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Anesthesiology

M-A: Impact of enhanced recovery protocols after pancreatoduodenectomy.

24 Jan, 2022 | 08:00h | UTC

Impact of enhanced recovery protocols after pancreatoduodenectomy: meta-analysis – British Journal of Surgery (link to abstract – $ for full-text)

Related:

RCT: Pancreatoduodenectomy with or without prophylactic falciform ligament wrap around the hepatic artery for prevention of postpancreatectomy haemorrhage.

Randomized Trial: Gastrointestinal Complications After Pancreatoduodenectomy With Epidural vs. Patient-Controlled Intravenous Analgesia

[Abstract Only] Meta‐analysis of Effect of Routine Enteral Nutrition on Postoperative Outcomes after Pancreatoduodenectomy

Randomized Trial: Oral vs. Enteral Feeding for Patients with Postoperative Pancreatic Fistula After Pancreatoduodenectomy

See also: Complete List of Enhanced Recovery After Surgery (ERAS) Society Guidelines (some guidelines are free)

 

Commentary on Twitter

 

Perioperative guidelines on antiplatelet and anticoagulant agents: 2022 Update.

21 Jan, 2022 | 09:53h | UTC

Perioperative Guidelines on Antiplatelet and Anticoagulant Agents: 2022 Update – Current Anesthesiology Reports

 

Consensus statement on hemostatic management, anticoagulation, and antiplatelet therapy in liver transplantation.

20 Jan, 2022 | 08:47h | UTC

Consensus Statement on Hemostatic Management, Anticoagulation, and Antiplatelet Therapy in Liver Transplantation – Transplantation

 

RCT: In critically ill adults, using a balanced multielectrolyte solution did not lower the risk of death or acute kidney injury compared to standard saline.

19 Jan, 2022 | 08:41h | UTC

Balanced Multielectrolyte Solution versus Saline in Critically Ill Adults – New England Journal of Medicine (link to abstract – $ for full-text)

Commentary: Australian study set to guide the treatment of critically ill patients worldwide – George Institute for Global Health

Related:

BaSICS RCT: Among critically ill patients requiring fluid therapy, treatment with a balanced solution did not lead to reduced mortality compared to a 0.9% saline solution.

BaSICS RCT: Among critically ill patients requiring fluid therapy, there was no difference in mortality with slower (333 mL/h) vs. faster (999 mL/h) intravenous fluid bolus rates.

Cochrane Review: Buffered Solutions Do Not Improve Mortality in Critically Ill Adults and Children Compared to 0,9% Saline

 

Commentary on Twitter

 

Pro-Con Debate: Cardiac Troponin measurement as part of routine follow-up of myocardial damage following noncardiac surgery.

18 Jan, 2022 | 09:36h | UTC

Pro-Con Debate: Cardiac Troponin Measurement as Part of Routine Follow-up of Myocardial Damage Following Noncardiac Surgery – Anesthesia & Analgesia

 

ERAS Guidelines for perioperative care in bariatric surgery.

16 Jan, 2022 | 23:21h | UTC

Guidelines for Perioperative Care in Bariatric Surgery: Enhanced Recovery After Surgery (ERAS) Society Recommendations: A 2021 Update – World Journal of Surgery

Related: Complete List of Enhanced Recovery After Surgery (ERAS) Society Guidelines

 

Commentary on Twitter

 

RCT: In patients undergoing emergency endotracheal intubation, 7-day survival was significantly lower with etomidate vs. ketamine (77.3% versus 85.1%), but 28 survival rates were not significantly different (etomidate 64.1% vs. ketamine 66.8%, p = 0.294).

16 Jan, 2022 | 23:09h | UTC

Etomidate versus ketamine for emergency endotracheal intubation: a randomized clinical trial – Intensive Care Medicine

Commentary: SGEM#356: Drugs are gonna knock you out – etomidate vs. ketamine for emergency endotracheal intubation – The Skeptics’ Guide to EM

 

Commentary on Twitter

 

Perioperative cardiovascular considerations prior to elective noncardiac surgery in patients with a history of Covid-19.

14 Jan, 2022 | 08:39h | UTC

Perioperative Cardiovascular Considerations Prior to Elective Noncardiac Surgery in Patients With a History of COVID-19 – JAMA Surgery

Related:

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

BJS commission on surgery and perioperative care post-COVID-19.

The risk of postoperative complications following major elective surgery in active or resolved COVID-19 in the United States – Major, elective surgery 0–4 weeks after Covid-19 is associated with greatly increased risk of postoperative complications; surgery performed 4–8 weeks after infection is still associated with an increased risk of pneumonia.

ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.

Position statement: Perioperative management of post-COVID-19 surgical patients.

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

 

Systematic Review: Restrictive transfusion thresholds can safely decrease transfusions by 41% across a broad range of clinical contexts.

