Journal of anesthesia
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Journal of anesthesia · Apr 2023
Review Meta AnalysisIntravenous oxytocin regimens in patients undergoing cesarean delivery: a systematic review and network meta-analysis of cluster-based groups.
Information on evaluations of different oxytocin regimens used to prevent post-partum hemorrhage during cesarean delivery is scarce, and there is a lack of statistically pooled results for comparative doses. In this review, we aimed to analyze the effectiveness of different oxytocin regimens used and rank them accordingly. We performed a meta-analysis of randomized controlled trials (RCTs) reporting the incidence of additional uterotonic (AUT) use or amount of blood loss during cesarean delivery, where different oxytocin regimens were compared. ⋯ In contrast, the dose range, > 5 IU regimen was associated with higher side effects (lowest rank). During cesarean delivery, a significant reduction in the use of AUTs or blood loss (Rank 2) was recorded for bolus-infusion combination regimens. High doses did not have enough evidence to draw meaningful conclusions.
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Journal of anesthesia · Apr 2023
Review Meta AnalysisPharmacological prevention of postoperative delirium in patients undergoing cardiac surgery: a bayesian network meta-analysis.
The incidence of postoperative delirium in patients undergoing cardiac surgery is very high and increases morbidity and mortality. The possibility of pharmacological means to reduce its incidence is very attractive. ⋯ Our NMA showed that preoperative ketamine at subanesthetic doses can significantly reduce the incidence of POD. Risperidone also decreases the incidence of POD, but not significantly.
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Journal of anesthesia · Apr 2023
Randomized Controlled TrialSedation efficacy of different dose of remimazolam with sufentanil for nerve block in young and elderly patients: a randomized, controlled study.
Anxiety and pain commonly occur during nerve block, we aimed to investigate the sedation efficacy of different doses of remimazolam with sufentanil in young and elderly patients. ⋯ Remimazolam 0.08 mg/kg provided the best sedation efficacy in young patients while remimazolam 0.04 mg/kg with the trend of less respiratory adverse events was more optimal for elderly patients.
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Journal of anesthesia · Apr 2023
Clinical TrialEfficacy of an aerosol suction device Free-100 M in removing aerosols produced by coughing to minimize COVID-19 infection.
The healthcare workers are at the greatest risk of being exposed to viral infection during airway management of a patient with coronavirus disease 2019 (COVID-19). An air extractor which suctions air around the patient's face would reduce the spread of viral aerosols during coughing, but no study has confirmed this. We assessed whether or not an air extractor reduces the amount of aerosols spreading toward the operator's face, during coughing of simulated patients. ⋯ The Free-100 M air extractor would reduce, but do not remove all, aerosols produced by coughing of a patient, and thus may reduce the risk of infection of COVID-19.
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Journal of anesthesia · Apr 2023
Meta AnalysisAssociation between intraoperative oliguria and postoperative acute kidney injury in non-cardiac surgical patients: a systematic review and meta-analysis.
This systematic review and meta-analysis aimed to evaluate the association between intraoperative oliguria and the risk of postoperative acute kidney injury (AKI) in patients undergoing non-cardiac surgery. ⋯ This study demonstrated a significant association between intraoperative oliguria and the risk of postoperative AKI, regardless of the definitions of oliguria or AKI used. Further prospective and multi-centre studies using standardised definitions of intraoperative oliguria are required to define the thresholds of oliguria and establish strategies to minimise the risk of AKI.