New Peripheral Nerve Block
Ampres® 2%, chloroprocaine 2%, is approved for peripheral nerve blocks in adults for surgery not exceeding an hour.
For many patients undergoing extremity surgery, a peripheral nerve block (PNB) offers them the benefits of avoiding a general anaesthetic, giving them early mobilisation with less nausea and vomiting and better satisfaction.
Why would you turn every light off in your city to change a lightbulb in your bedroom? Anaesthetising the procedural area and not the entire body makes complete sense. Why wouldn’t you want the individualised anaesthesia of a PNB when you are having for example hand surgery, versus putting your entire body into what some anaesthetists have described as the medical coma induced by a general anaesthetic?
It makes a lot of sense to individualise or “personalise” your anaesthesia (and analgesia) to the part of your body being operated on, although you don’t have to be awake or aware whilst your surgery is taking place.
Many patients choose to have a sedative or listen to their favourite music whilst their surgery takes place.
PNBs and regional anaesthesia provide many benefits for patients and anaesthetists, which is why Sintetica Limited is excited to share an important announcement, Ampres® 2% (chloroprocaine 2%), has been approved by the MHRA for PNBs.
Most day case surgeries last approximately 40 minutes, Ampres® 2% is approved for PNBs in adults for surgery not exceeding an hour.
“Any intelligent fool can make things bigger and more complex… it takes a touch of genius and a lot of courage to move in the opposite direction.”
How Marginal Gains Make the Difference in Intensive Care
Symposium Debate Intensive Care Society SOA Conference
Marginal gains in sport has turned losers into winners – how this practise can work in intensive care will be the subject of the Sintetica symposium at the Intensive Care Society’s SOA conference on December 9 2019. Here leading intensivist Dr Justin Kirk-Bayley and top sports psychologist Dr Jonathan Males, who will both be at the symposium, share their thoughts.
“Football is not a matter of life and death... it's much more important than that.” That quote from Bill Shankly, former manager of Liverpool Football Club, sums up just how passionate sports fans are about their team and winning.
When you work in the intensive care setting though, Shankly’s words can sound hollow. It is a matter of life and death every day for everyone involved from the pharmacist and physiotherapist to the consultant and the nurse. It’s about teamwork – multidisciplinary teams – but the stakes are a lot higher than winning the Premiership.
But are there lessons from the sporting world - like the practise of marginal gains - which can be used to improve care in the intensive care setting?
Jonathan Males:When I start to work with an athlete I ask them to look at the different stages they go through at any one time in their sport. They are either preparing to play, playing or reviewing how they played. It is about the state of mind at each given stage. You can’t have the same state of mind while you are waiting for your turn e.g. a cricketer may be standing around for much of the day before they go to the crease. The mindset they need for that stage will have to be very different from when they are standing in front of a fast bowler.
What is the mental demand people are facing at each of those three stages and what is going on in their mind as they transition from one stage to another? The question sports people have to ask themselves is what state of mind do I need at each stage of my performance to be at my best?
Justin Kirk-Bayley:When it comes to marginal gains we ask ourselves three things.
*What does the evidence say?
*What would be a good thing?
*What is reasonably achievable?
We have successfully used the Delphi consensus method and whittled it down to five things on which there is a consensus we could do to make that one per cent improvement. We walk through the process to uncover what the patient wants to happen, what the medical team want to happen and what the other members of the team i.e. pharmacists, physiotherapists want to happen on the journey, the patient’s pathway to recovery.
We decided to call this a pathway rather than a protocol or a guideline. A pathway implies a journey i.e. what is the next step I have to take or is being taken along the way. The word protocol is too rigid. It suggests something which must be done. We didn’t want that. A guideline of course is just that – a guideline and can be ignored. A pathway is something everyone follows to success.
