1
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Wong GSK, Cobain C, Pawa A. You don't know what you've got 'til it's gone: why anaesthetic rooms should stay. Anaesthesia 2024; 79:469-472. [PMID: 38214367 DOI: 10.1111/anae.16223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2023] [Indexed: 01/13/2024]
Affiliation(s)
- G S K Wong
- Department of Theatres, Anaesthesia and Peri-operative Medicine, Guy's St Thomas' NHS Foundation Trust, London, UK
| | - C Cobain
- Department of Theatres, Anaesthesia and Peri-operative Medicine, Guy's St Thomas' NHS Foundation Trust, London, UK
| | - A Pawa
- Department of Theatres, Anaesthesia and Peri-operative Medicine, Guy's St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King's College London, London, UK
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2
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Wiberg A, Pawa A, Quick TJ. Paraneurium - A veiled threat to peripheral nerve function. J Plast Reconstr Aesthet Surg 2024; 90:183-185. [PMID: 38387414 DOI: 10.1016/j.bjps.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024]
Affiliation(s)
- A Wiberg
- Cleveland Clinic London Hospital, London, UK; Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Science, University of Oxford, Oxford, UK
| | - A Pawa
- Cleveland Clinic London Hospital, London, UK; Department of Theatres, Anaesthesia and Peri-operative Medicine, Guy's St Thomas' NHS Foundation Trust, London, UK
| | - T J Quick
- Cleveland Clinic London Hospital, London, UK; Centre for Nerve Engineering, University College London, London, UK.
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3
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Chin KJ, Versyck B, Pawa A. Ultrasound-guided fascial plane blocks of the chest wall: a reply. Anaesthesia 2023; 78:261-262. [PMID: 36449361 DOI: 10.1111/anae.15929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/04/2022] [Indexed: 12/03/2022]
Affiliation(s)
- K J Chin
- Toronto Western Hospital, University of Toronto, Toronto, Canada
| | | | - A Pawa
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
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4
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Affiliation(s)
- D.L. Hamilton
- James Cook University Hospital, Middlesbrough, UK
- School of Medicine, University of Sunderland, UK
| | - A. Pawa
- Guy's and St Thomas' NHS Foundation Trust, London, UK
- Faculty of Life Sciences and Medicine, King's College London, UK
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5
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Bailey CR, Radhakrishna S, Asanati K, Dill N, Hodgson K, McKeown C, Pawa A, Plaat F, Wilkes A. Ergonomics in the anaesthetic workplace: Guideline from the Association of Anaesthetists. Anaesthesia 2021; 76:1635-1647. [PMID: 34251028 PMCID: PMC9292255 DOI: 10.1111/anae.15530] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 11/26/2022]
Abstract
Ergonomics in relation to anaesthesia is the scientific study of the interaction between anaesthetists and their workspace environment in order to promote safety, performance and well-being. The foundation for avoiding pain or discomfort at work is to adopt and maintain a good posture, whether sitting or standing. Anaesthetists should aim to keep their posture as natural and neutral as possible. The successful practice of anaesthesia relies on optimisation of ergonomics and lack of attention to detail in this area is associated with impaired performance. The anaesthetic team should wear comfortable clothing, including appropriately-sized personal protective equipment where necessary. Temperature, humidity and light should be adequate at all times. The team should comply with infection prevention and control guidelines and monitoring as recommended by the Association of Anaesthetists. Any equipment or machinery that is mobile should be positioned where it is easy to view or reach without having to change the body or head position significantly when interacting with it. Patients who are supine should, whenever possible, be raised upwards to limit the need to lean towards them. Any item required during a procedure should be positioned on trays or trolleys that are close to the dominant hand. Pregnancy affects the requirements for standing, manually handling, applying force when operating equipment or moving machines and the period over which the individual might have to work without a break. Employers have a duty to make reasonable adjustments to accommodate disability in the workplace. Any member of staff with a physical impairment needs to be accommodated and this includes making provision for a wheelchair user who needs to enter the operating theatre and perform their work.
