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pearl
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Perioperative lidocaine reduces the incidence of persistent post-surgical pain after breast cancer surgery.
Grigoras A, Lee P, Sattar F et al. Perioperative intravenous lidocaine decreases the incidence of persistent pain after breast surgery. Clin J Pain. 2012 Sep 1;28(7):567-72.
  Daniel Jolley
summary
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Excellent anaesthetists were identified by anaesthesia nurses as being:
1. Organised & focused: structured, responsible, and focused approach to work tasks.
2. Good communicators: clear and informative, briefing of team about the plan before induction.
3. Respectful of complexity: humble to the complexity of anaesthesia, admitting own fallibility.
4. Patient-centred: personal contact with the patient before induction.
5. Good situational awareness: fluent in practical work without losing overview.
6. Calm and clear in critical situations, being able to change to a strong leading style.
Larsson J Holmström IK. How excellent anaesthetists perform in the operating theatre: a qualitative study on non-technical skills. Br J Anaesth. 2013 Jan 1; 110 (1): 115121115-21.
  Daniel Jolley
pearl
1
Non-technical skills are of equal importance to technical anaesthesia skills, but are more challenging to define, measure and acquire.
Larsson J Holmström IK. How excellent anaesthetists perform in the operating theatre: a qualitative study on non-technical skills. Br J Anaesth. 2013 Jan 1; 110 (1): 115121115-21.
  Daniel Jolley
pearl
1
Meta-analysis suggests regional scalp block may reduce post-operative pain after craniotomy, although relies on small, low-quality studies.
Guilfoyle MR, Helmy A, Duane D et al. Regional scalp block for postcraniotomy analgesia: a systematic review and meta-analysis. Anesth. Analg. 2013 May 1; 116 (5): 1093-1102.
  Daniel Jolley
pearl
1
30mg intraperitoneal nebulized ropivacaine significantly reduces pain after laparoscopic cholecystectomy, reducing opioid use and speeding ambulation.
Ingelmo PM, Bucciero M, Somaini M et al. Intraperitoneal nebulization of ropivacaine for pain control after laparoscopic cholecystectomy: a double-blind, randomized, placebo-controlled trial. Br J Anaesth. 2013 May 1;110(5):800-6.
  Daniel Jolley
pearl
1
Implementation of a Surgical Safety Checklist had a positive, though small, impact on the theatre safety culture in a Norwegian university hospital.
Haugen AS, Søfteland E, Eide GE et al. Impact of the World Health Organization's Surgical Safety Checklist on safety culture in the operating theatre: a controlled intervention study. Br J Anaesth. 2013 May 1;110(5):807-15.
  Daniel Jolley
pearl
1
Renal impairment as indicated by low eGFR is associated with early post-operative mortality, particularly following cardiac or vascular surgery.
Mooney JF, Ranasinghe I, Chow CK et al. Preoperative estimates of glomerular filtration rate as predictors of outcome after surgery: a systematic review and meta-analysis. Anesthesiology. 2013 Apr 1;118(4):809-24.
  Daniel Jolley
pearl
1
Nitrous oxide exposure was not associated with 30-day MI, stroke, death or hypotension in an observational analysis of POISE subjects.
Leslie K, Myles P, Devereaux PJ et al. Nitrous oxide and serious morbidity and mortality in the POISE trial. Anesth. Analg. 2013 May 1;116(5):1034-40.
  Daniel Jolley
pearl
1
Severe obesity (BMI > 98th centile) in paediatric tonsillectomy is associated with an increased risk of perioperative respiratory complications.
Gleich SJ, Olson MD, Sprung J et al. Perioperative outcomes of severely obese children undergoing tonsillectomy. Paediatr Anaesth. 2012 Dec 1;22(12):1171-8.
  Daniel Jolley