screening [4] by a team led by an appropriately trained nurse in a pre-operative assessment clinic.Typically, nurses assess patients using a screening questionnaire, usually developed in conjunction with anaesthetists. ÔAnything out of the ordinaryÕ is referred to an anaesthetist for further evaluation, before the day of surgery [5,6]. The most valuable questions to ask to identify anything out of the ordinary are not yet clear.Our objective was to determine, using consensus methods, which questions used in pre-operative assessment questionnaires might identify patients who should be seen by an anaesthetist before the day of surgery.This information could facilitate standardisation of preoperative assessment which could be incorporated into the booked admissions system, and lead to a more reliable method of referral to an anaesthetist. MethodFlow diagrams summarising methods are shown in Figs 1 and 2.We collected a list of questions frequently used in preoperative assessment questionnaires from published literature and local day surgery protocols. We searched Medline from 1981 to 2001, using the MeSH terms: ÔanaesthesiaÕ, Ôpre-operative evaluationÕ, Ôassess...

SummaryWe examined the interobserver reliability, between a nurse and anaesthetist, of five tests used to predict difficult tracheal intubation: mouth opening; thyromental distance; head and neck movement; mandibular luxation; and assessment of oropharyngeal view. For each test, an anaesthetic nurse and a specialist registrar anaesthetist were trained to use a standard method of examination. Most of the tests had either good or very good reliability. Assessment of mouth opening demonstrated only moderate reliability and assessment of oropharyngeal view demonstrated poor reliability. The interobserver reliability estimates between a nurse and an anaesthetist are similar to those previously demonstrated between two anaesthetists.