Jonathan Males:When an athlete is standing on the starting line they have to be confident they have done everything they can to ensure they will win. This means they have to know they have an edge over their competitors – whatever that might be. Sometimes this means in their practise they have tried to do things differently to find that edge. Sometimes it works and sometimes it doesn’t. We call this a “safe to fail” experiment.
The athlete goes into this with the attitude of making a small change and then testing it to see if it works. If it does then do it for a week and if that goes well then do it for a longer period of time. But don’t be afraid to drop it if it isn’t working either.
The knowledge they have sorted out every possible advantage will give them confidence. It doesn’t have to be a big difference – it is the one per cent which counts. They have to know they have left no stone unturned in their pursuit of a gold medal.
Justin Kirk-Bayley: We all need to avoid becoming wedded to a certain way of doing things. We all potentially default to the automatic when we are under pressure – after all we are in life and death situations. But we need to recognise each patient is different. What worked for one may not work for another. Don’t assume things are always going to work. Don’t take anything for granted. Assess the response to the intervention. Believe in dogmalysis.
Medicine is an ever-changing discipline. What is law one year is ancient history the next. Even the gold standard of research can about-face concepts once, if not twice, in a career. The upshot of this is that we are duty bound to question what we do. Nothing must be taken for granted, and the utility or harm of intervention, or lack of must constantly be addressed.
Jonathan Males: Living in the moment is vital in sport which is why having the right mindset at the right time and place is so important. All the practice, the hours, days, week and months put in before the event won’t help if the sports person loses focus, not just on the day but on the next shot.
Things go wrong because people start to think too far ahead – particularly when the stakes are high. In some sports, like weightlifting for example, it is all over in three seconds. The same goes for taking a penalty shot in football. The pressure is on. They need to focus on what they are doing and not what might happen if they do or don’t succeed.
If a golfer is thinking - if I make this last hole, I will win the championship and a million pounds – the last metre feels like a long way off. It becomes overwhelming because it means so much. If they put their thoughts into each part of the game their focus will remain unhindered and the final goal won’t feel like such a burden.
Justin Kirk-Bayley: When you make changes – that one per cent – in any area of the patient’s pathway then changes occur in other areas too. This is why, whenever we discuss improvements, we involve the multi-disciplinary team. Everyone’s input is vital if we are to shave off, and we do, half days, and whole days in making the patient’s journey and outcome better.
The problem can occur when the individuals in the team are given too many complex tasks all at the same time. It is understandable they will forget something. To keep someone in the here and now you need to reduce the cognitive burden by breaking their workload into small tasks.
Question: How would you eat an elephant? Answer: One bite at a time. This is where pathways work because you can follow the line and refer back to what has worked and what hasn’t and where that fits into the journey. You focus on the task in hand rather than on what you have to do next.
Marginal Gains – Sporting Success
Former Team GB British Cycling performance director, Sir Dave Brailsford, believed it was possible to make marginal gains – a 1% improvement - by uncovering the team’s weaknesses and working out how to improve on them.
By using a wind tunnel he noted the bikes were not sufficiently aerodynamic. He looked at the mechanics area in the team truck and found dust on the floor which hampered maintenance. His answer was to paint the floor white to spot any dirt.
He encouraged the team to use antibacterial hand gel to cut down on infections. He looked at the team bus in terms of rest and recuperation. All small things which added up to a whole.
The result being Team GB achieving more gold medals in the Olympics than ever before and more British riders winning the Tour de France.
Marginal Gains – Recovery Success
By taking into account the patient’s pathway Justin’s team have been able to shave off half a day and even whole days in getting the patient onto their next stage of recovery i.e. ITU to hospital ward and home. In intensive care we use a lot of drugs and we try to determine who gets what, when and where is a problem. The difficulty now is medicine has become so complex that what we need is not people who are really clever but people who have good memories. There is almost too much to remember.
We need the information at our fingertips to be able to make decisions. It isn’t so much errors of omission but errors of commission i.e. the wrong amount in the wrong place. So the best thing is to compile things we need to remember and desire (our marginal gains) and assess patients’ responses to them.
