Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis
Inferior vena cava ultrasound to predict hypotension after general anesthesia induction: a systematic review and meta-analysis of observational studies.
Hypotension after induction of general anesthesia is common and is associated with significant adverse events. Identification of patients at high risk can inform the use of preoperative mitigation strategies. We conducted a systematic review and meta-analysis to assess the diagnostic accuracy of the inferior vena cava collapsibility index (IVC-CI) and maximal diameter (dIVCmax) in predicting postinduction hypotension and to identify their predictive performance across different threshold ranges. ⋯ PROSPERO ( CRD42022316140 ); first submitted 10 March 2022.
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Meta Analysis Comparative Study
Efficacy of different routes of acetaminophen administration for postoperative pain in children: a systematic review and network meta-analysis.
Acetaminophen is the most common drug used to treat acute pain in the pediatric population, given its wide safety margin, low cost, and multiple routes for administration. We sought to determine the most efficacious route of acetaminophen administration for postoperative acute pain relief in the pediatric surgical population. ⋯ PROSPERO (CRD42021286495); first submitted 19 November 2021.
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Randomized Controlled Trial Comparative Study
Remimazolam to prevent hemodynamic instability during catheter ablation under general anesthesia: a randomized controlled trial.
Maintaining hemodynamic stability during cardiac ablation under general anesthesia is challenging. Remimazolam, a novel ultrashort-acting benzodiazepine, is characterized by maintaining comparatively stable blood pressure and does not influence the cardiac conduction system, which renders it a reasonable choice for general anesthesia for cardiac ablation. We aimed to evaluate whether remimazolam is associated with a decreased incidence of intraoperative hypotension compared with desflurane. ⋯ ClinicalTrials.gov (NCT05486377); first submitted 1 August 2022.
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Pulmonary hypertension (PH) is a common cause of postoperative mortality in cardiac surgery that is commonly treated with conventional inhaled therapies, specifically nitric oxide and prostacyclin. Alternative therapies include inhaled milrinone and levosimendan, which are receiving more research interest and are increasing in clinical use as they may cut costs while allowing for easier administration. We sought to conduct a scoping review to appraise the evidence base for the use of these two novel inhaled vasodilators as an intervention for PH in cardiac surgery. ⋯ Open Science Framework ( https://osf.io/z3k6f/ ); first posted 21 July 2022.
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Children recovering from anesthesia commonly experience early postoperative negative behaviour, caused by pain and emergence delirium. Differentiating the two is challenging in young children. Perioperative pain influences the heart rate variability-derived Newborn Infant Parasympathetic Evaluation (NIPE) index and may also affect emergence delirium. We sought to investigate whether the perioperative NIPE index can discriminate between mild, moderate, or severe pain levels and can detect emergence delirium. ⋯ ClinicalTrials.gov ( NCT04909060 ); first submitted 26 May 2021.