Journal of clinical anesthesia
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Meta Analysis Comparative Study
C-MAC videolaryngoscope versus Macintosh laryngoscope for tracheal intubation: A systematic review and meta-analysis with trial sequential analysis.
The C-MAC laryngoscope (C-MAC) is a videolaryngoscope that uses a modified Macintosh blade. Although several anecdotal reports exist, it remains unclear whether the C-MAC is superior to the Macintosh laryngoscope for tracheal intubation in the adult population. ⋯ The C-MAC provided better glottic visualisation and less ELM (GRADE: Very Low or Moderate), with improved success rates, glottic visualisation, and less ELM in difficult airways.
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Preoperative oral rehydration solutions (ORS) are frequently used in clinical practice in Japan, although their effect remains to be explained. The purpose of this study was to investigate the clinical outcomes associated with ORS usage. ⋯ Our systematic review indicates that oral rehydration therapy does not increase the risk of aspiration or vomiting. In contrast, it may help stabilize circulatory dynamics during anesthesia induction.
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Review Meta Analysis
Systematic review and meta-analyses of tranexamic acid use for bleeding reduction in prostate surgery.
Prostate cancer and benign prostatic hyperplasia have an increased incidence with aging. The most effective treatments are radical prostatectomy and transurethral resection of the prostate. To reduce perioperative bleeding in these surgeries, an approach is the use of tranexamic acid (TXA). Studies show that TXA is effective in reducing the blood loss and the need for transfusion in cardiac, orthopedic, and gynecological surgeries. In prostate surgeries, its efficacy and safety have not been established yet. ⋯ TXA reduced intraoperative blood loss and the need for transfusion, without increasing the risk of DVT and PE in prostate surgeries. Due to the limited number of studies and the high heterogeneity of the results, more clinical trials with a large number of patients are necessary to confirm these findings.
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An ideal induction drug for cesarean section (CS) must have quick action, with minimum side effects such as awareness, hemodynamic compromise, and neonatal depression. Thiopentone is frequently used; however, no reliable evidence is available to support its use as a dedicated hypnotic agent in this setting. ⋯ The evidence, based on sparse and relatively old trials, indicates that propofol and thiopentone are equally suited for CS. After 1 and 5 min, ketamine yields lower Apgar scores than thiopentone. Additional well-designed trials are needed to reach firmer conclusions.
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Meta Analysis Comparative Study
Comparison between ultrasound guided technique and digital palpation technique for radial artery cannulation in adult patients: An updated meta-analysis of randomized controlled trials.
Possible advantages and risks associated with ultrasound guided radial artery cannulation in-comparison to digital palpation guided method in adult patients are not fully known. We have compared ultrasound guided radial artery cannulation with digital palpation technique in this meta-analysis. ⋯ Radial artery cannulation by ultrasound guidance may increase the first attempt success rate but not the overall cannulation success when compared to digital palpation technique. However, results of this meta-analysis should be interpreted with caution due presence of heterogeneity.