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2 Minute Medicine ® - Anesthesiology

Collection of high-impact paper summaries that have been hand-picked, written and peer-reviewed by practicing clinicians. Provides 2 minute summarization and application to bedside care. Updated weekly.

https://read.qxmd.com/read/101000668/opioid-reduced-analgesia-using-esketamine-for-gynecological-surgery-associated-with-similar-outcomes-as-opioid-analgesia
#21
SUMMARY
Michael Wong, Alex Chan
Opioid-reduced anesthesia based on esketamine in gynecological day surgery: a randomized double-blind controlled study : https://read.qxmd.com/read/36384481 1. In adult females undergoing day gynecological surgery, this randomized controlled trial found that opioid-reduced analgesia using esketamine did not result in improved postoperative nausea and vomiting (PONV) when compared to opioid analgesia. 2. There was no significant difference in subjective pain following surgery between patients who had opioid analgesia and opioid-reduced analgesia using esketamine...
November 24, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000648/pressure-support-ventilation-does-not-improve-ventilation-status-as-compared-to-t-piece-ventilation
#22
SUMMARY
David Xiang, Kiera Liblik
1. In patients with a high risk of extubation failure, using pressure-support ventilation (PSV) for spontaneous breathing trials did not result in more ventilator-free days than breathing trials conducted with T-piece ventilation. 2. Rates of reintubation did not differ significantly in the PSV or T-piece ventilation groups.  Evidence Rating Level: 1 (Excellent) Study Rundown: Reducing the amount of time that patients are exposed to invasive mechanical ventilation is crucial to avoid complications. Therefore, the early identification of patients who are able to breathe spontaneously on their own can hasten the time to tracheal extubation and reduce the duration of mechanical ventilation...
November 18, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000603/glycopyrrolate-not-associated-with-decreased-vasopressor-use-for-cesarean-deliveries
#23
SUMMARY
Keerthana Pasumarthi, Alex Chan
1. In pregnant patients undergoing non-elective cesarean section, the use of glycopyrrolate does not significantly reduce vasopressor requirements and prevent hypotension compared to placebo. Evidence Rating Level: 1 (Excellent) In cesarean sections, spinal anesthesia is a frequently used anesthetic technique; however, hypotension is a common adverse event which has negative implications on both maternal health and neonatal outcomes. Recent studies have explored the use of glycopyrrolate during spinal anesthesia as it increases maternal heart rate and consequently maintains cardiac output, while having a minimal effect on the fetus due to its inability to cross the placental barrier...
November 3, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000513/esketamine-as-an-adjunct-with-propofol-and-fentanyl-to-avoid-perioperative-hypotension
#24
SUMMARY
Keerthana Pasumarthi, Alex Chan
1. The use of esketamine in combination with propofol significantly reduced the risk of perioperative hypotension during abortive surgery compared to propofol and fentanyl. Evidence Rating Level: 1 (Excellent) Opioid analgesics commonly used in anesthesia practice such as fentanyl and propofol are associated with respiratory and circulatory system depression. Esketamine is a N-methyl-D-aspartate receptor (NMDA) antagonist which has a milder respiratory depression effect and lower circulatory excitation compared to its other analgesic counterparts due to its rapid onset and offset action...
October 7, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000501/2-minute-medicine-rewind-october-3-2022
#25
SUMMARY
Keerthana Pasumarthi, Alex Chan
A Healthy Lifestyle is Positively Associated with Mental Health and Well-Being and Core Markers in Ageing : https://read.qxmd.com/read/36171556 1. A healthy lifestyle defined by diet, smoking status, physical activity, alcohol consumption, and BMI was associated with better mental health outcomes. Evidence Rating Level: 2 (Good) It is well known that unhealthy lifestyles are associated with adverse health outcomes such as cardiovascular disease, respiratory illness, and mental health disorders. While many studies have examined individual health behaviors and their effects on health, the synergistic effects of multiple lifestyle modifications on mental well-being have not been thoroughly investigated...
October 3, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000282/spinal-anesthesia-for-hip-fracture-surgery-associated-with-increased-pain-and-analgesic-use
#26
SUMMARY
Bryant Lim, Kiera Liblik
1. Spinal anesthesia, as compared with general anesthesia, was associated with a small but significant increase in pain and prescription analgesic use after hip fracture surgery. 2. Patient satisfaction with care did not differ between groups. Evidence Rating Level: 1 (Excellent) Study Rundown: Spinal and general anesthesia confer similar survival and recovery outcomes for hip fracture surgery. Thus, the choice between these anesthesia procedures may be determined by patient preference based on associated risks and benefits...
June 28, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000210/the-quality-of-recovery-after-erector-spinae-plane-block-in-patients-undergoing-breast-surgery
#27
SUMMARY
Bipandeep Abbat, Alex Chan
1. In a cohort of patients undergoing breast surgery, erector spinae plane block improved the quality of recovery compared to the control. Evidence Rating Level : 1 (Excellent) Regional anesthesia techniques are commonly used for breast surgery. The erector spinae plane block is a newer technique for delivering regional anesthesia to patients undergoing breast surgery. It has proven to reduce pain severity and opioid consumptions. However, there is a lack of data with regards to the quality of recovery in patients following this procedure...
July 19, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000197/increasing-anesthesiologist-coverage-responsibilities-associated-with-increased-surgical-patient-mortality-and-significant-morbidity
#28
SUMMARY
Jake Engel, Yuchen Dai
1. This retrospective cohort study with 866 453 adults demonstrated that as overlapping anesthesiologist responsibilities increased, the risk of morbidity and 30-day mortality for surgical patients increased. 2. Future studies should evaluate the consequences of one anesthesiologist covering multiple operating rooms under direct care by anesthesiology residents. Evidence Rating Level: 2 (Good) Study Rundown: Overlapping responsibilities across different medical specialties has been linked to poor patient outcomes...
July 24, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000137/ciprofol-comparable-to-propofol-for-general-anesthesia-induction-for-gynecological-surgery
#29
SUMMARY
Keerthana Pasumarthi, Alex Chan
1. Ciprofol was just as effective to propofol for general anesthesia induction in patients undergoing gynecological surgery and presents fewer adverse events. Evidence Rating Level: 1 (Excellent) In anesthesia practice, propofol is traditionally used to induce and maintain general anesthesia. While it does have a strong utility, propofol also may cause several adverse effects such as the inhibition of the circulatory and respiratory systems. As such, alternative drug choices for general anesthesia are needed...
August 10, 2022: 2 Minute Medicine
https://read.qxmd.com/read/101000093/rates-of-postoperative-pulmonary-complications-higher-for-patients-receiving-etomidate-vs-propofol
#30
SUMMARY
Michael Wong, Alex Chan
1. For elderly patients receiving elective abdominal surgery, there was no significant difference in the rate of composite major in-hospital postoperative complications in older patients receiving etomidate or propofol for induction. 2. In patients who received etomidate versus propofol, there was a significantly higher incidence of postoperative pulmonary complications, specifically pneumonia. Evidence Rating Level: 1 (Excellent) Study Rundown:   The use of etomidate as an intravenous anaesthetic is controversial; its hemodynamic stability is a benefit for induction in high-risk patients, but it can potentially cause adrenal insufficiency postoperatively and has a controversial impact on outcomes, including pneumonia in trauma patients, which causes people to generally favour propofol as an induction agent...
August 22, 2022: 2 Minute Medicine
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