These marginal gains include simple things like ensuring a patient has their non-slip socks on at the top of the day and is therefore mentally and physically prepared for the physiotherapist and their daily exercise.
Patients weren’t able to continually exercise their core muscles well because they were full of tubes and had to stay lying in bed – the answer was an intensive care bed which converted into a chair.
Debunking myths like only one in twenty patients who have emergency abdominal surgery are unlikely to recover, Justin’s team produced irrefutable facts the figure was much higher – up to one in five patients died. Those facts immediately engaged the team to find a solution. The figure at the Royal Surrey is now actually very close to one in twenty.
Justin Kirk-Bayley: “ Clinicians need to take time to look about and unpick how their patients get from major surgery or illness to recovery and ask whether it ought to happen that way. Each step of the process should be questioned for its utility or its order in the process. Could it be done better? Nothing should be sacrosanct.
By really thinking about what we do, as an integrated multidisciplinary team, to nudge patients along their journey we need to get together, look at the things we can measure, constantly make small changes and re-measure, and not be afraid to alter things in the hope that we can do it better. That way everyone stands to win.”
Dr Jonathan Males is a sport psychologist and executive coach. He has helped athletes and coaches prepare for every Olympic Games since 1992, working with Team GB and Paralympics GB. His focus now is on humanising performance in the workplace, to enable people and teams to thrive, not simply survive.
Dr Justin Kirk-Bayley, MRCP, FRCA, EDIC, FFICMis a Consultant Intensivist & Anaesthetist at the Royal Surrey Hospital in Guildford. Whilst better known for advancing education in point of care ultrasound (POCUS), on the Intensive Care Society FUSIC committee, closer to home he works with surgeons, pharmacists, nurses, physiotherapists to improve patient outcomes after high-risk surgery.
Patients benefit from innovation and technology in the pharma industry
Sintetica team passionate about joint approach
From a pumping patch to help mend the damage caused by a heart attack to a new robotic system which can operate on patients, innovation and technology are an integral part of the work of the pharmaceutical industry. But where once it was assumed pharma concentrated on the drug solution and technology on creating devices to solve a problem, the two are increasingly coming together to benefit patients.
This joint approach encourages innovation across technology and healthcare – something which we at Sintetica www.sintetica.com/uk are passionate about. Our focus is on scientific leadership and where the technology and the medicines can work together this means being able to help more patients.
Technology such as remote healthcare equipment, mobile apps and artificial intelligence to target treatments for individuals has almost become the norm. It’s more about how technology can either support a patient, improve their life or provide an alternative to spending a lifetime on drugs. This is particularly important in the current debate around the use of opioid medicines for pain relief which can lead to addiction.
These innovations are not solely the brainchild (or brainchildren) or those of us who work in healthcare. Implanted wireless brain sensors which dissolve once they are no longer needed have been developed through research by a team of neurosurgeons and engineers with this article appearing in Plastics Today http://bit.ly/329OnLA
We all now know about 3D printing but now the technology can be used to produce surgical instruments and prosthetics. It’s predicted one day they will be used to make organs, doing away with the need for transplant surgery http://bit.ly/2KXYQUj Meanwhile a Swedish company has already showed it can print a life-size nose using a bio-ink containing human cells https://www.bbc.co.uk/news/business-41859942
But more important than the smart technology are the people behind it. Look at some of the greatest inventions and you will discover how committed these people were - whether it was finding a cure or better ways to support a patient going through surgery – think how anaesthetics has changed!
We’re fortunate to have committed people and have won awards for our human centric approach to our business https://www.europeanceo.com/awards-2018/best-ceos/37 . Technology and innovation in our sector will keep moving forward and we will continue to be part of that. For our future inventions it is our people who are our biggest asset and it is their commitment which will make a difference to the patient.
