Airway management research has historically incorporated heterogeneous outcome selection and definitions. This impedes evidence synthesis and hinders advances in patient care. So - here is a core outcome set to standardise airway management research! #AnSky

Here is the first consensus-based core outcome set for airway management research, with agreed definitions and measurement instruments. This will harmonise evidence synthesis and improve the translatability of findings to improve clinical care. #AnSky #AirwaySky doi.org/10.1111/anae...

Cross sensitivity between neuromuscular blocking agents If a patient has had a POHR to: • rocuronium, suxamethonium or vecuronium, then atracurium is the lowest risk alternative • atracurium, then rocuronium and suxamethonium are low risk alternatives #AnSky doi.org/10.1111/anae...

The chance of having an allergic reaction to a neuromuscular blocking drug is: • suxamethonium: ~1 in 1500 people • rocuronium: ~1 in 3300 people • atracurium: ~1 in 15,000 people Women were up to eight times more likely to have a reaction than men. #AnSky #MedSky doi.org/10.1111/anae...

• There is a significant difference between the rates of peri-operative hypersensitivity reactions with rocuronium and suxamethonium vs. atracurium. • Females may be higher risk than males of reacting to neuromuscular blocking drugs. #AnSky doi.org/10.1111/anae...

What is your platelet threshold for vascular access? There are inconsistent recommendations in recent guidelines for peri-procedural platelet transfusions and a lack of robust clinical evidence to underpin the strength of any recommendations. #AnSky #HemeSky #HaemSky doi.org/10.1111/anae...

The ‘afternoon effect’ as a proxy for systemic vulnerabilities in surgical care #AnSky #MedSky doi.org/10.1111/anae...

Time, sleep and children: integrating chronobiology into anaesthesia #AnSky #PedsAnSky

“If anaesthetists are to adopt a screening test for an otherwise asymptomatic population, we must be reasonably confident that: the test detects the target condition; detection changes management in a way that improves patient-centred outcomes; and harms are outweighed by benefits”

Routine pre-operative modified telephone interview for cognitive status screening: feasible, but is it justified? #AnSky #MedSky

Hyperangulated videolaryngoscopy: stylet first until benefit of bougie is shown "...the current challenge for the wider community of anaesthetists ... is not mastery of HAVL but access to devices, routine use, gaining familiarly and developing competence." #AnSky ttps://doi.org/10.1111/anae.70062

Default VL now recommended by multiple guidelines incl CAFG, PUMA & DAS Narrative review of default VL in @anaesjournal.bsky.social Discusses the benefits, challenges & myths of VL Provides the info make a business case for default VL Describes strategies for addressing implementation challenges

Slideset for my talk at #waam2025 celebrating the best airway papers published in @anaesjournal.bsky.social over the past 10 years sthjournalclub.wordpress.com/2025/11/07/w...

Not so much a criticism of the study but the issue is that because there is no mention of time, the practical implications are limited. The rate of failure and particularly infection are only useful if we know when they occur. Definitely a "more research please" area.

Arterial catheter infection rates remain notably higher than those of peripheral intravenous catheters, which have an incidence of approximately 0.03%. Why is a higher infection risk in arterial catheters tolerated? #AnSky #ICUSky doi.org/10.1111/anae...

8–12 million arterial catheters are inserted each year. Non-infectious complications represent the greater burden of arterial catheter failure in ICUs. This translates to up to 2.6 million non-infectious failures annually. #AnSky #ICUSky

Reminder to discontinue A-lines when they are no longer needed. Risk of infection is lower than with central lines (since A-lines usually stop working and get pulled relatively soon), but infection risk is real.

Arterial catheter complications: • 13/100 catheters failed for any reason • 20/100 catheters failed for reasons not caused by infection • bloodstream infections - 1/100 catheters • local infections (around the area where the catheter goes in) - 1/100 cases #ICUSky #AnSky doi.org/10.1111/anae...

Complications associated with central venous catheters are widely known. Less is known about arterial catheter-related complications. Here's a systematic review which quantifies the incidence of arterial catheter-related complications and failure in ICU. #ICUSky #AnSky

Preserving sleep in paediatric peri-operative care #AnSky #sleep doi.org/10.1111/anae...

"While the study by Meewisse et al. is reassuring in that it suggests that minor procedures under anaesthesia may not drastically alter sleep–wake rhythms in children, we must not assume this applies to all paediatric surgical scenarios." #AnSky #sleep

Reassessing the dose-onset relationship of remimazolam in children: a reply #AnSky

On MRI scans, people with chronic pain often had patterns that were like the patterns seen in people with Alzheimer's disease: less grey brain tissue, weaker white brain tissue, and signs of older brain age in places such as the hippocampus. #AnSky doi.org/10.1111/anae...

Brain health in adults with chronic pain For structural MRI studies, smaller grey matter volumes were found in the chronic pain group compared with healthy controls in most studies. #AnSky doi.org/10.1111/anae...

Adults with chronic pain exhibit widespread alterations in brain health compared with healthy controls. Several observed features overlap with biomarkers of Alzheimer's disease and other forms of neurodegeneration. #AnSky doi.org/10.1111/anae...

