British journal of anaesthesia
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Review Meta Analysis Comparative Study
Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: systematic review and meta-analysis of randomised controlled trials.
Postoperative adjunct use of serotonin-norepinephrine reuptake inhibitors (SNRIs) shows a small beneficial effect to reduce acute & chronic post-operative pain and opioid consumption.
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Review Meta Analysis
The potential for autonomic neuromodulation to reduce perioperative complications and pain: a systematic review and meta-analysis.
Autonomic dysfunction promotes organ injury after major surgery through numerous pathological mechanisms. Vagal withdrawal is a key feature of autonomic dysfunction, and it may increase the severity of pain. We systematically evaluated studies that examined whether vagal neuromodulation can reduce perioperative complications and pain. ⋯ Indirect vagal neuromodulation improves physiological measures associated with limiting organ dysfunction, although studies are of low quality, are susceptible to bias and lack specific focus on perioperative patients.
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Randomized Controlled Trial Comparative Study
High-dose steroids in high pain responders undergoing total knee arthroplasty: a randomised double-blind trial.
Total knee arthroplasty (TKA) is associated with moderate-to-severe postoperative pain despite multimodal opioid-sparing analgesia. Pain catastrophising or preoperative opioid therapy is associated with increased postoperative pain. Preoperative glucocorticoid improves pain after TKA, but dose-finding studies and benefit in high pain responders are lacking. ⋯ NCT03763734.
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Randomized Controlled Trial Multicenter Study Comparative Study
Individualised or liberal red blood cell transfusion after cardiac surgery: a randomised controlled trial.
Current practice guidelines for red blood cell (RBC) transfusion in ICUs are based on haemoglobin threshold, without consideration of oxygen delivery or consumption. We aimed to evaluate an individual physiological threshold-guided by central venous oxygen saturation ScvO2. ⋯ NCT02963883.