Anesthesiology

N95 Re-Use Instructions:

Guidelines:

Stanford: N95 masks can be decontaminated without decreasing filtration efficiency using 70C heat for 30 min. Alcohol and bleach should not be used.” (via @CMichaelGibson see Tweet)

“…among patients with COVID-19 infection, clinicians are advised to only measure troponin if the diagnosis of acute MI is being considered on clinical grounds and an abnormal troponin should not be considered evidence for an acute MI without corroborating evidence.”

Podcasts:

Videos:

Practical Advice: PPE Pearls

COVID Ethics: Should clinicians see patients without appropriate PPE?

Reviews:

Selected Articles:

“Coronaviruses have not shown to cause a more severe disease in immunosuppressed patients. For this family of viruses the host innate immune response appears the main driver of lung tissue damage during infection.”

News & Perspectives:

COVID-19 Critical Care: This page will be updated as often as necessary and will be fixed in the right column on our homepage.

 


COVID-19: Updates for Anesthesiologists

29 Mar, 2020 | 00:10h | UTC

Guidelines:

Articles:

COVID-19 Anesthesiology: This page will be updated as often as necessary and will be fixed in the right column on our homepage.

 


FDA Approves Label Changes to SGLT2 Inhibitors Regarding Temporary Discontinuation of Medication Before Scheduled Surgery – U.S. Food & Drug Administration (free)

Commentary: FDA advises stopping SGLT2 inhibitor treatment prior to surgery – The Hospitalist (free)

“- Canagliflozin, dapagliflozin, and empagliflozin should each be discontinued at least three days before scheduled surgery.

Ertugliflozin should be discontinued at least four days before scheduled surgery.

– Blood glucose levels should be carefully monitored after discontinuation of the SGLT2 inhibitor and appropriately managed before surgery.”

 


Podcast: Airway Management of COVID-19

1 Mar, 2020 | 19:07h | UTC

Effect of Hydroxyethyl Starch vs Saline for Volume Replacement Therapy on Death or Postoperative Complications Among High-Risk Patients Undergoing Major Abdominal Surgery: The FLASH Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Hydroxyethyl Starch for Fluid Replacement Therapy in High-Risk Surgical Patients: Context and Caution (free for a limited period)

Related Cochrane Review: Colloids vs Crystalloids for Fluid Resuscitation in Critically Ill People (free)

 

Related Commentary on Twitter

 


Homepage: Special Issue: Advances in Perioperative Care – BJS / Anaesthesia (free articles)

– Perioperative care and collaboration between surgeons and anaesthetists – it’s about time

– Role of the anaesthetist in postoperative care

– Framework for prehabilitation services

– Role of critical care in improving outcomes for high‐risk surgical patients

– Scoping review of mode of anaesthesia in emergency surgery

– Strategies to minimize intraoperative blood loss during major surgery

– Perioperative care of the obese patient

– Rational performance metrics for operating theatres, principles of efficiency, and how to achieve it

– Acute postoperative pain management

– Meta‐analysis of preoperative high‐sensitivity cardiac troponin measurement in non‐cardiac surgical patients at risk of cardiovascular complications

– Network meta‐analysis of urinary retention and mortality after Lichtenstein repair of inguinal hernia under local, regional or general anaesthesia

– Meta‐analysis of α‐blockade versus no blockade before adrenalectomy for phaeochromocytoma

– Network meta‐analysis of local and regional analgesia following colorectal resection

– Randomized clinical trial of intraoperative dexmedetomidine to prevent delirium in the elderly undergoing major non‐cardiac surgery

– Randomized clinical trial of continuous transversus abdominis plane block, epidural or patient‐controlled analgesia for patients undergoing laparoscopic colorectal cancer surgery

– Qualitative study of clinician and patient perspectives on the mode of anaesthesia for emergency surgery

– Variation in global uptake of the Surgical Safety Checklist

– Safety and efficacy of non‐steroidal anti‐inflammatory drugs to reduce ileus after colorectal surgery

– International multicentre review of perioperative management and outcome for catecholamine‐producing tumours

 

Related Commentary on Twitter

 


Effect of Rocuronium vs Succinylcholine on Endotracheal Intubation Success Rate Among Patients Undergoing Out-of-Hospital Rapid Sequence Intubation: A Randomized Clinical Trial – JAMA (link to abstract – $ for full-text)

Commentary: Newer Drug Falls Short for Quick Prehospital Intubation – MedPage Today (free registration required)

 

Related Commentary on Twitter

 


Homepage: CPR Guidelines (free summaries and infographics)

– 2019 Highlights – Guidelines Update for CPR & ECC

– 2019 FAQ – Guidelines Update for CPR & ECC

– 2019 Infographic – ACLS Guidelines Update

– 2019 Infographic – PALS Guidelines Update

Original Guidelines: AHA Updates on Advanced Cardiovascular Life Support (ACLS) (free) AND AHA Updates in Pediatric Life Support (free)

