Journal of clinical anesthesia
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Review
Perioperative use of angiotensin-converting-enzyme inhibitors and angiotensin receptor antagonists.
Clinical repercussions of perioperative treatment with ACEIs/ARBs. ⋯ Withholding AECI/ARBs on the morning prior to surgery could be recommended as a potentially effective measure, with a low level of evidence, in order to reduce the appearance of hypotension in the perioperative period of non-cardiac surgery.
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Review
Perioperative use of angiotensin-converting-enzyme inhibitors and angiotensin receptor antagonists.
Clinical repercussions of perioperative treatment with ACEIs/ARBs. ⋯ Withholding AECI/ARBs on the morning prior to surgery could be recommended as a potentially effective measure, with a low level of evidence, in order to reduce the appearance of hypotension in the perioperative period of non-cardiac surgery.
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Review Meta Analysis
Influence of the perioperative administration of magnesium sulfate on the total dose of anesthetics during general anesthesia. A systematic review and meta-analysis.
Perioperative magnesium reduces propofol induction and maintenance doses, and similarly reduces neuromuscular drug needs.
pearl -
Review Meta Analysis
Influence of the perioperative administration of magnesium sulfate on the total dose of anesthetics during general anesthesia. A systematic review and meta-analysis.
Perioperative magnesium reduces propofol induction and maintenance doses, and similarly reduces neuromuscular drug needs.
pearl -
Review Meta Analysis Comparative Study
Remifentanil as an alternative to epidural analgesia for vaginal delivery: A meta-analysis of randomized trials.
Although epidural analgesia is considered the gold standard for labor pain management, its use may be restricted in some conditions due to clinical contraindications or availability, and suitable alternatives may be required. The objective of this meta-analysis was to determine whether evidence from randomized trials suggests remifentanil PCA (R-PCA) results in significant differences in maternal satisfaction, analgesic efficacy, and safety compared with conventional epidural analgesia (EA). ⋯ While no significant differences were detected for maternal satisfaction or for most clinical outcomes, this meta-analysis remains underpowered to rule out clinically-important differences due to the few existing randomized trials. For obstetric patients who are not candidates for EA, R-PCA may provide an alternative for analgesia in the peri-partum period, but caution is warranted particularly regarding hypoxemia, and suggests the need for increased surveillance and monitoring for R-PCA. Further adequately powered randomized trials with a focus on clinically-relevant maternal and neonatal outcomes are required to more accurately characterize the relative benefits and risks of R-PCA versus EA in this population.