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pearl
1
Corticosteroids may reduce 28 day mortality in patients with severe sepsis or septic shock.
Ni YN, Liu YM, Wang YW et al. Can corticosteroids reduce the mortality of patients with severe sepsis? A systematic review and meta-analysis. Am J Emerg Med. 2019 Sep 1; 37 (9): 1657-1664.
  Daniel Jolley
pearl
1
Point-of-care ultrasound performed by emergency physicians to diagnose intussusception has a diagnostic accuracy equivalent to radiology-performed ultrasound.
Tsou PY, Wang YH, Ma YK et al. Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis. Am J Emerg Med. 2019 Sep 1; 37 (9): 1760-1769.
  Daniel Jolley
pearl
1
Intravenous resuscitation with balanced crystalloid fluids does not reduce mortality or kidney injury compared with normal saline in critically ill patients.
Liu C, Lu G, Wang D et al. Balanced crystalloids versus normal saline for fluid resuscitation in critically ill patients: A systematic review and meta-analysis with trial sequential analysis. Am J Emerg Med. 2019 Nov 1; 37 (11): 2072-2078.
  Daniel Jolley
pearl
1
Suprascapular block may be an acceptable and safer alternative to interscalene block for analgesia after shoulder surgery.
Hussain N, Goldar G, Ragina N et al. Suprascapular and Interscalene Nerve Block for Shoulder Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2017 Dec 1; 127 (6): 998-1013.
  Daniel Jolley
pearl
1
Use of processed-EEG monitoring to guide anaesthesia depth is associated with a 38% odds reduction of developing postoperative delirium.
MacKenzie KK, Britt-Spells AM, Sands LP et al. Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis. Anesthesiology. 2018 Sep 1; 129 (3): 417-427.
  Daniel Jolley
pearl
0
Up to 20% of patients ≥ 65 years experience post-operative delirium after major surgery.
MacKenzie KK, Britt-Spells AM, Sands LP et al. Processed Electroencephalogram Monitoring and Postoperative Delirium: A Systematic Review and Meta-analysis. Anesthesiology. 2018 Sep 1; 129 (3): 417-427.
  Daniel Jolley
pearl
1
Major adverse cardiac events and death after electroconvulsive therapy are infrequent and occur in about 1 of 50 patients and after about 1 of 200 to 500 electroconvulsive therapy treatments.
Duma A, Maleczek M, Panjikaran B et al. Major Adverse Cardiac Events and Mortality Associated with Electroconvulsive Therapy: A Systematic Review and Meta-analysis. Anesthesiology. 2019 Jan 1; 130 (1): 83-91.
  Daniel Jolley
pearl
1
The pectoralis-II myofascial block for breast cancer surgery is a safe and effective alternative to the paravertebral block, demonstrating non-inferiority for 24 hour pain and analgesia need.
Hussain N, Brull R, McCartney Colin J L CJL et al. Pectoralis-II Myofascial Block and Analgesia in Breast Cancer Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2019 Sep 1; 131 (3): 630-648.
  Daniel Jolley
pearl
1
When using supraglottic airways for laparoscopic surgery, the Ambu AuraGain® offers the highest oropharyngeal leak pressure before pneumoperitoneum, and the i-gel® the highest after pneumonperitoneum.
Yoon SW, Kang H, Choi GJ et al. Comparison of supraglottic airway devices in laparoscopic surgeries: A network meta-analysis. J Clin Anesth. 2019 Aug 1; 55: 52-66.
  Daniel Jolley
pearl
1
The combined spinal-epidural offers faster-onset and superior labour analgesia.
Guasch E, Brogly N, Gilsanz F. Combined spinal epidural for labour analgesia and caesarean section: indications and recommendations. Curr Opin Anaesthesiol. 2020 Jun 1; 33 (3): 284-290.
  Daniel Jolley