 

Related Commentary on Twitter

 


The effect of remote ischaemic preconditioning on myocardial injury in emergency hip fracture surgery (PIXIE trial): phase II randomised clinical trial – The BMJ (free)

Related Perspective: Remote ischaemic preconditioning: an intervention for anaesthetists? – British Journal of Anaesthesia (free)

 

Related Commentary on Twitter

 


Pharmacological interventions for the prevention of acute postoperative pain in adults following brain surgery – Cochrane Library (free)

Summary: Preventing pain after brain surgery – Cochrane Library (free)

 

Related Commentary on Twitter

 


Difficult Airway Society guidelines for awake tracheal intubation (ATI) in adults – Anaesthesia (free)

 

Related Commentary on Twitter

 


Recurrence of breast cancer after regional or general anaesthesia: a randomised controlled trial – The Lancet (link to abstract – $ for full-text)

Commentaries: Anesthesia for breast cancer surgery has no influence on risk of tumor recurrence – Medical University of Vienna (free) AND Anesthesia Technique Flops in Large Breast Cancer Trial – MedPage Today (free registration required)

 

Related Commentary on Twitter

 


Anaesthetic depth and complications after major surgery: an international, randomised controlled trial – The Lancet (link to abstract – $ for full-text)

 

Related Commentary on Twitter

 


Effect of a fluid bolus on cardiovascular collapse among critically ill adults undergoing tracheal intubation (PrePARE): a randomised controlled trial – The Lancet Respiratory Medicine (link to abstract – $ for full-text)

Source: Critical Care Reviews Newsletter

 

Related Commentary on Twitter

 


Effect of Postextubation High-Flow Nasal Oxygen With Noninvasive Ventilation vs High-Flow Nasal Oxygen Alone on Reintubation Among Patients at High Risk of Extubation Failure: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Added Benefit of Noninvasive Ventilation to High-Flow Nasal Oxygen to Prevent Reintubation in Higher-Risk Patients (free for a limited period)

 

 


Special Issue: Obstetric Anesthesia

2 Oct, 2019 | 02:08h | UTC

Perioperative covert stroke in patients undergoing non-cardiac surgery (NeuroVISION): a prospective cohort study – The Lancet (link to abstract – $ for full-text)

Commentaries: ‘Silent’ strokes common after surgery, linked to cognitive decline – McMaster University (free) AND ‘Silent’ strokes after elective surgeries in older adults double their risk of later cognitive decline, study finds – The Globe and Mail (free)

 

Related Commentary on Twitter

 


Perioperative Management of Patients With Atrial Fibrillation Receiving a Direct Oral Anticoagulant – JAMA Internal Medicine (free for a limited period)

Commentary: Study Sheds Light on Stopping and Resuming DOACs in Afib Patients Undergoing Surgery – NEJM Journal Watch (free)

“The DOAC regimens were omitted for 1 day before a low–bleeding-risk procedure and 2 days before a high–bleeding-risk procedure. The DOAC regimens were resumed 1 day after a low–bleeding-risk procedure and 2 to 3 days after a high–bleeding-risk procedure.”

 

Related Commentary on Twitter

 


International consensus statement on the use of uterotonic agents during caesarean section – Anaesthesia (free)

 

Related Commentary on Twitter

 


Survey: Suicide Amongst Anesthetists

4 Jul, 2019 | 10:47h | UTC

Suicide amongst anaesthetists – an Association of Anaesthetists survey – Anaesthesia (free)

News Release: Survey highlights need for improved mental health guidance & support for anaesthetists – Association of Anaesthetists (free)

 

Related Commentary on Twitter

 


Prevalence and Cost of Care Cascades After Low-Value Preoperative Electrocardiogram for Cataract Surgery in Fee-for-Service Medicare Beneficiaries – JAMA Internal Medicine (free for a limited period)

Commentary: Cascades Of Care – American Council on Science and Health (free)

Related: Evaluation of an Intervention to Reduce Low-Value Preoperative Care for Patients Undergoing Cataract Surgery (link to abstract and commentary) AND Systematic Review: Routine Preoperative Medical Testing for Cataract Surgery (free)

 

Related Commentary on Twitter (thread – click for more)

 


Effect of Intraoperative High Positive End-Expiratory Pressure (PEEP) With Recruitment Maneuvers vs Low PEEP on Postoperative Pulmonary Complications in Obese Patients: A Randomized Clinical Trial – JAMA (free for a limited period)

Editorial: Setting Positive End-Expiratory Pressure in Mechanically Ventilated Patients Undergoing Surgery (free)

 

Related Commentary on Twitter

 


Prophylactic antibiotics in the prevention of infection after operative vaginal delivery (ANODE): a multicentre randomised controlled trial – The Lancet (free)

Invited Commentary: Antibiotics for operative vaginal delivery: practice-changing data – The Lancet (free)

 

Related Commentary on Twitter