Articles: analgesics.
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Review Meta Analysis
Neuropathic pain clinical trials: factors associated with decreases in estimated drug efficacy.
Multiple recent pharmacological clinical trials in neuropathic pain have failed to show beneficial effect of drugs with previously demonstrated efficacy, and estimates of drug efficacy seems to have decreased with accumulation of newer trials. However, this has not been systematically assessed. Here, we analyze time-dependent changes in estimated treatment effect size in pharmacological trials together with factors that may contribute to decreases in estimated effect size. ⋯ Several factors that changed over time, such as larger study size, longer study duration, and more studies reporting 50% or 30% pain reduction, correlated with the decrease in estimated drug effect sizes. This suggests that issues related to the design, outcomes, and reporting have contributed to changes in the estimation of treatment effects. These factors are important to consider in design and interpretation of individual study data and in systematic reviews and meta-analyses.
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Review Meta Analysis
Dexmedetomidine combined with local anesthetics in thoracic paravertebral block: A systematic review and meta-analysis of randomized controlled trials.
Dexmedetomidine (DEX) improves postoperative pain scores and prolongs the duration of blockage when combined with local anesthetics (LAs) for neuraxial and brachial plexus block; however, there is little information about the effectiveness of DEX as an adjuvant to LAs in paravertebral block (PVB). Therefore, a systematic review and meta-analysis were performed to evaluate the safety and efficacy of DEX combined with LAs in PVB. ⋯ PROSPERO registration number CRD42018090251.
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Meta Analysis
Association of Cannabinoid Administration With Experimental Pain in Healthy Adults: A Systematic Review and Meta-analysis.
Cannabinoid drugs are widely used as analgesics, but experimental pain studies have produced mixed findings. The analgesic properties of cannabinoids remain unclear. ⋯ Cannabinoid drugs may prevent the onset of pain by producing small increases in pain thresholds but may not reduce the intensity of experimental pain already being experienced; instead, cannabinoids may make experimental pain feel less unpleasant and more tolerable, suggesting an influence on affective processes. Cannabis-induced improvements in pain-related negative affect may underlie the widely held belief that cannabis relieves pain.
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Review Meta Analysis
The efficacy and safety of parecoxib for reducing pain and opioid consumption following total knee arthroplasty: A meta-analysis of randomized controlled trials.
The goal of the current meta-analysis is to make a credible and overall assessment about the efficacy and safety of parenteral parecoxib for pain control in total knee arthroplasty (TKA). ⋯ Intravenous parecoxib is effective in reducing knee pain and opioid consumption in patient with TKA. Further well-designed research with large simple sizes is necessary to confirm our conclusion.
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Meta Analysis Comparative Study
Efficacy and Safety of Sufentanil-Propofol Versus Remifentanil-Propofol as Anesthesia in Patients Undergoing Craniotomy: A Meta-Analysis.
In this study, we aimed to evaluate the efficacy and safety of sufentanil-propofol (SF) versus remifentanil-propofol (RF) as maintenance therapy for anesthesia in patients undergoing craniotomy. ⋯ RF as anesthesia for craniotomy had better effects in reducing the time of postoperative wake-up and extubation and significantly alleviating pain. Moreover, there were no significant differences in the incidence of adverse reactions between the 2 groups. The findings will prove beneficial for the rational use of clinical anesthetic drugs in the future.