Articles: analgesia.
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Review Meta Analysis
Application of Transcutaneous Electrical Acupoint Stimulation (TEAS) for Management of Postoperative Pain After Gynecological Surgeries: A Meta-Analysis.
Transcutaneous Electrical Acupoint Stimulation (TEAS) is a noninvasive technique that involves the application of electrical stimulation to specific acupoints on the skin. This meta-analysis aimed to evaluate the clinical efficacy of TEAS in alleviating postoperative pain after gynecological surgeries. ⋯ Overall, the findings of this meta-analysis suggest that TEAS may be a promising adjunctive therapy for alleviating postoperative pain in gynecological surgery patients. However, caution should be exercised when interpreting the results and making clinical recommendations based on the low to moderate quality of the current evidence. Further high-quality studies are needed to confirm these results and establish optimal treatment protocols for TEAS in this patient population.
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Paediatric anaesthesia · Jan 2025
Review Meta Analysis Comparative StudyErector spinae plane block versus intravenous opioid for analgesia in pediatric cardiac surgery: A systematic review and meta-analysis.
The erector spinae plane block (ESPB) has recently emerged as a regional anesthesia technique for perioperative pain management in pediatric cardiac surgery. However, evidence comparing its effectiveness with intravenous (IV) opioid-based analgesia is limited. We aimed to evaluate and compare the analgesic efficacy of ESPB versus IV opioids in this setting. ⋯ CRD 42024526961.
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Review Meta Analysis
Efficacy and safety of neuraxial hydromorphone: A systematic review and meta-analysis with trial sequential analysis.
Neuraxial hydromorphone provides postoperative pain relief. However, the magnitude of this effect and the optimal dose remain unknown. The objective of this study is to clarify these uncertainties. ⋯ If neuraxial hydromorphone is to be used regularly, trials focusing on the optimal dose and side-effects should be performed before widely administering this medication into the neuraxial space. More trials focusing on the optimal dose and side-effects should be performed before widely administering this medication into the neuraxial space.
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Managing postoperative pain in patients with obesity is challenging. Although multimodal analgesia has proved effective for pain relief, the specific impacts of different nonopioid i.v. analgesics and adjuvants on these patients are not well-defined. This study aims to assess the effectiveness of nonsteroidal antiinflammatory drugs, paracetamol, ketamine, α-2 adrenergic receptor agonists, lidocaine, magnesium, and oral gabapentinoids in reducing perioperative opioid consumption and, secondarily, in mitigating the occurrence of general and postoperative pulmonary complications (POPCs), nausea, vomiting, PACU length of stay (LOS), and hospital LOS among surgical patients with obesity. ⋯ CRD42023399373 (PROSPERO).
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Meta Analysis
Regional Analgesia Techniques Following Thoracic Surgery: A Systematic Review and Network Meta-analysis.
Regional analgesia techniques have become the basis of multimodal analgesia for acute and chronic pain. They are widely used in thoracic surgery, but the best treatment is still uncertain. ⋯ The cTEA and cSAPB techniques are more likely to reduce the cumulative opioid consumption within 24 hours. The cTEA, cSAPB, ESPB techniques were more likely to improve pain at postoperative 6, 12, and 24 hours. Therefore, cTEA, cSAPB, and ESPB are the first choices for pain relief post thoracic surgery, whereas wound infiltration, intercostal block, continuous wound infiltration, and continuous intercostal block were less likely to be effective. We need more high-quality randomized controlled trials with larger sample sizes to validate our results and to determine the ideal regional analgesia technique and the optimal drug formula.