Publications
65 results found
Keane E, Johnson M, Laycock H, 2024, Rethinking paediatric peri-operative cardiac arrest: proactive preparation and tailored training., Anaesthesia
Charlesworth M, Laycock H, 2024, Driving down the carbon cost of peri-operative care: old controversies, new topics, fresh perspectives and the future., Anaesthesia, Vol: 79, Pages: 223-225
Bhattacharyya A, Laycock H, Brett S, et al., 2023, Health care professionals’ experiences of pain management in the Intensive Care Unit: a qualitative study, Anaesthesia, ISSN: 0003-2409
Despite the existence of evidence-based guidelines for the assessment and management of pain in the critical care setting, the prevalence of acute pain remains high. Inadequate pain management is associated with longer duration of mechanical ventilation, reduced capacity for rehabilitation and long-term psychological sequelae. This study aimed to describe the experiences of pain management from healthcare professionals working in intensive care units (ICUs), in order to understand any targetable barriers to delivering effective pain management in critical care.Healthcare professionals were recruited from ICUs in London (UK) using a purposive sampling technique to ensure a range of seniority, roles and environments. Semi-structured interviews, using an interview guide were recorded and transcribed verbatim. Transcripts were analysed using an inductive thematic analysis technique. Thirty participants were recruited from eight diverse ICUs. Five themes were identified. First, there was a lack of consensus in pain assessment in the ICU where nursing staff described more knowledge and confidence of validated pain measures than physicians and concerns over validity and usability were raised. Second, there was a universal perception of resource availability impacting the quality of pain management including high clinical workload, staff turnover and availability of certain pain management techniques. Third, acknowledgment of the importance of pain management was highest in those with experience of interacting with critical care survivors. Fourth, participants described their own emotional reaction to managing those in pain which influenced their learning. Finally, there was a perception that, due to the complexity of the ICU population, pain was de-prioritised and there were conflicting views as to whether standardised analgosedation algorithms were useful. This study highlights the differing perceptions around pain management in ICU based on role and provides evidence to
Wiles MD, Klein AA, Shelton CL, 2023, Position statement from the Editors of <i>Anaesthesia</i> and <i>Anaesthesia Reports</i> on best practice in academic medical publishing, ANAESTHESIA, Vol: 78, Pages: 1139-1146, ISSN: 0003-2409
Nagy I, Friston D, Cuddihy J, et al., 2023, Elevated 18:0 lysophosphatidylcholine contributes to the development of pain in tissue injury, Pain, Vol: 164, Pages: e103-e115, ISSN: 0304-3959
Tissue injuries, including burns, are major causes of death and morbidity worldwide. These injuries result in the release of intracellular molecules and subsequent inflammatory reactions, changing the tissues’ chemical milieu and leading to the development of persistent pain through activating pain-sensing primary sensory neurons. However, the majority of pain-inducing agents in injured tissues are unknown. Here, we report that, amongst other important metabolite changes, lysophosphatidylcholines (LPCs) including 18:0 LPC exhibit significant and consistent local burn injury-induced changes in concentration. 18:0 LPC induces immediate pain and the development of hypersensitivities to mechanical and heat stimuli through molecules including the transient receptor potential ion channel, vanilloid sub-family, member 1 and member 2 at least partly via increasing lateral pressure in the membrane. As levels of LPCs including 18:0 LPC increase in other tissue injuries, our data reveal a novel role for these lipids in injury-associated pain. These findings have high potential to improve patient care.
