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Related confirming the safety of nitrous oxide:
• Myles et al. ENIGMA-II trial (Lancet 2014): The safety of addition of nitrous oxide to general anaesthesia in at-risk patients having major non-cardiac surgery (ENIGMA-II)
• Møller et al. (BJA 2014): Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity?
Peyton PJ Wu CY. Nitrous Oxide-related Postoperative Nausea and Vomiting Depends on Duration of Exposure. Anesthesiology. 2014 May 1;120(5):1137-45.
  Daniel Jolley
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A brief review of post-operative delirium and post-operative cognitive decline, the possibility that anaesthesia and surgery may contribute (though for which evidence is observational and low quality), and potential methods for detection, quantification and avoidance.
Strøm C, Rasmussen LS, Sieber FE. Should general anaesthesia be avoided in the elderly? Anaesthesia. 2014 Jan 1; 69 Suppl 1 (Suppl 1): 354435-44.
  Daniel Jolley
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Anaesthesia-related neurotoxicity in the developing brain has been observed in animal models and suggested by observational human trials. Conclusive, quality evidence directing significant practice change is however lacking. Anaesthetists should be aware of the current evidence and future directions of research into this important area.
McCann ME Soriano SG. Perioperative central nervous system injury in neonates. Br J Anaesth. 2012 Dec 1;109 Suppl 1:i60-i67.
  Daniel Jolley
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Four-quadrant transversus abdominis plane block with bilateral posterior TAP catheters for 48 hours provides analgesia equivalent to epidural analgesia in patients having laparoscopic colorectal surgery.
Niraj G, Kelkar A, Hart E et al. Comparison of analgesic efficacy of four-quadrant transversus abdominis plane (TAP) block and continuous posterior TAP analgesia with epidural analgesia in patients undergoing laparoscopic colorectal surgery: an open-label, randomised, non-inferiority trial. Anaesthesia. 2014 Apr 1;69(4):348-55.
  Daniel Jolley
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Studies assessing the efficacy and safety of nitrous oxide analgesia during labour are generally of poor quality making it difficult to make any conclusions about this intervention.
Likis FE, Andrews JC, Collins MR et al. Nitrous oxide for the management of labor pain: a systematic review. Anesth. Analg. 2014 Jan 1; 118 (1): 153-67.
  Daniel Jolley
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The SLIP-2 score (Surgical Lung Injury Prediction) was found to offer acceptable accuracy in predicting the risk of post-operative ARDS in high-risk surgical patients (ROC 0.84).
Kor DJ, Lingineni RK, Gajic O et al. Predicting Risk of Postoperative Lung Injury in High-risk Surgical Patients: A Multicenter Cohort Study. Anesthesiology. 2014 May 1; 120 (5): 1168-81.
  Daniel Jolley
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This small study (N=60) found no significant clinical difference between bolus phenylephrine and phenylephrine infusion when used to maintain maternal blood pressure during caesarean section conducted under spinal anaesthesia.
Doherty A, Ohashi Y, Downey K et al. Phenylephrine infusion versus bolus regimens during cesarean delivery under spinal anesthesia: a double-blind randomized clinical trial to assess hemodynamic changes. Anesth. Analg. 2012 Dec 1;115(6):1343-50.
  Daniel Jolley
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This large, retrospective observational study found that neuraxial anaesthesia was associated with a significantly lower risk of both pneumonia (OR 0.51) and composite systemic infection (OR 0.77) than general anaesthesia in patients undergoing knee arthroplasty.
Liu J, Ma C, Elkassabany N et al. Neuraxial Anesthesia Decreases Postoperative Systemic Infection Risk Compared with General Anesthesia in Knee Arthroplasty. Anesth. Analg. 2013 Oct 1;117(4):1010-6.
  Daniel Jolley
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This analysis is not practice-changing, but instead highlights our continued lack of understanding of the outcome benefit (or not) of neuraxial versus general anaesthesia in high risk patient groups.
Interestingly, it is also a meta-analysis of meta-analyses, demonstrating that there are limits to the answers that re-analysing existing data may provide.
Guay J, Choi PT, Suresh S et al. Neuraxial Anesthesia for the Prevention of Postoperative Mortality and Major Morbidity: An Overview of Cochrane Systematic Reviews. Anesth. Analg. 2014 Sep 1;119(3):716-25.
  Daniel Jolley
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This small trial found that pre-operative stellate ganglion block before upper-limb orthopaedic surgery significantly reduced both 24 h tramadol consumption and pain at rest for up to 6 hours, although the later was of borderline clinical significance.
Kumar N, Thapa D, Gombar S et al. Analgesic efficacy of pre-operative stellate ganglion block on postoperative pain relief: a randomised controlled trial. Anaesthesia. 2014 Sep 1;69(9):954-660.
  Daniel Jolley