Article Notes

• Hide
  • Pearls
  • Summaries
  • Comments

pearl
1
The oral cannabinoid dronabinol has similar psychoactive effects to smoking marijuana.
Issa MA, Narang S, Jamison RN et al. The Subjective Psychoactive Effects of Oral Dronabinol Studied in a Randomized, Controlled Crossover Clinical Trial For Pain. Clin J Pain. 2014 Jun 1; 30 (6): 472-8.
  Daniel Jolley
pearl
1
Subparaneural injection for popliteal sciatic nerve block shows faster onset and longer duration than circumferential extraneural injection.
Choquet O, Noble GB, Abbal B et al. Subparaneural Versus Circumferential Extraneural Injection at the Bifurcation Level in Ultrasound-Guided Popliteal Sciatic Nerve Blocks: A Prospective, Randomized, Double-Blind Study. Reg Anesth Pain Med. 2014 Jul 1;39(4):306-11.
  Daniel Jolley
pearl
1
Perioperative pregabalin may improve postoperative analgesia, nausea and vomiting, though increases sedation and visual disturbances
Mishriky BM, Waldron NH, Habib AS. Impact of pregabalin on acute and persistent postoperative pain: a systematic review and meta-analysis. Br J Anaesth. 2015 Jan 1; 114 (1): 10-31.
  Daniel Jolley
summary
1
This small study of patients having lumbar spinal fusion was unable to show a statistically significant reduction in postoperative opioid consumption in those receiving epidural bupivacaine/opioid versus those receiving a sham epidural.
Choi S, Rampersaud YR, Chan VW et al. The addition of epidural local anesthetic to systemic multimodal analgesia following lumbar spinal fusion: a randomized controlled trial. Can J Anaesth. 2014 Apr 1;61(4):330-9.
  Daniel Jolley
pearl
1
Performing regional anesthetic blocks in children under general anesthesia is as safe as in sedated or awake children.
Taenzer AH, Walker BJ, Bosenberg AT et al. Asleep Versus Awake: Does It Matter?: Pediatric Regional Block Complications by Patient State: A Report From the Pediatric Regional Anesthesia Network. Reg Anesth Pain Med. 2014 Jul 1;39(4):279-83.
  Daniel Jolley
pearl
1
Suggestive techniques may reduce postoperative anxiety and pain, although not analgesic consumption or nausea.
Kekecs Z, Nagy T, Varga K. The Effectiveness of Suggestive Techniques in Reducing Postoperative Side Effects: A Meta-Analysis of Randomized Controlled Trials. Anesth. Analg. 2014 Dec 1;119(6):1407-19.
  Daniel Jolley
summary
1
This small, pilot study suggests that isoflurane may be more commonly associated with post-operative cognitive dysfunction than desflurane in older patients.
Zhang B, Tian M, Zhen Y et al. The effects of isoflurane and desflurane on cognitive function in humans. Anesth. Analg. 2012 Feb 1;114(2):410-5.
  Daniel Jolley
comment
1
The role of suggestibility just never goes away yet seems rarely considered in our hospital processes. Why has nursing as a science ignored this?
Kekecs Z, Nagy T, Varga K. The Effectiveness of Suggestive Techniques in Reducing Postoperative Side Effects: A Meta-Analysis of Randomized Controlled Trials. Anesth. Analg. 2014 Dec 1;119(6):1407-19.
  Allan Palmer
comment
1
All of these non-invasive monitors have inate variability but if you can see past that they do seem to add value to patient care.
Waldron NH, Miller TE, Thacker JK et al. A Prospective Comparison of a Noninvasive Cardiac Output Monitor Versus Esophageal Doppler Monitor for Goal-Directed Fluid Therapy in Colorectal Surgery Patients. Anesth. Analg. 2014 May 1;118(5):966-75.
  Allan Palmer
comment
1
Nice summary, seems like common sense with very useful number needed to harm data, though from personal experience surprising the NNH for itching was lower for Fentanyl than Morpine
Pöpping DM, Elia N, Marret E et al. Opioids added to local anesthetics for single-shot intrathecal anesthesia in patients undergoing minor surgery: a meta-analysis of randomized trials. Pain. 2012 Apr 1;153(4):784-93.
  Allan Palmer