SummarySpinal anaesthesia for caesarean section induces hypotension, which may cause severe adverse effects. Our goal was to determine whether hypotension could be predicted by pulse oximetry parameters, such as the perfusion index and pleth variability index, heart rate, ratio of low-frequency to high-frequency components of heart rate variability, and entropy of heart rate variability, measured before the induction of anaesthesia. The predictive value of these parameters for detecting hypotension was assessed using logistic regression and the grey zone approach in 81 parturients. Logistic regression revealed heart rate to be the only independent predictor (OR 1.06; 95% CI 1.01-1.13; p = 0.032). The grey zone for heart rate was in the range of 71-89 bpm, and 60.5% of parturients were in the grey zone. Pre-anaesthetic heart rate, but not other parameters derived from pulse oximetry or heart rate variability, may be a prognostic factor for hypotension associated with spinal anaesthesia.

Our meta-analysis suggests that the McGrath is superior to the Macintosh in terms of glottic visualization (GRADE: moderate). However, it significantly extends intubation time (GRADE: very low) and its success rate (GRADE: very low) for tracheal intubation is not excellent. TSA suggests that further studies are necessary to confirm the results of intubation time.

SummaryThe purpose of this meta-analysis was to determine the efficacy of lidocaine in preventing laryngospasm during general anaesthesia in children. An electronic search of six databases was conducted. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were adhered to. We included randomised controlled trials reporting the effects of intravenous and/or topical lidocaine on the incidence of laryngospasm during general anaesthesia. Nine studies including 787 patients were analysed. The combined results demonstrated that lidocaine is effective in preventing laryngospasm (risk ratio (RR) 0.39, 95% CI 0.24-0.66; I 2 = 0). Subgroup analysis revealed that both intravenous lidocaine (RR 0.34, 95% CI 0.14-0.82) and topical lidocaine (RR 0.42, 95% CI 0.22-0.80) lidocaine are effective in preventing laryngospasm. The results were not affected by studies with a high risk of bias. We conclude that, both topical and intravenous lidocaine are effective for preventing laryngospasm in children.

Ramosetron has a significant effect for preventing PONV compared with a placebo, but less than that reported in previous analyses. Ramosetron also has statistically significant differences in preventing early and late POV compared with ondansetron, but the clinical significance may be questioned because the NNTs are large.

We developed and validated an EA risk scale for children receiving sevoflurane anesthesia. In our validation cohort, this scale has excellent predictive performance (c-index > 0.8). The EA risk scale could be used to predict EA in children and adopt a preventive strategy for those at high risk. This score-based preventive approach should be studied prospectively to assess the safety and efficacy of such a strategy.