Journal of anesthesia
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Journal of anesthesia · Dec 2014
Meta Analysis Comparative StudyKetamine does not increase intracranial pressure compared with opioids: meta-analysis of randomized controlled trials.
Ketamine is traditionally avoided in sedation management of patients with risk of intracranial hypertension. However, results from many clinical trials contradict this concern. We critically analyzed the published data of the effects of ketamine on intracranial pressure (ICP) and other cerebral hemodynamics to determine whether ketamine was safe for patients with hemodynamic instability and brain injuries. ⋯ The results of this study suggest that ketamine does not increase ICP compared with opioids. Ketamine provides good maintenance of hemodynamic status. Clinical application of ketamine should not be discouraged on the basis of ICP-related concerns.
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Journal of anesthesia · Dec 2014
Meta Analysis Comparative StudyCardiac damage after carotid intervention: a meta-analysis after a decade of randomized trials.
This study synthesizes evidence from randomized controlled trials of the past decade regarding the relative safety of carotid endarterectomy (CEA) versus carotid angioplasty and stenting (CAS) as concerns postoperative cardiac damage. ⋯ Compared to open surgery, CAS is associated with significantly decreased risk for symptomatic and asymptomatic cardiac damage postoperatively. Therefore, a standardized troponin measurement after CEA should be further evaluated in future studies.