iiinova — where your digital self keeps evolving

★ metajournal @metajournal.bsky.social · 53m

"Enjoy the little things, for one day you may look back and realize they were the big things." – Robert Brault

★ metajournal @metajournal.bsky.social · 01/10/2026

When suitable for the surgery, using an LMA instead of ETT may reduce postoperative atelectasis by allowing faster airway placement and requiring less muscle relaxation. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 30/09/2026

Large Lanuguage Models may outperform physicians on diagnostic tasks, but simply providing access to AI tools does not improve doctors' diagnostic reasoning without effective integration. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 29/09/2026

Higher fresh gas flows during TIVA reduce costs without increasing environmental impact compared to low-flow techniques.… 1/2

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★ metajournal @metajournal.bsky.social · 28/09/2026

Prophylactic phenylephrine infusion is superior to bolus dosing in avoiding maternal hypotension in women receiving neuraxial anaesthesia for caesarean section, although is also associated with more hypertension and bradycardia. #MetaAnalysis… 1/2

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★ metajournal @metajournal.bsky.social · 27/09/2026

"I pay no attention to anyone’s praise or blame. I simply follow my own way." – Wolfgang Amadeus Mozart

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★ metajournal @metajournal.bsky.social · 24/09/2026

Adding lignocaine (1.5mg/kg + 2-4mg/kg/h) to propofol sedation for colonoscopy reduced propofol requirement, postop discomfort, shortened emergence time and increased patient satisfaction. #MetaAnalysis… 1/2

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★ metajournal @metajournal.bsky.social · 23/09/2026

Sugammadex may be associated with less postoperative neurocognitive dysfunction than neostigmine (RR 0.67 [CI] 0.48-0.94). #MetaAnalysis… 1/2

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★ metajournal @metajournal.bsky.social · 22/09/2026

"According to the current scientific evidence, in utero exposure to acetaminophen is unlikely to confer a clinically important increased risk of childhood ADHD or ASD." #Review… 1/2

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★ metajournal @metajournal.bsky.social · 21/09/2026

Acetaminophen use during pregnancy was not associated with children's risk of autism, ADHD, or intellectual disability in sibling control analysis. #ClinicalStudy… 1/2

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★ metajournal @metajournal.bsky.social · 20/09/2026

"The problem with the world is that the intelligent people are full of doubts, while the stupid ones are full of confidence." – Charles Bukowski

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★ metajournal @metajournal.bsky.social · 17/09/2026

BIS-titrated depth of anaesthesia did not improve outcomes in older patients. #RCT → Bispectral Index-guided Anesthesia for Older Patients Having Noncardiac Surgery: A Randomized Multicenter Trial. Anesthesiology. 2026 Feb 01; 144 (2): 353-364 metajournal.com/articles/pm40997029

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★ metajournal @metajournal.bsky.social · 16/09/2026

McGrath videolaryngoscopy showed no advantage when compared to standard direct laryngoscopy in Rapid Sequence Induction in low risk elective patients. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 15/09/2026

Cyclizine 50 mg is more effective at preventing postoperative nausea due to intrathecal morphine 200mcg than dexamethasone 8mg in patients undergoing caesarean section. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 14/09/2026

Prophylactic dexamethasone 10mg reduces post operative nausea & vomiting for 24 hours after caesarean section with intrathecal morphine. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 13/09/2026

"Everybody, soon or late, sits down to a banquet of consequences." – Robert Louis Stevenson

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★ metajournal @metajournal.bsky.social · 10/09/2026

Perioperative dexamethasone at doses > 0.1 mg/kg reduces post-operative pain and opioid consumption. #Review → Perioperative single dose systemic dexamethasone for postoperative pain: a meta-analysis of randomized controlled trials. Anesthesiology. 2011 Sep 1; 115 (3): 575-88.… 1/2

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★ metajournal @metajournal.bsky.social · 09/09/2026

Peri-induction dexamethasone 10mg reduces pain, nausea & vomiting after adult tonsillectomy. #RCT → Use of intravenous steroids at induction of anaesthesia for adult tonsillectomy to reduce post-operative nausea and vomiting and pain: a double-blind randomized controlled trial.… 1/2

