ANESTHESIA AND INTENSIVE CARE 是一本国际期刊，及时发表同行评议的文章，这些文章对与麻醉、重症监护医学和疼痛医学相关的临床医生和研究人员具有教育价值和科学价值。

Anaesthesia and Intensive Care is an international journal that publishes peer-reviewed articles in a timely manner. These articles provide significant educational and scientific value to clinicians and researchers in the fields of anesthesia, intensive care medicine, and pain medicine.

《Anaesthesia and Intensive Care》是一本国际期刊，及时发表经过同行评审的文章，这些文章对麻醉、重症监护医学和疼痛医学领域的临床医生和研究人员具有重要的教育和科学价值。

Anaesthesia and Intensive Care

Perioperative lidocaine (lignocaine) infusions are being employed with increasing frequency. The determinants of systemic lidocaine concentrations during prolonged administration are unclear. In the Long-term Outcomes after Lidocaine Infusions for PostOperative Pain (LOLIPOP) pilot trial, the impact of infusion duration and body size metrics on serum lidocaine concentrations was examined with regression models in 48 women undergoing breast cancer surgery. Lidocaine was delivered as an intravenous bolus (1.5 mg/kg) and infusion (2 mg/kg per h) intraoperatively, followed by a 12-h subcutaneous infusion (1.33 mg/kg per h) postoperatively. Dosing was based on total body weight. Wound infiltration with other long-acting local anaesthetics was permitted. Protein binding and pharmacogenomic data were also collected. Lidocaine concentrations (median (interquartile range) (range)) during prolonged administration were in the safe and potentially therapeutic range: post-anaesthesia care unit 2.16 (1.73-2.82) (1.12-6.06) µg/ml; ward 1.41 (1.22-1.75) (0.64-2.81) µg/ml. Concentrations increased non-linearly during the early intravenous phase of administration (mean rise 1.21 µg/ml per hour of infusion, P = 0.007) but reached a pseudo steady-state during the later subcutaneous phase. Higher dose rates received per kilogram of lean (P = 0.004), adjusted (P = 0.006) and ideal body weight (P = 0.009) were associated with higher steady-state concentrations. The lidocaine free fraction was unaffected by the presence of ropivacaine, and phenotypes linked to slow metabolism were infrequent. Serum lidocaine concentrations reached a pseudo steady-state during a 12-h postoperative infusion. Greater precision in steady-state concentrations can be achieved by dosing on lean body weight versus adjusted or ideal body weight (equivalent lean body weight doses: intravenous bolus 2.5 mg/kg; intravenous infusion 3.33 mg/kg per h; subcutaneous infusion 2.22 mg/kg per h.

Andrew J Toner

Martin A Bailey

Stephan A Schug

Michael Phillips

Jacobus PJ Ungerer

Andrew A Somogyi

Tomas B Corcoran

Serum lidocaine (lignocaine) concentrations during prolonged perioperative infusion in patients undergoing breast cancer surgery: A secondary analysis of a randomised controlled trial

乳腺癌手术患者围手术期持续输注利多卡因（利诺卡因）血清浓度：一项随机对照试验的二次分析

Electromyographic (EMG) recordings were made from the intrinsic laryngeal muscles (cricothyroid, thyroarytenoid) and the diaphragm of the cat to compare the effect of the same dose of different concentrations of lignocaine hydrocholoride applied topically to the laryngeal mucosa. All concentrations of lignocaine hydrochloride tested, two, five and ten per cent, produced desensitisation of the larynx, as demonstrated by a loss of response of the crocothyroid and thyroarytenoid to mechanical stimulation of the mucosa. Desensitisation was produced in a mean of 1.80 minutes in the thirty experiments performed. Return of baseline response took significantly longer when 5 or 10% lignocaine was used compared with that when 2% was used (p less than 0.05). The usefulness of lignocaine hydrochloride as a topical anaesthetic for the larynx is reviewed.

E. P. Robinson

M. A. E. Rex

T. C. K. Brown

A Comparison of Different Concentrations of Lignocaine Hydrochloride used for Topical Anaesthesia of the Larynx of the Cat

不同浓度盐酸利多卡因用于猫喉局部麻醉的比较

Christine M Ball

Peter J Featherstone

Anaesth Intensive Care

The history of heparin

肝素的历史

A ‘can’t intubate, can’t oxygenate’ (CICO) situation is an uncommon and time-critical emergency. Many institutions have adopted a ‘scalpel–bougie–endotracheal tube (ETT)’ technique based on evidence produced by the 4th National Audit Project of the Royal College of Anaesthetists and 2015 Difficult Airway Society guidelines. We made a modification to the traditional ‘scalpel–bougie–ETT’ technique, using a shortened bougie and replacing the ETT with a cuffed Melker airway in a preassembled device (called ‘Secure Airway for Front-of-neck Emergencies’ (SAFE airway device)), which we felt might reduce cognitive load on a single operator in an emergency CICO situation. We then performed a simulation crossover study using 20 volunteer anaesthetic doctors to compare this modification with the traditional technique. After a standardised pre-recorded video demonstration, participants performed simulated tube insertion using both the standard ‘scalpel–bougie–ETT’ technique and the SAFE airway device in randomised order. Participants were filmed for accurate timestamping. The primary outcome was time to successful tube insertion while secondary outcomes included number of attempts and ease of insertion. Overall time to cuff inflation was shorter, statistically and practically, with the SAFE airway device compared with the ETT (median 30 vs. 52 seconds, P &lt; 0.001). Twenty-five percent of participants required multiple attempts using the ETT method versus 5% using the SAFE airway device, which was also rated as being easier to use. This study demonstrates that the SAFE airway device was fast, effective, easy to use and acceptable to airway practitioners in a simulated manikin environment. These findings indicate that further studies of the SAFE airway device are warranted.

