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pearl
1
Sugammadex hypersensitivity is between 1 in 12,5000 and 1 in 50,000 perioperative exposures.
Crimmins D, Crilly H, van C et al. Sugammadex hypersensitivity: a multicentre retrospective analysis of a large Australian cohort. Br J Anaesth. 2025 Jan 1; 134 (1): 727972-79.
  Daniel Jolley
pearl
1
Neuraxial labour analgesia for vaginal delivery is associated with a significant reduction in the risk of severe maternal morbidity.
Guglielminotti J, Landau R, Daw J et al. Use of Labor Neuraxial Analgesia for Vaginal Delivery and Severe Maternal Morbidity. JAMA Netw Open. 2022 Feb 1; 5 (2): e220137.
  Daniel Jolley
pearl
1
Labour epidural analgesia is associated with a 35% reduction in severe maternal morbidity, and even greater in those preterm or with medical comorbidity.
Kearns RJ, Kyzayeva A, LOE Halliday et al. Epidural analgesia during labour and severe maternal morbidity: population based study. BMJ. 2024 May 22; 385: e077190e077190.
  Daniel Jolley
summary
0
Medical practitioners often use ISBAR (Introduction, Situation, Background, Assessment and Recommendation) to guide clinical handover. This tool aims to improve patient safety by providing a systematic approach to patient handover. The focus is on the clinical content, rather than the manner in which the handover is delivered. We suggest a greater emphasis on kindness, trust and respect, with the aim of improving collegiality. Hence, a new acronym: “K-ISBAR”. At every handover, doctors can display kindness (utilising empathy and understanding) towards each other, which may slowly rebuild our collegiality.
We should all be more reflective in our behaviour towards our colleagues, putting ourselves in their shoes and modelling our language and behaviour on what we would expect to receive.
Brewster DJ Waxman BP. Adding kindness at handover to improve our collegiality: the K-ISBAR tool. Med. J. Aust. 2018 Dec 10; 209 (11): 482-483.
  Daniel Jolley
pearl
1
The pain of subcutaneous 1% lignocaine injection is significantly less than cannulation pain across all peripheral cannula sizes down to 22-gauge.
Langham BT Harrison DA. Local anaesthetic: does it really reduce the pain of insertion of all sizes of venous cannula? Anaesthesia. 1992 Oct 1;47(10):890-1.
  Daniel Jolley
summary
1
Collection: Does subcutaneous local anaesthetic reduce the pain of cannulation?
Yes! Despite anaesthesiologist and anaesthetist reluctance to infiltrate with lignocaine/lidocaine before peripheral cannulation, we have several decades of evidence showing that:
• The pain of subcutaneous 1% lignocaine injection is significantly less than cannulation pain across all cannula sizes.
• Patients prefer pre-cannulation LA infiltration.
  Daniel Jolley
pearl
1
Pain severity of local anaesthetic infiltration for spinal anaesthesia predicts post-caesarean pain.
Orbach-Zinger S, Aviram A, Fireman S et al. Severe pain during local infiltration for spinal anaesthesia predicts post-caesarean pain. Eur J Pain. 2015 Oct 1; 19 (9): 1382-8.
  Daniel Jolley
pearl
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Patients with past depression or depressive-symptoms preoperatively have significantly greater risk of post-operative delirium (RR 1.91, 95% CI 1.68-2.17).
Diep C, Patel K, Petricca J et al. Incidence and relative risk of delirium after major surgery for patients with pre-operative depression: a systematic review and meta-analysis. Anaesthesia. 2024 Nov 1; 79 (11): 123712491237-1249.
  Daniel Jolley
pearl
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Sevoflurane post-conditioning improves survival in rats after subarachnoid haemorrhage.
Morax L, Beck-Schimmer B, Neff J et al. Sevoflurane Postconditioning Protects From an Early Neurological Deficit After Subarachnoid Hemorrhage: Results of a Randomized Laboratory Study in Rats. Anesth. Analg. 2024 Nov 1; 139 (5): 107510851075-1085.
  Daniel Jolley
pearl
1
Anaesthetic machine End-Tidal Control of ET-agent & ET-oxygen concentrations achieves and maintains desired targets at least as well as manual control.
McCabe MD, Dear GL, Klopman MA et al. End-Tidal Control Versus Manual Control of Inhalational Anesthesia Delivery: A Randomized Controlled Noninferiority Trial. Anesth. Analg. 2024 Oct 1; 139 (4): 812820812-820.
  Daniel Jolley