Anesthesiology (all articles)
RCT: Propafenone leads to quicker sinus rhythm restoration than amiodarone in supraventricular arrhythmias related to septic shock
1 Oct, 2023 | 15:19h | UTCStudy Design & Population: The research was a two-center, prospective, controlled parallel-group, double-blind trial involving 209 septic shock patients who had new-onset supraventricular arrhythmia and a left ventricular ejection fraction above 35%. Patients were randomized to receive either intravenous propafenone (70 mg bolus followed by 400–840 mg/24 h) or amiodarone (300 mg bolus followed by 600–1800 mg/24 h).
Main Findings: The primary outcomes focused on the proportion of patients in sinus rhythm 24 hours post-infusion, time to the first sinus rhythm restoration, and arrhythmia recurrence rates. No significant difference was observed in 24-hour sinus rhythm rates between the propafenone (72.8%) and amiodarone (67.3%) groups (p=0.4). Time to the first rhythm restoration was significantly shorter for the propafenone group (median 3.7 hours) compared to the amiodarone group (median 7.3 hours, p=0.02). Recurrence of arrhythmia was notably lower in the propafenone group (52%) than in the amiodarone group (76%, p<0.001). In the subgroup of patients with a dilated left atrium, amiodarone appeared to be more effective.
Implications & Limitations: The study suggests that while propafenone doesn’t offer better rhythm control at 24 hours compared to amiodarone, it does provide faster cardioversion and fewer arrhythmia recurrences, especially in patients with a non-dilated left atrium. No significant differences were observed in clinical outcomes, such as ICU or long-term mortality, between propafenone and amiodarone in the trial. Limitations include potential underpowering of the study and the inability to fully account for the impact of multiple covariates involved in the complex therapy of septic shock.
Commentary on Twitter:
Propafenone?70 mg bolus+ 400-840 mg/24h vs amiodarone?300 mg + by 600-1800 mg/24h for SVA in septic shock, RCT
?propafenone not better for rhythm control at 24h but excellent hemodynamic safety profile, cardioverting faster & fewer recurrences#FOAMCc
?https://t.co/GVuoxPD7Hy pic.twitter.com/rRlj00x71p— Intensive Care Medicine (@yourICM) September 13, 2023
RCT | Restrictive vs. liberal red blood cell transfusion strategy for critically injured patients
11 Aug, 2023 | 15:08h | UTC
Review | Regional anesthesia in the emergency department outside the operating theatre
8 Aug, 2023 | 13:17h | UTC
Review | Local anesthetic adjuncts for peripheral nerve blockade
8 Aug, 2023 | 13:16h | UTCLocal anaesthetic adjuncts for peripheral nerve blockade – Current Opinion in Anaesthesiology
M-A | Efficacy and safety of supraclavicular versus infraclavicular approach for subclavian vein catheterization
7 Aug, 2023 | 14:49h | UTC
M-A | Supine vs. nonsupine endotracheal intubation
4 Aug, 2023 | 11:45h | UTC
RCT | Ferric derisomaltose plus tranexamic acid may reduce blood transfusion risk by 50% in hip surgery
3 Aug, 2023 | 13:18h | UTCFerric derisomaltose and tranexamic acid, combined or alone, for reducing blood transfusion in patients with hip fracture (the HiFIT trial): a multicentre, 2 × 2 factorial, randomised, double-blind, controlled trial – The Lancet Haematology (link to abstract – $ for full-text)
International Study | Postoperative acute kidney injury affects one in five patients after major surgery
1 Aug, 2023 | 14:23h | UTC
Commentary on Twitter
? EPIS #AKI, epidemiology of major surgery associated acute kidney injury
➡️ > 10K pts, 1/5 develop PO-AKI: significant burden for health care worldwide!
