European journal of anaesthesiology
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Meta Analysis
Efficacy and safety of aprotinin in paediatric cardiac surgery: A systematic review and meta-analysis.
The relicensing of aprotinin in Europe and Canada has stimulated discussions on its usefulness in paediatric cardiac surgery. ⋯ This meta-analysis suggests that aprotinin is effective and well tolerated in paediatric cardiac surgery. Given the large heterogeneity of the results and the risk of selection bias in observational studies, large randomised controlled trials are warranted.
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Transversus abdominis plane (TAP) block and local anaesthetic wound infiltration are used to relieve pain after caesarean section. ⋯ There is moderate level evidence that TAP block and wound infiltration provide similar postoperative analgesia after caesarean section.
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Meta Analysis
Association between night-time extubation and clinical outcomes in adult patients: A systematic review and meta-analysis.
Whether night-time extubation is associated with clinical outcomes is unclear. ⋯ Night-time extubation of adult patients was not associated with higher adjusted risks for reintubation or death, in comparison with daytime extubation, but the certainty of the evidence was low.
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Meta Analysis
Dexmedetomidine vs. total intravenous anaesthesia in paediatric emergence delirium: A network meta-analysis.
Emergence delirium is a common complication in paediatric anaesthesia associated with significant morbidity. Total intravenous anaesthesia (TIVA) and intra-operative dexmedetomidine as an adjuvant to sevoflurane anaesthesia can both reduce the incidence of emergence delirium compared with sevoflurane alone, but no studies have directly compared their relative efficacy. ⋯ Clinical judgement, considering the patient's risk factors for the development of clinically significant outcomes such as emergence delirium and PONV, should be used when choosing between TIVA and sevoflurane with adjuvant dexmedetomidine. These findings are limited by the low quality of evidence (conditional recommendation).
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Meta Analysis
For nasotracheal intubation, which nostril results in less epistaxis: right or left?: A systematic review and meta-analysis.
Nasotracheal intubation is usually required in patients undergoing oromaxillofacial, otolaryngological or plastic surgery to prevent the airway encroaching into the operating field. Epistaxis is the most common complication, but which nostril is associated with a lower incidence and severity of epistaxis is still unclear. ⋯ On the basis of the current available evidence, when both nostrils are patent, the right nostril is more appropriate for nasotracheal intubation, with a lower incidence and severity of epistaxis and faster intubation time.