Journal of anesthesia
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Journal of anesthesia · Apr 2024
Meta AnalysisProphylaxis for paediatric emergence delirium in desflurane-based anaesthesia: a network meta-analysis.
The prevalence of postoperative emergence delirium in paediatric patients (pedED) following desflurane anaesthesia is considerably high at 50-80%. Although several pharmacological prophylactic strategies have been introduced to reduce the risk of pedED, conclusive evidence about the superiority of these individual regimens is lacking. The aim of the current study was to assess the potential prophylactic effect and safety of individual pharmacotherapies in the prevention of pedED following desflurane anaesthesia. ⋯ The current NMA showed that ketamine + propofol administration was associated with the lowest incidence of pedED among all of the pharmacologic interventions studied. Future large-scale trials to more fully elucidate the comparative benefits of different combination regimens are warranted.
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Journal of anesthesia · Feb 2024
Review Meta AnalysisPostoperative outcomes of pediatric patients with perioperative COVID-19 infection: a systematic review and meta-analysis of observational studies.
To quantify the risk of adverse postoperative outcomes in pediatric patients with COVID-19 infection. ⋯ Perioperative COVID-19 infection was strongly associated with increased risk of PPCs, but it did not increase the risk of postoperative early mortality, the rate of postoperative ICU admission, and the length of hospital stay in pediatric patients. Our preplanned sensitivity analyses confirmed the robustness of our study findings.
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Journal of anesthesia · Feb 2024
Meta AnalysisParamedian versus midline approach of spinal anesthesia: a systematic review and meta-analysis with trial sequential analysis.
Midline approach of spinal anesthesia has been widely used for patients undergoing surgical procedures. However, it might not be effective for obstetric patients and elderly with degenerative spine changes. Primary objective was to examine the success rate at the first attempt between the paramedian and midline spinal anesthesia in adults undergoing surgery. ⋯ CRD42023397781.
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Journal of anesthesia · Oct 2023
Review Meta AnalysisRenal safety of critical care sedation with sevoflurane: a systematic review and meta-analysis.
Volatile anesthetic agents are increasingly widely used for critical care sedation. There are concerns that sevoflurane presents a risk of renal injury when used in this role. RCTs comparing the use of critical care sevoflurane sedation with any control in humans were systematically identified using MEDLINE, Cochrane CENTRAL, web of Science, and CINAHL (until May 2022), if they presented comparative data on renal function or serum inorganic fluoride levels. ⋯ Sevoflurane was not associated with renal failure when used for critical care sedation of fewer than 72-h duration, despite the elevation of serum fluoride. Longer-term studies are currently inadequate, including in patients with compromised renal function, to further evaluate the role of sevoflurane in this setting. Trial registration PROSPERO (CRD42022333099).
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Journal of anesthesia · Aug 2023
Meta AnalysisEffect of active warming on perioperative cardiovascular outcomes: a systematic review and meta-analysis of randomized controlled trials.
The objective of this study was to provide an updated review on the active warming effects on major adverse cardiac events, 30-day all-cause mortality, and myocardial injury after noncardiac surgery. ⋯ Compared to routine perioperative care, we found that active warming methods are not necessary for cardiovascular prevention in patients undergoing noncardiac surgery.