Journal of clinical anesthesia
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Review Meta Analysis
Duloxetine for the treatment acute postoperative pain in adult patients: A systematic review with meta-analysis.
Duloxetine administered during the acute perioperative period has been associated with lesser postoperative pain and analgesic consumption. ⋯ Although statistically significant effects of duloxetine were found on postoperative pain and opioid consumption during the first 48 postoperative hours, the effect sizes were below the expected minimal clinically relevant differences. Also, high risk-of-bias and inter-study heterogeneity caused the very-low quality of evidence (GRADE). We conclude that the currently available evidence does not support the clinical use of duloxetine for the management of acute postoperative pain.
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Review Meta Analysis
Analgesic efficacy of PECS and serratus plane blocks after breast surgery: A systematic review, meta-analysis and trial sequential analysis.
To determine whether pectoral nerves (PECS) blocks provide effective postoperative analgesia when compared with no regional technique in patients undergoing breast surgery. ⋯ There is moderate-to-high level evidence that PECS blocks provide postoperative analgesia after breast surgery when compared with no regional technique and reduce rate of PONV. This might provide the most benefit to those at high-risk of postoperative pain.
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Low level of fibrinogen is a risk factor of perioperative bleeding, which is a major complication in surgical patients. However, the safety and efficacy of fibrinogen supplementation with fibrinogen concentrate to minimize postoperative bleeding remains unclear. ⋯ In this meta-analysis of 13 randomized trials, low level of evidence and substantial heterogeneity with small sample size limit strong recommendation on the use of fibrinogen concentrate in adult surgical patients. However, its use is tolerable without any notable adverse events.
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Randomized Controlled Trial
Impact of ultrasound-guided erector spinae plane block on postoperative quality of recovery in video-assisted thoracic surgery: A prospective, randomized, controlled trial.
Regional anesthesia improves postoperative analgesia and enhances the quality of recovery (QoR) after surgery. We examine the efficacy of ultrasound-guided erector spinae plane block (ESPB) on QoR after video-assisted thoracic surgery (VATS). ⋯ Preoperative single-injection thoracic ESPB with ropivacaine improves QoR, postoperative analgesia, and patient satisfaction after VATS.
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Observational Study
Comparison of spontaneous versus operative vaginal delivery using Obstetric Quality of Recovery-10 (ObsQoR-10): An observational cohort study.
We aimed to determine whether patient-reported quality of recovery differed between spontaneous and operative vaginal delivery. We also aimed to psychometrically evaluate the Obstetric Quality of Recovery-10 scoring tool (ObsQoR-10) for use in this setting. ⋯ Quality of recovery appears to be better following spontaneous compared to operative vaginal delivery. This study also demonstrates that ObsQoR-10 is a valid and reliable tool for use following these delivery modes.