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  1. Article ; Online: Judging the quality of anaesthesia research.

    Myles, P S

    Anaesthesia

    2020  Volume 76, Issue 4, Page(s) 452–454

    MeSH term(s) Anesthesiology ; Humans ; Journal Impact Factor ; Publishing/standards ; Research
    Language English
    Publishing date 2020-09-04
    Publishing country England
    Document type Editorial ; Research Support, Non-U.S. Gov't
    ZDB-ID 80033-8
    ISSN 1365-2044 ; 0003-2409
    ISSN (online) 1365-2044
    ISSN 0003-2409
    DOI 10.1111/anae.15237
    Database MEDical Literature Analysis and Retrieval System OnLINE

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    Zs.A 388: Show issues Location:
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  2. Article ; Online: More than just morbidity and mortality - quality of recovery and long-term functional recovery after surgery.

    Myles, P S

    Anaesthesia

    2020  Volume 75 Suppl 1, Page(s) e143–e150

    Abstract: Traditional surgical outcome measures include minor and major complications, hospital length of stay and sometimes longer-term survival. Each of these is important but there needs to be greater emphasis on patient-reported outcome measures. Global ... ...

    Abstract Traditional surgical outcome measures include minor and major complications, hospital length of stay and sometimes longer-term survival. Each of these is important but there needs to be greater emphasis on patient-reported outcome measures. Global measures of a patient's quality of recovery, avoidance of postoperative morbidities, early hospital discharge to home (without re-admission) and longer term disability-free survival can better define postoperative recovery. A patient's recovery pathway can be mapped through the immediate days or weeks after surgery with documentation of morbidity using the postoperative morbidity survey and/or a quality of recovery score, days alive and at home up to 30 days after surgery and then longer term disability-free survival using the WHO Disability Assessment Schedule 2.0 scale. These can be used to define quality of recovery after surgery.
    MeSH term(s) Humans ; Length of Stay/statistics & numerical data ; Outcome Assessment, Health Care/statistics & numerical data ; Postoperative Complications/epidemiology ; Recovery of Function ; Surgical Procedures, Operative
    Language English
    Publishing date 2020-01-06
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 80033-8
    ISSN 1365-2044 ; 0003-2409
    ISSN (online) 1365-2044
    ISSN 0003-2409
    DOI 10.1111/anae.14786
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Perioperative use of beta-blockers in vascular and endovascular surgery.

    Myles, P S

    British journal of anaesthesia

    2017  Volume 118, Issue 6, Page(s) 948–949

    MeSH term(s) Adrenergic beta-Antagonists ; Humans ; Perioperative Care ; Vascular Surgical Procedures
    Chemical Substances Adrenergic beta-Antagonists
    Language English
    Publishing date 2017-06-27
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1093/bja/aex145
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  4. Article ; Online: Treatments for major depression.

    Myles, Paul S / Kulkarni, Jayashri / Nagele, Peter

    Lancet (London, England)

    2023  Volume 401, Issue 10394, Page(s) 2111

    MeSH term(s) Humans ; Depressive Disorder, Major/drug therapy ; Depression/therapy
    Language English
    Publishing date 2023-06-24
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 3306-6
    ISSN 1474-547X ; 0023-7507 ; 0140-6736
    ISSN (online) 1474-547X
    ISSN 0023-7507 ; 0140-6736
    DOI 10.1016/S0140-6736(23)00950-9
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  5. Article: Professor Michael Paech-Editor of Anaesthesia and Intensive Care: 2007 to 2016.

    Myles, P S

    Anaesthesia and intensive care

    2016  Volume 44, Issue 5, Page(s) 534

    Language English
    Publishing date 2016-09-08
    Publishing country United States
    Document type Journal Article
    ZDB-ID 187524-3
    ISSN 1448-0271 ; 0310-057X
    ISSN (online) 1448-0271
    ISSN 0310-057X
    DOI 10.1177/0310057X1604400526
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  6. Article ; Online: Minimal clinically important difference in days at home up to 30 days after surgery.

    Ferguson, M T / Kusre, S / Myles, P S

    Anaesthesia

    2021  Volume 77, Issue 2, Page(s) 196–200

    Abstract: Patient-centred outcomes are increasingly recognised as crucial measures of healthcare quality. Days alive and at home up to 30 days after surgery ( ... ...

