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May's Anesthesia Digest

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

A dose-ranging pilot trial of dexmedetomidine-propofol in children undergoing magnetic resonance imaging

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

Effects of Dexmedetomidine Combined With Lidocaine Topical Administration on Cough Reflex During Extubation in Thyroidectomy Patients: A Randomized Clinical Trial

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

PONV

Comparative efficacy of sugammadex and neostigmine in postoperative nausea and vomiting management: a meta‑analysis of randomized controlled trials

In this meta-analysis, reversal with sugammadex decreased PONV metrics, especially when given at after the return of the second twitch.

emergence agitation

The effect of repeated maternal voice orientation on postoperative emergence agitation in children following tonsillectomy and adenoidectomy: A randomized controlled trial

Delivering prerecorded, repeated maternal voice orientation via noise cancelling headphones decreased emergence agitation in pediatric patients undergoing tonsillectomy and adenoidectomy

precedex

Effect of nebulized dexmedetomidine on gag reflex suppression and sedation quality in pediatric patients undergoing gastrointestinal endoscopy: a randomized controlled trial

Nebulized precedex significantly decreased gag and cough reflexes, anesthetic requirements, and enhanced endoscopist satisfaction.

caffeine

Preoperative oral caffeine as prophylaxis against post-spinal hypotension in patients undergoing orthopedic lower limb surgery: A randomized, placebo-controlled, double-blinded study

A preoperative administration of 200 mg caffeine tablet can reduce hypotensive episodes and ephedrine requirements within the first hour of spinal anesthesia.

April's Anesthesia Digest

Here is the The Sedation Station's curated list of anesthesia articles published in the month of April. Combined Use of Dexmedetomidine and Hydrocortisone to Prevent New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting Surgery: A Randomized Clinical Trial Combining dexmedetomidine and hydrocortisone effectively reduces POAF incidence after CABG,

atrial fibrillation

Combined Use of Dexmedetomidine and Hydrocortisone to Prevent New-Onset Atrial Fibrillation After Coronary Artery Bypass Grafting Surgery: A Randomized Clinical Trial

Combining dexmedetomidine and hydrocortisone effectively reduces POAF incidence after CABG, with manageable side effects

videolaryngoscopy

First-pass success rate and predictive factors for stylet use in videolaryngoscopic intubations with a Macintosh blade: a prospective observational study

"Routine stylet preparation may not be necessary for elective videolaryngoscopic intubations with a Macintosh blade in patients with a longer sternomental distance, increased thyromental height, and normal cervical spine mobility"

laparoscopic cholecystectomy

Redefining pain management: investigating the efficacy and safety of erector spinae plane block and oblique subcostal transversus abdominis plane block in laparoscopic cholecystectomy - a meta analysis of randomized controlled trials

"The erector spinae plane block (ESPB) appears to be the preferred option for acute postoperative pain and opioid reduction in adults undergoing laparoscopic cholecystectomy."

erector spinae plane block

Efficacy of erector spinae plane block for postoperative pain management: A meta-analysis and trial sequential analysis of randomized controlled trials

Erector Spinae Plane Block (ESPB) significantly reduced postop pain up to 48h, decreased postop opioid consumption, lowered postoperative nausea and vomiting (PONV), and without severe adverse events