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1
Intermittent epidural bolus when compared with continuous epidural infusion for labour analgesia results in slightly reduced local anaesthetic use and a small improvement in maternal satisfaction. Caesarean section and instrumental delivery rates were not significantly statistically different.
George RB, Allen TK, Habib AS. Intermittent epidural bolus compared with continuous epidural infusions for labor analgesia: a systematic review and meta-analysis. Anesth. Analg. 2013 Jan 1; 116 (1): 133-44.
  Daniel Jolley
pearl
2
The use of a cognitive aid improves the performance of non-technical skills during simulated 'can't intubate, can't oxygenate' crisis.
Marshall SD Mehra R. The effects of a displayed cognitive aid on non-technical skills in a simulated 'can't intubate, can't oxygenate' crisis. Anaesthesia. 2014 Jul 1;69(7):669-77.
  Daniel Jolley
pearl
2
Quadriceps strength is better preserved after adductor canal block for total knee arthroplasty than femoral nerve block with similar analgesic effect.
Jæger P, Zaric D, Fomsgaard JS et al. Adductor Canal Block Versus Femoral Nerve Block for Analgesia After Total Knee Arthroplasty: A Randomized, Double-blind Study. Reg Anesth Pain Med. 2013 Nov 1; 38 (6): 526-32.
  Daniel Jolley
pearl
1
Cyclosporine administered at the time of cardiac reperfusion may reduce reperfusion injury from CPB, although with uncertain clinical benefit.
Chiari P, Angoulvant D, Mewton N et al. Cyclosporine Protects the Heart during Aortic Valve Surgery. Anesthesiology. 2014 Aug 1;121(2):232-8.
  Daniel Jolley
pearl
1
Desflurane and sevoflurane anaesthesia may be associated with reduced mortality after cardiac surgery compared with total intravenous anaesthesia.
Landoni G, Greco T, Biondi-Zoccai G et al. Anaesthetic drugs and survival: a Bayesian network meta-analysis of randomized trials in cardiac surgery. Br J Anaesth. 2013 Dec 1;111(6):886-96.
  Daniel Jolley
pearl
1
Lidocaine with epinephrine is the most optimal solution for epidural top-up for emergency caesarean section. Adding fentanyl further speeds onset.
Hillyard SG, Bate TE, Corcoran TB et al. Extending epidural analgesia for emergency Caesarean section: a meta-analysis. Br J Anaesth. 2011 Nov 1;107(5):668-78.
  Daniel Jolley
pearl
1
Posterior transversus abdominis plane block continues to reduce pain scores and opioid consumption at up to 48 hours, though with lesser magnitude.
Abdallah FW, Laffey JG, Halpern SH et al. Duration of analgesic effectiveness after the posterior and lateral transversus abdominis plane block techniques for transverse lower abdominal incisions: a meta-analysis. Br J Anaesth. 2013 Nov 1; 111 (5): 721-35.
  Daniel Jolley
pearl
1
Peri-operative systemic magnesium reduces postoperative pain and opioid consumption, although it is of uncertain clinical significance.
De GS, Castro-Alves LJ, Khan JH et al. Perioperative systemic magnesium to minimize postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2013 Jul 1;119(1):178-90.
  Daniel Jolley
pearl
1
The Proseal LMA achieves higher oropharyngeal leak pressure and tidal volumes than does the LMA Supreme during elective laparoscopic cholecsystectomy.
Beleña JM, Núñez M, Anta D et al. Comparison of Laryngeal Mask Airway Supreme and Laryngeal Mask Airway Proseal with respect to oropharyngeal leak pressure during laparoscopic cholecystectomy: a randomised controlled trial. Eur J Anaesthesiol. 2013 Mar 1;30(3):119-23.
  Daniel Jolley
comment
0
Related confirming the safety of nitrous oxide:
• Myles et al. ENIGMA-II trial (Lancet 2014): The safety of addition of nitrous oxide to general anaesthesia in at-risk patients having major non-cardiac surgery (ENIGMA-II)
• Møller et al. (BJA 2014): Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity?
Peyton PJ Wu CY. Nitrous Oxide-related Postoperative Nausea and Vomiting Depends on Duration of Exposure. Anesthesiology. 2014 May 1;120(5):1137-45.
  Daniel Jolley