    Abstract Patient-centred outcomes are increasingly recognised as crucial measures of healthcare quality. Days alive and at home up to 30 days after surgery (DAH
    MeSH term(s) Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Minimal Clinically Important Difference ; Patient Discharge/standards ; Patient Discharge/trends ; Postoperative Care/standards ; Postoperative Care/trends ; Postoperative Period ; Surveys and Questionnaires ; Treatment Outcome
    Language English
    Publishing date 2021-11-19
    Publishing country England
    Document type Journal Article
    ZDB-ID 80033-8
    ISSN 1365-2044 ; 0003-2409
    ISSN (online) 1365-2044
    ISSN 0003-2409
    DOI 10.1111/anae.15623
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  7. Article ; Online: Intraoperative dexamethasone and chronic postsurgical pain: a propensity score-matched analysis of a large trial.

    Myles, Paul S / Corcoran, Tomas B / Chan, Matthew T / Asghari-Jafarabadi, Mohammad / Wu, William K K / Peyton, Philip / Leslie, Kate / Forbes, Andrew

    British journal of anaesthesia

    2024  

    Abstract: ... odds ratio 0.76 (95% confidence interval 0.78-1.00), P=0.052. After propensity score matching, CPSP occurred ... dexamethasone, adjusted risk ratio 0.88 (95% confidence interval 0.61-1.27), P=0.493. There was no difference ... between groups in quality of life or pain interference with daily activities, but 'least pain' (P=0.033 ...

    Abstract Background: Dexamethasone has been shown to reduce acute pain after surgery, but there is uncertainty as to its effects on chronic postsurgical pain (CPSP). We hypothesised that in patients undergoing major noncardiac surgery, a single intraoperative dose of dexamethasone increases the incidence of CPSP.
    Methods: We devised a propensity score-matched analysis of the ENIGMA-II trial CPSP dataset, aiming to compare the incidence of CPSP in patients who had received dexamethasone or not 12 months after major noncardiac surgery. The primary outcome was the incidence of CPSP. We used propensity score matching and inverse probability weighting to balance baseline variables to estimate the average marginal effect of dexamethasone on patient outcomes, accounting for confounding to estimate the average treatment effect on those treated with dexamethasone.
    Results: We analysed 2999 patients, of whom 116 of 973 (11.9%) receiving dexamethasone reported CPSP, and 380 of 2026 (18.8%) not receiving dexamethasone reported CPSP, unadjusted odds ratio 0.76 (95% confidence interval 0.78-1.00), P=0.052. After propensity score matching, CPSP occurred in 116 of 973 patients (12.2%) receiving dexamethasone and 380 of 2026 patients (13.8%) not receiving dexamethasone, adjusted risk ratio 0.88 (95% confidence interval 0.61-1.27), P=0.493. There was no difference between groups in quality of life or pain interference with daily activities, but 'least pain' (P=0.033) and 'pain right now' (P=0.034) were higher in the dexamethasone group.
    Conclusions: Dexamethasone does not increase the risk of chronic postsurgical pain after major noncardiac surgery.
    Clinical trial registration: Open Science Framework Registration DOI https://doi.org/10.17605/OSF.IO/ZDVB5.
    Language English
    Publishing date 2024-01-24
    Publishing country England
    Document type Journal Article
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2023.12.031
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  8. Article ; Online: Analgesia for major laparoscopic abdominal surgery: a randomised feasibility trial using intrathecal morphine.

    Pirie, K / Doane, M A / Riedel, B / Myles, P S

    Anaesthesia

    2022  Volume 77, Issue 4, Page(s) 428–437

    Abstract: ... unit, their postoperative pain scores at rest were lower across the four time-points measured (p = 0 ... 007), but not dynamic pain scores (p = 0.061), and pruritus was more common following intrathecal ... morphine (p = 0.007). Total oral morphine equivalents until postoperative day 3 were less ...