Darren Fergus, Managing Director, Sintetica Ltd
Expert talks on peri-operative care for children at national conference in Manchester
Event supported by APAGBI
Sintetica Ltd will be at the 4th National Paediatric Peri-operative Care Conference in Manchester on Friday October 11 2019. It is a great opportunity for us to hear from those of you working in this field and understand how we can help improve the peri-operative care of children.
The event is hosted by Royal Manchester Children’s Hospital and supported by APAGBI. The conference is for health professionals with an interest in pre-operative assessment and the peri-operative care of children, including consultant anaesthetists, trainees and pre-op nurses.
Expert talks include enhancing children’s experience of healthcare in the peri-operative period, management of children with autistic spectrum and ERAS – what we can learn from the experience in adults.
Tickets are available at https://www.tickettailor.com/events/ppoc/271842
Sintetica's top ways to retain staff features in Pharma Field
Shared values and trust most important
Sintetica's people-focused employment ethos is featured in the pharmaceutical magazine Pharma Field. The article was part of a special feature on retention and recruitment with tips on how to employ the best staff and how to keep them.
This article first appeared in the September issue of Pf Special Editions’ website https://pharmafield.co.uk/
Managing director, Darren Fergus talks about the setting up of Sintetica Ltd in the UK - a subsidiary of the almost 100 year old Swiss pharmaceutical company, Sintetica SA. He describes how he was influenced by the management style of SA's award winning CEO and how trust is the key to employee/management relationships. See link to Pharma Field's website above.
Sintetica Medical Director Wins International Life Sciences Award
Award Recognises Accomplishments of Specialists
Sintetica Ltd’s medical director and consultant anaesthetist, Dr Oliver Tweedie, has won the International Life Sciences award by Global Health and Pharma magazine.
The award recognises the accomplishments of specialists in their field and quantifiable contributions to the life sciences industry over the past year. https://www.ghp-news.com/international-life-science-awards-2019
Dr Tweedie, who works as a consultant anaesthetist in the NHS, has been recognised for his drive towards innovation in patient healthcare and as medical director of Sintetica changing the injectable anaesthetics and analgesics space for the better.
Sintetica’s preservative free anaesthetics are produced at the company’s manufacturing plant in Switzerland which is powered by 100 per cent by green energy.
Dr Tweedie said: “This award recognises the contribution Sintetica makes to changing the way we understand anaesthetics. Patients having operations or procedures no-longer have to “be asleep” under a general anaesthetic when we have the science and technology to provide them with a regional or spinal anaesthetic, allowing patients to go home the same day as their procedure.”
“The technology means, where medically safe to do so, we can give patients a choice and that is fundamental to what we as healthcare professionals should strive towards.”
Sintetica to hold symposium for knowledge share
Sintetica Ltd are proud to sponsor this year’s Intensive Care Society’s State of the Art Conference being held in Birmingham in December. The conference includes speakers from across the world who will share their expert knowledge of the latest intensive care medicine and treatments.
Sintetica will be holding a lunchtime symposium at the event as part of the knowledge share in this critical field of work. More information about the conference can be found at https://soa.ics.ac.uk
Early bird registration is available until September 23 2019.
Sintetica features in historic Commonwealth at 70 anniversary album
Sintetica chosen as one of two companies to represent pharmaceutical sector
A commemorative album marking the 70th anniversary of the Commonwealth has been launched with Sintetica featuring in this historic piece of work. Sintetica was chosen for inclusion by the editorial board of publisher St James’s House because of its people focused work style and corporate sustainability.
Sintetica is one of only two pharmaceutical companies selected to represent the pharmaceutical sector.
The book “The Commonwealth at 70: From Westminster to the World” was written by academics and experts and produced by The History of Parliament Trust. It was launched at Westminster Abbey.
Sintetica has offices across Europe and the UK – Sintetica Limited in London.
