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pearl
1
Either proximal or distal sciatic nerve block reduces pain in the first 6 hours after total knee arthroplasty. Distal (popliteal) may be superior.
Abdallah FW, Chan VW, Gandhi R et al. The Analgesic Effects of Proximal, Distal, or No Sciatic Nerve Block on Posterior Knee Pain after Total Knee Arthroplasty: A Double-blind Placebo-controlled Randomized Trial. Anesthesiology. 2014 Dec 1;121(6):1302-10.
  Daniel Jolley
comment
1
I find the existence of this study perplexing. This meta-analysis appears to simply confirm basic neuromuscular pharmacology and age-related cardiovascular changes. The unanswered question is why are they so interested in using mivacurium anyway?
I conclude that good conditions for tracheal intubation are more likely when using a muscle relaxant other than mivacurium.
Vanlinthout LE, Mesfin SH, Hens N et al. A systematic review and meta-regression analysis of mivacurium for tracheal intubation. Anaesthesia. 2014 Dec 1;69(12):1377-87.
  Daniel Jolley
pearl
1
Intraoperative ketamine and magnesium improves post-operative analgesia after scoliosis surgery when compared to ketamine alone.
Jabbour HJ, Naccache NM, Jawish RJ et al. Ketamine and magnesium association reduces morphine consumption after scoliosis surgery: prospective randomised double-blind study. Acta Anaesthesiol Scand. 2014 May 1;58(5):572-9.
  Daniel Jolley
pearl
1
Dexamethasone 8 mg has equal effect in prolonging single-shot supraclavicular block whether given perineurial or intravenously.
Abdallah FW, Johnson J, Chan V et al. Intravenous Dexamethasone and Perineural Dexamethasone Similarly Prolong the Duration of Analgesia After Supraclavicular Brachial Plexus Block: A Randomized, Triple-Arm, Double-Blind, Placebo-Controlled Trial. Reg Anesth Pain Med. 2015 Mar 1;40(2):125-32.
  Daniel Jolley
pearl
1
Intraoperative intravenous lidocaine improves the quality of recovery following ambulatory laparoscopic surgery.
De GS, Fitzgerald P, Streicher LF et al. Systemic lidocaine to improve postoperative quality of recovery after ambulatory laparoscopic surgery. Anesth. Analg. 2012 Aug 1;115(2):262-7.
  Daniel Jolley
pearl
1
Intrathecal fentanyl synergistically improves labour analgesia when given in combination with bupivacaine.
Kee WD, Khaw KS, Ng FF et al. Synergistic Interaction between Fentanyl and Bupivacaine Given Intrathecally for Labor Analgesia. Anesthesiology. 2014 May 1;120(5):1126-36.
  Daniel Jolley
pearl
1
Pulsed radiofrequency stimulation of the suprascapular nerve improves pain and range of motion in those with adhesive capsulitis.
Wu YT, Ho CW, Chen YL et al. Ultrasound-Guided Pulsed Radiofrequency Stimulation of the Suprascapular Nerve for Adhesive Capsulitis: A Prospective, Randomized, Controlled Trial. Anesth. Analg. 2014 Sep 1;119(3):686-92.
  Daniel Jolley
pearl
1
Peri-operative melatonin may cause small reductions in pre-operative anxiety and post-operative pain.
Andersen LP, Werner MU, Rosenberg J et al. A systematic review of peri-operative melatonin. Anaesthesia. 2014 Oct 1; 69 (10): 1163-71.
  Daniel Jolley
pearl
1
Periarticular infiltration with ropivacaine and ketorolac provides equivalent and likely superior post-op analgesia to intrathecal morphine after THA.
Kuchálik J, Granath B, Ljunggren A et al. Postoperative pain relief after total hip arthroplasty: a randomized, double-blind comparison between intrathecal morphine and local infiltration analgesia. Br J Anaesth. 2013 Nov 1;111(5):793-9.
  Daniel Jolley
comment
1
Despite the statistical significance of this finding, I question the clinical significance and appropriateness – especially in the context of ongoing questions regarding the safety of HES solutions and given there are alternative interventions also shown to reduce symptomatic hypotension in this setting.
Mercier FJ, Diemunsch P, Ducloy-Bouthors AS et al. 6% Hydroxyethyl starch (130/0.4) vs Ringer's lactate preloading before spinal anaesthesia for Caesarean delivery: the randomized, double-blind, multicentre CAESAR trial‡ Br J Anaesth. 2014 Sep 1; 113 (3): 459-67.
  Daniel Jolley