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pearl
1
High-inspired 80% FiO₂ shows no safety compromise when compared with standard 30-35% FiO₂ among surgical patients.
Mattishent K, Thavarajah M, Sinha A et al. Safety of 80% vs 30-35% fraction of inspired oxygen in patients undergoing surgery: a systematic review and meta-analysis. Br J Anaesth. 2019 Mar 1; 122 (3): 311-324.
  Daniel Jolley
pearl
1
Left-lateral tilt has no effect on neonatal acid-base status when maternal blood pressure is maintained with crystalloid coload & phenylephrine infusion during elective cesarean delivery.
Lee AJ, Landau R, Mattingly JL et al. Left Lateral Table Tilt for Elective Cesarean Delivery under Spinal Anesthesia Has No Effect on Neonatal Acid-Base Status: A Randomized Controlled Trial. Anesthesiology. 2017 Aug 1; 127 (2): 241-249.
  Daniel Jolley
pearl
1
Phenylephrine & noradrenaline show similar incidence of bradycardia when used for postspinal hypotension prophylaxis during Caesarean section.
Mohta M, Garg A, Chilkoti GT et al. A randomised controlled trial of phenylephrine and noradrenaline boluses for treatment of postspinal hypotension during elective caesarean section. Anaesthesia. 2019 Jul 1; 74 (7): 850-855.
  Daniel Jolley
pearl
1
Preeclampsia diagnostic technologies continue to advance. Peripartum care is improved with multidisciplinary teams, specialist anaesthesia care and the availability of critical care support.
Russell R. Preeclampsia and the anaesthesiologist: current management. Curr Opin Anaesthesiol. 2020 Jun 1; 33 (3): 305-310.
  Daniel Jolley
pearl
1
Closed-loop goal-directed fluid therapy with colloids is associated with lower volume infused and fewer postoperative complications than with crystalloids.
Joosten A, Delaporte A, Ickx B et al. Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery. Anesthesiology. 2018 Jan 1; 128 (1): 55-66.
  Daniel Jolley
pearl
1
Perineural dexamethasone prolongs interscalene block in a dose-dependent way between doses of 1 to 4 mg.
Albrecht E, Reynvoet M, Fournier N et al. Dose-response relationship of perineural dexamethasone for interscalene brachial plexus block: a randomised, controlled, triple-blind trial. Anaesthesia. 2019 Aug 1; 74 (8): 1001-1008.
  Daniel Jolley
pearl
1
Peri-operative hyperbaric oxygen therapy is associated with a range of outcome improvements, including various surgical-recovery and peri-operative indices.
Boet S, Martin L, Cheng-Boivin O et al. Can preventive hyperbaric oxygen therapy optimise surgical outcome?: A systematic review of randomised controlled trials. Eur J Anaesthesiol. 2020 Aug 1; 37 (8): 636-648.
  Daniel Jolley
pearl
1
Spinal anaesthesia for Caesarean section in patients with COVID can be provided safely, although anaesthetists are at risk of infection, significantly reduced by use of Level 3 PPE (PAPR + protective suit).
Zhong Q, Liu YY, Luo Q et al. Spinal anaesthesia for patients with coronavirus disease 2019 and possible transmission rates in anaesthetists: retrospective, single-centre, observational cohort study. Br J Anaesth. 2020 Jun 1; 124 (6): 670-675.
  Daniel Jolley
pearl
1
The Clinical Frailty Scale is the most feasible frailty measure and has the strongest association with mortality and non-favourable discharge.
Aucoin SD, Hao M, Sohi R et al. Accuracy and Feasibility of Clinically Applied Frailty Instruments before Surgery: A Systematic Review and Meta-analysis. Anesthesiology. 2020 Jul 1; 133 (1): 78-95.
  Daniel Jolley
pearl
1
Finger-cuff derived blood pressure & CO/CI measurement shows some accuracy when compared with invasive methods, however too much heterogeneity exists among studies for it to be reliably interchangeable.
Saugel B, Hoppe P, Nicklas JY et al. Continuous noninvasive pulse wave analysis using finger cuff technologies for arterial blood pressure and cardiac output monitoring in perioperative and intensive care medicine: a systematic review and meta-analysis. Br J Anaesth. 2020 Jul 1; 125 (1): 25-37.
  Daniel Jolley