Speaking from London, Darren Fergus, Managing Director, said, “As one of the most ambitious and well-researched academic projects in British history, it gives me immense pride to see Sintetica featured and recognised across the UK and the Commonwealth.
“The Commonwealth spans the globe and as Sintetica expands its global footprint the album will always be a reflection of our own ambitions and that makes me smile as it sits proudly in our library.”
Photo showing Sintetica page featuring Corporate CEO Augusto Mitidieri.
Pharmaceutical company Sintetica picked for historic Commonwealth at 70 anniversary project
Sintetica selected because of people focused work style
The innovative, scientific pharmaceutical company, Sintetica has been chosen as a patron of the official History of Parliament Trust commemorative album to mark the 70th anniversary of the Commonwealth.
The company was selected for inclusion by the editorial board of publisher St James’s House because of its people focused work style and corporate sustainability.
Sintetica is one of a handful of pharma companies selected to represent the pharmaceutical sector. The project marks 70 years of the Commonwealth with a commemorative album written by academics and experts. The book “The Commonwealth at 70: From Westminster to the World” will be launched at Westminster Abbey on June 25 2019.
The album includes photographs, stories and thought-provoking debate on all aspects of the states that make up the Commonwealth, which was born in April 1949. It brings together best practice and offers an insight into the major Commonwealth institutions, organisations and initiatives.
Sintetica Limited Managing Director, Darren Fergus, said he was proud of the work of the company and its people and thrilled that Sintetica was chosen to take part in the commemoration. Sintetica has offices across Europe and the UK – Sintetica Limited in London.
Darren Fergus said: “An organisation like the Commonwealth brings together so much knowledge and experience. It shows how countries can work together for the common interests of its peoples. Business can learn from this understanding and co-operation. Myself and my colleagues were overjoyed at Sintetica being chosen to take part in this body of work and we look forward to meeting the other contributors and learning from each other.”
The album was produced by The History of Parliament Trust which is a research project creating a comprehensive account of parliamentary politics in England and then Britain from the 13th century. It is regarded as one of the most ambitious and well-researched academic projects in British history.
Notes to editors:
A limited number of press tickets are available for the book launch. For further information or to find out more about the publication or the launch event please contact Stephen van der Merwe: email@example.com
For further information about Sintetica Limited contact:
Media and Communications,
(m) 07976 819913
About Sintetica Limited:
Sintetica Limited organisation has in its legacy specialist anaesthetics and analgesics that are manufactured in Switzerland, continuously supplied to its markets and integrated into healthcare pathways by people with a real passion and responsibility for what they do.
Committed to implementing access strategies for all of its new medicines based upon addressing the needs of patients in local communities. Through research, development and understanding, Sintetica Limited will improve the affordability of its medicines and strengthen future healthcare outcomes in the communities it serves.
Sintetica Limited is a wholly owned subsidiary of Sintetica SA.
Medical Information email:
Stock availability email:
Sintetica Limited email:
Adverse events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse events should also be reported to Sintetica Limited
Medical Information on 01748 827269 or via e-mail to SinteticaGB@EU.ProPharmaGroup.com
Sintetica Limited, 30th Floor, 40 Bank Street, Canary Wharf, London E14 5NR
Date of preparation: June 2019
Sedation and Restraint
Association of Paediatric Anaesthetists of Great Britain and Ireland Conference (APAGBI), Sheffield June 2019. Discussion on sedation and restraint.
Speakers gave accounts of their experience of working in paediatric sedation and how in some cases children had to be restrained. One speaker gave evidence of the long term impact on children in terms of their resistance to future healthcare.
Sintetica announces transfer of majority stake to build international growth
International Development Plans
It has been announced the Swiss pharmaceutical company Sintetica SA has transferred a majority stake in the business to Ardian – the largest private equity operator in Europe - as part of its international development strategy.
The partners of Sintetica SA will remain the holders of a minority stake with the right to retain a significant presence on the board of directors.
