Anaesthetists are inaccurate when identifying lumbar spinal interspace level using bony landmarks.
When anaesthetists were assessed on their ability to correctly identify a lumbar interspace level in 100 patients undergoing spinal MRI:
- Only 29% identified the space correctly.
- 68% indicated the space was lower than actual.
- 51% were one space out in their estimate.
- 15.5% two spaces.
- 1% three spaces.
- 0.5% four spaces.
And surprising to no obstetric anaesthesiologists... 🤔🙄
"...we have a case in our series in which a woman suffering from postpartum paraesthesia attempted a claim against the anaesthetist although she had received neither epidural nor spinal anaesthesia!
It is often only when an anaesthetic medicolegal opinion is sought that the obstetric nature of the injury is appreciated."
Among a prospective French obstetric cohort, 1 in 300 women demonstrated postpartum neuropathy, most commonly primiparous, sensory and in femoral nerve territory.
Duration of pre-operative fasting in children is associated with increased risk of post-induction hypotension.
A restrictive transfusion strategy in adult cardiac surgery does not alter mortality or complications.
Legal responses to obstetric neuraxial complications are best minimised by respecting patient autonomy, early provision of information, good communication and record-keeping.
Maternal sedation with local anaesthetic infiltration is comparable to spinal anaesthesia for women undergoing minimally-invasive fetal surgery, and in fact improves maternal hemodynamic stability.
New guidelines for paediatric button battery ingestion recommend preoperative administration with honey and/or sucralfate, and post-removal irrigation with 0.25% acetic acid.
Pre-operative infusion of 5mL/kg of 5% dextrose before laparoscopic cholecystectomy reduces post-operative nausea & vomiting by ~30%.