Is IJ or Subclavian Safer Under Ultrasound Guidance?

Is IJ or Subclavian Safer Under Ultrasound Guidance?

In this randomized trial of anesthetized patients, ultrasound-guided internal jugular venous catheters had a lower arterial puncture rate, pneumothorax rate, catheter misplacement, and access time compared to ultrasound-guided subclavian venous catheterization.

New Opiate Prescriptions and Downstream Risk of Misuse

New Opiate Prescriptions and Downstream Risk of Misuse

In patients given a new opiate prescription in the ED, 13.7% had persistent or high risk use over the next year. Higher doses led to greater risk, but even appropriate lower doses were associated with up to a 10% risk.

Tramadol Isn't Addictive, Right?

Tramadol Isn't Addictive, Right?

Use of tramadol post-op was associated with an increased risk of prolonged use compared with other short acting opiates.

Does Ramped Position Impact Intubation Success?

Does Ramped Position Impact Intubation Success?

There was no difference in first pass success with a non-supine (ramped) vs supine intubating position in this retrospective study, and composite adverse events were more common when ramped.  But patients most likely to be ramped were also obese or had predicted difficult airway.

Off-Label Gabapentin and Pregabalin - Sketchy Evidence

Off-Label Gabapentin and Pregabalin - Sketchy Evidence

Gabapentinoids play a limited role for specific types of neuropathic pain, and pain reduction is modest at best. Side effects of dizziness, somnolence, and gait problems occur frequently.

Do Muscle Relaxers Help Back Pain?

Do Muscle Relaxers Help Back Pain?

There was no benefit in functional outcome or pain at one week by using ibuprofen + either baclofen, metaxolone, or tizanidine over ibuprofen + placebo.

PRIME RCT - Ketamine or Fentanyl Intranasal For Pediatric Injuries?

PRIME RCT - Ketamine or Fentanyl Intranasal For Pediatric Injuries?

Intranasal ketamine is noninferior to intranasal fentanyl for pain associated with pediatric extremity injuries. However, there is a higher risk of minor adverse events.

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