People with opioid use disorder had about double the odds of postoperative respiratory events

The edition in brief

A systematic review of 40 studies found that adults with opioid use disorder had higher odds of postoperative pain (OR 2.87, 95% CI 1.63 to 5.06) and composite respiratory events (OR 2.10, 1.64 to 2.68), both moderate-certainty; readmission, length of stay and cost were also higher on low-certainty evidence, while in-hospital mortality did not differ clearly. In 58 patients with diabetes having surgery or ICU admission, a continuous glucose monitor agreed well with point-of-care testing (median absolute relative difference 10.9%, 98% of paired readings in clinically acceptable zones), with worse agreement during hypoperfusion, and no hypoglycaemia occurred. In an 86-patient trial, remimazolam reversed with flumazenil shortened eye-opening and extubation time against propofol but did not improve later recovery scores. A single-centre trial of 143 adults found that a mean arterial pressure alarm at 72 mmHg was noninferior to the Hypotension Prediction Index alarm for time below 65 mmHg (mean difference 0.03, 95% CI -0.24 to 0.29).