Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Oct 2016
Review Meta AnalysisGabapentin for post-operative pain management - a systematic review with meta-analyses and trial sequential analyses.
Perioperative pain treatment often consist of combinations of non-opioid and opioid analgesics, 'multimodal analgesia', in which gabapentin is currently used. The aim was to document beneficial and harmful effects of perioperative gabapentin treatment. ⋯ Based on GRADE assessment of the primary outcomes in trials with low risk of bias, the results are low or very low quality of evidence due to imprecision, inconsistency, and in some outcomes indirectness. Firm evidence for use of gabapentin is lacking as clinically relevant beneficial effect of gabapentin may be absent and harm is imminent, especially when added to multimodal analgesia.
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Acta Anaesthesiol Scand · Jan 2016
Review Meta AnalysisTachyphylaxis to local anaesthetics. What is the clinical evidence? A systematic review.
Tachyphylaxis or acute tolerance to local anaesthetics has been reported, but the prevalence in clinical analgesia is obscure, and the mechanisms behind this phenomenon remain unclear. We sought to examine the clinical significance of tachyphylaxis from the available literature. ⋯ Studies documenting tachyphylaxis with clinical use of local anaesthetics are surprisingly scarce, and the mechanisms behind it remain unclear.
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Acta Anaesthesiol Scand · Nov 2015
Review Meta AnalysisThe efficacy of propofol on emergence agitation - a meta-analysis of randomized controlled trials.
Emergence agitation (EA) is a common, post-anesthetic complication in pediatric patients following sevoflurane and desflurane anesthesia. The aim of this meta-analysis was to assess the effects of an adjunctive dose of propofol to reduce the incidence of EA in pediatric patients. ⋯ Future studies on the benefits of adjunct propofol in reducing the incidence of EA are required.
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Acta Anaesthesiol Scand · Aug 2015
Review Meta AnalysisPeripherally applied opioids for postoperative pain: evidence of an analgesic effect? A systematic review and meta-analysis.
Opioids applied peripherally at the site of surgery may produce postoperative analgesia with few side effects. We performed this systematic review to evaluate the analgesic effect of peripherally applied opioids for acute postoperative pain. ⋯ Evidence of a clinically relevant analgesic effect of peripherally applied opioids for acute postoperative pain is lacking. The analgesic effect of peripherally applied opioids may depend on the presence of preoperative inflammation.
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Acta Anaesthesiol Scand · May 2015
Review Meta AnalysisCentral venous pressure: we need to bring clinical use into physiological context.
The place of central venous pressure (CVP) measurement in acute care has been questioned during the past decade. We reviewed its physiological importance, utility and clinical use among anaesthetists and intensivists. ⋯ The correct measurement of CVP is pivotal to its proper clinical application. This relates to defining the pressure gradient for venous return and heart efficiency. The clinical appreciation of CVP should be restored by educational efforts of its physiological context.