Regional anesthesia practice in China: a survey.

STUDY OBJECTIVE: Neuraxial anesthesia has been widely used in China. Recently, Chinese anesthesiologists have applied nerve stimulator and ultrasound guidance for peripheral nerve blocks. Nationwide surveys about regional anesthesia practices in China are lacking. We surveyed Chinese anesthesiologists about regional anesthesia techniques, preference, drug selections, complications, and treatments. DESIGN: A survey was sent to all anesthesiologist members by WeChat. The respondents can choose mobile device or desktop to complete the survey. Each IP address is allowed to complete the survey once. MAIN RESULTS: A total of 6589 members read invitations. A total of 2654 responses were received with fully completed questionnaires, which represented an overall response rate of 40%. Forty-one percent of the respondents reported that more than 50% of surgeries in their hospitals were done under regional anesthesia. Most of the participants used test dose after epidural catheter insertion. The most common drug for test dose was 3-mL 1.5% lidocaine; 2.6% of the participants reported that they had treated a patient with epidural hematoma after neuraxial anesthesia. Most anesthesiologists (68.2%) performed peripheral nerve blocks as blind procedures based on the knowledge of anatomical landmarks. A majority of hospitals (80%) did not stock Intralipid; 61% of the respondents did not receive peripheral nerve block training. CONCLUSIONS: The current survey can serve as a benchmark for future comparisons and evaluation of regional anesthesia practices in China. This survey revealed potential regional anesthesia safety issues in China.

Availability of and use of Intralipid (lipid rescue therapy, lipid emulsion) in England and Wales.

There is increasing evidence for the use of Intralipid in the management of acute local anaesthetic toxicity. This is supported by the recent Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines for the management of local anaesthetic toxicity. Acute hospitals in England and Wales were surveyed to determine the proportion that currently stocked Intralipid, the locations of stocks within the hospital, guidelines related to its use and previous use in the last 12 months. The majority of hospitals surveyed stocked Intralipid in multiple locations, although not in all areas using high volumes of local anaesthetics. Guidelines were typically in place, although these were often local rather than those from the AAGBI. Use in the last 12 months was uncommon, but typically information was not available on indications for its use. More systematic data collection is required on the safety and efficacy of Intralipid in the management of acute drug toxicity.

Estudio reológico de emulsiones semisólidas de aplicación cutánea / Rheological study of semisolid emulsions for percutaneous application

En la formulacion de formas farmaceuticas de aplicacion percutanea, una de las caracteristicas mas importantes a estudiar son las propiedades reologicas, ya que estas tienen repercusion en la extensibilidad del preparado sobre la piel, su facilidad de aplicacion y su adherencia sobre la misma. Todo ello contribuye a la aceptacion por parte del paciente de la formulacion empleada. En este articulo se realiza el estudio reologico de tres formulaciones semisolidas (emulsiones A,B y C) para ver las posibles diferencias que existan entre ellas. La composicion de las mismas es similar, solo difieren en el agente emulsificante, que en el caso de las emulsiones A y B es Tefose 63„µ y en la emulsion C es Tween 80„µ y, en el componente de la fase oleosa, que en las emulsiones A y C es vaselina filante (solida) y en la emulsion B es vaselina liquida. Todas las emulsiones llevan acido salicilico (1%) como componente activo. Para ver las posibles diferencias reologicas que presentan entre ellas se realiza, a temperatura ambiente, la determinacion de la viscosidad del preparado utilizando, para ello, un viscosimetro Brookfield de cilindros concentricos (modelo RTV), aplicando todas las velocidades de cizalla (G) al semisolido. En todos los casos, los resultados indican que el coeficiente de viscosidad depende de la velocidad de cizalla aplicada. Estas determinaciones se llevan a cabo en las emulsiones recien preparadas (tiempo 0), a la semana y al mes de su elaboracion, con el fin de observar, no solo la influencia de los componentes de la formulacion en las propiedades reologicas, sino tambien, la posible influencia del almacenamiento en dichas propiedades. Con los datos obtenidos se deduce que, de las tres emulsiones ensayadas, la A es la mas estable (AU)

In the formulation of pharmaceutical forms of percutaneous application, rheological properties are amongst the most important characteristics to be studied, be- cause of its influence upon extensibility, easiness of application, and adherence to the skin, all of which contribute best to patient compliance. A rheological study on three semisolid formulations (emulsions A, B and C) is carried out in this paper to try to find out possible (rheological) differences between them. The composition of all three emulsions being similar, they nevertheless differ on the surfactant agent, Tefose 63 in emulsion A and B and Tween 80 in emulsion C, and on the oil agent, white soft Vaseline in emulsions A and C and mineral oil in emul- sion B. The active ingredient added to the formulations is salicylic acid (1%). Viscosity determinations are implemented by using a concentric cylinder Brookfield-RTV viscosimeter and then applying at room temperature all shear rates (G) to the semisolide. In all cases, the results indicate that the coefficient of viscosity de- pends on the share rate applied. Viscosity determinations are carried out at emulsion storage times 0 (fresh emulsion), 1 week and 1 month at room temperature in order to find out whether not only the composition of the emulsion, even the storage time has an influence on rheological properties. From the data, emulsion A was found out to be the most stable of the three (AU)