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pearl
1
Although the GlideScope videolaryngoscope reduces the force applied compared to direct Macintosh laryngoscopy, the longer duration of laryngoscopy with the GlideScope results in comparable total net force.
Cordovani D, Russell T, Wee W et al. Measurement of forces applied using a Macintosh direct laryngoscope compared with a Glidescope video laryngoscope in patients with predictors of difficult laryngoscopy: A randomised controlled trial. Eur J Anaesthesiol. 2019 Mar 1; 36 (3): 221-226.
  Daniel Jolley
pearl
1
Perioperative protocols aiming to reduce unnecessary preoperative tests can successfully achieve this without negative consequences for patient care.
Nelson SE, Li G, Shi H et al. The impact of reduction of testing at a Preoperative Evaluation Clinic for elective cases: Value added without adverse outcomes. J Clin Anesth. 2019 Aug 1; 55: 92-99.
  Daniel Jolley
pearl
1
There is still insufficient evidence to link particular anaesthetic or analgesic interventions with tumour recurrence following cancer surgery.
Wall T, Sherwin A, Ma D et al. Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: a narrative review. Br J Anaesth. 2019 Aug 1; 123 (2): 135-150.
  Daniel Jolley
pearl
1
Residual neuromuscular block is common at the time of extubation, occurring in up to two thirds of patients in the absence of quantitative neuromuscular monitoring.
Saager L, Maiese EM, Bash LD et al. Incidence, risk factors, and consequences of residual neuromuscular block in the United States: The prospective, observational, multicenter RECITE-US study. J Clin Anesth. 2019 Aug 1; 55: 33-41.
  Daniel Jolley
pearl
1
Post-operative fatigue and quality of life is not improved by intraoperative anti-inflammatory interventions, namely steroid administration, tight glucose control, and light anesthesia.
Abdelmalak BB, You J, Kurz A et al. The effects of dexamethasone, light anesthesia, and tight glucose control on postoperative fatigue and quality of life after major noncardiac surgery: A randomized trial. J Clin Anesth. 2019 Aug 1; 55: 83-91.
  Daniel Jolley
pearl
1
Evidence for cricoid pressure continues to be inadequate to make recommendations for its use or avoidance in patients at risk of pulmonary aspiration.
Zdravkovic M, Rice MJ, Brull SJ. The Clinical Use of Cricoid Pressure: First, Do No Harm. Anesth. Analg. 2021 Jan 1; 132 (1): 261267261-267.
  Daniel Jolley
pearl
1
Hypercapnia events are common in women receiving 150 mcg intrathecal morphine for cesarean delivery, although clinical significance is uncertain.
Bauchat JR, McCarthy R, Fitzgerald P et al. Transcutaneous Carbon Dioxide Measurements in Women Receiving Intrathecal Morphine for Cesarean Delivery: A Prospective Observational Study. Anesth. Analg. 2017 Mar 1; 124 (3): 872-878.
  Daniel Jolley
pearl
1
Cesarean section for morbidly adherent placenta can be successfully managed with neuraxial anesthesia, although with a modest conversion rate to general anesthesia.
Markley JC, Farber MK, Perlman NC et al. Neuraxial Anesthesia During Cesarean Delivery for Placenta Previa With Suspected Morbidly Adherent Placenta: A Retrospective Analysis. Anesth. Analg. 2018 Oct 1; 127 (4): 930-938.
  Daniel Jolley
pearl
1
Intraoperative dexmedetomidine infusions result in less postoperative pain, hypotension, shivering and PONV than remifentanil.
Grape S, Kirkham KR, Frauenknecht J et al. Intra-operative analgesia with remifentanil vs. dexmedetomidine: a systematic review and meta-analysis with trial sequential analysis. Anaesthesia. 2019 Jun 1; 74 (6): 793-800.
  Daniel Jolley
pearl
1
Modest reductions in fresh gas flow at the beginning of anaesthesia induction results in meaningful reduction in sevoflurane consumption.
Kennedy RR, French RA, Vesto G et al. The effect of fresh gas flow during induction of anaesthesia on sevoflurane usage: a quality improvement study. Anaesthesia. 2019 Jul 1; 74 (7): 875-882.
  Daniel Jolley