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pearl
1
Regional anesthesia appears to reduce persistent post-surgical pain in adults after thoracotomy, breast cancer surgery and cesarean section, although evidence is of modest quality.
Levene JL, Weinstein EJ, Cohen MS et al. Local anesthetics and regional anesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children: A Cochrane systematic review and meta-analysis update. J Clin Anesth. 2019 Aug 1; 55: 116-127.
  Daniel Jolley
pearl
1
Intravenous lidocaine infusions for 48 hours perioperatively do not reduce postoperative cognitive decline up to 1 year after cardiac surgery.
Klinger RY, Cooter M, Bisanar T et al. Intravenous Lidocaine Does Not Improve Neurologic Outcomes after Cardiac Surgery: A Randomized Controlled Trial. Anesthesiology. 2019 Jun 1; 130 (6): 958-970.
  Daniel Jolley
pearl
1
Remote ischemic preconditioning reduced renal injury and mechanical ventilation duration, after open total aortic arch replacement.
Zhou H, Yang L, Wang G et al. Remote Ischemic Preconditioning Prevents Postoperative Acute Kidney Injury After Open Total Aortic Arch Replacement: A Double-Blind, Randomized, Sham-Controlled Trial. Anesth. Analg. 2019 Jul 1; 129 (1): 287-293.
  Daniel Jolley
pearl
1
Taking oral antihypertensive agents at bedtime rather than the morning, improves BP control and reduces the incidence of cardiac death, myocardial infarct, revascularization, heart failure and stroke.
Hermida RC, Crespo JJ, Domínguez-Sardiña M et al. Bedtime hypertension treatment improves cardiovascular risk reduction: the Hygia Chronotherapy Trial. Eur. Heart J. 2020 Dec 21; 41 (48): 4565-4576.
  Daniel Jolley
pearl
1
Intravenous dexamethasone reduces the incidence and severity of sore throat after endotracheal intubation.
Kuriyama A Maeda H. Preoperative intravenous dexamethasone prevents tracheal intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis. Can J Anaesth. 2019 May 1; 66 (5): 562-575.
  Daniel Jolley
pearl
1
Low dose ketamine reduces pain and opioid requirements in the first 24 hours after major joint surgery.
Riddell JM, Trummel JM, Onakpoya IJ. Low-dose ketamine in painful orthopaedic surgery: a systematic review and meta-analysis. Br J Anaesth. 2019 Sep 1; 123 (3): 325-334.
  Daniel Jolley
pearl
1
Women are more satisfied with pain relief with labour epidural analgesia than with remifentanil PCA.
Logtenberg S, Oude K, Verhoeven CJ et al. Labour pain with remifentanil patient-controlled analgesia versus epidural analgesia: a randomised equivalence trial. BJOG. 2017 Mar 1; 124 (4): 652-660.
  Daniel Jolley
pearl
1
High level evidence does not show any clinically meaningful difference for early vs late labour epidural analgesia, whether on maternal or neonatal outcomes.
Sng BL, Leong WL, Zeng Y et al. Early versus late initiation of epidural analgesia for labour. Cochrane Db Syst Rev. 2014 Oct 9; 2014 (10): CD007238CD007238.
  Daniel Jolley
pearl
1
A greater relief in labor pain with epidural analgesia is associated with lower postpartum depression scores, although with less clinical significance than other risk factors.
Lim G, Farrell LM, Facco FL et al. Labor Analgesia as a Predictor for Reduced Postpartum Depression Scores: A Retrospective Observational Study. Anesth. Analg. 2018 May 1; 126 (5): 159816051598-1605.
  Daniel Jolley
pearl
1
Intending to deliver with labour epidural analgesia and then receiving a labour epidural is associated with slightly lower rate of postnatal depression.
Orbach-Zinger S, Landau R, Harousch AB et al. The Relationship Between Women's Intention to Request a Labor Epidural Analgesia, Actually Delivering With Labor Epidural Analgesia, and Postpartum Depression at 6 Weeks: A Prospective Observational Study. Anesth. Analg. 2018 May 1; 126 (5): 1590-1597.
  Daniel Jolley