Anesthesiology
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The authors reviewed efficacy and safety data for ondansetron for preventing postoperative nausea and vomiting (PONV). ⋯ If the risk of PONV is very high, for every 100 patients receiving an adequate dose of ondansetron 20 patients will not vomit who would have vomited had they received placebo. The antinausea effect is less pronounced. Of these 100, three will have elevated liver enzymes and three will have a headache who would not have had these adverse effects without the drug.
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Meta Analysis
Omission of nitrous oxide during anesthesia reduces the incidence of postoperative nausea and vomiting. A meta-analysis.
Postoperative nausea and vomiting are important causes of morbidity after general anesthesia. Nitrous oxide has been implicated as an emetogenic agent in many studies. However, several other trials have failed to sustain this claim. The authors tried to resolve this issue through a meta-analysis of randomized controlled trials comparing the incidence of postoperative nausea and vomiting after anesthesia with or without nitrous oxide. ⋯ Omission of nitrous oxide reduced the odds of postoperative nausea and vomiting by 37%, a reduction in risk of 28%.
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Meta Analysis Comparative Study
Comparisons between desflurane and isoflurane or propofol on time to following commands and time to discharge. A metaanalysis.
Anesthesiologists can best decide whether to use desflurane based on the magnitudes of its effects compared to other general anesthetics. The goal of this study was to estimate the mean decrease in times to following commands when desflurane was being used instead of isoflurane or propofol. The mean decrease in time to hospital discharge after ambulatory surgery when desflurane was used instead of propofol also was examined. ⋯ There are only minor clinically important differences between desflurane and isoflurane or propofol with respect to time to following commands and time to discharge.
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Meta Analysis Comparative Study
Anesthetic techniques during surgical repair of femoral neck fractures. A meta-analysis.
Fracture of the hip typically occurs in older women. These patients usually have serious accompanying chronic illnesses. There is a difference of opinion as to the choice of regional versus general anesthesia for surgery in these patients. ⋯ By probability difference, mortality was a non-significant 2.7 percentage points less following regional anesthesia. By odds ratio effect measure, death was 1.5 times more likely following general anesthesia, but the lower bound of the 95% confidence interval was close to 1. Meta-analysis does not allow a conclusion that important differences in mortality exist between regional and general anesthesia for traumatic hip fracture surgery.