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pearl
1
Inverted grayscale viewing of a PA chest x-ray is less sensitive for pneumothorax detection than conventional digital CXR viewing.
Musalar E, Ekinci S, Ünek O et al. Which is better and useful modality of X-ray for diagnosis of pneumothorax at emergency setting: Conventional or invert-grayscale? Am J Emerg Med. 2017 Sep 1; 35 (9): 1217-1221.
  Daniel Jolley
pearl
1
High-frequency heart rate variability (HRV) may be a useful intraoperative indicator of the balance between nociception and analgesia.
Anderson TA, Segaran JR, Toda C et al. High-Frequency Heart Rate Variability Index: A Prospective, Observational Trial Assessing Utility as a Marker for the Balance Between Analgesia and Nociception Under General Anesthesia. Anesth. Analg. 2020 Apr 1; 130 (4): 1045-1053.
  Daniel Jolley
pearl
1
Spinal ultrasound improves first-pass success for patients with abnormal spinal anatomy undergoing spinal block, although there was no difference in total procedure time.
Park SK, Bae J, Yoo S et al. Ultrasound-Assisted Versus Landmark-Guided Spinal Anesthesia in Patients With Abnormal Spinal Anatomy: A Randomized Controlled Trial. Anesth. Analg. 2020 Mar 1; 130 (3): 787-795.
  Daniel Jolley
pearl
1
Volatile anaesthesia is associated with both lower long-term mortality and less myocardial infarction compared to propofol anaesthesia for cardiac surgery under cardiopulmonary bypass.
Bonanni A, Signori A, Alicino C et al. Volatile Anesthetics versus Propofol for Cardiac Surgery with Cardiopulmonary Bypass: Meta-analysis of Randomized Trials. Anesthesiology. 2020 Jun 1; 132 (6): 1429-1446.
  Daniel Jolley
pearl
1
Rodent models suggest that there are sex-differences in anaesthesia-induced development neurotoxicity.
Cabrera OH, Gulvezan T, Symmes B et al. Sex differences in neurodevelopmental abnormalities caused by early-life anaesthesia exposure: a review. Br J Anaesth. 2020 Mar 1; 124 (3): e81-e91.
  Daniel Jolley
pearl
1
Although there is some statistically significant improvement in very early post-operative physiology for sugammadex vs neostigmine, it is not clinically significant, persistent nor occurs in other recovery domains.
Kim NY, Koh JC, Lee KY et al. Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study. J Clin Anesth. 2019 Nov 1; 57: 97-102.
  Daniel Jolley
summary
0
Figure 2 from the study shows overall recovery and for each domain between neostigmine (N) and sugammadex (S) at each time point (15 min, 40 min and Post-Op Day 1).
A significant difference was observed in physiological recovery at 15  min after surgery, but not for overall recovery or any other domain.

Kim NY, Koh JC, Lee KY et al. Influence of reversal of neuromuscular blockade with sugammadex or neostigmine on postoperative quality of recovery following a single bolus dose of rocuronium: A prospective, randomized, double-blinded, controlled study. J Clin Anesth. 2019 Nov 1; 57: 97-102.
  Daniel Jolley
pearl
1
For patients with an unstable cervical spine the Optiscope may produce less cervical spine movement than the McGrath videolaryngoscope.
Nam K, Lee Y, Park HP et al. Cervical Spine Motion During Tracheal Intubation Using an Optiscope Versus the McGrath Videolaryngoscope in Patients With Simulated Cervical Immobilization: A Prospective Randomized Crossover Study. Anesth. Analg. 2019 Dec 1; 129 (6): 166616721666-1672.
  Daniel Jolley
pearl
1
Within 30 days of their first COVID intubation, 10% of anaesthetists reported positive COVID infection.
El-Boghdadly K, WongD J NDJNDepartment of Anaesthesia Perioperative Medicine, Guy's St Thomas' NHS Foundation Trust, London, UK., Owen R et al. Risks to healthcare workers following tracheal intubation of patients with COVID-19: a prospective international multicentre cohort study. Anaesthesia. 2020 Nov 1; 75 (11): 1437-1447.
  Daniel Jolley
pearl
1
Direct impact by tear gas cannisters may result in traumatic brain injury, in addition to other chemical, thermal and mechanical trauma.
Alhillo HT, Arnaout MM, Radhi HS et al. Direct head injury caused by a tear gas cartridge. Questions on safety: A case report from Iraq and review of the literature. J Clin Neurosci. 2018 Oct 1; 56: 179-182.
  Daniel Jolley