McCahill C, Laycock HC, Guris RJD, et al., 2022, State-of-the-art management of the acutely unwell child, ANAESTHESIA, Vol: 77, Pages: 1288-1298, ISSN: 0003-2409
Schoth DE, Blankenburg M, Wager J, et al., 2022, Quantitative sensory testing in paediatric patients with chronic pain: a systematic review and meta-analysis., Br J Anaesth, Vol: 129, Pages: e94-e97
Agarwal S, El-Boghdadly K, 2022, Position statement from the Editors of <i>Anaesthesia</i> on equity, diversity and inclusion, ANAESTHESIA, Vol: 77, Pages: 1018-1022, ISSN: 0003-2409
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- Citations: 4
Casely E, Laycock H, 2022, Opioids in pain medicine, ANAESTHESIA AND INTENSIVE CARE MEDICINE, Vol: 23, Pages: 384-390, ISSN: 1472-0299
Baskozos G, Themistocleous AC, Hebert HL, et al., 2022, Classification of painful or painless diabetic peripheral neuropathy and identification of the most powerful predictors using machine learning models in large cross-sectional cohorts, BMC MEDICAL INFORMATICS AND DECISION MAKING, Vol: 22
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- Citations: 7
Granovsky Y, Topaz LS, Laycock H, et al., 2021, Conditioned pain modulation is more efficient in painful than in non-painful diabetic polyneuropathy patients., Pain, Vol: 00, ISSN: 0304-3959
ABSTRACT: Endogenous pain modulation, as tested by the conditioned pain modulation (CPM) protocol, is typically less efficient in chronic pain patients compared to healthy controls. We aimed to assess whether CPM is less efficient in painful compared to non-painful diabetic polyneuropathy (DPN) patients. Characterization of the differences in central pain processing between these two groups might provide a central nervous system explanation to the presence or absence of pain in diabetic neuropathy in addition to the peripheral one.271 patients with DPN underwent CPM testing and clinical assessment, including quantitative sensory testing. Two modalities of the test stimuli (heat and pressure) conditioned to cold noxious water were assessed and compared between painful and non-painful DPN patients. No significant difference was found between the groups for pressure pain CPM, however painful DPN patients demonstrated unexpectedly more efficient CPMHEAT ( -7.4±1.0 vs. -2.3±1.6; p=0.008). Efficient CPMHEAT was associated with higher clinical pain experienced in the 24 hours prior to testing (r=-0.15; P=0.029) and greater loss of mechanical sensation (r=-0.135; P=0.042). Moreover, patients who had mechanical hypoesthesia demonstrated more efficient CPMHEAT (p=0.005). More efficient CPM among painful patients might result from central changes in pain modulation, but also from altered sensory messages coming from tested affected body sites. This calls for the use of intact sites for proper assessment of pain modulation in neuropathy patients.
Odor PM, Bampoe S, Lucas DN, et al., 2021, Incidence of accidental awareness during general anaesthesia in obstetrics: a multicentre, prospective cohort study, ANAESTHESIA, Vol: 76, Pages: 759-776, ISSN: 0003-2409
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- Citations: 14
Small C, Laycock H, 2021, Are we near to making virtual reality the new reality in pain medicine?, ANAESTHESIA, Vol: 76, Pages: 590-593, ISSN: 0003-2409
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- Citations: 3
Laycock HC, Mullins E, 2021, The role of anaesthetists in women's health, Anaesthesia, Vol: 76, Pages: 3-5, ISSN: 0003-2409
Odor PM, Bampoe S, Moonesinghe SR, et al., 2021, General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study, ANAESTHESIA, Vol: 76, Pages: 460-471, ISSN: 0003-2409
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- Citations: 30
Laycock HC, Harrop-Griffiths W, 2021, Assessing pain: how and why?, ANAESTHESIA, Vol: 76, Pages: 559-562, ISSN: 0003-2409
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- Citations: 1
Agarwal S, Laycock HC, 2020, The debate ROTEMs on - the utility of point-of-care testing and fibrinogen concentrate in postpartum haemorrhage, ANAESTHESIA, Vol: 75, Pages: 1247-1251, ISSN: 0003-2409
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- Citations: 7
Casely EM, Laycock HC, 2020, Infusion Therapy for Pain, Headache and Related Conditions, ANESTHESIA AND ANALGESIA, Vol: 130, Pages: E167-E168, ISSN: 0003-2999
