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Introduction

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...

Introduction

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...

Introduction

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)...

Introduction

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

Cardiac surgery may involve adult, paediatric and neonatal patients and includes...

Introduction

Perioperative care refers to the practice of patient-centred, multidisciplinary and integrated clinical care for patients from contemplation of surgery until full recovery. Good perioperative care should improve the patient experience, quality and satisfaction with care. It should improve the health of populations, including returning to home/work and quality of life, and should reduce the per capita cost of healthcare...

Introduction

Day surgery is the planned admission of a surgical patient for a procedure where the patient is admitted, undergoes surgery and is discharged on the same calendar day.¹ 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’ surgery is short-stay...

Introduction

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’...

Introduction 

There are increasing numbers of diagnostic and therapeutic procedures performed outside the main theatre environment, in both elective and emergency situations. These procedures may require anaesthetic involvement through haemodynamic monitoring during the procedure, sedation, regional anaesthesia or general anaesthesia. The challenge for anaesthesia is to develop a framework that supports and regulates the safe delivery of care.

Commercial and...

Introduction

Pregnancy and childbirth remains a risky time for both mother and baby. In recent years, we have seen the maternal mortality rate plateau.^7,8,9 

However, the confidential review of every maternal death over the past seven decades continues to identify that substandard care, frequently caused by deficiencies in service provision, has led to avoidable...

Introduction

Infants, children, and young people have different requirements. There are marked developmental changes within the paediatric age range, and neonates, infants, and prepubertal children under the age of 8–12 years have particular anatomical and physiological differences. Doses of drugs and fluids need to be precisely calculated, and anaesthetic equipment for smaller children differs from that used in older children...