14 Jan, 2022 | 08:18h | UTC

Transfusion thresholds for guiding red blood cell transfusion – Cochrane Library

Summary: Is it safe to use lower blood counts (haemoglobin levels) as a trigger for blood transfusion in order to give fewer blood transfusions? – Cochrane Library

Related:

RCT: Among patients with acute MI and anemia, a restrictive transfusion strategy resulted in a noninferior rate of major cardiovascular events compared to a liberal transfusion strategy

Randomized trial: Liberal vs. restrictive transfusion thresholds in extremely low-birth-weight infants

Meta-Analysis: Effects of Restrictive vs. Liberal Transfusion Strategies on Longer-term Outcomes After Cardiac Surgery

Randomized Trial: In Patients Undergoing Cardiac Surgery, A Restrictive Transfusion Approach Does Not Increase the Risk of Acute Kidney Injury

Effects of restrictive red blood cell transfusion on the prognoses of adult patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials – Critical Care

Research: Restrictive or Liberal Red-Cell Transfusion for Cardiac Surgery

Transfusion Requirements After Cardiac Surgery: The TRACS Randomized Controlled Trial – JAMA

 

Commentary on Twitter

 

Systematic Review: In patients who are about to undergo noncardiac surgery, biomarkers (BNP/NT‐proBNP, troponin or their combination) may provide added prognostic value to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all‐cause mortality. The results cannot be interpreted as conclusive due to the high risks of bias in most papers.

13 Jan, 2022 | 08:15h | UTC

The comparative and added prognostic value of biomarkers to the Revised Cardiac Risk Index for preoperative prediction of major adverse cardiac events and all‐cause mortality in patients who undergo noncardiac surgery – Cochrane Library

Summary: Can biomarkers improve predictions of the RCRI tool to predict heart-related complications in patients undergoing surgery other than heart surgery? – Cochrane Library

 

Review: Management of coagulopathy in bleeding patients.

12 Jan, 2022 | 08:34h | UTC

Management of Coagulopathy in Bleeding Patients – Journal of Clinical Medicine

 

Special Issue: Peri‐operative and critical care management of the brain ‐ current evidence.

11 Jan, 2022 | 02:36h | UTC

Homepage: Special Issue:Peri‐operative and critical care management of the brain ‐ current evidence – Anaesthesia

Editorials:

In search of the perfect outcome in neuroanaesthesia and neurocritical care

Anaesthesia and the older brain: what should we do?

Review Articles:

Implications of nocebo in anaesthesia care

Chronic subdural haematoma: the role of peri-operative medicine in a common form of reversible brain injury

Acute peri-operative neurocognitive disorders: a narrative review

Pragmatic sedation strategies to prevent secondary brain injury in low-resource settings

Delirium and COVID-19: a narrative review of emerging evidence

Anaesthesia for mechanical thrombectomy: a narrative review

Clinical applications of point-of-care ultrasound in brain injury: a narrative review

Management of status epilepticus: a narrative review

Evidence-based strategies to reduce the incidence of postoperative delirium: a narrative review

Management of traumatic brain injury: a narrative review of current evidence

Peri-operative neurological monitoring with electroencephalography and cerebral oximetry: a narrative review

Peri-operative management of patients with Parkinson’s disease

 

RCT: In older patients undergoing hip fracture surgery, regional anesthesia did not reduce the incidence of postoperative delirium compared to general anesthesia.

8 Jan, 2022 | 23:09h | UTC

Effect of Regional vs General Anesthesia on Incidence of Postoperative Delirium in Older Patients Undergoing Hip Fracture Surgery: The RAGA Randomized Trial – JAMA (link to abstract – $ for full-text)

Commentary: China-wide study will boost understanding of fatal surgical complication – University of Birmingham

Related:

RCT: Spinal Anesthesia not Superior to General Anesthesia for Hip Surgery in Older Adults.

RCT: Similar long-term survival after combined epidural–general anesthesia vs. general anesthesia alone.

Delirium in Older Patients after Combined Epidural–General Anesthesia or General Anesthesia for Major Surgery: A Randomized Trial – Anesthesiology

 

RCT: In critically ill adults undergoing tracheal intubation, use of a bougie did not significantly increase the incidence of successful first attempt intubation vs. with use of an endotracheal tube with stylet.

9 Dec, 2021 | 10:22h | UTC

Effect of Use of a Bougie vs Endotracheal Tube With Stylet on Successful Intubation on the First Attempt Among Critically Ill Patients Undergoing Tracheal Intubation: A Randomized Clinical Trial – JAMA (free for a limited period)

Related: Randomized Trial: Comparison of Intubation Techniques in Patients with Difficult Airways

 

Review: Current issues in the use of opioids for the management of postoperative pain.

9 Dec, 2021 | 10:18h | UTC

Current Issues in the Use of Opioids for the Management of Postoperative Pain: A Review – JAMA Surgery (free for a limited period)

 

Blood sugar targets in surgical intensive care: management and special considerations in patients with diabetes.

9 Dec, 2021 | 10:06h | UTC

Blood Sugar Targets in Surgical Intensive Care – Deutsches Ärzteblatt International

 

Review: Perioperative pain management issues unique to older adults undergoing surgery.

