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pearl
1
Real-time ultrasound guidance for central line insertion significantly reduces complications and adverse events.
Wu SY, Ling Q, Cao LH et al. Real-time two-dimensional ultrasound guidance for central venous cannulation: a meta-analysis. Anesthesiology. 2013 Feb 1;118(2):361-75.
  Daniel Jolley
pearl
2
Dexmedetomidine 150 mcg significantly extends the duration of ropivacaine interscalene block by almost 30% without significant adverse effect.
Fritsch G, Danninger T, Allerberger K et al. Dexmedetomidine Added to Ropivacaine Extends the Duration of Interscalene Brachial Plexus Blocks for Elective Shoulder Surgery When Compared with Ropivacaine Alone: A Single-Center, Prospective, Triple-Blind, Randomized Controlled Trial. Reg Anesth Pain Med. 2014 Jan 1; 39 (1): 37-47.
  Daniel Jolley
pearl
1
A single-penetration dual-injection block of the sciatic and saphenous nerves was faster to perform but equally effective as traditional techniques.
Børglum J, Johansen K, Christensen MD et al. Ultrasound-Guided Single-Penetration Dual-Injection Block for Leg and Foot Surgery: A Prospective, Randomized, Double-blind Study. Reg Anesth Pain Med. 2014 Jan 1;39(1):18-25.
  Daniel Jolley
pearl
1
Midazolam 0.03 mg/kg IV given to children pre-emergence reduces delirium without a clinically significant delay in emergence.
Cho EJ, Yoon SZ, Cho JE et al. Comparison of the Effects of 0.03 and 0.05 mg/kg Midazolam with Placebo on Prevention of Emergence Agitation in Children Having Strabismus Surgery. Anesthesiology. 2014 Jun 1;120(6):1354-61.
  Daniel Jolley
comment
0
Although this Cochrane review supports the belief that epidural and paravertebral blocks may reduce persistent-surgical pain after thoracotomy or breast cancer surgery respectively, the authors highlight the low total number of subjects (only 339 patients) in the five trials analysed. This is enough evidence to consider the PSP-benefits of regional anesthesia, but far from enough to be conclusive or change practice.
Andreae MH Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013 Nov 1; 111 (5): 711-20.
  Daniel Jolley
pearl
1
Epidural anesthesia may reduce post-thoracotomy chronic pain (OR 0.33) and paravertebral block reduce that following breast ca surgery (OR 0.37).
Andreae MH Andreae DA. Regional anaesthesia to prevent chronic pain after surgery: a Cochrane systematic review and meta-analysis. Br J Anaesth. 2013 Nov 1; 111 (5): 711-20.
  Daniel Jolley
pearl
1
Maternal asthma control may be improved by multidisciplinary care, education and asthma monitoring.
Lim AS, Stewart K, Abramson MJ et al. Multidisciplinary Approach to Management of Maternal Asthma (MAMMA): A Randomized Controlled Trial. Chest. 2014 May 1;145(5):1046-54.
  Daniel Jolley
pearl
3
Greater depth of anaesthesia may be associated with a higher incidence of wound infection, mortality and composite risk of complications.
Short TG, Leslie K, Campbell D et al. A pilot study for a prospective, randomized, double-blind trial of the influence of anesthetic depth on long-term outcome. Anesth. Analg. 2014 May 1;118(5):981-6.
  Daniel Jolley
pearl
1
Videolaryngoscopic view using the C-MAC is improved when the anesthesia assistant applying cricoid pressure also has access to see the C-MAC screen.
Loughnan TE, Gunasekera E, Tan TP. Improving the C-MAC video laryngoscopic view when applying cricoid pressure by allowing access of assistant to the video screen. Anaesth Intensive Care. 2012 Jan 1;40(1):128-30.
  Daniel Jolley
pearl
1
Ultrasound-guided supraclavicular block has faster onset when a targeted intracluster-injection technique is used compared with double injection.
Techasuk W, González AP, Bernucci F et al. A randomized comparison between double-injection and targeted intracluster-injection ultrasound-guided supraclavicular brachial plexus block. Anesth. Analg. 2014 Jun 1;118(6):1363-9.
  Daniel Jolley