European journal of anaesthesiology
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Review Meta Analysis
Local anaesthetic wound infiltration for postcaesarean section analgesia: A systematic review and meta-analysis.
Wound infiltration with local anaesthetics has been investigated as a potentially useful method for providing analgesia after caesarean delivery, but the literature is inconclusive. ⋯ Local anaesthetic wound infiltration reduces postoperative opioid consumption but had minimal effect on pain scores and did not reduce opioid-related side-effects in women who had undergone delivery by caesarean section. The review is limited by a paucity of studies using intrathecal morphine and by the indirect comparisons performed for subgroup analyses.
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Review Meta Analysis
Cardiac troponins and volatile anaesthetics in coronary artery bypass graft surgery: A systematic review, meta-analysis and trial sequential analysis.
Reports from animal studies indicate that volatile anaesthetics protect the myocardium against the effects of acute ischaemia-reperfusion injury by reducing infarct size. This cardioprotective effect in the clinical setting of coronary artery bypass graft (CABG) surgery, where the heart is subjected to global ischaemia-reperfusion injury, remains controversial. ⋯ Studies investigating the cardioprotective effect of volatile anaesthetics on cardiac troponins in on-pump CABG surgery are no longer warranted. This is not yet the case for off-pump surgery.
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Review Meta Analysis
Targeting oliguria reversal in perioperative restrictive fluid management does not influence the occurrence of renal dysfunction: A systematic review and meta-analysis.
Interest in perioperative fluid restriction has increased, but it could lead to hypovolaemia. Urine output is viewed as a surrogate for renal perfusion and is frequently used to guide perioperative fluid therapy. However, the rationale behind targeting oliguria reversal - achieving and maintaining urine output above a previously defined threshold by additional fluid boluses - is often questioned. ⋯ Our data suggest that, even though event numbers are small, perioperative restrictive fluid management does not increase oliguria or postoperative ARF while decreasing intraoperative fluid intake, irrespective of targeting reversal of oliguria or not.
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Review Meta Analysis
Preoperative celecoxib in noncardiac surgery: A systematic review and meta-analysis of randomised controlled trials.
Postoperative pain continues to be undertreated after noncardiac surgery. Preoperative analgesic administration may enhance postoperative analgesia. ⋯ Results of this study are limited by significant heterogeneity and inclusion of mainly small trials. However, there appears to be a slight to modest benefit of preoperative celecoxib on reducing postoperative morphine consumption, pain, nausea and vomiting.