Sintetica SA’s five year development plans were recently endorsed for sustainability and credibility by McKinsey, the American worldwide management consulting firm. This includes Sintetica’s people-focused business model which has won international awards for being a “Great Place To Work”.
The plans see a constant growth in revenue, development registration and marketing in more than 100 countries involving about 600 new products and the hiring of hundreds of new employees.
Sintetica Chairman Luca Bolzani said: “I am convinced that this is the greatest guarantee that will allow all of us, me most of all, to continue to carry out our work with the same composure and commitment as we have done so far with deserved success.”
Prestigious European Business Award for Sintetica's CEO
Best Manager of the Year Augusto Mitidieri
The CEO of Sintetica SA, Augusto Mitidieri, has been awarded Best Manager of the Year by the Europe Business Assembly’s Socrates Committee of Oxford for his exceptional human-centric leadership and the global success of the business.
The company was also awarded the Best Enterprise Award in the EBA’s Corporation of Social Partnership.
The award was presented at the Socrates Award Ceremony of the Achievements Forum 2019 at the Institute of Directors in London.
The Europe Business Assembly comprises world leaders in politics, economy, science and culture from across Europe and has more than 12,000 top managers from 54 countries worldwide.
Managing director of London based Sintetica Ltd, Darren Fergus said: “Recognition of the exceptional global leadership of our CEO, Augusto Mitidieri, not only distinguishes an inspirational leader, it provides all of Sintetica with a huge feel good factor.
“Sintetica is a great place to work and feeling good about the work we do, knowing it is helping patients and constantly improving medicines and health technology, is what motivates us. It is at the heart of all we do.”
Sintetica CEO Wins Major Award for People-Centred Business Model
"Most Influential CEO of the Year 2018"
The award recognises the corporate strategy and operational elements that make up the 'human-centric philosophy which Augusto has put into the heart of the organisation. In an interview with the magazine www.cv-magazine.com/issues/issue-3-2019/6/he said the company’s philosophy was based on responsibility and merit for the employee and not a hierarchical structure.
Managers took on more of a coaching role than one of command and control.
He said: “Total respect from inside the organisation, in terms of corporate and individual priorities is fundamental for managers to make clear what they expect from their employees, and to frequently align these behaviours to expectations, thanks to the continuous and constructive share of feedback. Not to judge their work but to address them towards a continuous improvement.”
The award from Corporate Vision magazine is one of a number of accolades received by Augusto and Sintetica SA in the past three years. Others include European CEO of the Year 2016 by CV Magazine, Best Pharmaceutical Company – Switzerland in the European Enterprise Awards and Award for Excellence in Anaesthetics and Analgesia – Switzerland Small Business Elite 2018 in the Worldwide Business Review.
Sintetica, set up in 1921, delivers injectable anaesthetics and analgesics to patients worldwide through innovative science and excellence in development, production and marketing.
Symposium - AAGBI WSM 2019
Symposium - AAGBI WSM 2019
Anaesthetists should not be defaulting to a GA technique
Many anaesthetists are hindered by their organisation’s capabilities, culture and even their own habits that stand in the way of offering patient choice.
Dr Morné Wolmarans
Symposium - AAGBI WSM 2019
Symposium - AAGBI WSM 2019
Symposium - AAGBI WSM 2019
Symposium - AAGBI WSM 2019
Spinal Anaesthesia in Day Surgery – Right Drug, Right Patient, Right Procedure
Our handbook on the use of spinal anaesthesia in day surgery is now available. Contributors include expert clinicians from across Europe. The handbook contains chapters illustrating techniques used by current SA anaesthetists and guidance on dosage and refers to studies into the use of SA v GA and outcome.
The handbook "Spinal Anaesthesia in Day Surgery - Right Drug, Right Patient, Right Procedure" is available free by contacting firstname.lastname@example.org
WSM19 -Winter Scientific Meeting 2019
Winter Scientific Meeting 2019