Evidence
Alert

Ultrasound guided nerve blocks are safe, effective and save time

This Cochrane review found that nerve blocks to provide local anaesthesia in the arms or legs of adults before a surgical procedure were safe and effective when guided by ultrasound compared to other guidance techniques. They were successful about nine times out of ten with ultrasound guidance, compared to about eight times out of ten ...

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Providing regular feedback on patient outcomes improves anaesthetists’ performance

This NIHR-funded study found that enhanced continuous monitoring and feedback was associated with an improvement in the performance of anaesthetists. A detailed monthly report contained data about outcomes, such as nausea, pain and discomfort, for individual patients. Anaesthetists received data by subspecialty and this included details of unusual cases, comparative data across patients and anaesthetists ...

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NHS services can help in sustaining quit rates for smoking

Almost eight per cent of users of NHS Stop Smoking services are still smoke-free after a year, compared with only about three per cent of smokers who try to quit without treatment. This NIHR-funded study added data on quit rates at one year to routinely collected short-term data, by showing England’s stop smoking services achieved ...

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A trial of probiotics for treating sepsis in very premature babies poses more questions than it answers

Contrary to a previous review of trials, this large, NIHR-funded trial found that probiotic treatment did not prevent two common life-threatening conditions in very premature babies. The conditions were necrotising enterocolitis, which is a severe gut inflammation/infection that can result in the death of intestinal tissue, and sepsis (blood poisoning) from bacteria that have crossed ...

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A new tool may help identify more patients at risk of developing pressure ulcers

This was an NIHR-funded study to develop and evaluate a new pressure ulcer assessment tool, called PURPOSE-T. The tool, developed as part of a five year NIHR research programme, is used by following a manual and assesses eight risk factors: mobility; skin; previous pressure ulcer; sensory perception; perfusion (blood flow); nutrition; moisture; and diabetes. Field testing ...

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Lack of evidence on whether collagenase or surgery is more clinically or cost effective in managing Dupuytren’s contracture

This review aimed to compare injections of collagenase clostridium histolyticum with standard surgical treatments for Dupuytren’s contracture. Unfortunately existing trials are small and there are no head to head trials of surgery vs collagenase, so it is not possible to determine which therapy is more effective in the short or longer term - nor which ...

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Saline irrigation and corticosteroid spray are effective first choice treatments for chronic sinusitis

The authors of this systematic review found that high-volume saline irrigation and corticosteroid nasal sprays were effective at reducing symptoms of sinusitis. They recommend a combination of these two therapies as the first line treatment of choice, in accordance with guidelines from the Royal College of Surgeons and ENT UK. In addition they found that, ...

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Protocol-led therapy for septic shock did not reduce mortality compared to usual resuscitation care

This NIHR funded randomised controlled trial found that early goal-directed therapy for people with septic shock offered no benefit over usual resuscitation care. About three in ten people died in both groups. Early goal-directed therapy differed from routine care in that it involved rigorous monitoring with use of a central venous “oximetry” catheter to manage ...

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Evidence is growing that early mechanical removal of clots from blocked brain arteries may improve recovery after stroke

Restoring blood flow to the brain within a few hours of having a stroke improves a person’s chances of recovery. Early use of drugs to dissolve clots (thrombolysis) has been the mainstay of management in recent years and there has also been rapid development of devices to remove clots. Using evidence from trials published in ...

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Noradrenaline confirmed as first-choice vasopressor for septic shock

This review supports current guidance that noradrenaline should be used as the first-choice vasopressor for adults with septic shock. Noradrenaline reduced mortality by 11% and major adverse events by two-thirds compared to dopamine. However, evidence of its effectiveness compared to the other vasopressors remains limited. Septic shock accounts for nearly one in ten admissions to ...

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