    Abstract Effective pain control enhances patient recovery after surgery. Laparoscopic techniques for major abdominal surgery are increasingly utilised to reduce surgical trauma. Intrathecal morphine is an attractive analgesic option that is gaining popularity. However, limited evidence guides its use in the setting of laparoscopic surgery. In addition, enhanced recovery after surgery pathways advocate opioid-sparing techniques. We conducted a feasibility trial to compare intrathecal morphine with non-neuraxial analgesia in laparoscopic or laparoscopic-assisted major abdominal surgery to inform the design of a future large clinical trial. This multicentre, double-blind, randomised controlled trial was conducted at two tertiary hospitals in Australia. Fifty-one patients were randomly allocated to receive either intrathecal morphine (intervention group) or a sham subcutaneous injection of normal saline in the lumbar area (control group) immediately before the induction of general anaesthesia. Co-primary outcomes were patient recruitment and successful adherence to treatment allocation as per the study protocol. The primary endpoints of feasibility and protocol adherence were met with a 46% recruitment rate (51 of 110 eligible patients) and 96% protocol adherence. There was only one patient with failed access to the intrathecal space. For secondary endpoints, fewer patients in the intrathecal morphine group required opioids in the post-anaesthesia care unit, their postoperative pain scores at rest were lower across the four time-points measured (p = 0.007), but not dynamic pain scores (p = 0.061), and pruritus was more common following intrathecal morphine (p = 0.007). Total oral morphine equivalents until postoperative day 3 were less in the intrathecal morphine group (median (95%CI) difference 82 (-13 to 168) mg), but this reduction was not statistically significant (p = 0.10). These findings support conducting a definitive clinical trial.
    MeSH term(s) Analgesia ; Analgesia, Patient-Controlled/methods ; Analgesics, Opioid/therapeutic use ; Anesthetics, Local ; Double-Blind Method ; Feasibility Studies ; Humans ; Injections, Spinal ; Laparoscopy ; Morphine/therapeutic use ; Pain, Postoperative/drug therapy ; Pain, Postoperative/prevention & control
    Chemical Substances Analgesics, Opioid ; Anesthetics, Local ; Morphine (76I7G6D29C)
    Language English
    Publishing date 2022-01-17
    Publishing country England
    Document type Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 80033-8
    ISSN 1365-2044 ; 0003-2409
    ISSN (online) 1365-2044
    ISSN 0003-2409
    DOI 10.1111/anae.15651
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Postoperative systemic inflammatory dysregulation and corticosteroids: a narrative review.

    Bain, C R / Myles, P S / Corcoran, T / Dieleman, J M

    Anaesthesia

    2022  Volume 78, Issue 3, Page(s) 356–370

    Abstract: In some patients, the inflammatory-immune response to surgical injury progresses to a harmful, dysregulated state. We posit that postoperative systemic inflammatory dysregulation forms part of a pathophysiological response to surgical injury that places ... ...

    Abstract In some patients, the inflammatory-immune response to surgical injury progresses to a harmful, dysregulated state. We posit that postoperative systemic inflammatory dysregulation forms part of a pathophysiological response to surgical injury that places patients at increased risk of complications and subsequently prolongs hospital stay. In this narrative review, we have outlined the evolution, measurement and prediction of postoperative systemic inflammatory dysregulation, distinguishing it from a healthy and self-limiting host response. We reviewed the actions of glucocorticoids and the potential for heterogeneous responses to peri-operative corticosteroid supplementation. We have then appraised the evidence highlighting the safety of corticosteroid supplementation, and the potential benefits of high/repeated doses to reduce the risks of major complications and death. Finally, we addressed how clinical trials in the future should target patients at higher risk of peri-operative inflammatory complications, whereby corticosteroid regimes should be tailored to modify not only the a priori risk, but also further adjusted in response to markers of an evolving pathophysiological response.
    MeSH term(s) Humans ; Glucocorticoids/adverse effects ; Adrenal Cortex Hormones/adverse effects ; Intraoperative Complications/chemically induced
    Chemical Substances Glucocorticoids ; Adrenal Cortex Hormones
    Language English
    Publishing date 2022-10-29
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 80033-8
    ISSN 1365-2044 ; 0003-2409
    ISSN (online) 1365-2044
    ISSN 0003-2409
    DOI 10.1111/anae.15896
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Auditing the national audit projects: impact and implementation.

    Avidan, M S / Myles, P S

    British journal of anaesthesia

    2018  Volume 121, Issue 1, Page(s) 107–111

    MeSH term(s) Anaphylaxis/chemically induced ; Anaphylaxis/epidemiology ; Anaphylaxis/therapy ; Humans ; Intraoperative Complications/epidemiology ; Intraoperative Complications/prevention & control ; Intraoperative Complications/therapy ; Medical Audit ; Perioperative Care ; Postoperative Complications/epidemiology ; Postoperative Complications/prevention & control ; Postoperative Complications/therapy ; United Kingdom
    Language English
    Publishing date 2018-05-26
    Publishing country England
    Document type Editorial ; Introductory Journal Article
    ZDB-ID 80074-0
    ISSN 1471-6771 ; 0007-0912
    ISSN (online) 1471-6771
    ISSN 0007-0912
    DOI 10.1016/j.bja.2018.05.044
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