8 Dec, 2021 | 09:52h | UTC

Perioperative Pain Management Issues Unique to Older Adults Undergoing Surgery: A Narrative Review – Annals of Surgery Open

 

The risk of postoperative complications following major elective surgery in active or resolved COVID-19 in the United States – Major, elective surgery 0–4 weeks after Covid-19 is associated with greatly increased risk of postoperative complications; surgery performed 4–8 weeks after infection is still associated with an increased risk of pneumonia.

7 Dec, 2021 | 10:23h | UTC

The Risk of Postoperative Complications following Major Elective Surgery in Active or Resolved COVID-19 in the United States – Annals of Surgery

Related:

Guideline: SARS‐CoV‐2 infection, COVID‐19 and timing of elective surgery

Study from 116 countries suggests surgery should be delayed for at least seven weeks following a COVID-19 diagnosis to reduce mortality risk

ASA Guidance: Preoperative testing for COVID-19 is essential, regardless of vaccination.

Position statement: Perioperative management of post-COVID-19 surgical patients.

Cohort study: Postoperative in-hospital mortality of patients with COVID-19 infection was more than double that in patients without COVID-19

 

Review: Preprocedural fasting for contrast-enhanced CT (CECT) – “Traditional preparatory fasting policy prior to CECT lacks methodologically acceptable evidence”.

5 Dec, 2021 | 23:29h | UTC

Preprocedural fasting for contrast-enhanced CT: when experience meets evidence – Insights into Imaging

 

Editorial: The rationale for the recommendations of the European Pediatric Fasting Guideline – “the authors of the 2021 ESAIC pediatric guideline have found reasons to recommend reductions to the minimum fasting times for infant formula to 4 h, for breast milk to 3 h and for clear fluids to 1 h”.

5 Dec, 2021 | 23:26h | UTC

The rationale for the recommendations of the European Paediatric Fasting Guideline: Improving paediatric anaesthesia and perioperative medicine – European Journal of Anaesthesiology

Original Guideline: Pre-operative fasting in children: A guideline from the European Society of Anaesthesiology and Intensive Care – European Journal of Anesthesiology

Related:

Pro-Con Debate: 1- vs 2-Hour Fast for Clear Liquids Before Anesthesia in Children.

ESPEN practical guideline: Clinical nutrition in surgery – “Preoperative fasting from midnight is unnecessary in most patients. Patients undergoing surgery, who are considered to have no specific risk of aspiration, shall drink clear fluids until 2 h before anesthesia. Solids shall be allowed until 6 h before anesthesia.”

 

Carbon footprint of general, regional, and combined anesthesia for total knee replacements.

21 Nov, 2021 | 22:50h | UTC

Carbon Footprint of General, Regional, and Combined Anesthesia for Total Knee Replacements – Anesthesia

Related:

Global Consensus Statement: Principles of environmentally-sustainable anesthesia.

Environmental and Occupational Considerations of Anesthesia: A Narrative Review and Update.

Working toward the triple bottom line in surgery to limit the impact of surgery on the environment

Effects Of Surgery On A Warming Planet: Can Anesthesia Go Green? – NPR

Anaesthetic gases, climate change, and sustainable practice – The Lancet Planetary Health

Greenhouse gases: the choice of volatile anesthetic does matter – Canadian Journal of Anesthesiology

People, planet and profits: the case for greening operating rooms – Canadian Medical Association Journal

 

Position Statement: Preoperative Care for Cataract Surgery – “In spite of evidence debunking the utility of testing before cataract surgery, studies suggest that medical testing and the use of medical consultations before cataract surgery continue to increase”.

17 Nov, 2021 | 08:33h | UTC

Preoperative Care for Cataract Surgery: The Society for Ambulatory Anesthesia Position Statement – Anesthesia & Analgesia

 

Commentary on Twitter

 

Nursing care for oncologic patients undergoing surgery using an enhanced recovery approach.

17 Nov, 2021 | 08:22h | UTC

Oncologic Surgical Care Using an Enhanced Recovery Approach – AACN Advanced Critical Care

News release: Enhanced Recovery Approach Changes Care for Surgical Oncology Patients – American Association of Critical-Care Nurses

Related: Complete List of Enhanced Recovery After Surgery (ERAS) Society Guidelines

 

Review: Cardiac device troubleshooting in the intensive care unit.

16 Nov, 2021 | 08:21h | UTC

Cardiac device troubleshooting in the intensive care unit: an educational review – European Heart Journal. Acute Cardiovascular Care

 

Commentary on Twitter

 

2022 ASA Guidelines for Management of the Difficult Airway.

12 Nov, 2021 | 10:31h | UTC

2022 American Society of Anesthesiologists Practice Guidelines for Management of the Difficult Airway – Anesthesiology

Related:

Consensus-based recommendations for management of the difficult airway: part 1. Difficult airway management encountered in an unconscious patient.

Difficult airway management in neonates and infants: knowledge of devices and a device-oriented strategy.

Consensus Guideline: Pediatric Airway Management in COVID-19 Patients

Guidelines for Awake Tracheal Intubation in Adults

Position Paper: Management of Unanticipated Difficult Airways in Children in Anesthetic Practice

Review: Difficult Airway Management Algorithms (several resources on the subject)

The Difficult Airway Trolley: A Narrative Review and Practical Guide

 

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