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pearl
1
Perioperative vitamin C in patients undergoing non-cardiac surgery likely does not offer significant outcome benefit.
Suter M, Bollen PintoBernardoBDivision of Anaesthesiology, Department of Acute Medicine, Geneva University Hospitals, Geneva, Switzerland., Belletti A et al. Efficacy and safety of perioperative vitamin C in patients undergoing noncardiac surgery: a systematic review and meta-analysis of randomised trials. Br J Anaesth. 2022 Apr 1; 128 (4): 664-678.
  Daniel Jolley
pearl
1
Goal-directed haemodynamic therapy might decrease mortality, hospital stay & postoperative complications, yet only infectious complications & anastomotic leak show moderate evidence certainty.
Jessen MK, Vallentin MF, Holmberg MJ et al. Goal-directed haemodynamic therapy during general anaesthesia for noncardiac surgery: a systematic review and meta-analysis. Br J Anaesth. 2022 Mar 1; 128 (3): 416433416-433.
  Daniel Jolley
pearl
1
Intrathecal 2-chloropocaine 3% is an acceptable alternative to intrathecal hyperbaric bupivacaine for cervical cerclage placement, providing a shorter time to sensory resolution and PACU discharge.
Lee A, Shatil B, Landau R et al. Intrathecal 2-Chloroprocaine 3% Versus Hyperbaric Bupivacaine 0.75% for Cervical Cerclage: A Double-Blind Randomized Controlled Trial. Anesth. Analg. 2022 Mar 1; 134 (3): 624632624-632.
  Daniel Jolley
pearl
1
Prehabilitation may improve postoperative outcomes, but the evidence base is still sparse and uncertain.
McIsaac DI, Gill M, Boland L et al. Prehabilitation in adult patients undergoing surgery: an umbrella review of systematic reviews. Br J Anaesth. 2022 Feb 1; 128 (2): 244-257.
  Daniel Jolley
pearl
1
Postoperative adjunct use of serotonin-norepinephrine reuptake inhibitors (SNRIs) shows a small beneficial effect to reduce acute & chronic post-operative pain and opioid consumption.
Wang L, Tobe J, Au E et al. Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: systematic review and meta-analysis of randomised controlled trials. Br J Anaesth. 2022 Jan 1; 128 (1): 118-134.
  Daniel Jolley
pearl
1
Routine postoperative noninvasive respiratory support does not prevent pneumonia in adults undergoing elective surgery.
Hui S, Fowler AJ, RMJ Cashmore et al. Routine postoperative noninvasive respiratory support and pneumonia after elective surgery: a systematic review and meta-analysis of randomised trials. Br J Anaesth. 2022 Feb 1; 128 (2): 363-374.
  Daniel Jolley
pearl
1
Post-caesarean section local anaesthetic wound infusion reduces acute postoperative pain & hyperalgesia although had no effect on persistent postoperative pain.
MÁ Gómez-Ríos, Codesido-Barreiro P, Seco-Vilariño C et al. Wound Infusion of 0.35% Levobupivacaine Reduces Mechanical Secondary Hyperalgesia and Opioid Consumption After Cesarean Delivery. A Prospective, Randomized, Triple-Blind, Placebo-Controlled Trial. Anesth. Analg. 2022 Apr 1; 134 (4): 791-801.
  Daniel Jolley
pearl
1
Companion presence during labour epidural placement reduces maternal anxiety and improves maternal satisfaction.
Morell E, Peralta FM, Higgins N et al. Effect of companion presence on maternal satisfaction during neuraxial catheter placement for labor analgesia: a randomized clinical trial. Int J Obstet Anesth. 2019 May 1; 38: 66-74.
  Daniel Jolley
pearl
1
In a rabbit-model of infant front-of-neck airway rescue, a cuffed 3.0 mm ETT was non-inferior to uncuffed 3.5 mm ETT for success & time-to-perform, but required greater force.
Thomas J, Alonso E, Wendel PD et al. Cuffed versus uncuffed tracheal tubes in a rabbit training model for establishing an emergency front-of-neck airway in infants: a prospective trial. Br J Anaesth. 2022 Feb 1; 128 (2): 382-390.
  Daniel Jolley
pearl
1
Prone positioning improves oxygenation & reduces mortality among non-intubated COVID positive patients, but does not appear to reduce the intubation rate.
Fazzini B, Page A, Pearse R et al. Prone positioning for non-intubated spontaneously breathing patients with acute hypoxaemic respiratory failure: a systematic review and meta-analysis. Br J Anaesth. 2022 Feb 1; 128 (2): 352362352-362.
  Daniel Jolley