Articles: analgesia.
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Review Meta Analysis
Thoracolumbar interfascial plane block in spinal surgery: A systematic review with meta-analysis.
As the thoracolumbar interfascial plane (TLIP) block may be a promising alternative in spinal surgery, there is a need for timely meta-analysis of this method's effectiveness in different medical outcomes. ⋯ The TLIP block reduces postoperative pain intensity, opioid consumption, side effects, and requests for rescue analgesia after spinal surgery more than the no-block alternative.
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Meta Analysis
Analgesic efficacy of quadratus lumborum block in patients undergoing nephrectomy: A systematic review and meta-analysis.
To evaluate the analgesic efficacy of quadratus lumborum block (QLB) in adults undergoing nephrectomy. ⋯ Single-shot QLB provided a statistically significant but clinically small improvement in postoperative analgesia and recovery for patients undergoing nephrectomy. The QLB would be beneficial as part of multimodal analgesia. Future research might need to determine which approach of QLB is superior for postoperative analgesia after nephrectomy.
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Int J Obstet Anesth · May 2023
Meta AnalysisSystematic review of the effectiveness of remifentanil in term breech pregnancies undergoing external cephalic version.
External cephalic version (ECV) is a moderately painful procedure used to turn a fetus from a non-vertex to cephalic position. This systematic review and meta-analysis compared intravenous remifentanil with other analgesia or no analgesia or placebo on the success rate and associated pain of ECV. ⋯ Remifentanil increases the procedural success of ECV and reduces pain compared with placebo. Trials were at low risk of bias and contained a sufficient number of participants to have reasonable confidence in this finding.
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Thoracotomy is associated with severe postoperative pain. Effective management of acute pain after thoracotomy may reduce complications and chronic pain. Epidural analgesia (EPI) is considered the gold standard for postthoracotomy analgesia; however, it is associated with complications and limitations. Emerging evidence suggests that an intercostal nerve block (ICB) has a low risk of severe complications. Anesthetists will benefit from a review that assesses the advantages and disadvantages associated with ICB and EPI in thoracotomy. ⋯ ICB may be as effective as EPI for pain relief after thoracotomy.
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Meta Analysis
Opioid versus non-opioid analgesia for craniotomy: A systematic review and meta-analysis of randomized controlled trials.
Despite the use of intraoperative opioid analgesia, postoperative pain is often reported by patients undergoing craniotomies. Opioids also cause undesirable side effects in neurosurgical patients. Hence, the role of nonopioid analgesia has been explored for craniotomies in recent years. ⋯ There were no important differences in clinical outcomes between the groups in our review. The GRADE certainty of evidence was rated low for most outcomes. Available evidence does not suggest superiority of intraoperative nonopioid over opioid analgesia for postoperative pain in patients undergoing craniotomy. More studies are needed to firmly establish the role of nonopioid intraoperative analgesics as an alternative to opioids in this population.