British journal of anaesthesia
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Regional analgesia is a core component of an optimal multimodal analgesia technique. Several advanced regional analgesic techniques have been evaluated for mastectomy; however, the optimal choice remains unclear. Many randomised clinical trials (RCTs) evaluating various local/regional analgesic techniques do not include basic analgesics (i.e. paracetamol, non-steroidal anti-inflammatory drugs, cyclooxygenase-2 specific inhibitors, and dexamethasone) which precludes objective evaluation of their efficacy. ⋯ The key finding of this study is that almost 90% (n=82/92) of the RCTs evaluating local/regional analgesic techniques in patients undergoing mastectomy did not administer well accepted basic analgesics in the comparator groups. Consequently, the conclusions of the RCTs assessing local/regional analgesic techniques for mastectomy should be interpreted with caution. Also, clinical guidelines based on meta-analyses of these RCTs could be inadequate or inappropriate.
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Randomized Controlled Trial
Effect of driving pressure-guided positive end-expiratory pressure on postoperative pulmonary complications in patients undergoing laparoscopic or robotic surgery: a randomised controlled trial.
Individualised positive end-expiratory pressure (PEEP) improves respiratory mechanics. However, whether PEEP reduces postoperative pulmonary complications (PPCs) remains unclear. We investigated whether driving pressure-guided PEEP reduces PPCs after laparoscopic/robotic abdominal surgery. ⋯ KCT0004888 (http://cris.nih.go.kr, registration date: April 6, 2020).
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Prophylactic administration of tranexamic acid is associated with a reduction of blood loss after Caesarean delivery, but cost-effectiveness for this indication has not been assessed. ⋯ NCT03431805.
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Airway-related articles have featured heavily in the British Journal of Anaesthesia since it was founded in 1923. In the 100 years thereafter, 1102 airway-related articles have been published in the journal, written by 2955 unique authors from 55 different countries. In this editorial, we highlight some of the major publications in airway management and their impact on the specialty. Summaries of the most cited articles are contained within online supplementary material as well as links to all airway-related articles for readers who wish to delve deeper into this body of work.