Journal of clinical anesthesia
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Review Meta Analysis
Rebound pain prevention after peripheral nerve block: A network meta-analysis comparing intravenous, perineural dexamethasone, and control.
Peripheral nerve blocks (PNBs) are widely used for postoperative analgesia, but rebound pain following block resolution poses a significant clinical challenge. Dexamethasone, administered either intravenously (IV) or perineurally, has shown promise in reducing rebound pain incidence, but the optimal route remains unclear. This network meta-analysis (NMA) aims to compare the effectiveness of different routes of dexamethasone administration, including IV, perineural, and control, in reducing the incidence of rebound pain following PNBs. ⋯ PROSPERO CRD42024530943.
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Review Meta Analysis
Continuation versus discontinuation of renin-angiotensin aldosterone system inhibitors before non-cardiac surgery: A systematic review and meta-analysis.
A large number of patients undergoing noncardiac surgeries are on long-term use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARBs). The current guidelines regarding the continuation or discontinuation of renin-angiotensin-aldosterone system inhibitors (RAAS) inhibitors before noncardiac surgery are conflicting. This meta-analysis aims to evaluate whether continuing or withholding RAAS inhibitors before noncardiac surgery influences perioperative mortality and complications. ⋯ Withholding RAAS inhibitors before noncardiac surgery reduces intraoperative hypotension and AKI with nonsignificant effects on mortality and MACE.
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Randomized Controlled Trial Multicenter Study
Effect of perioperative rehabilitation exercise on postoperative outcomes in patients aged ≥65 years undergoing gastrointestinal surgery: A multicenter randomized controlled trial.
This study aimed to assess the effect of perioperative rehabilitation exercise, initiated shortly after hospital admission, on postoperative outcomes in elderly patients. ⋯ Perioperative rehabilitation exercise has a positive impact on postoperative complications, quality of life and psychological well-being in elderly patients undergoing gastrointestinal surgery, even when implemented after hospital admission.