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pearl
1
Propofol TIVA anesthesia does not reduce hepatic reperfusion injury after liver transplant when compared to desflurane anesthesia.
Shin S, Joo DJ, Kim MS et al. Propofol intravenous anaesthesia with desflurane compared with desflurane alone on postoperative liver function after living-donor liver transplantation: A randomised controlled trial. Eur J Anaesthesiol. 2019 Sep 1; 36 (9): 656-666.
  Daniel Jolley
pearl
1
Propofol TIVA may be associated with improved survival after colon cancer surgery when compared with desflurane inhalation anaesthesia.
Wu ZF, Lee MS, Wong CS et al. Propofol-based Total Intravenous Anesthesia Is Associated with Better Survival Than Desflurane Anesthesia in Colon Cancer Surgery. Anesthesiology. 2018 Nov 1; 129 (5): 932-941.
  Daniel Jolley
comment
0
Take this one with a large grain of salt. At best it shows cerebral perfusion was safely maintained in this small cohort of patients receiving a rather unique, though not personalized, anesthetic recipe.
It’s very unlikely that this 22 patient observational study is sufficiently powered to reassure concerns that prone positioning does not effect cerebral blood flow, although it does point in that direction.
Bombardieri AM, Beckman J, Urban M et al. An Observational Study of Cerebral Blood Flow Velocity Evaluation in the Prone Position During Posterior Lumbar Surgery. Anesth. Analg. 2019 Aug 1; 129 (2): 487-492.
  Daniel Jolley
pearl
1
Cerebral perfusion is probably maintained during prone positioning for spinal surgery during stable hemodynamics.
Bombardieri AM, Beckman J, Urban M et al. An Observational Study of Cerebral Blood Flow Velocity Evaluation in the Prone Position During Posterior Lumbar Surgery. Anesth. Analg. 2019 Aug 1; 129 (2): 487-492.
  Daniel Jolley
pearl
1
The single greatest predictor of the amount of opioid used after surgical discharge is the amount of postoperative opioid prescribed.
Howard R, Fry B, Gunaseelan V et al. Association of Opioid Prescribing With Opioid Consumption After Surgery in Michigan. JAMA Surg. 2019 Jan 1; 154 (1): e184234.
  Daniel Jolley
pearl
1
Intraoperative remifentanil infusions above a certain threshold may be associated with Opioid Induced Hyperalgesia and Acute Opioid Tolerance, although the clinical significance is uncertain,
Collection: Is remifentanil associated with Opioid Induced Hyperalgesia and Acute Opioid Tolerance?
  Daniel Jolley
pearl
1
Beware anesthesiologist number 7... the quality of intraoperative conduct of anesthesia effects patient outcomes.
Slogoff S Keats AS. Does perioperative myocardial ischemia lead to postoperative myocardial infarction? Anesthesiology. 1985 Feb 1; 62 (2): 107-14.
  Daniel Jolley
comment
1
Also see Carbon Footprint from Anaesthetic gas use [pdf] from the UK’s Sustainable Development Unit.

Collection: What contribution does anesthesia make to climate change?
  Daniel Jolley
pearl
1
Anesthesiologists have the ability to contribute either positively or negatively to the growing opioid misuse crisis.
Soffin EM, Lee BH, Kumar KK et al. The prescription opioid crisis: role of the anaesthesiologist in reducing opioid use and misuse. Br J Anaesth. 2019 Jun 1; 122 (6): e198e208e198-e208.
  Daniel Jolley
comment
1
Metajournal now automatically tracks and can filter for retracted articles – simply hit search in your article view and filter by article type. Easily check if there are any retracted articles among those you’ve favourited or read previously.
It’s a sad indictment on a minority in the medical community that this kind of technology is now necessary...
Collection: Retracted anesthesia & perioperative medicine publications
  Daniel Jolley