Results Among 33 514 exposed children (22 484 male and 11 030 female) and 159 619 unexposed children (105 812 male and 53 807 female) in the primary study cohort, 1 exposure before age 4 years was associated with a mean difference of 0.41% (95% CI, 0.12%-0.70%) lower school grades and 0.97% (95% CI, 0.15%-1.78%) lower IQ test scores. The magnitude of the difference was the same after multiple exposures. There was no difference in school grades with 1 exposure before ages 6 months, 7 to 12 months, 13 to 24 months, or 25 to 36 months. The overall difference was markedly less than the differences associated with sex, maternal educational level, or month of birth during the same year.
Conclusions and Relevance Exposure to anesthesia and surgery before age 4 years has a small association with later academic performance or cognitive performance in adolescence on a population level. While more vulnerable subgroups of children may exist, the low overall difference in academic performance after childhood exposure to surgery is reassuring. These findings should be interpreted in light of potential adverse effects of postponing surgery.
I wonder how much is due to disease e.g. middle ear infection vs the anaesthesiapoi160080
The Medical Board of Australia has released its commissioned research paper on revalidation here;
If you can explain what all this means in 100 words or less, please do so below….
Hugh Stephens has graciously supplied the following articles on airway management;
- Airway risk assessment – a review of current evidence to aid clinical decision-making Download
- Airway management roundtable – six international airway experts offer their opinions on various airway matters Download
- Submental tracheal intubation for a patient with multiple facial fractures – let me know if you plan to do one of these and I’ll come and watch Download
If you come across any interesting articles that you think are worth sharing, please contact me and I’ll post details on GCAPE.
Disruptive and inappropriate behaviour by Medical Practitioners has featured quite prominently in the media recently. An article by the Cognitive Institute’s Associate Medical Director Dr Stephen Walker summarises the implications for patient outcomes and the bottom line.
The NAP5 report has been released. There have already been sensationalised reports in the popular media, so expect questions from patients! Registered users can download the report and a summary from Anaesthesia below.
Download full NAP5 report
Download Anaesthesia NAP5 summary
ACC/AHA & PONV
Updated Consensus Guidelines for PONV were published in Anesthesia and Analgesia in January. You can download the article below.
Download PONV Guidelines
Also hot off the press are the 2014 ACC/AHA Guidelines on Perioperative Cardiovascular Evaluation and Management of Patients Undergoing Noncardiac Surgery. You can download the 100+ pages of the full article and the executive summary below.
Download ACC AHA Guidelines
Download ACC AHA Summary
ANZCA publishes safety alerts on their website at http://www.anzca.edu.au/fellows/quality-safety/safety-alerts
NZ review of safety, basically existing restrictions are appropriate. More info…
Here is the Anesthesia and Analgesia article by Van der LInden evaluating its safety in surgery.
Safety of Starches pdf
Restrictions have been lifted, more info…