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summary
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An exploration of the growth and evolution of Office Based Anesthesia in North America, including safety and regulatory concerns. The authors note that although recent data somewhat supports the safety of OBA, this is based upon lesser-quality retrospective studies.
Shapiro FE, Punwani N, Rosenberg NM et al. Office-based anesthesia: safety and outcomes. Anesth. Analg. 2014 Aug 1;119(2):276-85.
  Daniel Jolley
pearl
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The Ambu AuraOnce™ laryngeal mask is a non-inferior alternative to the LMA Classic and the LMA Unique.
Baidya DK, Chandralekha, Darlong V et al. Comparative efficacy and safety of the Ambu(®) AuraOnce(™) laryngeal mask airway during general anaesthesia in adults: a systematic review and meta-analysis. Anaesthesia. 2014 Sep 1;69(9):1023-32.
  Daniel Jolley
pearl
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Use of an electronic decision support tool increases adherence to peri-operative ACC/AHA guidelines among anesthesia residents.
Hand WR, Bridges KH, Stiegler MP et al. Effect of a Cognitive Aid on Adherence to Perioperative Assessment and Management Guidelines for the Cardiac Evaluation of Noncardiac Surgical Patients. Anesthesiology. 2014 Jun 1; 120 (6): 1339-49, quiz 1349-53.
  Daniel Jolley
summary
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Low average volatile concentration shows some association with post-operative delirium in a sub-study analysis of cardiothoracic patients admitted post-operatively to ICU, although clinical implications are unclear. Use of BIS was not statistically significantly associated with a lower incidence of delirium, although there was a trend to lower incidence.
Whitlock EL, Torres BA, Lin N et al. Postoperative Delirium in a Substudy of Cardiothoracic Surgical Patients in the BAG-RECALL Clinical Trial. Anesth. Analg. 2014 Apr 1;118(4):809-17.
  Daniel Jolley
summary
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Although general anaesthesia was associated with greater blood loss than regional anaesthesia in this meta-analysis (only ~100 mL), this is of questionable significance, and meta-analysis of RCTs showed there was no greater risk of blood transfusion.
Heesen M, Hofmann T, Klöhr S et al. Is general anaesthesia for caesarean section associated with postpartum haemorrhage? Systematic review and meta-analysis. Acta Anaesthesiol Scand. 2013 Oct 1;57(9):1092-102.
  Daniel Jolley
comment
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Of course the issue here is whether occlusion of the oesophageal entrance sufficient to prevent antegrade passage of a flexible silicon tube is a valid surrogate for the ability to prevent retrograde passage of liquid (ie. gastric fluid). There is a significant difference here and I feel this research adds little to the debate regarding benefit (or not) of cricoid pressure.
Zeidan AM, Salem MR, Mazoit JX et al. The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth. Analg. 2014 Mar 1; 118 (3): 580-6.
  Daniel Jolley
summary
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Cricoid pressure of 30N prevented the passage of both small and large gastric tubes into the oesophageal entrance, which the authors believe supports the utility of cricoid pressure in successfully occluding the oesophagus.
Zeidan AM, Salem MR, Mazoit JX et al. The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth. Analg. 2014 Mar 1; 118 (3): 580-6.
  Daniel Jolley
summary
1
This meta-analysis included 13 studies and demonstrates that ketamine added to caudal local anaesthesia prolongs analgesia in children with minimal adverse effects, though highlights that the potential neurotoxicity of ketamine has not yet been conclusively addressed.
Schnabel A, Poepping DM, Kranke P et al. Efficacy and adverse effects of ketamine as an additive for paediatric caudal anaesthesia: a quantitative systematic review of randomized controlled trials. Br J Anaesth. 2011 Oct 1; 107 (4): 601-11.
  Daniel Jolley
pearl
1
Prophylactic phenylephrine infusion reduces the incidence of hypotension, nausea and vomiting in women undergoing caesarean section under spinal.
Heesen M, Kölhr S, Rossaint R et al. Prophylactic phenylephrine for caesarean section under spinal anaesthesia: systematic review and meta-analysis. Anaesthesia. 2014 Feb 1; 69 (2): 143-65.
  Daniel Jolley
pearl
2
Intraoperative clonidine or dexmedetomidine significantly reduce emergence delirium in children after general anaesthesia (OR 0.28)
Pickard A, Davies P, Birnie K et al. Systematic review and meta-analysis of the effect of intraoperative α2-adrenergic agonists on postoperative behaviour in children. Br J Anaesth. 2014 Jun 1;112(6):982-90.
  Daniel Jolley