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pearl
1
At nadir haemoglobin above 90 g/L in-hospital, 30-day and 1-year mortality is higher with transfusion.
Trentino KM, Leahy MF, Sanfilippo FM et al. Associations of nadir haemoglobin level and red blood cell transfusion with mortality and length of stay in surgical specialties: a retrospective cohort study. Anaesthesia. 2019 Jun 1; 74 (6): 726-734.
  Daniel Jolley
pearl
1
The systemic antinociceptive effects of lidocaine occur by mechanisms other than sodium channel blockade, including silencing of ectopic discharges, inflammatory suppression, and neurotransmission modulation.
Hermanns H, Hollmann MW, Stevens MF et al. Molecular mechanisms of action of systemic lidocaine in acute and chronic pain: a narrative review. Br J Anaesth. 2019 Sep 1; 123 (3): 335-349.
  Daniel Jolley
pearl
1
Perioperative dexamethasone does not appear to increase postoperative wound infection risk, although is associated with mild BSL increase among non-diabetics.
Polderman J A W JAW Department of Anaesthesiology, Amsterdam University Medical Centre, Amsterdam, the Netherlands., Farhang-Razi V, van S et al. Adverse side-effects of dexamethasone in surgical patients - an abridged Cochrane systematic review. Anaesthesia. 2019 Jul 1; 74 (7): 929-939.
  Daniel Jolley
pearl
1
Severe acute pain in orthopaedic trauma patients is more common among female patients and those having had previous injury-related surgery, and preoperative pain severity is associated with persistent pain at 3 months.
Edgley C, Hogg M, De A et al. Severe acute pain and persistent post-surgical pain in orthopaedic trauma patients: a cohort study. Br J Anaesth. 2019 Sep 1; 123 (3): 350-359.
  Daniel Jolley
comment
1
File this under:
It is more important who is behind the syringe than what is in the syringe.
Hayes JA, Aljuhani T, De K et al. Safety and Efficacy of the Combination of Propofol and Ketamine for Procedural Sedation/Anesthesia in the Pediatric Population: A Systematic Review and Meta-analysis. Anesth. Analg. 2021 Apr 1; 132 (4): 979992979-992.
  Daniel Jolley
pearl
1
Propofol and ketamine are acceptable either alone or in combination for pediatric procedural sedation.
Hayes JA, Aljuhani T, De K et al. Safety and Efficacy of the Combination of Propofol and Ketamine for Procedural Sedation/Anesthesia in the Pediatric Population: A Systematic Review and Meta-analysis. Anesth. Analg. 2021 Apr 1; 132 (4): 979992979-992.
  Daniel Jolley
pearl
0
Intubation in microgravity by novices was more successful using videolaryngoscopy than direct laryngoscopy.
Starck C, Thierry S, Bernard CI et al. Tracheal intubation in microgravity: a simulation study comparing direct laryngoscopy and videolaryngoscopy†. Br J Anaesth. 2020 Jul 1; 125 (1): e47-e53.
  Daniel Jolley
pearl
1
Goal-directed fluid therapy offered no benefit over standard therapy in patients undergoing open radical cystectomy, although was associated with a higher incidence of acute kidney injury.
Arslan-Carlon V, Tan KS, Dalbagni G et al. Goal-directed versus Standard Fluid Therapy to Decrease Ileus after Open Radical Cystectomy: A Prospective Randomized Controlled Trial. Anesthesiology. 2020 Aug 1; 133 (2): 293-303.
  Daniel Jolley
pearl
1
Among infants & children < 3y having prone general anaesthesia, regular hourly alveolar recruitment reduces pre-extubation atelectasis.
Jang YE, Ji SH, Kim EH et al. Effect of regular alveolar recruitment on intraoperative atelectasis in paediatric patients ventilated in the prone position: a randomised controlled trial. Br J Anaesth. 2020 May 1; 124 (5): 648-655.
  Daniel Jolley
comment
1
More on the Clinical Frailty Score at the NHS' Specialised Clinical Frailty Network.

McIsaac DI, Harris EP, Hladkowicz E et al. Prospective Comparison of Preoperative Predictive Performance Between 3 Leading Frailty Instruments. Anesth. Analg. 2020 Jul 1; 131 (1): 263-272.
  Daniel Jolley