The Takeaway The opioid free regimen reduced the overall incidence of PONV and reduced the risk of developing first postoperative PONV compared to standard opioid-based general anesthesia - without an increase in pain scores at rest or with movement after surgery. Study Design * blinded, randomized, parallel-group trial * 168 patients aged
Takeaway A bolus of 1.5 mg/kg, followed by an infusion of 2 mg/kg/h until the end of the surgery can help reduce postoperative laryngopharyngeal symptoms, including sore throat, hoarseness, and cough, without increasing adverse reactions. Design * Prospective, randomized, double-blind, controlled, single-center clinical trial with 160 patients.
pulmonary complications
“In planned open heart surgery, use of DBEs with IS in the preop period may contribute to a reduced PPCs, duration of MV, length of ICU stay, duration of hospitalisation, and improved in pre- and postop oxygenation”
delirium
Conventional wisdom suggests that benzodiazepines increase delirium risk in the elderly. Although they remain on the Beer’s list as a high risk prescription medication, this recent study suggests that perioperative use does not increase risk of postoperative delierium.
fluid management
When Hurricane Helene ravaged North Carolina in 2024, it also took out Baxter’s ability to provide 60% of the United States’ intravenous fluid supplies. Despite significant changes in fluid management strategies, there were no changes in patient outcomes.
acetaminophen
What if a commonly used analgesic isn’t as effective as we think?
lidocaine
A lidocaine induction dose followed by infusion can reduce propofol requirements, leading to decreased desaturation episodes, coughing, involuntary movement, and improved endoscopist satisfaction
difficult airway
The success rate of ventilation with an end endotracheal tube in the pharynx is similar to face mask ventilation in adult patients at risk for difficult airways.
magnesium sulfate
"magnesium is an underrepresented nonopioid adjuvant for perioperative pain management. Magnesium could serve as an effective intervention to improve postoperative pain outcomes and reduce both analgesic and anesthetic requirements in surgical patients"
methylene blue
Methylene Blue offers an adjunctive therapy for severe, resistant hypotension when traditional vasopressors are insufficient
anemia
"odds of death, adjusted for ASA, Fried Frailty, and covariates, were 2.7 times higher for those in the mild anemic group compared to those who were not anemic"
fluid management
"approximately 2 L of net fluid can be a turning point for patients’ postoperative outcomes after complex spine surgeries that can serve as a guide for intraoperative fluid management"
