June featured a few simple interventions for c-sections, with dexamethasone killing two birds with one stone. Also, you'll find elegant formula for initial PEEP levels for some of our intubated patients. Adjustment of positive end-expiratory pressure based on body mass index during general anaesthesia: a randomised controlled trial
In intubated adults under general anesthesia, setting PEEP levels to BMI/3 is a practical initial step towards optimizing individual PEEP settings.
8mg of intravenous dexamethasone significantly reduced the incidence of spinal hypotension during caesarean delivery.
Evidence suggests that intravenous dexamethasone not only decreases nausea and vomiting, but delays first request for analgesia after cesarean section. It also reduces total analgesic demand and pain scores up to 24 hours post delivery.
Continuous vasopressor infusion is superior to rescue boluses in preventing post spinal hypotension and subsequent intraoperative nausea and vomiting. In addition, continuous norepinephrine infusion is superior to phenylephrine, with an effective dose of 0.07 μg/kg/min.
This month featured multiple practical articles on pediatric anesthesia. These articles include the use of maternal voice recordings to decrease emergence delirium, nebulized precedex in endoscopy, and a dose-finding propofol-precedex study for MRI cases. Preoperative oral caffeine as prophylaxis against post-spinal hypotension in patients undergoing orthopedic lower limb surgery: A
The Takeaway An anesthetic plan with propofol infusion and single dexmedetomidine provides a safe sedation and didn't significantly extend recovery time. Study Design * 79 children aged 1-12, scheduled for MRI * Single-center, prospective, sequential, dose-ranging trial * ASA I-III, natural airway, intravenous access prior to sedation * Propofol-Only cohort received an
The Takeaway topical administration of dexmedetomidine, when combined with lidocaine, significantly enhances the reduction in both the incidence and intensity of cough reflex during extubation Study Design * 180 patients (60 per group) * Inclusion criteria: female patients aged 18 to 65, ASA I or II, BMI 18 to 30 kg/m²
In this meta-analysis, reversal with sugammadex decreased PONV metrics, especially when given at after the return of the second twitch.
Delivering prerecorded, repeated maternal voice orientation via noise cancelling headphones decreased emergence agitation in pediatric patients undergoing tonsillectomy and adenoidectomy
Nebulized precedex significantly decreased gag and cough reflexes, anesthetic requirements, and enhanced endoscopist satisfaction.
A preoperative administration of 200 mg caffeine tablet can reduce hypotensive episodes and ephedrine requirements within the first hour of spinal anesthesia.
