British journal of anaesthesia
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Multicenter Study
Association of postoperative complications with persistent post-surgical pain: a multicentre prospective cohort study.
Persistent post-surgical pain is an important and under-recognised problem that is difficult to treat. Postoperative complications have been identified as possible risk factors for persistent post-surgical pain. We conducted a secondary analysis of the Measurement of Exercise Tolerance before Surgery (METS) cohort study to characterise the association of major postoperative complications with post-surgical pain at 30 days and 1 yr after major surgery. ⋯ Patients who developed major complications were more likely to report pain at 30 days and possibly 1 yr after surgery. Research is necessary to validate these findings and delineate underlying mechanisms.
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Editorial Comment
Meta-analyses of clinical trials: are we getting lemonade from lemons?
Meta-analyses guide planning of clinical trials and clinical care, but are subject to all the methodologic problems and potential biases present in the underlying trials. Furthermore, publication bias often contributes to overestimated benefit in meta-analyses of small trials, which are often 'corrected' by subsequent large trials. Meta-analyses are no substitute for large robust trials.
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Review Meta Analysis
Prone positioning for non-intubated spontaneously breathing patients with acute hypoxaemic respiratory failure: a systematic review and meta-analysis.
Prone positioning improves oxygenation & reduces mortality among non-intubated COVID positive patients, but does not appear to reduce the intubation rate.
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Review Meta Analysis
Routine postoperative noninvasive respiratory support and pneumonia after elective surgery: a systematic review and meta-analysis of randomised trials.
Routine postoperative noninvasive respiratory support does not prevent pneumonia in adults undergoing elective surgery.
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Seasonal trends in patient outcomes are an under-researched area in perioperative care. This systematic review evaluates the published literature on seasonal variation in surgical outcomes worldwide. ⋯ PROSPERO CRD42019137214.