Stuart Paterson

Zeik Devereaux-McLean

Georgia Mohler

Dheeraj Sharma

Malcolm B Anderson

Adam J Mahoney

A simulated ‘can’t intubate, can’t oxygenate’ manikin crossover study investigating a modified front-of-neck access airway device

一项模拟“无法插管、无法氧合”的模型交叉研究：探讨改良颈部前路气道装置

The relationship between a person's height and the dimensions of that person's upper airways has been studied in adult subjects. Using this relationship, formulae have been derived which predict appropriate lengths for endotracheal tubes. The formulae are as follows: 1. Orotracheal tube (teeth to mid-point of trachea) = Subject height (cm)/10 + 2 2. Orotracheal tube (teeth to mid-point of trachea + 3 cm) = Subject height (cm)/10 + 5 3. Nasotracheal tube (external naris to mid-point of trachea) = Subject height (cm)/10 + 8 These formulae are not foolproof but provide a useful working guide. All usual comfirmatory tests of correct placement should be employed.

C. C. P. Eagle

The Relationship between a Person's Height and Appropriate Endotracheal Tube Length

The Complex Decision Pathway (CDP) is a novel perioperative shared decision-making pathway that was established in the Bay of Plenty, New Zealand in 2018. Unique features of the pathway include the use of a structured communication tool to facilitate a goals-of-care conversation in addition to medical assessment, and the use of a tikanga Māori framework for Māori patients. From May 2019 until May 2022, 81 patients attending the CDP clinic were recruited to a prospective study of their demographics, health status and experience at the time of presentation, along with outcomes and opinions over the subsequent 12 months. Participants were mostly elderly and frail with multiple comorbidities, and just over half of participants chose to undergo surgery. Participants who chose, or were recommended, not to undergo surgery were older, more comorbid and had worse outcomes over the subsequent 12 months. Qualitative data suggested an overall positive patient experience of the pathway, and an economic analysis demonstrated its cost-effectiveness. Overall, the data presented here suggested that the CDP assisted in risk-stratifying patients into operative and non-operative groups, provided a positive patient experience, and was a cost-effective intervention.

Heidi C Omundsen

Renee L Franklin

Mark S Omundsen

Trevor R Richardson

Experiences and outcomes of patients participating in a perioperative shared decision-making pathway

围手术期共享决策路径中患者的体验与结果

Survival in hostile environments: The fight to understand and protect against acceleration-induced visual disturbance and loss of consciousness in pilots of powered, heavier-than-air aircraft

敌对环境中的生存：努力理解并保护飞行员免受动力、重于空气飞行器加速引起的视觉障碍和意识丧失

Michael G Cooper

Dr Gilbert Reynolds Troup: A founder of the Australian Society of Anaesthetists

吉尔伯特·雷诺兹·特鲁普博士：澳大利亚麻醉师协会的创始人

Abbreviation	Anaesth Intensive Care
Journal Impact	1.14
Quartiles(Global)	CRITICAL CARE MEDICINE(Q3)

ISSN	0310-057X, 1448-0271
h-index	72

Publication Information	Publisher: Australian Society of Anaesthetists，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1972，Proportion of original research papers: 75.00%，Self Citation Rate:18.20%， Gold OA Rate: 8.97%
Average review cycle	网友分享经验：偏慢,4-8周
Average recruitment ratio	网友分享经验：容易

Anaesthesia and Intensive Care

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Serum lidocaine (lignocaine) concentrations during prolonged perioperative infusion in patients undergoing breast cancer surgery: A secondary analysis of a randomised controlled trial

A Comparison of Different Concentrations of Lignocaine Hydrochloride used for Topical Anaesthesia of the Larynx of the Cat

The history of heparin

A simulated ‘can’t intubate, can’t oxygenate’ manikin crossover study investigating a modified front-of-neck access airway device

The Relationship between a Person's Height and Appropriate Endotracheal Tube Length

A simulated ‘can’t intubate, can’t oxygenate’ manikin crossover study investigating a modified front-of-neck access airway device

The history of heparin

Experiences and outcomes of patients participating in a perioperative shared decision-making pathway

Survival in hostile environments: The fight to understand and protect against acceleration-induced visual disturbance and loss of consciousness in pilots of powered, heavier-than-air aircraft

Dr Gilbert Reynolds Troup: A founder of the Australian Society of Anaesthetists