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★ metajournal @metajournal.bsky.social · 08/09/2026

Breastfeeding should continue normally after receiving anaesthesia or sedation for almost all mothers and infants. #Review → Guidelines for anaesthesia and sedation for patients who are breastfeeding: Guidelines from the Association of Anaesthetists. Anaesthesia. 2026 May; 81 (5): 685-701… 1/2

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★ metajournal @metajournal.bsky.social · 07/09/2026

High-flow nasal oxygen significantly improves oxygenation and reduces desaturation for obese patients undergoing gastroscopy under sedation. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 06/09/2026

"Have nothing in your houses that you do not know to be useful or believe to be beautiful." – William Morris

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★ metajournal @metajournal.bsky.social · 03/09/2026

Dexamethasone 8mg significantly reduces postoperative nausea & vomiting in patients having bowel surgery, with NNT 13. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 02/09/2026

Following general anaesthesia caesarean section, sugammadex was not detectable in breastmilk. → Plasma levels and postpartum breastmilk concentrations of sugammadex: a pharmacokinetic study in women undergoing general anaesthesia for caesarean delivery. Int J Obstet Anesth.… 1/2

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★ metajournal @metajournal.bsky.social · 01/09/2026

Processed EEGs may offer pre-operative screening potential for those at risk of post-operative cognitive defects. → The potential of processed EEG monitoring systems in predicting postoperative cognitive deficits. J Clin Anesth. 2026 May 20; 112: 112219 metajournal.com/articles/pm42160881

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★ metajournal @metajournal.bsky.social · 31/08/2026

Pre-incision four-quadrant transversus abdominal plane blocks demonstrate little analgesic benefit for patients undergoing major abdominal surgery. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 30/08/2026

"All you need in life is ignorance and confidence, and then success is sure." – Mark Twain

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★ metajournal @metajournal.bsky.social · 27/08/2026

Many routine adult vaccines are associated with a lower risk of dementia. → Article collection: Vaccines associated with reduced dementia risk metajournal.com/collections/uZYgT7F…

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★ metajournal @metajournal.bsky.social · 26/08/2026

There is no significant difference in 28 day mortality between critical ill patients receiving etomidate vs ketamine for intubation in the emergency department. #RCT → Ketamine or Etomidate for Tracheal Intubation of Critically Ill Adults. N Engl J Med. 2026 Apr 23; 394 (16): 1608-1620… 1/2

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★ metajournal @metajournal.bsky.social · 25/08/2026

In healthy patients, 1-minutely non-invasive oscillometric BP monitoring at induction is non-inferior to intra-arterial BP monitoring, although invasive monitoring was associated with more vasopressor use. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 24/08/2026

Continuous intra-arterial pressure monitoring significantly reduces anaesthetic induction hypotension, compared to intermittent oscillometric BP monitoring, when intraoperative IABP is already clinically indicated. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 23/08/2026

"Formal education will make you a living; self-education will make you a fortune." – Jim Rohn

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★ metajournal @metajournal.bsky.social · 20/08/2026

The Shingrix recombinant zoster vaccine is associated with a significant reduced risk of dementia in adults ≥65 years old. → Recombinant zoster vaccine is associated with a reduced risk of dementia. Nat Commun. 2026 Feb 09; 17 (1) metajournal.com/articles/pm41663414

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★ metajournal @metajournal.bsky.social · 19/08/2026

The recombinant zoster vaccine is associated with reduced risk of myocardial infarction and stroke in adults ≥50 years old… 1/2

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★ metajournal @metajournal.bsky.social · 18/08/2026

Both recombinant zoster vaccine and anti-virals used to treat zoster infection are protective against dementia → Recombinant zoster vaccine and the risk of dementia. Vaccine. 2025 Feb 06; 46: 126673 metajournal.com/articles/pm39733478

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★ metajournal @metajournal.bsky.social · 17/08/2026

Use of face mask continuous flow insufflation of oxygen during CPR for out-of-hospital cardiac arrest, was associated with worse 30-day neurological outcome, compared to standard bag-mask ventilation. #MulticenterStudy… 1/2

