Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisLocal anaesthetic wound infiltration and abdominal nerves block during caesarean section for postoperative pain relief.
Caesarean section delivery is becoming more frequent. Childbirth is an emotion-filled event and the mother needs to bond with her newborn baby as early as possible. Any intervention that leads to improvement in pain relief is worthy of investigation. Local anaesthetics, either on their own or in combination with opioids or nonsteroidal antiinflammatory drugs, have been employed as an adjunct to other postoperative pain relief strategies. Conflicting reports were noted. ⋯ Local analgesia infiltration and abdominal nerve blocks as adjuncts to regional analgesia and general anaesthesia are of benefit in caesarean section by reducing opioid consumption. Nonsteroidal anti-inflammatory drugs as an adjuvant may confer additional pain relief.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisInterventions for the prevention and treatment of herpes simplex virus in patients being treated for cancer.
Treatment of cancer is increasingly effective, but associated with oral complications such as mucositis, fungal infections, bacterial infections and viral infections such as the herpes simplex virus (HSV). ⋯ There is evidence that aciclovir is efficacious in the prevention and treatment of herpes simplex virus infections. There is no evidence that valaciclovir is more efficacious than aciclovir, or that a high dose of valaciclovir is better than a low dose of valaciclovir. There is evidence that as a prophylaxis, placebo is more efficacious than prostaglandin E. However, in all included trials, risk of bias is unclear.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisTreatment blood pressure targets for hypertension.
When treating elevated blood pressure, doctors need to know what blood pressure (BP) target they should try to achieve. The standard of clinical practice for some time has been = 140 - 160/ 90 - 100 mmHg. New guidelines are recommending BP targets lower than this standard. It is not known whether attempting to achieve targets lower than the standard reduces mortality and morbidity. ⋯ Treating patients to lower than standard BP targets, =140-160/90-100 mmHg, does not reduce mortality or morbidity. Because guidelines are recommending even lower targets for diabetes mellitus and chronic renal disease, we are currently conducting systematic reviews in those groups of patients.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisRecruitment manoeuvres for adults with acute lung injury receiving mechanical ventilation.
Recruitment manoeuvres are often used to treat patients with acute lung injury (ALI) or acute respiratory distress syndrome (ARDS) but the effect of this treatment on clinical outcomes has not been well established. ⋯ There is not evidence to make conclusions on whether recruitment manoeuvres reduce mortality or length of ventilation in patients with ALI or ARDS.
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Around one percent of people in industrialised countries will suffer from a leg ulcer at some time. The majority of these leg ulcers are due to problems in the veins, resulting in an accumulation of blood in the legs. Leg ulcers arising from venous problems are called venous (varicose or stasis) ulcers. The main treatment has been a firm compression garment (bandage or stocking) in order to aid venous return. There is a large number of compression garments available and it is unclear whether they are effective in treating venous ulcers and which compression garment is the most effective. ⋯ Compression increases ulcer healing rates compared with no compression. Multi-component systems are more effective than single-component systems. Multi-component systems containing an elastic bandage appear more effective than those composed mainly of inelastic constituents.