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pearl
1
Sevoflurane post-conditioning improves survival in rats after subarachnoid haemorrhage.
Morax L, Beck-Schimmer B, Neff J et al. Sevoflurane Postconditioning Protects From an Early Neurological Deficit After Subarachnoid Hemorrhage: Results of a Randomized Laboratory Study in Rats. Anesth. Analg. 2024 Nov 1; 139 (5): 107510851075-1085.
  Daniel Jolley
pearl
1
Anaesthetic machine End-Tidal Control of ET-agent & ET-oxygen concentrations achieves and maintains desired targets at least as well as manual control.
McCabe MD, Dear GL, Klopman MA et al. End-Tidal Control Versus Manual Control of Inhalational Anesthesia Delivery: A Randomized Controlled Noninferiority Trial. Anesth. Analg. 2024 Oct 1; 139 (4): 812820812-820.
  Daniel Jolley
pearl
1
Higher inspired oxygen fraction during one-lung ventilation is not independently associated with postoperative pulmonary complications.
Douville NJ, Smolkin ME, Naik BI et al. Association between inspired oxygen fraction and development of postoperative pulmonary complications in thoracic surgery: a multicentre retrospective cohort study. Br J Anaesth. 2024 Nov 1; 133 (5): 107310841073-1084.
  Daniel Jolley
pearl
1
Frailty is associated with patient surgical-regret at 1 year post-op among older patients, particularly for non-orthopaedic surgery.
Agung Y, Hladkowicz E, Boland L et al. Frailty and decisional regret after elective noncardiac surgery: a multicentre prospective cohort study. Br J Anaesth. 2024 Nov 1; 133 (5): 965972965-972.
  Daniel Jolley
pearl
1
Intrathecal morphine has a dose-dependent effect to increase post-operative nausea, vomiting, pruritus and urinary retention.
Renard Y, El-Boghdadly K, Rossel JB et al. Non-pulmonary complications of intrathecal morphine administration: a systematic review and meta-analysis with meta-regression. Br J Anaesth. 2024 Oct 1; 133 (4): 823838823-838.
  Daniel Jolley
pearl
1
While controlled intraoperative hypotension significantly reduces blood loss, existing trials are not adequately powered to investigate safety, particularly myocardial and renal injury.
Dauterman L, Khan N, Tebbe C et al. Efficacy and safety of intraoperative controlled hypotension: a systematic review and meta-analysis of randomised trials. Br J Anaesth. 2024 Nov 1; 133 (5): 940954940-954.
  Daniel Jolley
comment
1
Rather than the authors' conclusion that "intrathecal hyperbaric ropivacaine dose requirements for scheduled cesarean delivery were not different between patients with twins and singletons", despite the lack of statistical significance between the ED50 & ED90 doses for singletons and twins, there's a clear trend for twins requiring lower IT doses – suggesting that this small study (n=75) was underpowered instead of showing a lack of difference.
Zhu M, Liu JJ, Shen YP et al. Comparative dose-response study of intrathecal hyperbaric ropivacaine for cesarean delivery in preterm singleton versus twin pregnancies. Reg Anesth Pain Med. 2024 Oct 8; 49 (10): 764769764-769.
  Daniel Jolley
pearl
1
The use of volatile anaesthetic agents has a negligible impact on climate change, instead being dominated by our ability to reduce carbon dioxide emissions.
Slingo JM Slingo ME. The science of climate change and the effect of anaesthetic gas emissions. Anaesthesia. 2024 Mar 1; 79 (3): 252260252-260.
  Daniel Jolley
pearl
1
Because it takes at least a year for emitted greenhouse gases to be mixed throughout the troposphere, only desflurane (lifetime 14 years) has even the potential to be fully radioactively effective, compared with isoflurane (1.4 years) & sevoflurane (3.5 years).
Slingo JM Slingo ME. The science of climate change and the effect of anaesthetic gas emissions. Anaesthesia. 2024 Mar 1; 79 (3): 252260252-260.
  Daniel Jolley
pearl
1
Second-generation supraglottic airway devices have a role in selected patients undergoing general anaesthesia for cesarean section.
Sanganee U, Jansen K, Lucas N et al. The role of supraglottic airway devices for caesarean section under general anaesthesia. A scoping literature review with a proposed algorithm for the appropriate use of supraglottic airway devices for caesarean sections. Eur J Anaesthesiol. 2024 Sep 1; 41 (9): 668676668-676.
  Daniel Jolley