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summary
1
A small audit showing the acceptability and absence of significant side effects of ketofol when used for brief procedural sedation (tubal ligation), particularly in the low resource setting.
Patients received a premixed ketofol dose of 0.5 mg/kg ketamine and 0.9 mg/kg propofol after fentanyl 1 mcg/kg.
Notably there was universal hemodynamic stability, although almost half of the audited patients required airway support.
Grace RF, Tang DW, Namel E. An audit of the haemodynamic and emergence characteristics of single-shot 'ketofol'. Anaesth Intensive Care. 2015 Jul 1; 43 (4): 503-5.
  Daniel Jolley
pearl
1
Use of the WHO Surgical Safety Checklist reduces perioperative morbidity and mortality in low resource settings.
Collection: Surgical safety checklists
  Daniel Jolley
summary
1
Implementation of the Surgical Safety Checklist in Ontario, Canada did not reduce surgical morbidity or mortality.
Urbach DR, Govindarajan A, Saskin R et al. Introduction of surgical safety checklists in Ontario, Canada. N. Engl. J. Med. 2014 Mar 13;370(11):1029-38.
  Daniel Jolley
summary
1
Collection: Surgical safety checklists
The World Health Organisation's Surgical Safety Checklist has been adopted and implemented by many hospitals throughout the world: from large tertiary teaching hospitals in wealthy countries, to small hospitals in low-resource settings.
The benefits to each hospital however are likely not the same. Does the WHO SSC implemented in a hospital that already has a 'Time Out' process bring the same benefit, if any, as to a hospital for which the checklist was completely new? Possibly not.
Several studies across a wide range of health systems have shown conflicting results in terms of reducing morbidity, mortality and length of stay.
  Daniel Jolley
comment
1
Good critique of this study by Skeptical Scalpel here:
Do OR checklists improve outcomes?
Haugen AS, Søfteland E, Almeland SK et al. Effect of the World Health Organization checklist on patient outcomes: a stepped wedge cluster randomized controlled trial. Ann. Surg. 2015 May 1;261(5):821-8.
  Daniel Jolley
pearl
1
Implementing the WHO Safe Surgery Checklist may reduce morbidity, length of stay and mortality, although many questions remain.
Haugen AS, Søfteland E, Almeland SK et al. Effect of the World Health Organization checklist on patient outcomes: a stepped wedge cluster randomized controlled trial. Ann. Surg. 2015 May 1;261(5):821-8.
  Daniel Jolley
pearl
1
Wearing double gloves during intubation then removing the outer set, may reduce contamination of the intraoperative anesthesia environment.
Birnbach DJ, Rosen LF, Fitzpatrick M et al. Double Gloves: A Randomized Trial to Evaluate a Simple Strategy to Reduce Contamination in the Operating Room. Anesth. Analg. 2015 Apr 1;120(4):848-52.
  Daniel Jolley
comment
0
It's fascinating that the mechanism of something as common as propofol-injection pain is still not completely understood.
Galgon RE, Strube P, Heier J et al. Magnesium sulfate with lidocaine for preventing propofol injection pain: a randomized, double-blind, placebo-controlled trial. J Anesth. 2015 Apr 1;29(2):206-11.
  Daniel Jolley
pearl
1
Pre-treatment with IV lignocaine and magnesium does not have an additive effect on reducing the pain of propofol injection compared with lignocaine alone.
Galgon RE, Strube P, Heier J et al. Magnesium sulfate with lidocaine for preventing propofol injection pain: a randomized, double-blind, placebo-controlled trial. J Anesth. 2015 Apr 1;29(2):206-11.
  Daniel Jolley
comment
0
The 20^th most cited pediatric anesthesia paper of all time, and 940^th overall with 150 citations.
Hicks CL, von CL, Spafford PA et al. The Faces Pain Scale-Revised: toward a common metric in pediatric pain measurement. Pain. 2001 Aug 1; 93 (2): 173-183.
  Daniel Jolley