International journal of clinical and experimental medicine
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Dexmedetomidine, as a sole or combinable sedative, has served in pediatric sedation undergoing MRI. However, clinical effects of dexmedetomidine are still controversial. This meta-analysis was to assess the effects between dexmedetomidine and propofol in children undergoing MRI, especially outcomes and adverse events of patients. ⋯ There were statistically significant increased in the pediatric anesthesia emergence Delirium scores of 5-min after awakening (WMD: 2.40; 95% CI: 1.00 to 3.81; P = 0.0008) and 10-min after awakening (WMD: 3.06; 95% CI: 1.81 to 4.31; P < 0.00001) in patients who were treated with dexmedetomidine than propofol. Improved the prognosis of patients, nonetheless, dexmedetomidine must have an indispensable role to undergoing pediatric MRI scanning. Compared with propofol, however, dexmedetomidine did not induce the duration of sedation and might lead to a longer recovery time.
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Review
Development of prognostic models for patients with traumatic brain injury: a systematic review.
Outcome prediction following traumatic brain injury (TBI) is a widely investigated field of research. Several outcome prediction models have been developed for prognosis after TBI. There are two main prognostic models: International Mission for Prognosis and Clinical Trials in Traumatic Brain Injury (IMPACT) prognosis calculator and the Corticosteroid Randomization after Significant Head Injury (CRASH) prognosis calculator. ⋯ Through fluid biomarker analysis, the advent of multi-analyte profiling technology has enabled substantial advances in the diagnosis and treatment of a variety of conditions. Application of this technology to create a bio-signature for TBI using multiple biomarkers in combination will hopefully facilitate much-needed advances. We believe that further investigations about brain injury biomarkers may improve the predictive power of the contemporary outcome calculators and prognostic models, and eventually improve the care of patients with TBI.
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Postoperative nausea and vomiting (PONV) is a common complication after gynecological surgeries. This meta-analysis was conducted to evaluate the efficacy of dexmedetomidine on PONV after gynecological surgeries. ⋯ The current meta-analysis exhibits that dexmedetomidine is superiority to placebo in attenuating the incidence of PONV, postoperative shivering, pruritus, as well as the pain scores in patients undergoing gynecological surgeries. Still, the potential cardiovascular complications should be taken seriously.
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The surgical methods of degenerative lumbar spinal stenosis include spinal decompression with or without instrumented or non-instrumented spinal fusion. Previous meta-analysis and systematic reviews have reported the contrast between surgical management and nonsurgical management for degenerative lumbar spinal stenosis, while no literature did among surgical managements. And it is evidenced that whether fusion should be added to spinal decompression in patients of lumbar spinal stenosis is still divisive. So our purpose is to identify whether spinal fusion with or without decompression has a better effect than decompression alone for patients with degenerative lumbar spinal stenosis. ⋯ This meta-analysis provides robust evidence of a better clinical outcome but a higher reoperation rate for spinal fusion compared with decompression alone.
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To determine the minimum alveolar concentration (MAC) of sevoflurane required for 50% blockade of the adrenergic response (BAR) to surgical incision in patients treated with neoadjuvant chemotherapy prior to radical gastrectomy. ⋯ Neoadjuvant chemotherapy reduced the MAC-BAR value of sevoflurane in gastric cancer patients by enhancing the inhibitory effect of sevoflurane on the stress response.