Anaesthesia essentials: Overview

Abstract
Background: Neuraxial blockade, typically guided by manual palpation, can be challenging in certain patient populations. Ultrasound-assisted neuraxial access has the potential to improve success rates, particularly for novice anaesthesiologists, though structured training programs in this technique are limited.

Methods: This multicentre, randomised controlled trial will evaluate the use of ultrasound-assisted neuraxial block, following a simulation-based training programme based on the mastery-learning approach. Participants, consisting of novice and senior anaesthesiologists, will receive training in either ultrasound-assisted or traditional manual palpation techniques. Performance will be assessed in a clinical setting during elective lower limb surgery. Statistical analyses will compare the clinical outcomes of ultrasound-assisted versus manual palpation techniques.

Results: The primary outcome is the success rate of the first spinal block attempt. Secondary outcomes include the number of attempts, needle redirections, time spent, and the need for additional interventions. Patient satisfaction and complications will be evaluated as tertiary outcomes.

Conclusion: This study may present the potential impact of a structured training program on anaesthesiologists' skills in ultrasound-assisted neuraxial access and potentially lead to better patient outcomes. By comparing ultrasound-assisted techniques with traditional manual palpation, the findings may lead to improvements in training methods and ultrasound-assisted approaches for neuraxial access.

Abstract
Background: Cardiac arrhythmias, particularly atrial fibrillation, are highly prevalent and represent a growing global health burden. Cardiac ablation is a commonly used procedure for the treatment of cardiac arrhythmias, often requiring anaesthesia to ensure patient safety and procedural success. Despite its widespread use, there is no consensus on the optimal anaesthetic strategy, and existing literature mainly addresses isolated techniques or specific populations. The aim of this scoping review is to systematically map the current evidence on anaesthetic methods used during cardiac ablation procedures.

Methods: A scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews (PRISMA-ScR) guidelines. A comprehensive search strategy will be applied across multiple databases, including Medline, EMBASE, Cochrane, Scopus and Google Scholar. Eligible studies will include all research on adult patients undergoing cardiac ablation, focusing on any anaesthetic or sedative techniques used. Study selection and data extraction will be performed by independent reviewers, and results will be summarized descriptively.

Results: In the final review, findings will be presented through a descriptive and narrative summary, supplemented by tables, figures and graphs where applicable.

Conclusion: This scoping review will provide a structured overview of the landscape of anaesthesia methods in cardiac ablations. The findings will help uncover knowledge gaps and inform future research and clinical decision-making regarding anaesthesia strategies in the management of cardiac arrhythmias.