British journal of anaesthesia
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Review Meta Analysis
Non-pulmonary complications of intrathecal morphine administration: a systematic review and meta-analysis with meta-regression.
Intrathecal morphine has a dose-dependent effect to increase post-operative nausea, vomiting, pruritus and urinary retention.
pearl -
The science of pilot trials is evolving, and understanding of their role in medical research is increasing. Perioperative randomised controlled trials often test interventions that are inherently multidisciplinary and complex; therefore, there might be compelling reasons to conduct pilot studies to assess feasibility and inform trial design. As pilot studies themselves require resources, investigators should not squander this opportunity; they should design them so that they properly address the sources of uncertainty regarding the success of the definitive trial.
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Case Reports
Visualising myocardial injury after noncardiac surgery: a case series using postoperative cardiovascular MRI.
Myocardial injury after noncardiac surgery (MINS) and perioperative myocardial injury are associated with increased morbidity and mortality. Both are diagnosed by a perioperative increase in troponin, yet there is controversy if MINS is a genuine myocardial insult. ⋯ The burden of myocardial oedema was substantially higher in four patients with elevated troponin qualifying for MINS, compared with patients without MINS. The data and images suggest that MINS represents genuine myocardial injury.
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Letter Comparative Study Observational Study
Comparison between cold and sharp modalities for testing sensory block in neuraxial labour analgesia: a prospective observational trial.