European Journal of Anaesthesiology highlights

From the deputy editor:

With this article, we open up a new rubric for all members of our Society who are thirsty for new and exciting research published in the European Journal of Anaesthesiology. It is another good example of collaborative work between different groups of ESAIC with the sole objective of helping the clinicians answering day to day clinical dilemmas or unknowns.

Marc Gimenez
gimimarc@gmail.com

We strongly recommend the prospective cohort study by Wang et al (1) studying the incidence and risk factors of delirium (POD) on patients admitted in ICU after intracranial surgery. Although there are abundant studies on POD, there are only small retrospective series dedicated to patients undergoing neurosurgical procedures. The authors found not only that one-fifth of patients were diagnosed with postoperative delirium, but also new risk factors such as frontal approach craniotomy and the nature of the intracranial lesion.

On similar lines, we reflect on the findings of the systematic review and meta-analysis by Pereira et al (2)comparing propofol with dexmedetomidine in reducing POD in ICU. Six randomised controlled trials (RCT) and two retrospective studies seemed to show that dexmedetomidine protected against POD compared with propofol (RR 0.70 95% CI 0.52-0.95 p=0.02). Also, no differences were found with side effects, time of mechanical ventilation or hospital and ICU length of stay.

Staying with ICU, Taboada et al. (3) propose a prospective observational study on reintubation in the ICU after cardiac surgery. The authors report a higher difficulty with laryngoscopy and incidence of relevant haemodynamic and respiratory complications during reintubation in ICU as compared with intubations in the operating theatre. Findings that may help with respiratory weaning protocols and workload schedules in cardiac ICUs.

The last study we would like to bring to your attention is the RCT performed by Zhang et al (4) that could help us providing safer anaesthesia to paediatric patients with recent upper respiratory tract infection having interventional cardiac surgery. 134 children were allocated to receive intranasal dexmedetomidine or placebo (saline) before induction of anaesthesia and pre-defined respiratory incidents were studied. Administration of dexmedetomidine seemed to reduce the appearance of respiratory events such as bronchospasm, laryngospasm and desaturation in children less than three years.

References

1. Wang, Chun-Mei; Huang, Hua-Wei; Wang, Yu-Mei; et al. Eur J Anaesthesiol 2020; 37:14-24.
2. Pereira, Jarett V.; Sanjanwala, Rohan M.; Mohammed, Mohammed K.; et al.. Eur J Anaesthesiol 2020 ;37:121-131
3. Taboada, Manuel; Rey, Raúl; Martínez, Susana; et al. Eur J Anaesthesiol 2020;37:25-30
4. Zhang S, Zhang R, Cai M, et al.. Eur J Anaesthesiol 2020;37:85-90