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Affiliation(s)
- C R Bailey
- Department of Anaesthesia, Guy's and St. Thomas' NHS Foundation Trust, Council Member, Association of Anaesthetists and Co-Chair of the Working Party, London, UK
| | - S Radhakrishna
- Department of Anaesthesia, University Hospitals of Coventry and Warwickshire, Difficult Airway Society representative and Co-Chair of the Working Party, Coventry, UK
| | | | - N Dill
- British Anaesthetic Respiratory Equipment Manufacturers Association (BAREMA), Bromley, UK
| | - K Hodgson
- South East Scotland School of Anaesthesia, Member of the Association of Anaesthetists Training Committee, UK
| | | | - A Pawa
- Department of Anaesthesia, Guy's and St. Thomas' NHS Foundation Trust, President of Regional Anaesthesia (RA) UK, London, UK
| | - F Plaat
- Department of Anaesthesia, Imperial College Healthcare NHS Trust, Council Member, Royal College of Anaesthetists, London, UK
| | - A Wilkes
- Department of Anaesthesia, Edinburgh, UK
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6
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Klein AA, Meek T, Allcock E, Cook TM, Mincher N, Morris C, Nimmo AF, Pandit JJ, Pawa A, Rodney G, Sheraton T, Young P. Recommendations for standards of monitoring during anaesthesia and recovery 2021: Guideline from the Association of Anaesthetists. Anaesthesia 2021; 76:1212-1223. [PMID: 34013531 DOI: 10.1111/anae.15501] [Citation(s) in RCA: 116] [Impact Index Per Article: 38.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2021] [Indexed: 02/06/2023]
Abstract
This guideline updates and replaces the 5th edition of the Standards of Monitoring published in 2015. The aim of this document is to provide guidance on the minimum standards for monitoring of any patient undergoing anaesthesia or sedation under the care of an anaesthetist. The recommendations are primarily aimed at anaesthetists practising in the UK and Ireland, but it is recognised that these guidelines may also be of use in other areas of the world. Minimum standards for monitoring patients during anaesthesia and in the recovery phase are included. There is also guidance on monitoring patients undergoing sedation and during transfer. There are new sections specifically discussing capnography, sedation and regional anaesthesia. In addition, the indications for processed electroencephalogram and neuromuscular monitoring have been updated.
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Affiliation(s)
- A A Klein
- Department of Anaesthesia and Intensive Care, Royal Papworth Hospital, Co-Chair, Association of Anaesthetists Working Party, Cambridge, UK
| | - T Meek
- Department of Anaesthesia, James Cook University Hospital, Co-Chair, Association of Anaesthetists Working Party, Middlesbrough, UK
| | - E Allcock
- Department of Anaesthesia, James Cook University Hospital, Middlesbrough, UK
| | - T M Cook
- Royal United Hospital NHS Trust, Bath, UK
| | - N Mincher
- Department of Anaesthesia, Royal Gwent Hospital, Newport, UK
| | | | - A F Nimmo
- Department of Anaesthesia, Royal Infirmary of Edinburgh, Edinburgh, UK
| | - J J Pandit
- University of Oxford, Royal College of Anaesthetists, Oxford, UK
| | - A Pawa
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, President, Regional Anaesthesia UK (RA-UK), London, UK
| | - G Rodney
- Department of Anaesthesia, Ninewells Hospital, Dundee, UK
| | - T Sheraton
- Department of Anaesthesia, Royal Gwent Hospital, Newport, UK
| | - P Young
- Department of Anaesthesia and Critical Care, Queen Elizabeth Hospital, Kings Lynn, UK
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7
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Chin KJ, Versyck B, Pawa A. Ultrasound-guided fascial plane blocks of the chest wall: a reply. Anaesthesia 2021; 76:865. [PMID: 33591575 DOI: 10.1111/anae.15438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/27/2021] [Indexed: 11/26/2022]
Affiliation(s)
- K J Chin
- University of Toronto, Toronto, Canada
| | - B Versyck
- Catharina Hospital, Eindhoven, The Netherlands
| | - A Pawa
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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8
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Affiliation(s)
- T Alexander
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - D J N Wong
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | | | - A Pawa
- Guy's and St Thomas' NHS Foundation Trust, London, UK
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9
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Chin KJ, Versyck B, Pawa A. Ultrasound-guided fascial plane blocks of the chest wall: a state-of-the-art review. Anaesthesia 2021; 76 Suppl 1:110-126. [PMID: 33426660 DOI: 10.1111/anae.15276] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2020] [Indexed: 01/11/2023]
Abstract
Ultrasound-guided fascial plane blocks of the chest wall are increasingly popular alternatives to established techniques such as thoracic epidural or paravertebral blockade, as they are simple to perform and have an appealing safety profile. Many different techniques have been described, which can be broadly categorised into anteromedial, anterolateral and posterior chest wall blocks. Understanding the relevant clinical anatomy is critical not only for block performance, but also to match block techniques appropriately with surgical procedures. The sensory innervation of tissues deep to the skin (e.g. muscles, ligaments and bone) can be overlooked, but is often a significant source of pain. The primary mechanism of action for these blocks is a conduction blockade of sensory afferents travelling in the targeted fascial planes, as well as of peripheral nociceptors in the surrounding tissues. A systemic action of absorbed local anaesthetic is plausible but unlikely to be a major contributor. The current evidence for their clinical applications indicates that certain chest wall techniques provide significant benefit in breast and thoracic surgery, similar to that provided by thoracic paravertebral blockade. Their role in trauma and cardiac surgery is evolving and holds great potential. Further avenues of research into these versatile techniques include: optimal local anaesthetic dosing strategies; high-quality randomised controlled trials focusing on patient-centred outcomes beyond acute pain; and comparative studies to determine which of the myriad blocks currently on offer should be core competencies in anaesthetic practice.
