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LANDMARK TRIALS FOR THE PART II EXAM

Key practice-changing papers to be familiar with for the part II exam, in order of publication year

PADDI

  • In progress

BALANCED

  • In progress

RELIEF

  • Restrictive versus Liberal Fluid Therapy for Major Abdominal Surgery
  • N Engl J Med. DOI: 10.1056/NEJMoa1801601.
  • Available at https://www.nejm.org/doi/10.1056/NEJMoa1801601

NAP6 – anaphylaxis

  • National Audit Project 6 – anaesthesia, surgery and life-threatening allergic reactions
  • RCOA UK 2018
  • Available at www.nationalauditprojects.org.uk/NAP6home

WOMAN

  • Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage: an international, randomised, double-blind, placebo-controlled trial
  • Lancet 2017; 389: 2105-16

ATACAS

  • Aspirin and tranexamic acid for coronary artery surgery
  • N Engl J Med 2017; 376: 136-148 (tranexamic acid in patients undergoing coronary-artery surgery)
  • N Engl J Med 2016; 374(8): 728-37 (stopping vs. continuing aspirin before coronary artery surgery)

GAS

  • A multi-site randomized controlled trial comparing regional and general anesthesia for effects on neurodevelopmental outcome and apnea in infants
  • Lancet 2016; 387: 239–250 (neurodevelopment)
  • Anesthesiology 2015; 123: 38-54 (apnoea)

THRIVE

  • Transnasal Humidified Rapid-Insufflation Ventilatory Exchange: a physiological method of increasing apnoea time in patients with difficult airway
  • Anaesthesia 2015; 70(3) 323-329

ENIGMA II

  • The safety of addition of nitrous oxide to general anaesthesia in at-risk patients having major non-cardiac surgery: a randomised, single blinded trial
  • Lancet 2014; 384: 1446-54

POISE II

  • Aspirin in patients undergoing noncardiac surgery
  • NEJM 2014; 370(16):1494-1503

NAP5 – awareness

  • National Audit Project 5 – awareness
  • RCOA UK 2014
  • Available at www.nationalauditprojects.org.uk/NAP5home

REASON

  • Postoperative complications in Australia and New Zealand
  • Periop Med 2013; 2:16

NAP4 – airway complications

  • National Audit Project 4 – airway complications
  • RCOA UK 2011
  • Available at www.nationalauditprojects.org.uk/NAP4_home

CRASH-2

  • Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage
  • The Lancet 2010; 376(9734): 23-32

Prospective multi-centre RCT of cuffed or unruffled endotracheal tubes in small children

  • Br J Anaesth 2009; 103(6): 867-73

PROXI

  • Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial
  • JAMA 2009; 14;302(14): 1543-50

NAP3 – neuraxial complications

  • National Audit Project 3 – neuraxial complications
  • RCOA UK 2009
  • Available at www.nationalauditprojects.org.uk/NAP3_home

GALA

  • General anaesthesia versus local anaesthesia for carotid surgery: a multicentre, randomised controlled trial
  • Lancet 2008; 372: 2132-42

POISE

  • Effects of extended-release metoprolol succinate in patients undergoing non-cardiac surgery: a randomised controlled trial
  • Lancet 2008; 371: 1839-47

ENIGMA

  • Risk factors for severe postoperative nausea and vomiting in a randomized trial of nitrous oxide-based vs nitrous oxide-free anaesthesia
  • Br J Anaesth 2008; 101: 498-505

The risk of cesarean delivery with neuraxial analgesia given in early versus late in labor

  • NEJM 2005 Feb 17;352(7):655-65

B-AWARE

  • Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial
  • Lancet 2004; 363: 1757-63.

CRASH

  • Effect of intravenous corticosteroids on death within 14 days in 10 008 adults with clinically significant head injury: randomised placebo-controlled trial
  • Lancet 2004; 364: 1321-8

SAFE

  • A comparison of albumin and saline for fluid resuscitation in the intensive care unit
  • NEJM 2004; 350(22):2247-2256.

MASTER

  • Epidural anaesthesia and analgesia and outcome of major surgery: a randomised trial
  • Lancet 2002; 359: 1276-82

Fetal and maternal effects of phenylephrine and ephedrine during spinal anaesthesia for cesarean delivery

  • Anesthesiology 2002; 97(6):1582-90

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