Changes

=Ideas=

=Ideas=

==Good==

==Good==

* Does change in PPV/CO after SCD activation predict fluid responsiveness and how does it compare to SLR?

* Does change in PPV/CO after SCD activation predict fluid responsiveness and how does it compare to SLR?

* Does sugammadex interfere with HRT in post-menopausal and/or lactating women? (0 articles mentioning both Sugammadex and Menopause)

* Does sugammadex interfere with HRT in post-menopausal and/or lactating women? (0 articles mentioning both Sugammadex and Menopause)

* EPIC timeline builder

* EPIC timeline builder

* Ultrasound vs blind A-line first attempt success rate and complications?

* Ultrasound vs blind A-line first attempt success rate and complications?

 

* How do epidurals affect gastric emptying in labor?

* Schnell lab

 

When did the ASA make their guideline for fasting? Which studies were cited? Which studies was the ASA (presumably) aware of? Ultimately, the clinical implications of answering this question would hinge on whether the results would change the ASA guidelines. If new information is unlikely to change guidance, then pursuing this question would be less relevant. Fasting for a few hours post-epidural is very low risk compared to the admittedly rare event of clinically significant aspiration. If you show that epidurals increase gastric emptying that would suggest that they also decrease risk of aspiration. However, if you then let patients with epidurals eat, they have a full stomach and their risk of aspiration is heightened despite any protective effect of an epidural. In other words, the lowest risk category of patients, assuming my hypothesis is true, remains fasted patients with epidurals.

When did the ASA make their guideline for fasting? Which studies were cited? Which studies was the ASA (presumably) aware of? Ultimately, the clinical implications of answering this question would hinge on whether the results would change the ASA guidelines. If new information is unlikely to change guidance, then pursuing this question would be less relevant. Fasting for a few hours post-epidural is very low risk compared to the admittedly rare event of clinically significant aspiration. If you show that epidurals increase gastric emptying that would suggest that they also decrease risk of aspiration. However, if you then let patients with epidurals eat, they have a full stomach and their risk of aspiration is heightened despite any protective effect of an epidural. In other words, the lowest risk category of patients, assuming my hypothesis is true, remains fasted patients with epidurals.

| [https://ovidsp.dc2.ovid.com/ovid-new-b/ovidweb.cgi?WebLinkFrameset=1&S=EGLNFPLEIIEBMLKBIPKJOFPFCBGDAA00&returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.20%257c13%257c50%26FORMAT%3dtitle%26FIELDS%3dTITLES%26S%3dEGLNFPLEIIEBMLKBIPKJOFPFCBGDAA00&fromjumpstart=0&directlink=https%3a%2f%2fovidsp.dc2.ovid.com%2fovftpdfs%2fFPEBIPPFOFKBII00%2ffs047%2fovft%2flive%2fgv024%2f00000539%2f00000539-199710000-00022.pdf&filename=A+Comparison+of+the+Effect+of+Intrathecal+and+Extradural+Fentanyl+on+Gastric+Emptying+in+Laboring+Women.&navigation_links=NavLinks.S.sh.20.13&PDFIdLinkField=%2ffs047%2fovft%2flive%2fgv024%2f00000539%2f00000539-199710000-00022&link_from=S.sh.20%7c13&pdf_key=B&pdf_index=S.sh.20&D=medall Mirakhur et al Anes and Analg 1997] || 105 parturiants || APAP absorption assay was done in women getting neuraxial labor analgesia || Neuraxial analgesia was administered with bupivacaine and 25 mcg intrathecal fentanyl (S), 50 mcg epidural fentanyl (E), or no opioid (C). APAP CMax, TMax, and AUC were measured at 60 and 120 min || Median (range) TMax values were 120 (15-180), 82.5 (15-180), and 90 (15-180) min in Groups S, E, and C, respectively (P < 0.05). Mean ± SD CMax was 13.4 ± 8.82, 17.9 ± 8.06, and 15.0 ± 6.22 µg/mL in Groups S, E, and C, respectively (P < 0.05). Mean ± SD AUC90 and AUC120 were also significantly smaller in Group S than in the other two groups (430 ± 616, 736 ± 504, and 672 ± 453; and 649 ± 592, 1063 ± 627, and 1053 ± 616 µg/ml/min in Groups S, E, and C, respectively).  

| [https://ovidsp.dc2.ovid.com/ovid-new-b/ovidweb.cgi?WebLinkFrameset=1&S=EGLNFPLEIIEBMLKBIPKJOFPFCBGDAA00&returnUrl=ovidweb.cgi%3f%26Titles%3dS.sh.20%257c13%257c50%26FORMAT%3dtitle%26FIELDS%3dTITLES%26S%3dEGLNFPLEIIEBMLKBIPKJOFPFCBGDAA00&fromjumpstart=0&directlink=https%3a%2f%2fovidsp.dc2.ovid.com%2fovftpdfs%2fFPEBIPPFOFKBII00%2ffs047%2fovft%2flive%2fgv024%2f00000539%2f00000539-199710000-00022.pdf&filename=A+Comparison+of+the+Effect+of+Intrathecal+and+Extradural+Fentanyl+on+Gastric+Emptying+in+Laboring+Women.&navigation_links=NavLinks.S.sh.20.13&PDFIdLinkField=%2ffs047%2fovft%2flive%2fgv024%2f00000539%2f00000539-199710000-00022&link_from=S.sh.20%7c13&pdf_key=B&pdf_index=S.sh.20&D=medall Mirakhur et al Anes and Analg 1997] || 105 parturiants || APAP absorption assay was done in women getting neuraxial labor analgesia || Neuraxial analgesia was administered with bupivacaine and 25 mcg intrathecal fentanyl (S), 50 mcg epidural fentanyl (E), or no opioid (C). APAP CMax, TMax, and AUC were measured at 60 and 120 min || Median (range) TMax values were 120 (15-180), 82.5 (15-180), and 90 (15-180) min in Groups S, E, and C, respectively (P < 0.05). Mean ± SD CMax was 13.4 ± 8.82, 17.9 ± 8.06, and 15.0 ± 6.22 µg/mL in Groups S, E, and C, respectively (P < 0.05). Mean ± SD AUC90 and AUC120 were also significantly smaller in Group S than in the other two groups (430 ± 616, 736 ± 504, and 672 ± 453; and 649 ± 592, 1063 ± 627, and 1053 ± 616 µg/ml/min in Groups S, E, and C, respectively).  

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=SCD hemodynamic effects=

=SCD hemodynamic effects=