Journal of clinical anesthesia
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Meta Analysis Comparative Study
High-dose versus low-dose opioid anesthesia in adult cardiac surgery: A meta-analysis.
We performed a systematic comparison of high-dose and low-dose opioid anesthesia in cardiac surgery. ⋯ Our data suggest that low-dose opioids, both short acting and long acting, are safe and effective to use in adult cardiac surgery patients, independent of the clinical characteristics of the patients and the type of opioid used. In view of the current opioid epidemic, low-dose opioid anesthesia should be considered for cardiac surgery patients.
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Review Meta Analysis
Depth of anesthesia measured by bispectral index and postoperative mortality: A meta-analysis of observational studies.
Whether anesthesia depth affects postoperative mortality remains uncertain. ⋯ We observed a significant relationship between deep anesthesia and long-term mortality, though this was not significant 30 days following surgery. In patients who had received cardiac surgery, deep anesthesia may increase mortality. However, this trend was not observed in patients who had undergone other forms of surgery.
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This study aimed to explore the effects of platelet-rich plasmapheresis (PRP) on the amount of postoperative blood loss and the requirements for allogeneic fresh frozen plasma (FFP) and red blood cell (RBC) transfusions during cardiovascular surgery. ⋯ Conducting PRP before cardiopulmonary bypass (CPB) and transfusing autologous platelet-rich plasma (aPRP) after reversal of heparin could reduce postoperative blood loss, the requirements for blood products transfusion during cardiovascular surgery. A higher mean platelet count in aPRP may improve the final outcome. However, there was a high degree of undetermined heterogeneity among the analyzed trials, and larger and more precise RCTs are needed to confirm these conclusions.
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Meta Analysis Comparative Study
Local anesthetics and regional anesthesia versus conventional analgesia for preventing persistent postoperative pain in adults and children: A Cochrane systematic review and meta-analysis update.
Regional anesthesia appears to reduce persistent post-surgical pain in adults after thoracotomy, breast cancer surgery and cesarean section, although evidence is of modest quality.
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Review Meta Analysis
Patient outcomes related to the daytime versus after-hours surgery: A meta-analysis.
After hours surgery is associated with greater mortality and morbidity, although underlying cause remains unclear.
pearl