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pearl
1
High-dose epidural fentanyl does not slow gastric emptying in labouring women compared to low-dose fentanyl.
Fiszer E, Aptekman B, Baar Y et al. The effect of high-dose versus low-dose epidural fentanyl on gastric emptying in nonfasted parturients: A double-blinded randomised controlled trial. Eur J Anaesthesiol. 2022 Jan 1; 39 (1): 505750-57.
  Daniel Jolley
pearl
1
Although reducing excessive anaesthetic depth, closed-loop TIVA did not reduce postoperative neurocognitive complications when compared to manual BIS-guided TIVA.
Mahr N, Bouhake Y, Chopard G et al. Postoperative Neurocognitive Disorders After Closed-Loop Versus Manual Target Controlled-Infusion of Propofol and Remifentanil in Patients Undergoing Elective Major Noncardiac Surgery: The Randomized Controlled Postoperative Cognitive Dysfunction-Electroencephalographic-Guided Anesthetic Administration Trial. Anesth. Analg. 2021 Oct 1; 133 (4): 837-847.
  Daniel Jolley
summary
0
Infratentorial craniotomies require a longer duration of surgery and higher exposure to anesthetic drugs and analgesics, and consequently are associated with higher rates of PONV. The article describes a 3 drug regimen adding scopolamine to the usual combination of dexamethasone and ondansetron.
Uribe AA, Stoicea N, Echeverria-Villalobos M et al. Postoperative Nausea and Vomiting After Craniotomy: An Evidence-based Review of General Considerations, Risk Factors, and Management. J Neurosurg Anesthesiol. 2021 Jul 1; 33 (3): 212220212-220.
  Matthew Smith
pearl
1
Dexmedetomidine does not improve day 3 behaviour among 2-7 year olds after day case surgery.
Lee-Archer PF, von BS, Reade M et al. The effect of dexmedetomidine on postoperative behaviour change in children: a randomised controlled trial. Anaesthesia. 2020 Nov 1; 75 (11): 1461-1468.
  Daniel Jolley
pearl
1
Propofol-based TIVA may be associated with improved overall survival after cancer surgery than volatile anaesthesia.
Chang CY, Wu MY, Chien YJ et al. Anesthesia and Long-Term Oncological Outcomes: A Systematic Review and Meta-analysis. Anesth. Analg. 2021 Mar 1; 132 (3): 623634623-634.
  Daniel Jolley
pearl
1
Epidural analgesia for video-assisted thoracoscopic lung cancer surgery does not improve cancer recurrence or cancer-specific survival.
Xu ZZ, Li HJ, Li MH et al. Epidural Anesthesia-Analgesia and Recurrence-free Survival after Lung Cancer Surgery: A Randomized Trial. Anesthesiology. 2021 Sep 1; 135 (3): 419-432.
  Daniel Jolley
pearl
1
Older patients with low pre-operative cognitive performance may inadvertently be receiving a relative overdose during volatile general anaesthesia.
Gutiérrez RG, Egaña JI, Maldonado FA et al. Association Between Lower Preoperative Cognition With Intraoperative Electroencephalographic Features Consistent With Deep States of Anesthesia in Older Patients: An Observational Cohort Study. Anesth. Analg. 2021 Jul 1; 133 (1): 205214205-214.
  Daniel Jolley
pearl
1
When used for post caesarean section analgesia, both intrathecal hydromorphone (75 mcg) and intrathecal morphine (150 mcg) are equally effective.
Sharpe EE, Molitor RJ, Arendt KW et al. Intrathecal Morphine versus Intrathecal Hydromorphone for Analgesia after Cesarean Delivery: A Randomized Clinical Trial. Anesthesiology. 2020 Jun 1; 132 (6): 138213911382-1391.
  Daniel Jolley
pearl
1
The erector spinae plane block has similar efficacy to paravertebral block for reducing post breast surgery pain, but is inferior to pectoralis nerve block.
Leong RW, ESJ Tan, Wong SN et al. Efficacy of erector spinae plane block for analgesia in breast surgery: a systematic review and meta-analysis. Anaesthesia. 2021 Mar 1; 76 (3): 404-413.
  Daniel Jolley
pearl
1
Preoperative lymphopaenia is associated with increased postoperative mortality and morbidity.
Schroth J, Weber V, Jones TF et al. Preoperative lymphopaenia, mortality, and morbidity after elective surgery: systematic review and meta-analysis. Br J Anaesth. 2021 Jul 1; 127 (1): 324032-40.
  Daniel Jolley