⬆️ increasing severity of PO-AKI associated with progressive increase in adverse outcomes#FOAMcc
?️ https://t.co/Ps7N7zoMKP pic.twitter.com/gcxkve9OKV— Intensive Care Medicine (@yourICM) July 30, 2023
Review | Regional analgesia for acute pain relief after open thoracotomy and video-assisted thoracoscopic surgery
31 Jul, 2023 | 14:03h | UTC
Review | Perioperative iron deficiency anemia
31 Jul, 2023 | 14:02h | UTCPerioperative iron deficiency anaemia – BJA Education
RCT | Combined pre-operative olanzapine regimen lowers postoperative nausea in high-risk cancer patients
24 Jul, 2023 | 12:49h | UTC
ASA Consensus Guidance | Preoperative management of patients on GLP-1 agonists
5 Jul, 2023 | 01:17h | UTCCommentary: Anesthesiologists Say Ozempic, Wegovy Should Be Halted Prior to Surgery – HealthDay
M-A | Clinical tests for confirming tracheal intubation or excluding esophageal intubation
3 Jul, 2023 | 14:19h | UTC
Consensus Statement 2023 Update | Timing of elective surgery and risk assessment after SARS-CoV-2 infection
30 Jun, 2023 | 15:00h | UTCTiming of elective surgery and risk assessment after SARS-CoV-2 infection: 2023 update – Anaesthesia
Commentary on Twitter
?"In most circumstances, surgery should proceed unless risk assessment indicates that the risk of proceeding exceeds the risk of delay."@Assoc_Anaes @RCoANews @UkFssa @RCSnews @elboghdadly @doctimcook @justin_kua @NigelMercer @rmoonesinghe
?https://t.co/gfjymze0oi pic.twitter.com/D8bEfAHBD7
— ??????????? (@Anaes_Journal) June 20, 2023
Development and validation of an international preoperative risk assessment model for postoperative delirium
30 Jun, 2023 | 14:43h | UTC
M-A | Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery
29 Jun, 2023 | 14:03h | UTC
Review | Update on the management of patients with HIV infection in anesthesia and critical care
26 Jun, 2023 | 00:36h | UTC
RCT | Dexmedetomidine administration shows promise in PTSD reduction for trauma surgery patients
23 Jun, 2023 | 13:30h | UTCSee also: Visual Abstract
Review | Nonsurgical management of major hemorrhage
22 Jun, 2023 | 15:16h | UTCNonsurgical management of major hemorrhage – Canadian Medical Association Journal
ERAS Guideline | Perioperative care for emergency laparotomy
22 Jun, 2023 | 15:14h | UTCGuidelines for Perioperative Care for Emergency Laparotomy Enhanced Recovery After Surgery (ERAS) Society Recommendations – World Journal of Surgery
Part 1: Preoperative: Diagnosis, Rapid Assessment and Optimization
Part 2: Emergency Laparotomy: Intra- and Postoperative Care
Part 3: Organizational Aspects and General Considerations for Management of the Emergency Laparotomy Patient
Qualitative Study | International perspectives on modifications to the surgical safety checklist
21 Jun, 2023 | 13:36h | UTCInternational Perspectives on Modifications to the Surgical Safety Checklist – JAMA Network Open
Invited Commentary: Modifications of the World Health Organization’s Surgical Safety Checklist—Ways Forward to Ensure Sustainable Implementation – JAMA Network Open
Commentary on Twitter
Qualitative study: >10 years after the surgical safety checklist was developed, systems should consider checklist modification to improve safety, teamwork & buy-in. https://t.co/5xisRqzWkf @N8turl3y @MaryEBrindle @ucalgarymed @ariadnelabs
— JAMA Network Open (@JAMANetworkOpen) June 7, 2023
Review | Traumatic hemorrhage and chain of survival
21 Jun, 2023 | 13:17h | UTC
SR | Automated mandatory bolus vs. basal infusion for maintenance of epidural analgesia in labor
20 Jun, 2023 | 12:24h | UTC
RCT | Video laryngoscopy improves first-attempt intubation, severe complications unchanged
19 Jun, 2023 | 14:15h | UTCVideo versus Direct Laryngoscopy for Tracheal Intubation of Critically Ill Adults – New England Journal of Medicine (link to abstract – $ for full-text)
News Release: Study shows video laryngoscope increases successful intubation on first attempt – Vanderbilt University Medical Center
Practice advisory for preoperative and intraoperative pain management of thoracic surgical patients
19 Jun, 2023 | 14:05h | UTCPart 1: Practice Advisory for Preoperative and Intraoperative Pain Management of Thoracic Surgical Patients – Anesthesia and Analgesia (free for a limited period)
Part 2: Practice Advisory for Preoperative and Intraoperative Pain Management of Cardiac Surgical Patients – Anesthesia and Analgesia (free for a limited period)
See also: Prevalence and Characteristics of Persistent Postoperative Pain After Thoracic Surgery: A Systematic Review and Meta-Analysis – Anesthesia and Analgesia (free for a limited period)
Infographic: Persistent Pain After Thoracic Surgery—What Works, What Doesn’t – Anesthesia and Analgesia (free for a limited period)