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★ metajournal @metajournal.bsky.social · 16/08/2026

"It is remarkable how much long-term advantage people like us have gotten by trying to be consistently not stupid, instead of trying to be very intelligent." – Charlie Munger

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★ metajournal @metajournal.bsky.social · 13/08/2026

It is practical and safe to facilitate dreaming during anaesthesia with a simple pro-dreaming perioperative protocol, and was associated with higher sleep quality.… 1/2

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★ metajournal @metajournal.bsky.social · 12/08/2026

Pre-operative positive suggestion increases dream recall pleasantness during anaesthesia, and may increase dream recall. #RCT… 1/2

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★ metajournal @metajournal.bsky.social · 11/08/2026

Remote ischaemic preconditioning did not reduce myocardial injury after abdominal surgery. #RCT → Effect of two-session remote ischaemic preconditioning on myocardial injury after noncardiac surgery in patients undergoing abdominal surgery: a randomised clinical trial. Br J Anaesth.… 1/2

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★ metajournal @metajournal.bsky.social · 10/08/2026

"Posttraumatic growth" positive psychologic changes are common after major surgery, and are associated with less postoperative analgesia use. #ObservationalStudy → Association of Posttraumatic Growth and Analgesic Use in Postoperative Patients. Anesthesiology. 2026 Jul 01; 145 (1): 48-58… 1/2

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★ metajournal @metajournal.bsky.social · 09/08/2026

"I always appear smarter when I dress up in my giant nipple costume. I know this because I'll overhear people say things like, 'At least he's not a complete boob.'" – Judy Sheindlin, Beauty Fades, Dumb is Forever

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★ metajournal @metajournal.bsky.social · 06/08/2026

Xenon's general anaesthetic effects appear to be primarily mediated through noncompetitive NMDA receptor inhibition. #Review → Xenon anesthesia: shedding light on brain dynamics and clinical niches. Curr Opin Anaesthesiol. 2026 Aug 01; 39 (4): 431-438 metajournal.com/articles/pm42054173

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★ metajournal @metajournal.bsky.social · 05/08/2026

Propofol-based anaesthesia does not improve 2-year survival after cancer surgery when compared to volatile anaesthesia. #RCT → Anesthesia Type during Cancer Surgery: Results of the GA-CARES Randomized, Multicenter Trial. Anesthesiology. 2026 Jan 01; 144 (1): 51-62… 1/2

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★ metajournal @metajournal.bsky.social · 04/08/2026

When treating malignant hyperthermia, dantrolene should be dosed on actual bodyweight, up to the per-dose 300 mg maximum. #PracticeGuideline… 1/2

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★ metajournal @metajournal.bsky.social · 03/08/2026

Surgical facilities should have 720 mg of dantrolene immediately available, plus 480 mg accessible within 60 minutes. Remote facilities should have all 1200 mg on-site. #PracticeGuideline… 1/2

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★ metajournal @metajournal.bsky.social · 02/08/2026

"Bad business models produce bad technology." – Moxie

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Reposted by ★ metajournal

Daniel Jolley @djoll.bsky.social · 01/08/2026

Anaesthetics have a certain rhythm. At the beginning, the anaesthetist sets that rhythm. 🎶 But as the anaesthetic evolves, particularly late in a case, you risk the rhythm being defined by things outside your control… #Anesthesiology

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★ metajournal @metajournal.bsky.social · 30/07/2026

Alveolar deadspace fraction for volatile anesthetic agents is much larger than for carbon dioxide, and its magnitude increases as volatile blood solubility decreases. #MulticenterStudy… 1/2

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★ metajournal @metajournal.bsky.social · 29/07/2026

Photoacoustic measurement of breath-gas propofol concentration is feasible with high accuracy, quantifying propofol concentration via the sound waves emitted when propofol molecules are excited by specific wavelength light.… 1/2

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★ metajournal @metajournal.bsky.social · 28/07/2026

Prophylactic IV tranexamic acid results in a modest reduction of postpartum haemorrhage or transfusion incidence in women with known placenta praevia undergoing caesarean section. #RCT… 1/2

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