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Affiliation(s)
- K J Chin
- Department of Anaesthesiology and Pain Medicine, Toronto Western Hospital, University of Toronto, Canada
| | - B Versyck
- Department of Anaesthesia and Pain Medicine, AZ Turnhout, Belgium.,Department of Anaesthesia and Pain Medicine, Catharina Hospital, Eindhoven, The Netherlands
| | - A Pawa
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK
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10
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Fox B, Pawa A. Future directions in regional anaesthesia: a reply. Anaesthesia 2020; 75:555. [DOI: 10.1111/anae.14975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- B. Fox
- Queen Elizabeth Hospital King's Lynn NHS Foundation Trust Kings Lynn UK
| | - A. Pawa
- Guy’s and St. Thomas’ Hospitals London UK
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11
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Affiliation(s)
- B Versyck
- AZ Turnhout, Turnhout, Belgium.,Catharina Hospital, Eindhoven, the Netherlands
| | - J Boublik
- Stanford University, Stanford, CA, USA
| | - A Pawa
- Guy's & St Thomas' NHS Foundation Trust, London, UK
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12
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Cho N, Kang RS, McCartney CJL, Pawa A, Costache I, Rose P, Abdallah FW. Analgesic benefits and clinical role of the posterior suprascapular nerve block in shoulder surgery: a systematic review, meta-analysis and trial sequential analysis. Anaesthesia 2019; 75:386-394. [PMID: 31583679 DOI: 10.1111/anae.14858] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2019] [Indexed: 11/28/2022]
Abstract
The posterior suprascapular nerve block has been proposed as an analgesic alternative for shoulder surgery based on the publication of several comparisons with interscalene block that failed to detect differences in analgesic outcomes. However, quantification of the absolute treatment effect of suprascapular nerve block on its own, in comparison with no block (control), to corroborate the aforementioned conclusions has been lacking. This study examines the absolute analgesic efficacy of suprascapular nerve block compared with control for shoulder surgery. We systematically sought electronic databases for studies comparing suprascapular nerve block with control. The primary outcomes included postoperative 24-h cumulative oral morphine consumption and the difference in area under the curve for 24-h pooled pain scores. Secondary outcomes included the incidence of opioid-related side-effects (postoperative nausea and vomiting) and patient satisfaction. Data were pooled using random-effects modelling. Ten studies (700 patients) were analysed; all studies examined landmark-guided posterior suprascapular nerve block performed in the suprascapular fossa. Suprascapular nerve block was statistically but not clinically superior to control for postoperative 24-h cumulative oral morphine consumption, with a weighted mean difference (99%CI) of 11.41 mg (-21.28 to -1.54; p = 0.003). Suprascapular nerve block was also statistically but not clinically superior to control for area under the curve of pain scores, with a mean difference of 1.01 cm.h. Nonetheless, suprascapular nerve block reduced the odds of postoperative nausea and vomiting and improved patient satisfaction. This review suggests that the landmark-guided posterior suprascapular nerve block does not provide clinically important analgesic benefits for shoulder surgery. Investigation of other interscalene block alternatives is warranted.
