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1
The legitimacy of Poldermans' DECREASE trials, in particular DECREASE IV, has been called into question due to scientific misconduct.
Results from other trials, such as POISE greatly undermine the argument for both benefit and safety of starting perioperative beta-blockade, even in high-risk patients. Read more about Poldermans and scientific misconduct.
Dunkelgrun M, Boersma E, Schouten O et al. Bisoprolol and fluvastatin for the reduction of perioperative cardiac mortality and myocardial infarction in intermediate-risk patients undergoing noncardiovascular surgery: a randomized controlled trial (DECREASE-IV). Ann. Surg. 2009 Jun 1;249(6):921-6.
  Daniel Jolley
comment
0
Kinda interesting, but not too surprising given that their technique really just increases the catheterisation threshold (albeit individualized for each patient). Nonetheless the practicality and cost-effectiveness of patients pre-measuring their MBC is questionable. To avoid 27 unnecessary catheterizations they measured 931 pre-operative MBC's.
Brouwer TA, Rosier PF, Moons KG et al. Postoperative Bladder Catheterization Based on Individual Bladder Capacity: A Randomized Trial. Anesthesiology. 2015 Jan 1;122(1):46-54.
  Daniel Jolley
pearl
1
Use of an individualised maximum bladder volume in post-op patients reduces the need for catheterization compared with arbitrary 500mL threshold.
Brouwer TA, Rosier PF, Moons KG et al. Postoperative Bladder Catheterization Based on Individual Bladder Capacity: A Randomized Trial. Anesthesiology. 2015 Jan 1;122(1):46-54.
  Daniel Jolley
summary
1
This review and case series examines this uncommon complication following airway management - most commonly after intubation, although not exclusively. Reassuringly hypoglossal nerve palsy resolves in 80% of cases within 4 months.
Shah AC, Barnes C, Spiekerman CF et al. Hypoglossal nerve palsy after airway management for general anesthesia: an analysis of 69 patients. Anesth. Analg. 2015 Jan 1; 120 (1): 105-120.
  Daniel Jolley
pearl
1
Initial liberal fluid resuscitation strategies in trauma patients may be associated with higher mortality.
Wang CH, Hsieh WH, Chou HC et al. Liberal Versus Restricted Fluid Resuscitation Strategies in Trauma Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Observational Studies. Crit. Care Med. 2014 Apr 1; 42 (4): 954-61.
  Daniel Jolley
pearl
1
There is limited evidence supporting superiority between plain or hyperbaric spinal bupivacaine for spinal cesarean section.
Heng SiaAlex TiongATFrom the Duke-NUS Graduate Medical School, Singapore, Singapore; Medical Board, Obstetrics Gynaecology, Women's Anaesthesia, KK Women's Children's Hospital, Singapore, Singapore; Clinical Research Institute, Singapore, , Tan KH, Sng BL et al. Hyperbaric versus plain bupivacaine for spinal anesthesia for cesarean delivery. Anesth. Analg. 2015 Jan 1; 120 (1): 132-140.
  Daniel Jolley
pearl
1
Fentanyl-only epidural infusion shows no benefit over fentanyl/bupiv in respect to duration of labor, motor block, delivery, analgesia, or outcomes.
Craig MG, Grant EN, Tao W et al. A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor. Anesthesiology. 2015 Jan 1; 122 (1): 172-7.
  Daniel Jolley
summary
1
The researchers found that in a cohort of 198 patients admitted to ICU after major abdominal cancer surgery, those subjected to a liberal blood transfusion threshold of < 9 g/dL experienced fewer major complications (NNT 6.2) than those subjected to a restrictive transfusion threshold (< 7 g/dL).
Pinheiro J, Vincent JL, Galas FR et al. Transfusion Requirements in Surgical Oncology Patients: A Prospective, Randomized Controlled Trial. Anesthesiology. 2015 Jan 1;122(1):29-38.
  Daniel Jolley
pearl
1
Opioid sparing is a feasible pragmatic endpoint for pediatric pain analgesic trials.
Kossowsky J, Donado C, Berde CB. Immediate Rescue Designs in Pediatric Analgesic Trials: A Systematic Review and Meta-analysis. Anesthesiology. 2015 Jan 1; 122 (1): 150-171.
  Daniel Jolley
pearl
1
Local infiltration with either 50mL 0.5% or 125mL 0.2% ropivacaine did not improve post-operative pain after elective caesarean section.
Larsen KR, Kristensen BB, Rasmussen MA et al. Effect of high-volume systematic local infiltration analgesia in Caesarean section: a randomised, placebo-controlled trial. Acta Anaesthesiol Scand. 2015 May 1;59(5):632-9.
  Daniel Jolley