Journal of clinical anesthesia
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Review Meta Analysis
Analgesic efficacy of PECS vs paravertebral blocks after radical mastectomy: A systematic review, meta-analysis and trial sequential analysis.
Due to conflicting results published in the literature regarding the analgesic superiority between the paravertebral block and the PECS block, the study objective is to determine which one should be the first line analgesic treatment after radical mastectomy. ⋯ There is low quality evidence that a PECS block provides marginal postoperative analgesic benefit after radical mastectomy at 2 postoperative hours only, when compared with a paravertebral block, and not beyond. Clinical trial number: PROSPERO - registration number: CRD42019131555.
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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
Effects of remote ischemic preconditioning on prognosis in patients with lung injury: A meta-analysis.
A number of trials have shown that remote ischemic preconditioning (RIPC) could reduce lung injury of patients suffering cardiovascular surgery, pulmonary transplantation surgery and thoracic surgery with one-lung ventilation. However, there is still a controversy over the lung protection of RIPC in patients who suffers different types of surgery. We undertook meta-analysis of the randomized controlled trials to evaluate the effect of remote ischemic preconditioning on clinical outcomes of patients with lung injury. ⋯ RIPC can decrease pulmonary inflammatory responses, reduce the duration of ICU and mechanical ventilation time, and improve the clinical outcomes of patients with lung injury.
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Review Meta Analysis
Dexmedetomidine versus other sedatives for non-painful pediatric examinations: A systematic review and meta-analysis of randomized controlled trials.
Procedural sedation for non-painful pediatric examinations outside the operating room remains a challenge, this study was designed to compare the safety and effectiveness of sedation provided by dexmedetomidine versus other sedatives including chloral hydrate, midazolam, and pentobarbital for pediatric patients to complete diagnostic examinations. ⋯ The meta-analysis shows that sedation by dexmedetomidine has lower incidence of respiratory depression and provides higher success rates in completing examinations than other traditional sedatives without compromising safety, indicating a prospective clinical use for procedural sedation.
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Review Meta Analysis
Single injection Quadratus Lumborum block for postoperative analgesia in adult surgical population: A systematic review and meta-analysis.
The Quadratus lumborum (QL) block was first reported as a postoperative analgesic technique for abdominoplasty, and since has been used for a variety of surgeries. In this systematic review and meta-analysis, we summarize the current literature on the postoperative analgesic effect of QL block. ⋯ QL block significantly reduces opioid requirement in cesarean delivery and in renal surgery. The evidence for other surgery types are limited. QL block may have analgesic effect for up to 24 h postoperatively, but the evidence is again limited. There is currently limited evidence comparing QL block to other analgesic techniques, further studies are needed in this area.