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pearl
1
Routine lorazepam premedication before surgery does not improve patient experience but does prolong time to extubation, even among anxious patients.
Maurice-Szamburski A, Auquier P, Viarre-Oreal V et al. Effect of sedative premedication on patient experience after general anesthesia: a randomized clinical trial. JAMA. 2015 Mar 3;313(9):916-25.
  Daniel Jolley
pearl
1
Intraoperative dexamethasone for antiemesis does not appear to significantly alter glucostasis during the first 24 post-operative hours in non-diabetic patients.
Murphy GS, Szokol JW, Avram MJ et al. The Effect of Single Low-Dose Dexamethasone on Blood Glucose Concentrations in the Perioperative Period: A Randomized, Placebo-Controlled Investigation in Gynecologic Surgical Patients. Anesth. Analg. 2014 Jun 1;118(6):1204-12.
  Daniel Jolley
pearl
1
Maintaining anesthesia with either sevoflurane or propofol for laparoscopic gynaecology surgery has no differential effect on post-operative pain.
Pokkinen SM, Yli-Hankala A, Kalliomäki ML. The effects of propofol vs. sevoflurane on post-operative pain and need of opioid. Acta Anaesthesiol Scand. 2014 Sep 1; 58 (8): 980-5.
  Daniel Jolley
comment
2
Great to see a new agent in the pipeline but why oh why use BIS as an endpoint as by definition BIS has never been calibrated against the new agent.
Monagle J, Siu L, Worrell J et al. A Phase 1c Trial Comparing the Efficacy and Safety of a New Aqueous Formulation of Alphaxalone with Propofol. Anesth. Analg. 2015 Oct 1; 121 (4): 914-924.
  Allan Palmer
comment
1
If what you are currently doing works for you keep doing it. If it doesn't, use hyperbaric!
Sia AT, Tan KH, Sng BL et al. Use of hyperbaric versus isobaric bupivacaine for spinal anaesthesia for caesarean section. Cochrane Db Syst Rev. 2013 Jan 1;5:CD005143.
  Allan Palmer
pearl
1
Phaxan™, an alphaxalone-cyclodextrin preparation offers fast-onset & short-duration anesthesia equivalent to propofol without pain on injection and with less hypotension.
Monagle J, Siu L, Worrell J et al. A Phase 1c Trial Comparing the Efficacy and Safety of a New Aqueous Formulation of Alphaxalone with Propofol. Anesth. Analg. 2015 Oct 1; 121 (4): 914-924.
  Daniel Jolley
pearl
1
Postoperative delirium is a risk factor for developing post traumatic stress disorder (PTSD) in elderly patients after surgery and hospital stay.
Drews T, Franck M, Radtke FM et al. Postoperative delirium is an independent risk factor for posttraumatic stress disorder in the elderly patient: A prospective observational study. Eur J Anaesthesiol. 2015 Mar 1;32(3):147-51.
  Daniel Jolley
pearl
1
Pre-admission smoking cessation interventions have significant effect on successful longterm quitting.
Lee SM, Landry J, Jones PM et al. Long-term quit rates after a perioperative smoking cessation randomized controlled trial. Anesth. Analg. 2015 Mar 1; 120 (3): 582-587.
  Daniel Jolley
pearl
1
Use of propofol for ambulatory surgery results in less post-operative nausea and vomiting, though no difference in post-discharge nausea and vomiting, and with greater cost compared with volatiles.
Kumar G, Stendall C, Mistry R et al. A comparison of total intravenous anaesthesia using propofol with sevoflurane or desflurane in ambulatory surgery: systematic review and meta-analysis. Anaesthesia. 2014 Oct 1; 69 (10): 1138-50.
  Daniel Jolley
pearl
1
Spinal anesthesia for neonatal hernia repair reduces the incidence of early post-operative apnea but has no effect on later apnea (30 min to 12 hours).
Davidson AJ, Morton NS, Arnup SJ et al. Apnea after Awake Regional and General Anesthesia in Infants: The General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes, A Randomized Controlled Trial. Anesthesiology. 2015 Jul 1; 123 (1): 38-54.
  Daniel Jolley