The efficacy of peri-operative interventions to decrease postoperative delirium in non-cardiac surgery: a systematic review and meta-analysis.

Z. Moyce Registrar, et al

Anaesthesia

Volume 69, Issue 3, pages 259–269, March 2014

Meta-analysis revealed that peri-operative geriatric consultation (OR 0.46, 95% CI 0.32–0.67) and lighter anaesthesia (OR 2.66, 95% CI 1.27–5.56) were associated with a decreased incidence of postoperative delirium. For the other interventions, the point estimate suggested possible protection with prophylactic haloperidol (OR 0.62, 95% CI 0.36–1.05), bright light therapy (OR 0.20, 95% CI 0.03–1.19) and general as opposed to regional anaesthesia (OR 0.76, 95% CI 0.47–1.23). This meta-analysis has shown that peri-operative geriatric consultations with multicomponent interventions and lighter anaesthesia are potentially effective in decreasing the incidence of postoperative delirium

Prophylactic vs therapeutic blood patch for obstetric patients with accidental dural puncture – a randomised controlled trial

M. H. Stein Associate Professor et al

Anaesthesia

Volume 69, Issue 4, pages 320–326, April 2014

Patients who sustained an accidental dural puncture during establishment of epidural analgesia during labour or at caesarean delivery were randomly assigned to receive a prophylactic epidural blood patch or conservative treatment with a therapeutic epidural blood patch if required. Eleven of 60 (18.3%) patients in the prophylactic epidural blood patch group developed a post-dural puncture headache compared with 39 of 49 (79.6%) in the therapeutic epidural blood patch group (p < 0.0001). A blood patch was performed in 36 (73.4%) of patients in the therapeutic group. The number of patients who needed a second blood patch did not differ significantly between the two groups: 6 (10.0%) for prophylactic epidural blood patch and 4 (11.1%) for therapeutic epidural blood patch. We conclude that prophylactic epidural blood patch is an effective method to reduce the development of post-dural puncture headache in obstetric patients.

Recovery from Anesthesia after Craniotomy for Supratentorial Tumors: Comparison of Propofol-Remifentanil and Sevoflurane-Sufentanil (the PROMIFLUNIL Trial)

Necib, Skander MD; Tubach, Florence MD, PhD; Peuch, Clarisse MD; LeBihan, Eric MD; Samain, Emmanuel MD, PhD; Mantz, Jean MD, PhD; Dahmani, Souhayl MD, PhD

Journal of Neurosurgical Anesthesiology:

January 2014 - Volume 26 - Issue 1 - p 37-44

During craniotomy for Supratentorial  tumors, the authors could not demonstrate a reduction in the time to extubation when comparing a BIS-guided anesthesia associating Propofol-Remifentanil  to a BIS-guided anesthesia associating  Sevoflurane-Sufentanil

Airway management in cervical spine injury

Naola Austin, Vijay Krishnamoorthy, and Arman Dagal

Int J Crit Illn Inj Sci. 2014 Jan-Mar; 4(1): 50–56.

Overall, there is no one perfect way to manage the airway in patients with potential cervical spine injury. Providers must use their judgment and weigh various risks like spinal cord injury, aspiration, and hypoxia in each patient and  have the most experienced provider available to safely secure the airway. An airway management and anesthetic plan must be designed based on the patient, surgeon, situation urgency, and individual provider's level of expertise. 

see PMC text

General anesthesia soon after dialysis may increase postoperative hypotension - A pilot study

J Deng, J Lenart, and R L Applegate

Heart Lung Vessel. 2014; 6(1): 52–59.

Post-anesthetic hypotension within 48 hours was more common in those with < 7 hours interval between dialysis and anesthesia. Therefore, if surgical urgency permits, a delay of ≥7 hours may limit postoperative hypotension

The effect of a subhypnotic dose of propofol for the prevention of coughing in adults during emergence from anesthesia with sevoflurane and remifentanil

Soon Yong Jung, Hee Bin Park, and Ju Deok Kim

Korean J Anesthesiol. Feb 2014; 66(2): 120–126.

During emergence from sevoflurane-remifentanil anesthesia, a subhypnotic dose (0.3 mg/kg) of propofol decreases the incidence and severity of coughing without delaying wake up in adults undergoing nasal surgery.

Spica cast as an alternative to general anesthesia for lower limb MRI in young children

P.-Y. Rabattu, A. Courvoisier, [...], and J. Griffet

J Orthop Traumatol. Mar 2014; 15(1): 55–58.

TSCI (temporary spica cast immobilization ) is a safe, effective and costless procedure avoiding general anesthesia for young patients under 3 years old who require MRI for pelvis or lower limb disorders.