It is important to note that the drivers of growth in Office Based Anesthesia are primarily economic and professional autonomy focused rather than patient care or quality of care. That is not to say these former priorities are in opposition to patient-centered goals, just that the patient is not the primary diver of this shift.
An exploration of the growth and evolution of Office Based Anesthesia in North America, including safety and regulatory concerns. The authors note that although recent data somewhat supports the safety of OBA, this is based upon lesser-quality retrospective studies.
The Ambu AuraOnce™ laryngeal mask is a non-inferior alternative to the LMA Classic and the LMA Unique.
Use of an electronic decision support tool increases adherence to peri-operative ACC/AHA guidelines among anesthesia residents.
Low average volatile concentration shows some association with post-operative delirium in a sub-study analysis of cardiothoracic patients admitted post-operatively to ICU, although clinical implications are unclear. Use of BIS was not statistically significantly associated with a lower incidence of delirium, although there was a trend to lower incidence.
Although general anaesthesia was associated with greater blood loss than regional anaesthesia in this meta-analysis (only ~100 mL), this is of questionable significance, and meta-analysis of RCTs showed there was no greater risk of blood transfusion.
Of course the issue here is whether occlusion of the oesophageal entrance sufficient to prevent antegrade passage of a flexible silicon tube is a valid surrogate for the ability to prevent retrograde passage of liquid (ie. gastric fluid). There is a significant difference here and I feel this research adds little to the debate regarding benefit (or not) of cricoid pressure.
Cricoid pressure of 30N prevented the passage of both small and large gastric tubes into the oesophageal entrance, which the authors believe supports the utility of cricoid pressure in successfully occluding the oesophagus.
This meta-analysis included 13 studies and demonstrates that ketamine added to caudal local anaesthesia prolongs analgesia in children with minimal adverse effects, though highlights that the potential neurotoxicity of ketamine has not yet been conclusively addressed.
Prophylactic phenylephrine infusion reduces the incidence of hypotension, nausea and vomiting in women undergoing caesarean section under spinal.