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As of February 28th 2023, pholcodine has FINALLY been banned in Australia by the Therapeutic Goods Administration (TGA).
Press release here: TGA - Pholcodine
It's very sad that it took 14 years after Florvaag & Johansson's landmark 2009 paper describing the connection between pholcodine and NMBD anaphylaxis, for this problem to be addressed.
How many patients were exposed to avoidable harm?
Collection: What is the significance of Pholcodine for anesthesia?
  Daniel Jolley
summary
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Collection: Drowning in the Sea of Evidence
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?
  Daniel Jolley
pearl
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50% of retracted anesthesiology papers are retracted because of fraud, and 30% because of inadequate ethics approval.
Nair S, Yean C, Yoo J et al. Reasons for article retraction in anesthesiology: a comprehensive analysis. Can J Anaesth. 2020 Jan 1; 67 (1): 57-63.
  Daniel Jolley
pearl
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90% of fraudulent papers in perioperative medicine retracted over the last 30 years were authored by only six researchers.
Nato CG, Tabacco L, Bilotta F. Fraud and retraction in perioperative medicine publications: what we learned and what can be implemented to prevent future recurrence. J Med Ethics. 2022 Jul 1; 48 (7): 479484479-484.
  Daniel Jolley
summary
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Carlisle investigated the distribution of independent variables between study groups in Fujii's fraudulent research:
"The published distributions of 28/33 variables (85%) were inconsistent with the expected distributions, such that the likelihood of their occurring ranged from 1 in 25 to less than 1 in 1 000 000 000 000 000 000 000 000 000 000 000 (1 in 10³³), equivalent to p values of 0.04 to < 1 × 10^-33 , respectively."
Carlisle JB. The analysis of 168 randomised controlled trials to test data integrity. Anaesthesia. 2012 May 1; 67 (5): 521-537.
  Daniel Jolley
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"It usually comes as a surprise to students to learn that some (perhaps most) published articles belong in the bin, and should certainly not be used to inform practice." – Greenhalgh.
Greenhalgh T. How to read a paper. Getting your bearings (deciding what the paper is about). BMJ. 1997 Jul 26; 315 (7102): 243246243-6.
  Daniel Jolley
pearl
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Videolaryngoscopy is associated with improved glottic view, less failed attempts and fewer complications.
Hansel J, Rogers AM, Lewis SR et al. Videolaryngoscopy versus direct laryngoscopy for adults undergoing tracheal intubation: a Cochrane systematic review and meta-analysis update. Br J Anaesth. 2022 Oct 1; 129 (4): 612623612-623.
  Daniel Jolley
pearl
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A lower processed-EEG based measure of anaesthetic resistance is associated with greater post-operative delirium risk.
Cooter M, Bunning T, Eleswarpu SS et al. A Processed Electroencephalogram-Based Brain Anesthetic Resistance Index Is Associated With Postoperative Delirium in Older Adults: A Dual Center Study. Anesth. Analg. 2022 Jan 1; 134 (1): 149158149-158.
  Daniel Jolley
pearl
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Unsuccessful epidural blood patch is associated with higher lumbar levels, shorter time between puncture & patch, and with patients with migraine history.
Gupta A, Van M, Magnuson A et al. Factors associated with failed epidural blood patch after accidental dural puncture in obstetrics: a prospective, multicentre, international cohort study. Br J Anaesth. 2022 Nov 1; 129 (5): 758766758-766.
  Daniel Jolley
pearl
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Other than acute kidney injury, there appears no outcome difference between spinal and general anaesthesia in hip fracture surgery.
Kunutsor SK, Hamal PB, Tomassini S et al. Clinical effectiveness and safety of spinal anaesthesia compared with general anaesthesia in patients undergoing hip fracture surgery using a consensus-based core outcome set and patient-and public-informed outcomes: a systematic review and meta-analysis of randomised controlled trials. Br J Anaesth. 2022 Nov 1; 129 (5): 788800788-800.
  Daniel Jolley