Knowledge
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Yes! Despite anaesthesiologist and anaesthetist reluctance to infiltrate with lignocaine/lidocaine before peripheral cannulation, we have several decades of evidence showing that:
- The pain of subcutaneous 1% lignocaine injection is significantly less than cannulation pain across all cannula sizes.
- Patients prefer pre-cannulation LA infiltration.
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Also see Carbon Footprint from Anaesthetic gas use [pdf] from the UK’s Sustainable Development Unit.
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The pressure to practice truly patient-focused, evidence-based medicine weighs on every anaesthetist and anaesthesiologist. Yet as the volume of evidence has grown, so has the expectation to always provide the highest quality care.
There is a trap of unknown knowns: evidence known in the greater medical-knowledge body but that we are naively ignorant of.
Bastardising William Gibson (1993), we risk that the evidence:
“…is already here – it's just not very evenly distributed.”
The greatest challenge for evidence-based anaesthesia continues to be the translation of research findings into actual practice change. The key to this is the intersection between quality, personal relevance, general significance, and credibility. But how can we achieve this?
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