Minerva anestesiologica
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Minerva anestesiologica · Jan 2023
Meta AnalysisBrain tissue oxygenation monitoring in subarachnoid hemorrhage for the detection of delayed ischemia: a systematic review and meta-analysis.
Subarachnoid hemorrhage (SAH) is a severe subtype of stroke which can be caused by the rupture of an intracranial aneurysm. Following SAH, about 30% of patients develop a late neurologic deterioration due to a delayed cerebral ischemia (DCI). This is a metanalysis and systematic review on the association between values of brain tissue oxygenation (PbtO2) and DCI in patients with SAH. ⋯ PbtO2 values were significantly lower in patients with DCI. Waiting for definitive results, monitoring of PbtO2 should be considered as a complementary parameter for multimodal monitoring of the risk of DCI in patients with SAH.
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Minerva anestesiologica · Dec 2022
Meta AnalysisNorepinephrine versus phenylephrine for post-spinal hypotension in parturients undergoing caesarean section: a systematic review and meta-analysis.
Multiple studies have compared varying prophylactic and therapeutic doses of norepinephrine and phenylephrine given as either intermittent bolus or fixed-rate infusion to combat postspinal hypotension in patients undergoing cesarean section (CS). We conducted a systematic review to figure out the best alternative to treat postspinal hypotension. ⋯ Comparable efficacy for management of postspinal hypotension, though, norepinephrine was found to cause less incidence of maternal bradycardia as compared to phenylephrine.
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Minerva anestesiologica · Dec 2022
Meta AnalysisRemimazolam versus propofol for procedural sedation and anesthesia: a systemic review and meta-analysis.
The aim of this systemic review and meta-analysis was to evaluate the efficacy and safety of remimazolam compared with propofol when used for procedural sedation and general anesthesia. ⋯ Remimazolam could be alternatively used in procedural sedation and general anesthesia. Additional research is needed to develop higher quality evidence on the use of remimazolam, especially in general anesthesia.
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Minerva anestesiologica · Nov 2022
Meta AnalysisRemimazolam versus traditional sedatives for procedural sedation: a systematic review and meta-analysis of efficacy and safety outcomes.
Remimazolam is a novel and ultra-short-acting benzodiazepine currently approved for procedural sedation and induction of general anaesthesia, with a possible indication for ICU sedation. This study aimed to evaluate the efficacy and safety of remimazolam and traditional sedatives for patients undergoing procedural sedation. ⋯ Remimazolam is a safe and effective sedative for procedural sedation on account of a higher success procedure rate, a faster recovery, a shorter discharge time, and a superior safety profile in comparison with traditional sedatives. Larger sample-sized and well-designed clinical trials are needed to verify our finding.
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Minerva anestesiologica · Oct 2022
Meta AnalysisA systematic review and meta-analysis of three risk factors for chronic postsurgical pain: age, sex and preoperative pain.
Chronic postsurgical pain (CPSP) is a common and disabling postoperative complication. Several risk factors for CPSP have been established, but it is unclear whether they are significant for any type of surgery. This systematic review aimed to assess the risk of CPSP related to three known preoperative risk factors "age, sex and preoperative pain" in the adult population after any type of elective non-obstetrical surgery. ⋯ This systematic review confirms that younger age, female sex, and preoperative pain are associated with higher risk of developing CPSP in any type of elective non-obstetrical surgery. However, effect sizes are small and quality of evidence low-moderate only, limiting comparisons of different types of surgery.