Journal of clinical anesthesia
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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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The repetitive hypoxic and hypercapnia events of obstructive sleep apnea (OSA) are believed to adversely affect cardiopulmonary function, which make them vulnerable to a higher incidence of postoperative complications. The primary aim of this systematic review and meta-analysis was to examine the association of OSA and the composite endpoints of postoperative cardiac or cerebrovascular complications in adult undergoing non-cardiac surgery. ⋯ CRD42019136564.
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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.
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Evidence suggests that administering appropriate volumes of perioperative fluid replacement therapies can decrease the incidence of postoperative nausea and vomiting (PONV). However, the relative effects of colloids and crystalloids on PONV are still unclear. The objective of this systematic review was to determine whether administering colloids to adults undergoing noncardiac surgery significantly reduces PONV incidence and rescue antiemetic use, compared with administering crystalloids. ⋯ Colloid administration reduced the incidence of PONV in adults undergoing elective, noncardiac, major surgery under general anesthesia for >3 h. However, clinical studies performed in larger cohorts are required to determine the impact of colloids on PONV.
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Review Meta Analysis
Efficacy and safety of haloperidol for delirium prevention in adult patients: An updated meta-analysis with trial sequential analysis of randomized controlled trials.
To identify the efficacy and safety of haloperidol prophylaxis in adult patients with a high risk for delirium. ⋯ The results of our meta-analysis suggested the use of prophylactic haloperidol compared with placebo had no beneficial impacts on incidence of delirium, duration of mechanical ventilation, length of intensive care unit (ICU) stay, length of hospital stay and mortality in adult patients. It appeared to have a positive effect on duration of delirium, while with a significant heterogeneity. These findings do not support the routine usage of haloperidol for delirium prevention.