Article Notes

• Hide
  • Pearls
  • Summaries
  • Comments

pearl
1
There is limited evidence supporting superiority between plain or hyperbaric spinal bupivacaine for spinal cesarean section.
Heng SiaAlex TiongATFrom the Duke-NUS Graduate Medical School, Singapore, Singapore; Medical Board, Obstetrics Gynaecology, Women's Anaesthesia, KK Women's Children's Hospital, Singapore, Singapore; Clinical Research Institute, Singapore, , Tan KH, Sng BL et al. Hyperbaric versus plain bupivacaine for spinal anesthesia for cesarean delivery. Anesth. Analg. 2015 Jan 1; 120 (1): 132-140.
  Daniel Jolley
pearl
1
Fentanyl-only epidural infusion shows no benefit over fentanyl/bupiv in respect to duration of labor, motor block, delivery, analgesia, or outcomes.
Craig MG, Grant EN, Tao W et al. A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor. Anesthesiology. 2015 Jan 1; 122 (1): 172-7.
  Daniel Jolley
summary
1
The researchers found that in a cohort of 198 patients admitted to ICU after major abdominal cancer surgery, those subjected to a liberal blood transfusion threshold of < 9 g/dL experienced fewer major complications (NNT 6.2) than those subjected to a restrictive transfusion threshold (< 7 g/dL).
Pinheiro J, Vincent JL, Galas FR et al. Transfusion Requirements in Surgical Oncology Patients: A Prospective, Randomized Controlled Trial. Anesthesiology. 2015 Jan 1;122(1):29-38.
  Daniel Jolley
pearl
1
Opioid sparing is a feasible pragmatic endpoint for pediatric pain analgesic trials.
Kossowsky J, Donado C, Berde CB. Immediate Rescue Designs in Pediatric Analgesic Trials: A Systematic Review and Meta-analysis. Anesthesiology. 2015 Jan 1; 122 (1): 150-171.
  Daniel Jolley
pearl
1
Local infiltration with either 50mL 0.5% or 125mL 0.2% ropivacaine did not improve post-operative pain after elective caesarean section.
Larsen KR, Kristensen BB, Rasmussen MA et al. Effect of high-volume systematic local infiltration analgesia in Caesarean section: a randomised, placebo-controlled trial. Acta Anaesthesiol Scand. 2015 May 1;59(5):632-9.
  Daniel Jolley
summary
1
This prospective matched-cohort study from Thailand found that children experiencing a perioperative respiratory event were subsequently hospitalized twice as long, incurred 30% higher hospital costs, along with 58% higher indirect costs.
Oofuvong M, Geater AF, Chongsuvivatwong V et al. Excess Costs and Length of Hospital Stay Attributable to Perioperative Respiratory Events in Children. Anesth. Analg. 2015 Feb 1;120(2):411-9.
  Daniel Jolley
pearl
2
It is likely that there is an interaction between tramadol and ondansetron that decreases the early-postoperative analgesic efficacy of tramadol.
Stevens AJ, Woodman RJ, Owen H. The effect of ondansetron on the efficacy of postoperative tramadol: a systematic review and meta-analysis of a drug interaction. Anaesthesia. 2015 Feb 1; 70 (2): 209-18.
  Daniel Jolley
summary
1
Small study of data collected more than 15 years ago suggests hemoglobin-based oxygen carrier HBOC-201 may reduce transfusion requirements in a non-cardiac surgery cohort. Although no significant difference in adverse events or mortality, a trend to higher incidence of both among the HBOC-201 group requires a much larger trial to be conducted before any conclusion regarding safety of such a novel therapy can be made.
Van J, Levien LJ, Veeckman L et al. A Safety and Efficacy Evaluation of Hemoglobin-Based Oxygen Carrier HBOC-201 in a Randomized, Multicenter Red Blood Cell-Controlled Trial in Noncardiac Surgery Patients. Anesth. Analg. 2014 Oct 1;119(4):766-76.
  Daniel Jolley
pearl
1
Higher dosing, waiting longer or combining with an opioid improve mivacurium intubating conditions, particularly in older patients.
Vanlinthout LE, Mesfin SH, Hens N et al. A systematic review and meta-regression analysis of mivacurium for tracheal intubation. Anaesthesia. 2014 Dec 1;69(12):1377-87.
  Daniel Jolley
pearl
1
Either proximal or distal sciatic nerve block reduces pain in the first 6 hours after total knee arthroplasty. Distal (popliteal) may be superior.
Abdallah FW, Chan VW, Gandhi R et al. The Analgesic Effects of Proximal, Distal, or No Sciatic Nerve Block on Posterior Knee Pain after Total Knee Arthroplasty: A Double-blind Placebo-controlled Randomized Trial. Anesthesiology. 2014 Dec 1;121(6):1302-10.
  Daniel Jolley