British journal of anaesthesia
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Randomized Controlled Trial Observational Study
Validation of three nociception indices to predict immediate postoperative pain before emergence from general anaesthesia: a prospective double-blind, observational study.
Nociception monitoring devices are designed to estimate nociception during general anaesthesia. We evaluated the predictive accuracy of heart rate and three nociception indices to predict postoperative pain before emergence from general anaesthesia. ⋯ NCT05063227.
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We determined the first prescribed opioid and the prescribers of opioids after knee and hip arthroplasty (KA/HA) between 2013 and 2018 in the Netherlands. We also evaluated whether the first prescribed opioid dose was associated with the total dispensed dose and long-term opioid use in the first postoperative year. ⋯ Oxycodone increased as first out-of-hospital prescription between 2013 and 2018. The dose of the first prescribed opioid was associated with the total dose and a small increased risk of prolonged use. First prescriptions were mostly written by orthopaedic surgeons and consecutive prescriptions by general practitioners.
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Editorial Comment
Incremental advances will improve medical device alarm sounds.
The March issue contains a laboratory study of auditory perception, which is an unusual topic for this journal. A perspective is provided on how the study relates to recent research on clinical auditory alarms and displays. Techniques used in the study are explored and explained, such as enrolment of non-clinician volunteer participants, use of coordinate response measure phrase stimuli, presentation of sound loudness levels using the decibel scale, and analysis using signal detection theory. Such efforts to improve the safety, efficacy, and tolerability of modern medical device alarms are critical for improved patient safety.
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Randomized Controlled Trial
Effect of transauricular nerve stimulation on perioperative pain: a single-blind, analyser-masked, randomised controlled trial.
Activation of central autonomic pathways, including those regulating the arterial baroreflex, might reduce acute pain. We tested the hypothesis that transcutaneous auricular nerve stimulation (TAN) reduces pain after orthopaedic trauma surgery through autonomic modulation. ⋯ Bilateral TAN reduces perioperative pain through autonomic modulation. These proof-of-concept data support a non-pharmacological, generalisable approach to improve perioperative analgesia.
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Randomized Controlled Trial
Inhaled Δ9-tetrahydrocannabinol does not enhance oxycodone-induced respiratory depression: randomised controlled trial in healthy volunteers.
In humans, the effect of cannabis on ventilatory control is poorly studied, and consequently, the effect of Δ9-tetrahydrocannabinol (THC) remains unknown, particularly when THC is combined with an opioid. We studied the effect of THC on breathing without and with oxycodone pretreatment. We hypothesised that THC causes respiratory depression, which is amplified when THC and oxycodone are combined. ⋯ 2021-000083-29 (EU Clinical Trials Register.).