Machine learning and the NHS pre-operative assessment "Presenting subgroup-stratified performance and quantifying the warning flag system would enhance transparency, support safe adoption and broaden the impact on peri-operative services and health system planning." #AnSky doi.org/10.1111/anae...

Too often surgical programs are presented to anaesthesia as a fait accompli. Anaesthesia then has to figure out the logistics on their own usually with no new resources.

Postop sore throat Treatments that seemed to help reduce a sore throat included keeping the pressure in the airway tube/mask low. For breathing tubes, medicines such as ketamine, steroids or anti-inflammatory drugs (sprays, creams or through a drip) also helped. #AnSky doi.org/10.1111/anae...

Comparison of two peripheral regional analgesic techniques for primary elective total hip arthroplasty: a reply #AnSky

To make a TAVI programme work, all team members require the following: • high-level understanding of the procedure • knowledge of what can and might go wrong and the complications which are avoidable • proper governance processes • expert clinical management #AnSky doi.org/10.1111/anae...

Interpreting the afternoon disadvantage: accounting for mediation, weighting and secular trends #AnSky doi.org/10.1111/anae...

The relationship between generative AI and predictive analytics underscores the possibility for individual patient data and dynamic risk prediction to enhance care quality. eg. ‘tri-hybrid model’ - integrates AI; predictive analytics; and human intelligence #AnSky #AI doi.org/10.1111/anae...

When you're doing a block for lower limb surgery, should you prioritise function or analgesia? #AnSky #RASky doi.org/10.1111/anae...

Postoperative sore throat has an incidence of up to 62%. The current literature lacks high-quality randomised controlled trials on treatments that prevent a complication that is of importance to patients and their recovery. #AnSky #MedSky doi.org/10.1111/anae...

What strategies can be used to reduce the incidence of post operative sore throat? • Cuff pressure ≤ 30 cmH2O • IV/topical corticosteroids • Nebulised/topical ketamine • Topical NSAIDs • Smaller tube: 7.0 mm (male); 6.0 mm female • Use a SAD instead #AnSky #MedSky doi.org/10.1111/anae...

Are large national observational studies (eg NAP, SNAP, POPPY and SONAR) including the wider determinants of health? Promisingly, over time the number of PROGRESS-Plus characteristics recorded has increased. #AnSky doi.org/10.1111/anae...

What characteristics relevant to equity can identify which populations are at higher risk of adverse outcomes? PROGRESS-Plus: Place of residence; Race/ethnicity/culture/language; Occupation; Gender/sex; Religion; Education; Socio-economic status; and Social capital. #AnSky

People taking SGLT2 inhibitors: • were less likely to die w/i 30 days • had fewer heart problems, kidney injuries and cases of diabetic ketoacidosis Benefits greater in: • women • people with obesity • people with protein in their urine • heart surgery. #AnSky #MedSky doi.org/10.1111/anae...

What can peri-operative rehabilitation to ⬇️ pulmonary complications in cardiac surgery look like? • 6 sessions of inspiratory muscle training • 33 sessions of active cycle of breathing techniques • 12 sessions of early mobilisation during hospitalisation #AnSky #MedSky doi.org/10.1111/anae...

People with heart valve problems who need surgery often get lung problems after. This study showed that a special program (learning about their condition, training the breathing muscles, breathing techniques and moving soon after surgery) helped ⬇️ lung problems. #AnSky doi.org/10.1111/anae...

There is no formal, internationally recognised definition of ‘high’ neuraxial blockade. Symptoms: • cardiovascular instability • weakness of the upper limbs • respiratory compromise • collapse #AnSky doi.org/10.1111/anae...

High neuraxial block in obstetrics: are we only seeing the tip of the iceberg? The presence of local anaesthetic in the epidural space makes the effect of subsequent intrathecal drug administration less predictable. #AnSky #ObSky #PainSky doi.org/10.1111/anae...

We LOVE hearing the voice of our patients and publishing the patient experience. If you have a unique story, think about sending it through to us for consideration for publication. #AnSky doi.org/10.1111/anae...

Also, if you do TIVA, you don't actually need an anaesthetic machine, scavenging or CO2 reabsorption. You just need a vent.

Did you know that CA125 is well known to be elevated in ovarian cancer but can also be elevated in heart failure, particularly right-sided heart failure & heart failure with preserved ejection fraction? @rgdavies70 @USW_Oxygen #MedSky #AnSky #ICUSky doi.org/10.1002/anr3...

Peri-operative rehabilitation in patients undergoing elective cardiac valve surgery: a randomised controlled trial #AnSky #MedSky doi.org/10.1111/anae...

Peri-operative rehabilitation reduced the incidence of postoperative pulmonary complications in patients having surgery for valvular heart disease. #AnSky doi.org/10.1111/anae...

Motor-sparing regional anaesthesia in lower-limb arthroplasty: balancing analgesia and function #AnSky #RASky doi.org/10.1111/anae...

Are motor-sparing approaches universally advantageous or are their benefits more limited and contingent on careful patient selection? Here is a tiered, patient-centred decision model about prioritising function or analgesia. #AnSky #RASky doi.org/10.1111/anae...

Do we need the ASA physical status classification system anymore? #AnSky