Articles: analgesics.
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The meta-analysis was conducted to assess the effectiveness and safety of intravenous administration of dexmedetomidine for cesarean section under general anesthesia, as well as neonatal outcomes. ⋯ Intravenous administration of dexmedetomidine could efficiently attenuate the maternal cardiovascular response during cesarean section, without affecting Apgar score of the neonate.
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Review Meta Analysis
Combination Drug Therapy for the Management of Low Back Pain and Sciatica: Systematic Review and Meta-Analysis.
Combining medicines may give greater pain relief and/or improved tolerability. We conducted a systematic review to investigate the effects of combination drug therapy in patients with low back pain and/or sciatica on pain, disability, and adverse events. Databases and trial registers were searched from inception to July 27, 2017, for randomized trials of (sub)acute or chronic back pain or sciatica participants that were administered combination drug therapy compared with monotherapy or placebo. ⋯ There is no clear evidence to support any combination drug therapy for the management of low back pain and sciatica due to the limited number of studies and overall low quality of evidence. Perspective: Combining medicines may give greater pain relief and/or improved tolerability compared with single-ingredient medicines. However, the lack of studies and overall low quality of evidence limit the recommendation of combination drug therapy for the management of low back pain and sciatica.
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Meta Analysis
Effects of the OPRM1 A118G Polymorphism(rs1799971) on Opioids Analgesia in Cancer Pain: A Systematic Review and Meta-Analysis.
Although previous studies have demonstrated that the OPRM1 A118G polymorphism may influence the analgesia response to cancer pain, the results are inconsistent. In this article we aimed to fully examine the association between OPRM1 A118G (rs1799971) polymorphism and opioid analgesia by analyzing published information. This will provide information for better cancer pain management. ⋯ Our meta-analysis indicates that G allele (AG+GG) carriers of OPRM1 A118G polymorphism required more opioid analgesia in cancer pain management. The OPRM1 A118G polymorphism may help predict individuals' response to analgesia and achieve satisfactory cancer pain control.
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Even though osteoarthritis is a chronic and progressive disease, pharmacological agents are mainly studied over short-term periods, resulting in unclear recommendations for long-term disease management. ⋯ In this systematic review and network meta-analysis of studies of patients with knee osteoarthritis and at least 12 months of follow-up, there was uncertainty around the estimates of effect size for change in pain for all comparisons with placebo. Larger RCTs are needed to resolve the uncertainty around efficacy of medications for knee osteoarthritis.
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Cochrane Db Syst Rev · Dec 2018
Meta AnalysisPerioperative intravenous ketamine for acute postoperative pain in adults.
Inadequate pain management after surgery increases the risk of postoperative complications and may predispose for chronic postsurgical pain. Perioperative ketamine may enhance conventional analgesics in the acute postoperative setting. ⋯ Perioperative intravenous ketamine probably reduces postoperative analgesic consumption and pain intensity. Results were consistent in different operation types or timing of ketamine administration, with larger and smaller studies, and by higher and lower pain intensity. CNS adverse events were little different with ketamine or control. Perioperative intravenous ketamine probably reduces postoperative nausea and vomiting by a small extent, of arguable clinical relevance.