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pearl
1
For cesarean section under spinal, addition of intrathecal fentanyl to bupivacaine, with or without morphine, may improve intraop & immediate postop analgesia, but increases pruritis incidence.
Uppal V, Retter S, Casey M et al. Efficacy of Intrathecal Fentanyl for Cesarean Delivery: A Systematic Review and Meta-analysis of Randomized Controlled Trials With Trial Sequential Analysis. Anesth. Analg. 2020 Jan 1; 130 (1): 111-125.
  Daniel Jolley
pearl
1
Survival after out-of-hospital cardiac arrest has improved globally over the last four decades.
Yan S, Gan Y, Jiang N et al. The global survival rate among adult out-of-hospital cardiac arrest patients who received cardiopulmonary resuscitation: a systematic review and meta-analysis. Crit Care. 2020 Feb 22; 24 (1): 61.
  Daniel Jolley
pearl
1
Atelectasis during general anaesthesia increases with age up to 50 years and BMI up to 30 kg/m^2, but appears curiously limited beyond this.
Hedenstierna G, Tokics L, Reinius H et al. Higher age and obesity limit atelectasis formation during anaesthesia: an analysis of computed tomography data in 243 subjects. Br J Anaesth. 2020 Mar 1; 124 (3): 336-344.
  Daniel Jolley
pearl
1
It is still uncertain whether intraoperative PEEP actually reduces postoperative respiratory complications.
Zhang P, Wu L, Shi X et al. Positive End-Expiratory Pressure During Anesthesia for Prevention of Postoperative Pulmonary Complications: A Meta-analysis With Trial Sequential Analysis of Randomized Controlled Trials. Anesth. Analg. 2020 Apr 1; 130 (4): 879-889.
  Daniel Jolley
pearl
1
There is an association between after-hours surgery and mortality risk that is not entirely explained by the emergent and morbidity characteristics of patients or the surgical procedure.
Cortegiani A, Ippolito M, Misseri G et al. Association between night/after-hours surgery and mortality: a systematic review and meta-analysis. Br J Anaesth. 2020 May 1; 124 (5): 623-637.
  Daniel Jolley
pearl
1
Perioperative administration of vasopressors in patients having major abdominal surgery may reduce complications and length of stay.
Deng C, Bellomo R, Myles P. Systematic review and meta-analysis of the perioperative use of vasoactive drugs on postoperative outcomes after major abdominal surgery. Br J Anaesth. 2020 May 1; 124 (5): 513-524.
  Daniel Jolley
pearl
1
Although feasible, non-surgical antibiotic treatment of uncomplicated acute appendicitis is associated with both a lower treatment success rate and higher complication rate than primary surgical appendicectomy.
Podda M, Gerardi C, Cillara N et al. Antibiotic Treatment and Appendectomy for Uncomplicated Acute Appendicitis in Adults and Children: A Systematic Review and Meta-analysis. Ann. Surg. 2019 Dec 1; 270 (6): 1028-1040.
  Daniel Jolley
pearl
1
Corticosteroids may reduce length of ICU stay in patients with septic shock.
Wen Y, Zhu Y, Jiang Q et al. The Effectiveness and Safety of Corticosteroids Therapy in Adult Critical Ill Patients With Septic Shock: A Meta-Analysis of Randomized Controlled Trials. Shock. 2019 Aug 1; 52 (2): 198-207.
  Daniel Jolley
pearl
1
Corticosteroids may reduce 28 day mortality in patients with severe sepsis or septic shock.
Ni YN, Liu YM, Wang YW et al. Can corticosteroids reduce the mortality of patients with severe sepsis? A systematic review and meta-analysis. Am J Emerg Med. 2019 Sep 1; 37 (9): 1657-1664.
  Daniel Jolley
pearl
1
Point-of-care ultrasound performed by emergency physicians to diagnose intussusception has a diagnostic accuracy equivalent to radiology-performed ultrasound.
Tsou PY, Wang YH, Ma YK et al. Accuracy of point-of-care ultrasound and radiology-performed ultrasound for intussusception: A systematic review and meta-analysis. Am J Emerg Med. 2019 Sep 1; 37 (9): 1760-1769.
  Daniel Jolley