British journal of anaesthesia
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Review Meta Analysis
Effects of acetaminophen on morphine side-effects and consumption after major surgery: meta-analysis of randomized controlled trials.
Acetaminophen is commonly used for the management of perioperative pain. However, there is a marked discrepancy between the extent to which acetaminophen is used and the available evidence for an analgesic effect after major surgery. The aim of this systematic review is to determine the morphine-sparing effect of acetaminophen combined with patient-controlled analgesia (PCA) with morphine and to evaluate its effects on opioid-related adverse effects. ⋯ Acetaminophen combined with PCA morphine induced a significant morphine-sparing effect but did not change the incidence of morphine-related adverse effects in the postoperative period.
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Dopexamine is increasingly being used in high-risk surgical and critically ill patients to preserve hepatosplanchnic and renal perfusion. This systematic review of randomized controlled trials was undertaken to investigate the clinical evidence for using dopexamine in this role. ⋯ The evidence provided by the existing studies is both inadequate and inconsistent. There is insufficient evidence to offer reliable recommendations on the clinical use of dopexamine for the protection of either hepatosplanchnic or renal perfusion in high-risk surgical patients. Furthermore, there is no current evidence to support a role for dopexamine in protecting either hepatosplanchnic or renal perfusion in critically ill patients.