Three papers from the first BJA of the new decade highlight the importance of non-inferiority: protective ventilation strategies, dexamethasone for prolonging interscalene blocks, and high inspired oxygen and surgical site infections.
Although none investigated new questions, they all represent studies into areas of ongoing uncertainty. They are each a useful reminder that most perioperative interventions do not significantly improve outcomes, although the majority of these probably do not ever make it to publication.
Lung-protection and atelectasis
Généreux et al. investigated the atelectasis-preventing benefit of a common protective ventilation strategy (PEEP and regular recruitment manoeuvres). Notable not just because there was no difference in atelectasis after extubation, but because the use of ultrasound to measure atelectasis helped to better track the intraoperative and post-extubation changes between the intervention and control groups. [→ article summary]