Journal of clinical anesthesia
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Review Meta Analysis
The effect of tranexamic acid to reduce blood loss and transfusion on off-pump coronary artery bypass surgery: A systematic review and cumulative meta-analysis.
To assess the safety and efficacy of tranexamic acid (TA) on off-pump coronary artery bypass (OPCAB) surgery. ⋯ TA reduced the probability of receiving a PRBCs and FFP transfusion during OPCAB surgery. And no association with postoperative death and thrombotic events was found. However, further trials with an appropriate sample size are required to confirm TA safety in OPCAB surgery.
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Meta Analysis Comparative Study
Videolaryngoscope versus Macintosh laryngoscope for tracheal intubation in adults with obesity: A systematic review and meta-analysis.
Videolaryngoscopy has become more common since the 2000s. Despite several anecdotal reports in the literature, it remains unclear whether videolaryngoscopy is superior to direct Macintosh laryngoscopy for tracheal intubation in adults with obesity. This systematic review and meta-analysis focused on prospective randomised trials comparing videolaryngoscopes with the Macintosh laryngoscope for tracheal intubation in adults with obesity. ⋯ Videolaryngoscopes were superior to the Macintosh laryngoscope for tracheal intubation in adults with obesity. (GRADE score: low or very low.).
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To review research highlights of manuscripts published in 2016 that pertain to all aspects of the clinical practice of anesthesiology. ⋯ This recent body of evidence will both help inform anesthesiologists of the developing trends in anesthesiology and will also pose new challenges for further studies.
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Review
Strategies to prevent ischemic optic neuropathy following major spine surgery: A narrative review.
Postoperative vision loss following a major spine operation is a rare but life-changing event. Most of reports have been linked to ischemic optic neuropathy, and patients undergoing surgery for scoliosis correction or posterior lumbar fusion seem to be at the highest risk. Despite that some key risk factors have been identified, much of the pathophysiology still remain unknown. ⋯ Therefore, it is appropriate for clinicians involved in these cases to inform their patients about the existence of a small but unpredictable risk of vision loss. Since ischemic optic neuropathy is deemed to be the leading cause of vision loss in the context of major spine surgery in prone position, this review will be focused on its main aspects related to the frequency, diagnosis, predisposing factors, and prevention. Regrettably, no treatment has been proved to be effective for this condition.
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Review Comparative Study
Outcomes of cancer surgery after inhalational and intravenous anesthesia: A systematic review.
Perioperative factors are probably essential for different oncological outcomes. This systematic review investigates the literature concerning overall mortality and postoperative complications after cancer surgery with inhalational (INHA) and intravenous anesthesia (TIVA). A search was conducted according to the PRISMA guidelines, including studies with patients undergoing surgery for cancer and where TIVA was compared with INHA. ⋯ In one study, the rate of pulmonary complications was significantly higher after INHA compared with TIVA, while other postoperative complications were comparable. There are currently four propensity-adjusted retrospective studies indicating that TIVA might be the preferred anesthetic choice in cancer surgery. However, evidence is currently of low quality and randomized clinical trials are required for further investigation.