Odor PM, Bampoe S, Lucas DN, et al., 2020, Protocol for direct reporting of awareness in maternity patients (DREAMY): a prospective, multicentre cohort study of accidental awareness during general anaesthesia, INTERNATIONAL JOURNAL OF OBSTETRIC ANESTHESIA, Vol: 42, Pages: 47-56, ISSN: 0959-289X
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- Citations: 4
Thomas SE, Laycock H, 2020, The use of high dose topical capsaicin in the management of peripheral neuropathy: narrative review and local experience, BRITISH JOURNAL OF PAIN, Vol: 14, Pages: 133-140, ISSN: 2049-4637
Friston D, Junttila S, Borges Paes Lemes J, et al., 2020, Leptin and fractalkine: novel subcutaneous cytokines in burn injury, Disease Models and Mechanisms, Vol: 13, ISSN: 1754-8403
Burn injury is a pathology underpinned by progressive and aberrant inflammation. It is a major clinical challenge to survival and quality of life. While burn injury’s complex local and disseminating pathological processes ultimately stem from local tissue damage, to date relatively few studies have attempted to characterise the local inflammatory mediator profile. Here, cytokine content and associated transcriptional changes were measured in rat skin for three hours immediately following induction of a scald-type (60oC, 2 minutes) burn injury model. Leptin (p = 0.0002) and fractalkine (p = 0.0478) concentrations were significantly elevated post-burn above pre-burn and control site values, coinciding with the development of burn site oedema and differential expression of leptin mRNA (p = 0.0004). Further, gene sequencing enrichment analysis indicated cytokine-cytokine receptor interaction (p = 1.45x10-6). Subsequent behavioural studies demonstrated that, following subcutaneous injection into the dorsum of the paw, both leptin and fractalkine induced mechanical allodynia, heat hyperalgesia and the recruitment of macrophages. This is the first report of leptin’s elevation specifically at the burn site and the first report of fractalkine’s elevation in any tissue post-burn which, together with the functional findings, calls for exploration of the influence of these cytokines on pain, inflammation and burn wound progression. Additionally targeting these signalling molecules represents a therapeutic potential as early formative mediators of these pathological processes.
Laycock H, Bailey CR, 2020, The influence of first author sex on acceptance rates of submissions to Anaesthesia Cases: a reply, ANAESTHESIA, Vol: 75, Pages: 420-420, ISSN: 0003-2409
Friston D, Junttila S, Lemes JBP, et al., 2020, Leptin and fractalkine: Novel subcutaneous cytokines in burn injury., Dis Model Mech
Burn injury is a pathology underpinned by progressive and aberrant inflammation. It is a major clinical challenge to survival and quality of life. While burn injury's complex local and disseminating pathological processes ultimately stem from local tissue damage, to date relatively few studies have attempted to characterise the local inflammatory mediator profile. Here, cytokine content and associated transcriptional changes were measured in rat skin for three hours immediately following induction of a scald-type (60°C, 2 minutes) burn injury model. Leptin (p=0.0002) and fractalkine (p=0.0478) concentrations were significantly elevated post-burn above pre-burn and control site values, coinciding with the development of burn site oedema and differential expression of leptin mRNA (p=0.0004). Further, gene sequencing enrichment analysis indicated cytokine-cytokine receptor interaction (p=1.45x10-6). Subsequent behavioural studies demonstrated that, following subcutaneous injection into the dorsum of the paw, both leptin and fractalkine induced mechanical allodynia, heat hyperalgesia and the recruitment of macrophages. This is the first report of leptin's elevation specifically at the burn site and the first report of fractalkine's elevation in any tissue post-burn which, together with the functional findings, calls for exploration of the influence of these cytokines on pain, inflammation and burn wound progression. Additionally targeting these signalling molecules represents a therapeutic potential as early formative mediators of these pathological processes.
