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Interestingly though, despite improved satisfaction and dramatically less morphine consumed, there was no difference in pain scores or common opioid side effects.
Tan TT, Teoh WH, Woo DC et al. A randomised trial of the analgesic efficacy of ultrasound-guided transversus abdominis plane block after caesarean delivery under general anaesthesia. Eur J Anaesthesiol. 2012 Feb 1;29(2):88-94.
  Daniel Jolley
pearl
1
Ultrasound guided TAP block significantly reduces morphine consumption and improves satisfaction following general anaesthesia caesarean section.
Tan TT, Teoh WH, Woo DC et al. A randomised trial of the analgesic efficacy of ultrasound-guided transversus abdominis plane block after caesarean delivery under general anaesthesia. Eur J Anaesthesiol. 2012 Feb 1;29(2):88-94.
  Daniel Jolley
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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.
Shapiro FE, Punwani N, Rosenberg NM et al. Office-based anesthesia: safety and outcomes. Anesth. Analg. 2014 Aug 1;119(2):276-85.
  Daniel Jolley
pearl
1
The Ambu AuraOnce™ laryngeal mask is a non-inferior alternative to the LMA Classic and the LMA Unique.
Baidya DK, Chandralekha, Darlong V et al. Comparative efficacy and safety of the Ambu(®) AuraOnce(™) laryngeal mask airway during general anaesthesia in adults: a systematic review and meta-analysis. Anaesthesia. 2014 Sep 1;69(9):1023-32.
  Daniel Jolley
pearl
1
Use of an electronic decision support tool increases adherence to peri-operative ACC/AHA guidelines among anesthesia residents.
Hand WR, Bridges KH, Stiegler MP et al. Effect of a Cognitive Aid on Adherence to Perioperative Assessment and Management Guidelines for the Cardiac Evaluation of Noncardiac Surgical Patients. Anesthesiology. 2014 Jun 1; 120 (6): 1339-49, quiz 1349-53.
  Daniel Jolley
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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.
Zeidan AM, Salem MR, Mazoit JX et al. The effectiveness of cricoid pressure for occluding the esophageal entrance in anesthetized and paralyzed patients: an experimental and observational glidescope study. Anesth. Analg. 2014 Mar 1; 118 (3): 580-6.
  Daniel Jolley
pearl
1
Prophylactic phenylephrine infusion reduces the incidence of hypotension, nausea and vomiting in women undergoing caesarean section under spinal.
Heesen M, Kölhr S, Rossaint R et al. Prophylactic phenylephrine for caesarean section under spinal anaesthesia: systematic review and meta-analysis. Anaesthesia. 2014 Feb 1; 69 (2): 143-65.
  Daniel Jolley
pearl
2
Intraoperative clonidine or dexmedetomidine significantly reduce emergence delirium in children after general anaesthesia (OR 0.28)
Pickard A, Davies P, Birnie K et al. Systematic review and meta-analysis of the effect of intraoperative α2-adrenergic agonists on postoperative behaviour in children. Br J Anaesth. 2014 Jun 1;112(6):982-90.
  Daniel Jolley
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Interesting. One wonders how many blocks would be improved by the addition of dex. Cost:benefit analysis would be nice as (in my setting anyway) the cost of dex is prohibitive.
Fritsch G, Danninger T, Allerberger K et al. Dexmedetomidine Added to Ropivacaine Extends the Duration of Interscalene Brachial Plexus Blocks for Elective Shoulder Surgery When Compared with Ropivacaine Alone: A Single-Center, Prospective, Triple-Blind, Randomized Controlled Trial. Reg Anesth Pain Med. 2014 Jan 1; 39 (1): 37-47.
  Mike Blackburn
pearl
1
Remifentanil PCIA is likely inferior to labour epidural analgesia.
Liu ZQ, Chen XB, Li HB et al. A comparison of remifentanil parturient-controlled intravenous analgesia with epidural analgesia: a meta-analysis of randomized controlled trials. Anesth. Analg. 2014 Mar 1;118(3):598-603.
  Daniel Jolley