Awareness occurred in 1 in 19,000 general anaesthetics, resulting in distress in 51% of cases and longterm harm in 41%. BIS monitoring was used in 5% of cases of awareness.
75% of cases of accidental awareness under general anaesthesia are likely preventable.
Experiencing paralysis during awareness under general anaesthesia, even without pain, is in particular associated with distress and longterm harm.
Even short periods of awareness during general anaesthesia commonly result in severe patient distress and longterm consequences.
Wow! They had a 21% incidence of PDPH in their control group (and almost 8% in the treatment arm) because they were using 25g Quincke needles! It is interesting that they have access to ondansetron but presumably not pencil-point needles.
This study leaves me asking why? why? why?
The monoclonal antibody-fragment idarucizumab reliably reverses the thrombin-inhibitor anticoagulant dabigatran ('Pradaxa') within minutes of administration.
Fascinating. Hazard of small studies but would love to see a mechanism. Big dose of Ondansetron too. Ummm.
No significant difference between plain or hyperbaric spinal bupivacaine, though the authors dismissed a faster onset in the hyperbaric group which may be of more practical benefit.
Pre-operative oral carbohydrate decreases postoperative insulin resistance, speeds gastrointestinal functional recovery and reduces hospital stay, most significantly after major surgery.
Though has limited application outside of the low-resource setting. This basically shows ketofol is non-inferior to propofol alone, rather than superior.
The audited group is a pretty low-risk one for negative hemodynamic consequences from propofol (alone) sedation. Adding a drug (ketamine) increases technique complexity and needs to be balanced against a demonstrable benefit.