Search

Total knee arthroplasty is a frequently performed orthopaedic surgery and the trend indicates an increase in annual procedures. Many patients experience severe postoperative pain. In this review article, a review of the literature reveals evidence supporting a multimodal approach to pain management, which involves basic analgesic treatment in combination with glucocorticoids and local infiltration analgesia. Effective pain control can reduce postoperative pain, lower opioid consumption, and its associated adverse effects, and enhance postoperative rehabilitation and patient satisfaction., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

A systematic review provides an overview of primary studies investigating a given research question, e.g., the effect of a certain treatment. Individual study results are sometimes synthesised in a meta-analysis. A critical reader should consider whether the systematic review is relevant and reliable, e.g., does it follow a protocol, address the risk of bias, and consider potential heterogeneity. PRISMA 2020 guideline recommends a minimum set of items that should be reported in a systematic review article, and AMSTAR 2 and ROBIS are tools for critical appraisal of systematic reviews., (Published under Open Access CC-BY-NC-BD 4.0. https://creativecommons.org/licenses/by-nc-nd/4.0/.)

More and more people travel to high altitudes, some develop mountain sickness, a possible life-threatening condition. The most common and benign case of mountain sickness is acute mountain sicknes, this condition is easily treatable by descending or low dose aceatazolamide. Treatment is important to avoid development to the more severe cases of mountain sickness high-altitude cerebral oedema and high-altitude pulmonary oedema. These conditions require early recognition and treatment. This review gives an overview of available treatment of these conditions and how to avoid them in the first place.

Rebound pain is a severe post-surgical pain which occurs after the resolution of peripheral nerve blocks. Current literature suggests that rebound pain affects around 50% of those receiving a peripheral nerve block. Possible interventions constitute patient education, bridging analgesia from the resolution of the nerve block, multimodal analgesic regimes, block adjuvants, or continuous pain catheters. Factors such as low age, female gender, bone surgery, and absence of IV dexamethasone are likely to be associated with rebound pain, as argued in this review.

A track and trigger (TAT) system and mobile emergency team (MET) can aid observation and care for admitted patients in the hospital ward. We have examined the literature and find evidence, though not strong, that the introduction of TAT and MET systems reduce hospital mortality. However, in Denmark, many different TAT systems are used, and several hospitals do not have MET. We believe, that a standardised national TAT system could encourage interregional research and the investigation of system compliance, cost-benefit and impact on intensive care unit admissions.

A Cochrane review investigated the effect of blinding information of authors, institutions, journals and sponsorships in assessing the presence of bias in trials that were assessed for inclusion in a systematic review. Six randomized trials were included. The results of these were quite heterogeneous and from this review it is not possible to conclude anything about the effect of blinding with certainty. However, it proved time-consuming to implement a secure blinding and until further evidence appears, it is recommended to refrain from attempts to do so.

There is an increased risk of intubation failure and aspiration when performing Caesarean section (CS) in general anaesthesia. We describe an incidence of failed intubation and airway management of a CS patient at Herlev Hospital in 2007. Intubation and placement of an intubating laryngeal mask (LM) was unsuccessful. The patient was ventilated with an LM. There was no local failed intubation drill guideline, but a national algorithm was partially followed. Any hospital performing obstetric operations should frequently perform a failed intubation drill.