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Affiliation(s)
- N Cho
- Department of Anesthesiology and Pain Medicine, University of Ottowa, ON, Canada
| | - R S Kang
- Ottawa Hospital Research Institute, University of Ottawa, Ontario, Canada
| | - C J L McCartney
- Department of Anesthesiology and Pain Medicine, University of Ottowa, ON, Canada
| | - A Pawa
- Department of Anaesthesia, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - I Costache
- Department of Anesthesiology and Pain Medicine, University of Ottowa, ON, Canada
| | - P Rose
- Department of Anesthesiology and Pain Medicine, University of Ottowa, ON, Canada
| | - F W Abdallah
- Department of Anesthesiology and Pain Medicine, University of Ottowa, ON, Canada
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13
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Affiliation(s)
- C Johnstone
- Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - C Razavi
- Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - A Pawa
- Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - D N Onwochei
- Guy's and St, Thomas' NHS Foundation Trust, London, UK
| | - R Vargulescu
- Guy's and St, Thomas' NHS Foundation Trust, London, UK
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14
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Costache I, Abdallah FW, Pawa A. Mid-point transverse process to pleura block: clarity or confusion? A reply. Anaesthesia 2019; 74:401. [PMID: 30734943 DOI: 10.1111/anae.14594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - A Pawa
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
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15
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Affiliation(s)
- D.N. Onwochei
- Guy's & St. Thomas' NHS Foundation Trust, London, UK
| | - J. Børglum
- Zealand University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - A. Pawa
- Guy's & St. Thomas' NHS Foundation Trust, London, UK
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16
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Pawa A, Wight J, Onwochei DN, Vargulescu R, Reed I, Chrisman L, Pushpanathan E, El-Boghdadly K. Regional anaesthesia as the principle technique in breast surgery - a reply. Anaesthesia 2018; 73:906-907. [PMID: 29889998 DOI: 10.1111/anae.14339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Pawa
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - J Wight
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - D N Onwochei
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Vargulescu
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - I Reed
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - L Chrisman
- Guy's and St. Thomas' NHS Foundation Trust, London, UK
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17
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Affiliation(s)
- I. Costache
- Department of Anesthesiology and Pain Medicine The Ottawa Hospital University of Ottawa Ottawa Canada
| | - A. Pawa
- Guy's and St Thomas’ NHS Foundation Trust London UK
| | - F. W. Abdallah
- Department of Anesthesiology and Pain Medicine The Ottawa Hospital Ottawa Hospital Research Institute University of Ottawa Ottawa Canada
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18
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Pawa A, Wight J, Onwochei DN, Vargulescu R, Reed I, Chrisman L, Pushpanathan E, Kothari A, El-Boghdadly K. Combined thoracic paravertebral and pectoral nerve blocks for breast surgery under sedation: a prospective observational case series. Anaesthesia 2018; 73:438-443. [DOI: 10.1111/anae.14213] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2017] [Indexed: 11/29/2022]
Affiliation(s)
- A. Pawa
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - J. Wight
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - D. N. Onwochei
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - R. Vargulescu
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - I. Reed
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - L. Chrisman
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - E. Pushpanathan
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - A. Kothari
- Department of Breast Surgery; Guy's and St. Thomas’ NHS Foundation Trust; London UK
| | - K. El-Boghdadly
- Department of Anaesthesia; Guy's and St. Thomas’ NHS Foundation Trust; London UK
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19
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Affiliation(s)
| | | | - A. Pawa
- Guy's and St. Thomas’ NHS Foundation Trust; London UK
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20
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Costache I, de Neumann L, Ramnanan CJ, Goodwin SL, Pawa A, Abdallah FW, McCartney CJL. The mid-point transverse process to pleura (MTP) block: a new end-point for thoracic paravertebral block. Anaesthesia 2017; 72:1230-1236. [DOI: 10.1111/anae.14004] [Citation(s) in RCA: 96] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2017] [Indexed: 11/28/2022]
Affiliation(s)
- I. Costache
- Department of Anesthesiology and Pain Medicine; The Ottawa Hospital; University of Ottawa; Ontario Canada
| | - L. de Neumann
- Department of Anesthesiology and Pain Medicine; The Ottawa Hospital; University of Ottawa; Ontario Canada
| | - C. J. Ramnanan
- Department of Innovation in Medical Education; Division of Clinical and Functional Anatomy; Faculty of Medicine; University of Ottawa; Ontario Canada
| | - S. L. Goodwin
- Department of Innovation in Medical Education; Division of Clinical and Functional Anatomy; Faculty of Medicine; University of Ottawa; Ontario Canada
| | - A. Pawa
- Guy's and St Thomas' NHS Foundation Trust; UK
| | - F. W. Abdallah
- St Michael's Hospital; Li Ka Shing Knowledge Institute; University of Toronto; Ontario Canada
