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Middle ear pressures with different anaesthetic agents

The use of appropriate anaesthetic agents is essential to avoid complications during middle ear surgery. This Turkish study attempted to identify whether intravenous (IV) anaesthetics (propofol) or inhalational agents (sevoflurane) cause more variations in middle ear pressures. The authors performed...

ENT in this issue...Anaesthetics and ENT

Nick Crombie, BMedSci BMBS FRCA FIMC RCSEd RCPathME, Associate Medical Director (Governance); Consultant Trauma Anaesthetist; Honorary Researcher, National Institute for Health Research SRMRC: Clinical Lead for Resuscitation Services, QEHB, UK. E: Nicholas.Crombie@uhb.nhs.uk Plastic surgeons think we do endless crosswords. Orthopaedic...

IV dexamethasone versus LA infiltration during paediatric tonsillectomy

Postoperative nausea and vomiting following tonsillectomy is important to control for improved oral intake and satisfaction following surgery. Optimal management is still debated. This team from Beirut conducted a randomised double blind clinical trial comparing the effect of intravenous dexamethasone...

The use of THRIVE in laryngology and phonosurgery

The team in Lewisham has been using THRIVE for our phonosurgical cases for about a year. Here, we discuss the pros, cons and potential pitfalls of setting up and using THRIVE as ventilation during anaesthesia rather than using an ML...

Anaesthesia for sleep nasendoscopy and snoring / obstructive sleep apnoea surgery

Surgery for sleep disordered breathing inevitably requires surgeon and anaesthetist to share the airway. Here, Edward Bick gives us the anaesthetic viewpoint, reiterating that communication is the key. A specific note is made of the anaesthetic technique for sleep nasendoscopy,...

From aaargh to zzzzz: the ABC of paediatric anaesthesia

Andrew McTavish is one of those special breeds who not only relishes complex anaesthesia, but also does so in paediatric patients. Dealing with this group of patients requires careful planning according to accepted practice, and here he discusses some recent...

Anaesthesia for free-flap surgery

Adel Hutchinson is one of those calm and controlled anaesthetists for whom nothing seems too difficult. In this article, she describes the key perioperative factors for one of the highest complexity operations in ENT; free-flap surgery. It makes good reading...

Multidisciplinary airway simulation workshops: ‘preparing your team for the difficult airway’

Can human factor issues be better addressed within a multidisciplinary learning environment? Would this improve team working and patient outcomes? Are these important training considerations? Mona Thornton discusses the experience of a multidisciplinary simulation airway workshop in the unit she...

An overview of human factors in ENT and anaesthesia

James Bates and Chris Frerk are both passionate about how human factors science can improve safety in healthcare and have co-authored this article describing how communication, ergonomics and other non-technical skills are making operating theatres safer. There is no doubt...

Anaesthesia for excision of vestibular schwannomas

The ‘shared airway’ relationship between ENT surgeons and anaesthetists is well documented. But ENT surgery and anaesthesia interact in numerous other ways, particularly in complex skull base surgery. What do our anaesthetic colleagues want us to know about vestibular schwannoma...

Do intratympanic injections require local anaesthesia?

Intratympanic injections are becoming increasingly acceptable in the management of Meniere’s disease, tinnitus and sudden hearing loss. This is because they avoid the need for hospitalisation and can be performed as low-cost outpatient procedures. It is traditional to freeze the...

TIVA in FESS: a meta-analysis

This meta-analysis is from Rochester, New York, and aims to add more evidence for the use of TIVA in endoscopic sinus surgery (FESS) to arm rhinologists keen for a quick, bloodless FESS in the discussion with anaesthetists who prefer inhalation....