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pearl
1
Available evidence does not support the claim that nitrous oxide affects mortality or cardiovascular morbidity.
Imberger G, Orr A, Thorlund K et al. Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity? A systematic review with meta-analysis and trial sequential analysis. Br J Anaesth. 2014 Mar 1;112(3):410-26.
  Daniel Jolley
comment
1
Interesting to note that not only did the pudendal nerve block group experience better analgesia than the caudal block group, they were also exposed to a much smaller absolute dose of bupivacaine (0.75 mg/kg vs 2.5 mg/kg). This is important not only because of the safety implications, but also because allows extra LA for top-up if the block is inadequate or fails.
Naja ZM, Ziade FM, Kamel R et al. The effectiveness of pudendal nerve block versus caudal block anesthesia for hypospadias in children. Anesth. Analg. 2013 Dec 1;117(6):1401-7.
  Daniel Jolley
pearl
1
Pudendal nerve block provides better analgesia in the first 24 hours for children following hypospadias repair than does caudal block.
Naja ZM, Ziade FM, Kamel R et al. The effectiveness of pudendal nerve block versus caudal block anesthesia for hypospadias in children. Anesth. Analg. 2013 Dec 1;117(6):1401-7.
  Daniel Jolley
pearl
1
Non-invasive haemoglobin monitoring devices show clinically-acceptable, though imperfect, accuracy when compared with laboratory Hb measurement.
Kim SH, Lilot M, Murphy LS et al. Accuracy of Continuous Noninvasive Hemoglobin Monitoring: A Systematic Review and Meta-Analysis. Anesth. Analg. 2014 Aug 1;119(2):332-46.
  Daniel Jolley
pearl
3
Adductor canal block analgesia is comparable to femoral nerve block while improving early (6-8 h) quadriceps strength after total knee arthroplasty.
Kim DH, Lin Y, Goytizolo EA et al. Adductor Canal Block versus Femoral Nerve Block for Total Knee Arthroplasty: A Prospective, Randomized, Controlled Trial. Anesthesiology. 2014 Mar 1;120(3):540-50.
  Daniel Jolley
pearl
1
A single 60 mg/kg IV dose of magnesium sulphate does not impede rocuronium reversal by sugammadex.
Czarnetzki C, Tassonyi E, Lysakowski C et al. Efficacy of Sugammadex for the Reversal of Moderate and Deep Rocuronium-induced Neuromuscular Block in Patients Pretreated with Intravenous Magnesium: A Randomized Controlled Trial. Anesthesiology. 2014 Jul 1;121(1):59-67.
  Daniel Jolley
summary
1
Despite increasing the likelihood of a Cormack-Lehane grade 1 view, pooled results from the studies showed no difference between the Pentax Airway Scope and standard Macintosh laryngoscope for:
• Rate of intubation on first attempt.
• Time for intubation.
• Incidence of oral or pharyngeal injury.
Hoshijima H, Kuratani N, Hirabayashi Y et al. Pentax Airway Scope(®) vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta-analysis. Anaesthesia. 2014 Aug 1;69(8):911-8.
  Daniel Jolley
pearl
1
The Pentax Airway Scope improves laryngeal view compared with the standard Macintosh laryngoscope but does not facilitate intubation.
Hoshijima H, Kuratani N, Hirabayashi Y et al. Pentax Airway Scope(®) vs Macintosh laryngoscope for tracheal intubation in adult patients: a systematic review and meta-analysis. Anaesthesia. 2014 Aug 1;69(8):911-8.
  Daniel Jolley
summary
1
Real-time ultrasound guidance of central line insertion dramatically reduces the incidence of procedural failure (RR 0.18), arterial puncture (RR 0.25), haematoma (RR 0.30), pneumothorax (RR 0.21), and haemothorax (RR 0.10). Studies specifically investigating children and infants were however too small to make significant conclusions.
Wu SY, Ling Q, Cao LH et al. Real-time two-dimensional ultrasound guidance for central venous cannulation: a meta-analysis. Anesthesiology. 2013 Feb 1;118(2):361-75.
  Daniel Jolley
pearl
1
Real-time ultrasound guidance for central line insertion significantly reduces complications and adverse events.
Wu SY, Ling Q, Cao LH et al. Real-time two-dimensional ultrasound guidance for central venous cannulation: a meta-analysis. Anesthesiology. 2013 Feb 1;118(2):361-75.
  Daniel Jolley