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pearl
1
Continuous interscalene block offers analgesic benefits up to 1 week after shoulder surgery when compared with either single-shot block or GA alone.
Salviz EA, Xu D, Frulla A et al. Continuous interscalene block in patients having outpatient rotator cuff repair surgery: a prospective randomized trial. Anesth. Analg. 2013 Dec 1;117(6):1485-92.
  Daniel Jolley
pearl
1
TAP blocks may offer some small analgesic benefit after caesarean section at 6h and 12h, but not 24h, in patients also receiving intrathecal morphine.
Singh S, Dhir S, Marmai K et al. Efficacy of ultrasound-guided transversus abdominis plane blocks for post-cesarean delivery analgesia: a double-blind, dose-comparison, placebo-controlled randomized trial. Int J Obstet Anesth. 2013 Jul 1;22(3):188-93.
  Daniel Jolley
pearl
1
Perineural dexamethasone may significantly increase the duration of analgesia after regional blockade, though without dose-response effect.
Albrecht E, Kern C, Kirkham KR. A systematic review and meta-analysis of perineural dexamethasone for peripheral nerve blocks. Anaesthesia. 2015 Jan 1; 70 (1): 71-83.
  Daniel Jolley
pearl
1
The oral cannabinoid dronabinol has similar psychoactive effects to smoking marijuana.
Issa MA, Narang S, Jamison RN et al. The Subjective Psychoactive Effects of Oral Dronabinol Studied in a Randomized, Controlled Crossover Clinical Trial For Pain. Clin J Pain. 2014 Jun 1; 30 (6): 472-8.
  Daniel Jolley
pearl
1
Subparaneural injection for popliteal sciatic nerve block shows faster onset and longer duration than circumferential extraneural injection.
Choquet O, Noble GB, Abbal B et al. Subparaneural Versus Circumferential Extraneural Injection at the Bifurcation Level in Ultrasound-Guided Popliteal Sciatic Nerve Blocks: A Prospective, Randomized, Double-Blind Study. Reg Anesth Pain Med. 2014 Jul 1;39(4):306-11.
  Daniel Jolley
pearl
1
Perioperative pregabalin may improve postoperative analgesia, nausea and vomiting, though increases sedation and visual disturbances
Mishriky BM, Waldron NH, Habib AS. Impact of pregabalin on acute and persistent postoperative pain: a systematic review and meta-analysis. Br J Anaesth. 2015 Jan 1; 114 (1): 10-31.
  Daniel Jolley
pearl
1
Performing regional anesthetic blocks in children under general anesthesia is as safe as in sedated or awake children.
Taenzer AH, Walker BJ, Bosenberg AT et al. Asleep Versus Awake: Does It Matter?: Pediatric Regional Block Complications by Patient State: A Report From the Pediatric Regional Anesthesia Network. Reg Anesth Pain Med. 2014 Jul 1;39(4):279-83.
  Daniel Jolley
pearl
1
Suggestive techniques may reduce postoperative anxiety and pain, although not analgesic consumption or nausea.
Kekecs Z, Nagy T, Varga K. The Effectiveness of Suggestive Techniques in Reducing Postoperative Side Effects: A Meta-Analysis of Randomized Controlled Trials. Anesth. Analg. 2014 Dec 1;119(6):1407-19.
  Daniel Jolley
comment
1
The role of suggestibility just never goes away yet seems rarely considered in our hospital processes. Why has nursing as a science ignored this?
Kekecs Z, Nagy T, Varga K. The Effectiveness of Suggestive Techniques in Reducing Postoperative Side Effects: A Meta-Analysis of Randomized Controlled Trials. Anesth. Analg. 2014 Dec 1;119(6):1407-19.
  Allan Palmer
comment
1
All of these non-invasive monitors have inate variability but if you can see past that they do seem to add value to patient care.
Waldron NH, Miller TE, Thacker JK et al. A Prospective Comparison of a Noninvasive Cardiac Output Monitor Versus Esophageal Doppler Monitor for Goal-Directed Fluid Therapy in Colorectal Surgery Patients. Anesth. Analg. 2014 May 1;118(5):966-75.
  Allan Palmer