| | - C. J. L. McCartney
- Department of Anesthesiology and Pain Medicine; The Ottawa Hospital; University of Ottawa; Ontario Canada
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21
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Affiliation(s)
- J. M. Wight
- Guy's and St Thomas' NHS Foundation Trust; London UK
| | - L. Chrisman
- Guy's and St Thomas' NHS Foundation Trust; London UK
| | - I. Reed
- Guy's and St Thomas' NHS Foundation Trust; London UK
| | - G. S. K. Wong
- Guy's and St Thomas' NHS Foundation Trust; London UK
| | - A. Pawa
- Guy's and St Thomas' NHS Foundation Trust; London UK
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22
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Abdallah FW, Børglum J, van Geffen G, Pawa A, Greher M, Costache I, Lonnqvist PA. Eligibility criteria in paravertebral block meta-analysis. Anaesthesia 2017; 72:543. [DOI: 10.1111/anae.13845] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
| | - J. Børglum
- Zealand University Hospital; Zealand Denmark
| | - G. van Geffen
- Radboud University Medical Centre; Nijmegen Netherlands
| | - A. Pawa
- St. Thomas’ Hospital; London UK
| | - M. Greher
- Hospital of the Sacred Heart of Jesus; Vienna Austria
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23
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Affiliation(s)
- K El-Boghdadly
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Pawa
- Department of Anaesthetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
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24
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Affiliation(s)
| | - A. Pawa
- Guys and St Thomas’ NHS Foundation Trust; London UK
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25
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Affiliation(s)
- A. Pawa
- Department of Anaesthesia; Guy's and St. Thomas' Hospitals; London UK
| | - A. P. Devlin
- Department of Anaesthesia; Guy's and St. Thomas' Hospitals; London UK
| | - A. Kochhar
- Department of Anaesthesia; Guy's and St. Thomas' Hospitals; London UK
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26
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Al-Shather H, El-Boghdadly K, Pawa A. Awake laparoscopic sleeve gastrectomy under paravertebral and superficial cervical plexus blockade. Anaesthesia 2015; 70:1210-1. [DOI: 10.1111/anae.13220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - A. Pawa
- Guy's & St Thomas' NHS Foundation Trust; London UK
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27
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Affiliation(s)
- S J West
- Guy's and St Thomas' Hospital, London, UK.
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28
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Pawa A, Szawarski P, Dada A. Use of regional analgesia in proximal femoral fractures. Anaesthesia 2012; 67:673; author reply 674-5. [PMID: 22563962 DOI: 10.1111/j.1365-2044.2012.07147.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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29
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Dada A, Elnour S, Pawa A. Litigation relating to central and peripheral venous access by anaesthetists. Anaesthesia 2011; 66:627-8. [PMID: 21682714 DOI: 10.1111/j.1365-2044.2011.06779.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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Matthew G, Pawa A. 428. Nerve Damage Under Anaesthesia. Are We Telling the Whole Truth? A Survey. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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31
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Pawa A, Aziz E, Gulati S. 5. Audit of Patient Satisfaction With Ultrasound-Guided Supraclavicular Blocks for Hand Surgery. Reg Anesth Pain Med 2008. [DOI: 10.1136/rapm-00115550-200809001-00194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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32
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Pawa A. Epidural needle hub breakage. Int J Obstet Anesth 2007; 16:386-7; author reply 387. [PMID: 17643290 DOI: 10.1016/j.ijoa.2007.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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33
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Pawa A, Noble WC, Howell SA. Co-transfer of plasmids in association with conjugative transfer of mupirocin or mupirocin and penicillin resistance in methicillin-resistant Staphylococcus aureus. J Med Microbiol 2000; 49:1103-1107. [PMID: 11129723 DOI: 10.1099/0022-1317-49-12-1103] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Two distinct strains of methicillin-resistant Staphylococcus aureus (MRSA) isolated from patients in a dermatology ward were also resistant to mupirocin. The mupirocin resistance plasmids from both strains were indistinguishable by EcoRI and HindIII restriction digest analysis, except for the presence of genes apparently mediating penicillinase production in some transconjugants. Conjugative transfer of the plasmid mediating mupirocin resistance from one of these strains to a recipient S. aureus was accompanied in some cases by co-transfer of plasmids mediating resistance to tetracycline or erythromycin; in some instances a plasmid which possessed no apparent resistance markers was also transferred. The second strain demonstrated conjugative transfer of penicillin and mupirocin resistance as well as transfer of a plasmid mediating gentamicin resistance, but transfer of erythromycin resistance was not apparently plasmid-mediated.
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Affiliation(s)
| | | | - S A Howell
- Department of Microbial Diseases, St John's Institute of Dermatology, St Thomas' Hospital, London SE1 7EH
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