Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · May 2021
Review Meta AnalysisPre-operative epidural analgesia in hip fracture patients - A systematic review and meta-analysis.
Hip fracture is a common, painful injury with increasing global incidence. Patients require optimal acute pain management. Systematic reviews have investigated the postoperative use of epidural analgesia and found that it may have advantages over systemic analgesia. It is of interest to determine whether pre-operative use of epidural analgesia is also advantageous. We conducted a systematic review and meta-analyses on the effect of epidural analgesia on pre-operative pain management in hip fracture patients. ⋯ We did not find a difference in pre-operative pain at rest between epidural analgesia and any other method of pre-operatively initiated analgesia. The studies were few, of low quality and the difference between the two interventions remains unknown.
-
Acta Anaesthesiol Scand · Mar 2021
Review Meta AnalysisProphylactic acid suppressants in children in the intensive care unit: a systematic review with meta-analysis and trial sequential analysis.
Critically ill children are at risk of stress-induced gastrointestinal ulceration. Acid suppressants are frequently used in intensive care units even though there is uncertainty about the benefits and harms. With this systematic review, we aimed to assess patient-important benefits and harms of stress ulcer prophylaxis (SUP) in children in intensive care. ⋯ We found no difference in all-cause mortality, overt gastrointestinal bleeding or hospital-acquired pneumonia in children in intensive care receiving acid suppressants compared with placebo/no prophylaxis. However, the quantity and quality of evidence was very low with no firm evidence for benefit or harm.
-
Acta Anaesthesiol Scand · Sep 2020
Review Meta AnalysisFemoral nerve blocks for the treatment of acute prehospital pain: a systematic reviewwith meta-analysis.
The analgesic benefit and safety of pre-hospital femoral nerve block compared with other, more common forms of pain-relief remains uncertain.
pearl -
Acta Anaesthesiol Scand · Aug 2020
Review Meta AnalysisCritical Care Transition Programs on Readmission or Death: A Systematic Review and Meta-Analysis.
Deterioration after ICU discharge may lead to readmission or even death. Interventions (eg, critical care transition programs) have been developed to improve the clinical handover between the ICU and the ward. We conducted a systematic review with meta-analysis and trial sequential analysis (TSA) according to Cochrane Handbook and Grading of recommendations, assessment, development and evaluations (GRADE) methodology to assess the impact of these interventions on readmission and death (PROSPERO, no CRD42019121746). ⋯ We found no clear benefit in terms of reducing risk of readmission or death after ICU discharge, however, with overall very low certainty of evidence.
-
Acta Anaesthesiol Scand · Jul 2020
Review Meta AnalysisProphylactic use of acid suppressants in adult acutely ill hospitalised patients: a systematic review with meta-analysis and trial sequential analysis.
Acutely ill patients are at risk of stress-related gastrointestinal (GI) bleeding and prophylactic acid suppressants are frequently used. In this systematic review, we assessed the effects of stress ulcer prophylaxis (SUP) with proton pump inhibitors (PPIs) or histamine-2 receptor antagonists (H2RAs) versus placebo or no prophylaxis in acutely ill hospitalised patients. ⋯ PROSPERO registration number CRD42017055676; published study protocol: Marker, et al 2017 in Systematic Reviews.