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Concerns regarding hypersensitivity to sugammadex are reportedly one of the primary sticking points for sugammadex still lacking FDA approval.
Godai K, Hasegawa-Moriyama M, Kuniyoshi T et al. Three cases of suspected sugammadex-induced hypersensitivity reactions. Br J Anaesth. 2012 Aug 1; 109 (2): 216-8.
  Daniel Jolley
pearl
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Reversal with sugammadex produces better recovery of diaphragm function than neostigmine reversal.
Schepens T, Cammu G, Saldien V et al. Electromyographic activity of the diaphragm during neostigmine or sugammadex-enhanced recovery after neuromuscular blockade with rocuronium: A study in anaesthetised healthy volunteers. Eur J Anaesthesiol. 2015 Jan 1;32(1):49-57.
  Daniel Jolley
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A collection of evidence looking specifically at the issue of our poor stewardship of neuromuscular blocking agents can be found here: Neuromuscular myths: the lies we tell ourselves
Collection: Is sugammadex as good as we think?
  Daniel Jolley
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What's significant here is not confirmation that spinal anaesthesia improves ECV success, which has been noted before, but rather that this is not due to the analgesic effect as previously thought (ie. IV remifentanil improved pain during the ECV but not success rate), but instead may be primarily due to abdominal muscle relaxation.
Khaw KS, Lee SW, Ngan WD et al. Randomized trial of anaesthetic interventions in external cephalic version for breech presentation. Br J Anaesth. 2015 Jun 1;114(6):944-50.
  Daniel Jolley
pearl
1
Spinal anaesthesia improves the success of external cephalic version for breech presentation during pregnancy.
Khaw KS, Lee SW, Ngan WD et al. Randomized trial of anaesthetic interventions in external cephalic version for breech presentation. Br J Anaesth. 2015 Jun 1;114(6):944-50.
  Daniel Jolley
pearl
1
High intraoperative PEEP and recruitment manoeuvres during open abdominal surgery do not protect against post-op pulmonary complications, though are associated with intraoperative hypotension.
PROVE Network Investigators for the Clinical Trial Network of the European Society of Anaesthesiology, Hemmes SN, Gama de AbreuMarceloM et al. High versus low positive end-expiratory pressure during general anaesthesia for open abdominal surgery (PROVHILO trial): a multicentre randomised controlled trial. Lancet. 2014 Aug 9; 384 (9942): 495-503.
  Daniel Jolley
pearl
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The ED90 of carbetocin is approximately 15 mcg after elective cesarean section.
Khan M, Balki M, Ahmed I et al. Carbetocin at elective Cesarean delivery: a sequential allocation trial to determine the minimum effective dose. Can J Anaesth. 2014 Mar 1; 61 (3): 242-8.
  Daniel Jolley
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In my experience, 80% success is about right. It can be a somewhat hit-n-miss technique, though with reasonable evidence to support both safety and potential superiority vs neonatal general anaesthesia. You know pretty much instantly when it hasn't worked.
Frawley G, Bell G, Disma N et al. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair: Data from the General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes. Anesthesiology. 2015 Jul 1; 123 (1): 55-65.
  Daniel Jolley
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Why does any study with the words 'adherence' and 'guideline' in the same sentence immediately get my back up. If its a guideline you dont need to ADHERE to it. Think about it, follow it, maybe, but not ADHERE. Grrrrrrrr
McEvoy MD, Hand WR, Stoll WD et al. Adherence to guidelines for the management of local anesthetic systemic toxicity is improved by an electronic decision support tool and designated "reader". Reg Anesth Pain Med. 2014 Jul 1; 39 (4): 299-305.
  Allan Palmer
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83% success rate. ~20% failure rate. 1:5 failure. Not so sure I would agree with the comment the "failure rate of spinal anaesthesia was low". I like a little more certainty than this!
Frawley G, Bell G, Disma N et al. Predictors of Failure of Awake Regional Anesthesia for Neonatal Hernia Repair: Data from the General Anesthesia Compared to Spinal Anesthesia Study-Comparing Apnea and Neurodevelopmental Outcomes. Anesthesiology. 2015 Jul 1; 123 (1): 55-65.
  Allan Palmer