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pearl
1
Midazolam 0.03 mg/kg IV given to children pre-emergence reduces delirium without a clinically significant delay in emergence.
Cho EJ, Yoon SZ, Cho JE et al. Comparison of the Effects of 0.03 and 0.05 mg/kg Midazolam with Placebo on Prevention of Emergence Agitation in Children Having Strabismus Surgery. Anesthesiology. 2014 Jun 1;120(6):1354-61.
  Daniel Jolley
comment
0
Although this Cochrane review supports the belief that epidural and paravertebral blocks may reduce persistent-surgical pain after thoracotomy or breast cancer surgery respectively, the authors highlight the low total number of subjects (only 339 patients) in the five trials analysed. This is enough evidence to consider the PSP-benefits of regional anesthesia, but far from enough to be conclusive or change practice.
Andreae MH Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013 Nov 1; 111 (5): 711-20.
  Daniel Jolley
pearl
1
Epidural anesthesia may reduce post-thoracotomy chronic pain (OR 0.33) and paravertebral block reduce that following breast ca surgery (OR 0.37).
Andreae MH Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013 Nov 1; 111 (5): 711-20.
  Daniel Jolley
pearl
1
Maternal asthma control may be improved by multidisciplinary care, education and asthma monitoring.
Lim AS, Stewart K, Abramson MJ et al. Multidisciplinary Approach to Management of Maternal Asthma (MAMMA): A Randomized Controlled Trial. Chest. 2014 May 1;145(5):1046-54.
  Daniel Jolley
pearl
3
Greater depth of anaesthesia may be associated with a higher incidence of wound infection, mortality and composite risk of complications.
Short TG, Leslie K, Campbell D et al. A pilot study for a prospective, randomized, double-blind trial of the influence of anesthetic depth on long-term outcome. Anesth. Analg. 2014 May 1;118(5):981-6.
  Daniel Jolley
pearl
1
Videolaryngoscopic view using the C-MAC is improved when the anesthesia assistant applying cricoid pressure also has access to see the C-MAC screen.
Loughnan TE, Gunasekera E, Tan TP. Improving the C-MAC video laryngoscopic view when applying cricoid pressure by allowing access of assistant to the video screen. Anaesth Intensive Care. 2012 Jan 1;40(1):128-30.
  Daniel Jolley
pearl
1
Ultrasound-guided supraclavicular block has faster onset when a targeted intracluster-injection technique is used compared with double injection.
Techasuk W, González AP, Bernucci F et al. A randomized comparison between double-injection and targeted intracluster-injection ultrasound-guided supraclavicular brachial plexus block. Anesth. Analg. 2014 Jun 1;118(6):1363-9.
  Daniel Jolley
summary
1
Tatsioni found that earlier disproven observational studies were still positively cited in 50% or more of peer reviewed publications, despite the existence of well-established contrary evidence.
Tatsioni A, Bonitsis NG, Ioannidis JP. Persistence of contradicted claims in the literature. JAMA. 2007 Dec 5;298(21):2517-26.
  Daniel Jolley
summary
1
To explore the future contradiction of highly-cited research Ioannidis investigated just under 50 of the most significant and highly regarded medical research findings from 1990 to 2003. Of 45 that concluded their interventions were effective, 34 had had their hypothesis retested. Of these 34, over 40% (14) were subsequently shown to be incorrect or exaggerated. Forty percent of some of the most highly regarded, practice-changing medical evidence from the 20th century subsequently disproven!
Ioannidis JP. Contradicted and initially stronger effects in highly cited clinical research. JAMA. 2005 Jul 13;294(2):218-28.
  Daniel Jolley
summary
1
Ioannidis demonstrated that 80% of non-randomized studies were wrong, and among randomized controlled studies 25% were incorrect. Even large, multicenter, randomized clinical trials were predictably wrong in 10% of studies.
Ioannidis JP. Why most published research findings are false. PLoS Med. 2005 Aug 1; 2 (8): e124e124.
  Daniel Jolley