Small C, Laycock H, 2020, Acute postoperative pain management, BRITISH JOURNAL OF SURGERY, Vol: 107, Pages: E70-E80, ISSN: 0007-1323
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- Citations: 77
Jaggar SI, Laycock HC, 2020, Pain Management after Cardiac Surgery, CORE TOPICS IN CARDIAC ANAESTHESIA, 3 EDITION, Editors: Arrowsmith, Roscoe, Mackay, Publisher: CAMBRIDGE UNIV PRESS, Pages: 280-284
Laycock H, Bailey CR, 2019, The influence of first author sex on acceptance rates of submissions to <i>Anaesthesia Cases</i>, ANAESTHESIA, Vol: 74, Pages: 1432-1438, ISSN: 0003-2409
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- Citations: 10
Brinkler R, Edwards Z, Abid S, et al., 2019, A survey of antenatal and peripartum provision of information on analgesia and anaesthesia, ANAESTHESIA, Vol: 74, Pages: 1101-1111, ISSN: 0003-2409
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- Citations: 7
Laycock H, Bantel C, 2019, Opioid mechanisms and opioid drugs, ANAESTHESIA AND INTENSIVE CARE MEDICINE, Vol: 20, Pages: 450-455, ISSN: 1472-0299
Kemp HI, Laycock H, Costello A, et al., 2019, Chronic pain in critical care survivors: a narrative review, British Journal of Anaesthesia, Vol: 123, Pages: e372-e384, ISSN: 1471-6771
Chronic pain is an important problem after critical care admission. Estimates of the prevalence of chronic pain in the year after discharge range from 14% to 77% depending on the type of cohort, the tool used to measure pain, and the time point when pain was assessed. The majority of data available come from studies using health-related quality of life tools, although some have included pain-specific tools. Nociceptive, neuropathic, and nociplastic pain can occur in critical care survivors, but limited information about the aetiology, body site, and temporal trajectory of pain is currently available. Older age, pre-existing pain, and medical co-morbidity have been associated with pain after critical care admission. No trials were identified of interventions to target chronic pain in survivors specifically. Larger studies, using pain-specific tools, over an extended follow-up period are required to confirm the prevalence, identify risk factors, explore any association between acute and chronic pain in this setting, determine the underlying pathological mechanisms, and inform the development of future analgesic interventions.
Friston D, Laycock H, Nagy I, et al., 2019, Microdialysis workflow for metabotyping superficial pathologies: application to burn injury, Analytical Chemistry, Vol: 91, Pages: 6541-6548, ISSN: 0003-2700
Burn injury can be a devastating traumatic injury, with long-term personal and social implications for the patient. The many complex local and disseminating pathological processes underlying burn injury's clinical challenges are orchestrated from the site of injury and develop over time, yet few studies of the molecular basis of these mechanisms specifically explore the local signaling environment. Those that do are typically destructive in nature and preclude the collection of longitudinal temporal data. Burn injury therefore exemplifies a superficial temporally dynamic pathology for which experimental sampling typically prioritizes either specificity to the local burn site or continuous collection from circulation. Here, we present an exploratory approach to the targeted elucidation of complex, local, acutely temporally dynamic interstitia through its application to burn injury. Subcutaneous microdialysis is coupled with ultraperformance liquid chromatography-mass spectrometry (UPLC-MS) analysis, permitting the application of high-throughput metabolomic profiling to samples collected both continuously and specifically from the burn site. We demonstrate this workflow's high yield of burn-altered metabolites including the complete structural elucidation of niacinamide and uric acid, two compounds potentially involved in the pathology of burn injury. Further understanding the metabolic changes induced by burn injury will help to guide therapeutic intervention in the future. This approach is equally applicable to the analysis of other tissues and pathological conditions, so it may further improve our understanding of the metabolic changes underlying a wide variety of pathological processes.
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