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pearl
1
It's known that the addition of opiates to LA improves epidural analgesia in labour. This trial should have compared oxycodone to fentanyl.
Zhong HY, Yang ZY, Zhang W et al. Effects of Adding Oxycodone to Ropivacaine on Labor Analgesia: A Randomized Controlled Trial. Clin J Pain. 2020 Feb 1; 36 (2): 96-100.
  Peter Effeney
comment
0
The ethics of treating family members – when is care ‘treating’, and when is it appropriate?
Hutchison C McConnell PC. The ethics of treating family members. Curr Opin Anaesthesiol. 2019 Apr 1; 32 (2): 169-173.
  Daniel Jolley
summary
1
An exploration of the ethics, challenges and practical reality of treating family members. Hutchison & McConnell deploy models of virtue, utilitarianism, deontology and principlism in an accessible and applied way.
1. Virtue ethics – behaving in the way we think is right; embodying courage.
2. Utilitarianism – behaving so as to maximise the best outcomes for the greater number of people.
3. Deontology – obeying the rules; following a duty to moral law.
4. Principlism – balances beneficence, nonmaleficence, autonomy and justice.
They cautiously challenge the blanket prohibitions of many professional bodies against treating family members.
Well worth reading.
“Only by constantly questioning whether they are the correct person to deliver care can they hope to do right by both their relative and themselves.”
Hutchison C McConnell PC. The ethics of treating family members. Curr Opin Anaesthesiol. 2019 Apr 1; 32 (2): 169-173.
  Daniel Jolley
pearl
1
Pressure-controlled face mask ventilation during paediatric induction reduces gastric insufflation compared with manual ventilation.
Lee JH, Jung H, Jang YE et al. Manual versus pressure-controlled facemask ventilation during the induction of general anaesthesia in children: a prospective randomised controlled study. Paediatr Anaesth. 2019 Apr 1; 29 (4): 331-337.
  Daniel Jolley
pearl
1
High intraoperative FiO₂ does not significantly reduce surgical site infections.
Myles PS, Carlisle JB, Scarr B. Evidence for compromised data integrity in studies of liberal peri-operative inspired oxygen. Anaesthesia. 2019 May 1; 74 (5): 573-584.
  Daniel Jolley
pearl
1
Intravenous lidocaine improves postoperative analgesia at 4h and 24h after laparoscopic or open abdominal surgery, but not at 48h or for other surgery types.
Weibel S, Jokinen J, Pace NL et al. Efficacy and safety of intravenous lidocaine for postoperative analgesia and recovery after surgery: a systematic review with trial sequential analysis. Br J Anaesth. 2016 Jun 1; 116 (6): 770-83.
  Daniel Jolley
pearl
1
Spinal 2-chloroprocaine has pharmacokinetic advantages over low dose bupivacaine that make it a useful choice for ambulatory surgery.
Saporito A, Ceppi M, Perren A et al. Does spinal chloroprocaine pharmacokinetic profile actually translate into a clinical advantage in terms of clinical outcomes when compared to low-dose spinal bupivacaine? A systematic review and meta-analysis. J Clin Anesth. 2019 Feb 1; 52: 99-104.
  Daniel Jolley
pearl
1
Dexmedetomidine reduces perioperative stress and inflammation, while supporting surgical patients’ immune function.
Wang K, Wu M, Xu J et al. Effects of dexmedetomidine on perioperative stress, inflammation, and immune function: systematic review and meta-analysis. Br J Anaesth. 2019 Dec 1; 123 (6): 777-794.
  Daniel Jolley
pearl
1
LMA use in children with URTIs reduces cough compared to intubation, but possibly not laryngospasm, although quality of evidence is poor.
de Carvalho Ana Lygia R ALR From the Departamento de Anestesiologia., Vital RB, CCS de Lira et al. Laryngeal Mask Airway Versus Other Airway Devices for Anesthesia in Children With an Upper Respiratory Tract Infection: A Systematic Review and Meta-analysis of Respiratory Complications. Anesth. Analg. 2018 Oct 1; 127 (4): 941-950.
  Daniel Jolley
pearl
1
Intrathecal hyperbaric and isobaric bupivacaine are equally clinically effective when used for elective cesarean section, although hyperbaric has slightly faster block onset.
Sng BL, NLR Han, Leong WL et al. Hyperbaric vs. isobaric bupivacaine for spinal anaesthesia for elective caesarean section: a Cochrane systematic review. Anaesthesia. 2018 Apr 1; 73 (4): 499-511.
  Daniel Jolley