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summary
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An exploration of the growth and evolution of Office Based Anesthesia in North America, including safety and regulatory concerns. The authors note that although recent data somewhat supports the safety of OBA, this is based upon lesser-quality retrospective studies.
Shapiro FE, Punwani N, Rosenberg NM et al. Office-based anesthesia: safety and outcomes. Anesth. Analg. 2014 Aug 1;119(2):276-85.
  Daniel Jolley
summary
1
Low average volatile concentration shows some association with post-operative delirium in a sub-study analysis of cardiothoracic patients admitted post-operatively to ICU, although clinical implications are unclear. Use of BIS was not statistically significantly associated with a lower incidence of delirium, although there was a trend to lower incidence.
Whitlock EL, Torres BA, Lin N et al. Postoperative Delirium in a Substudy of Cardiothoracic Surgical Patients in the BAG-RECALL Clinical Trial. Anesth. Analg. 2014 Apr 1;118(4):809-17.
  Daniel Jolley
summary
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Although general anaesthesia was associated with greater blood loss than regional anaesthesia in this meta-analysis (only ~100 mL), this is of questionable significance, and meta-analysis of RCTs showed there was no greater risk of blood transfusion.
Heesen M, Hofmann T, Klöhr S et al. Is general anaesthesia for caesarean section associated with postpartum haemorrhage? Systematic review and meta-analysis. Acta Anaesthesiol Scand. 2013 Oct 1;57(9):1092-102.
  Daniel Jolley
comment
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Of course the issue here is whether occlusion of the oesophageal entrance sufficient to prevent antegrade passage of a flexible silicon tube is a valid surrogate for the ability to prevent retrograde passage of liquid (ie. gastric fluid). There is a significant difference here and I feel this research adds little to the debate regarding benefit (or not) of cricoid pressure.
Zeidan AM, Salem MR, Mazoit JX et al. The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth. Analg. 2014 Mar 1; 118 (3): 580-6.
  Daniel Jolley
summary
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Cricoid pressure of 30N prevented the passage of both small and large gastric tubes into the oesophageal entrance, which the authors believe supports the utility of cricoid pressure in successfully occluding the oesophagus.
Zeidan AM, Salem MR, Mazoit JX et al. The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth. Analg. 2014 Mar 1; 118 (3): 580-6.
  Daniel Jolley
summary
1
This meta-analysis included 13 studies and demonstrates that ketamine added to caudal local anaesthesia prolongs analgesia in children with minimal adverse effects, though highlights that the potential neurotoxicity of ketamine has not yet been conclusively addressed.
Schnabel A, Poepping DM, Kranke P et al. Efficacy and adverse effects of ketamine as an additive for paediatric caudal anaesthesia: a quantitative systematic review of randomized controlled trials. Br J Anaesth. 2011 Oct 1; 107 (4): 601-11.
  Daniel Jolley
comment
1
Interesting. One wonders how many blocks would be improved by the addition of dex. Cost:benefit analysis would be nice as (in my setting anyway) the cost of dex is prohibitive.
Fritsch G, Danninger T, Allerberger K et al. Dexmedetomidine Added to Ropivacaine Extends the Duration of Interscalene Brachial Plexus Blocks for Elective Shoulder Surgery When Compared with Ropivacaine Alone: A Single-Center, Prospective, Triple-Blind, Randomized Controlled Trial. Reg Anesth Pain Med. 2014 Jan 1; 39 (1): 37-47.
  Mike Blackburn
summary
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Remote ischaemic preconditioning was induced using a BP cuff on one arm with three 5-min-ON / 5-min-OFF cycles before surgical start. Patients receiving RIPC before elective thoracotomy and pulmonary resection experienced less acute lung injury (indicated by PaO₂/FiO₂) and a 30% shorter hospital stay compared to those who did not receive RIPC.
Li C, Xu M, Wu Y et al. Limb Remote Ischemic Preconditioning Attenuates Lung Injury after Pulmonary Resection under Propofol-Remifentanil Anesthesia: A Randomized Controlled Study. Anesthesiology. 2014 Aug 1;121(2):249-59.
  Daniel Jolley
comment
0
The results of the trial should only be considered 'hypothesis forming' rather than practice changing, due to the:
• Small number of subjects in each arm.
• Non-randomised, observational nature of the trial.
• Difficulty generalising these findings to those from different cultural backgrounds.
Ding T, Wang DX, Qu Y et al. Epidural Labor Analgesia Is Associated with a Decreased Risk of Postpartum Depression: A Prospective Cohort Study. Anesth. Analg. 2014 Aug 1;119(2):383-92.
  Daniel Jolley
summary
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Women who received epidural analgesia during labour had a lower risk of post-natal depression at 6 weeks (OR 0.30), similar to the lowered risk in those who attended childbirth classes (OR 0.30).
Ding T, Wang DX, Qu Y et al. Epidural Labor Analgesia Is Associated with a Decreased Risk of Postpartum Depression: A Prospective Cohort Study. Anesth. Analg. 2014 Aug 1;119(2):383-92.
  Daniel Jolley