June's Anesthesia Digest
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.
Norepinephrine vs. phenylephrine for spinal hypotension in cesarean section: a network meta-analysis
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.
Efficacy and safety of intravenous administration of dexamethasone on post-cesarean delivery pain: a systematic review and meta-analysis of current literature
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.
Dexamethasone for prevention of spinal hypotension during caesarean delivery: a randomised controlled trial
8 mg of intravenous dexamethasone significantly reduced the incidence of spinal hypotension during caesarean delivery.
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