Articles: general-anesthesia.
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Review Meta Analysis
Efficacy of prophylactic doses of intravenous nitroglycerin in preventing myocardial ischemia under general anesthesia: A systematic review and meta-analysis with trial sequential analysis.
To evaluate the efficacy of intravenous nitroglycerin (TNG) in preventing intraoperative myocardial ischemia (MI) under general anesthesia. Moreover, we analyzed the hemodynamic changes in heart rate (HR), mean blood pressure (MBP), and pulmonary capillary wedge pressure (PCWP) associated with TNG administration both before and after the induction of anesthesia. ⋯ Our analyses showed that prophylactic intravenous TNG does not reduce the incidence of intraoperative MI. Moreover, TSA suggests that further studies are necessary to confirm the results (GRADE: very low). Prophylactic doses of intravenous TNG significantly reduced the MBP both pre and post anesthesia induction (GRADE: very low).
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Review Meta Analysis Comparative Study
Effects of different fresh gas flows with or without a heat and moisture exchanger on inhaled gas humidity in adults undergoing general anaesthesia: A systematic review and meta-analysis of randomised controlled trials.
The minimum inhaled gas absolute humidity level is 20 mgH2O l for short-duration use in general anaesthesia and 30 mgH2O l for long-duration use in intensive care to avoid respiratory tract dehydration. ⋯ All intubated patients should receive a HME with low or high flows. With minimal flow, a HME adds cost and is not needed to achieve an appropriate inhaled gas absolute humidity.
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Minerva anestesiologica · Aug 2017
Meta AnalysisEffect of remifentanil for general anaesthesia on parturients and newborns undergoing caesarean section: a meta-analysis.
The results presented by studies investigating the effect of remifentanil on both parturients and newborns during cesarean section differed significantly. Therefore, we performed a meta-analysis to estimate the effect of remifentanil on these patients. ⋯ Remifentanil shows potential value of maternal circulation response during general anesthesia, which reduces maternal blood pressure in response to intubation and surgery. However, whether it is beneficial for the neonate is still controversial. More randomized-controlled trials with larger sample size are required to assess the adverse effects of remifentanil.
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J. Perianesth. Nurs. · Aug 2017
Meta AnalysisManagement of Emergence Delirium in Adult PTSD Patients: Recommendations for Practice.
Emergence delirium is a known phenomenon which occurs after general anesthesia in approximately 5% of the general population. However, individuals who have been diagnosed with post-traumatic stress disorder may present with symptoms refractory to conventional methods of reorientation. In the past several years, literature has begun to address the problem, but no standardized guidelines exist at present. The authors synthesize the available literature, combining data with evidence-driven principles from multiple disciplines, to submit an initial set of guidelines until research either supports or disproves these recommendations.
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Review Meta Analysis
General vs. neuraxial anaesthesia in hip fracture patients: a systematic review and meta-analysis.
Hip fracture is a trauma of the elderly. The worldwide number of patients in need of surgery after hip fracture will increase in the coming years. The 30-day mortality ranges between 4 and 14%. Patients' outcome may be improved by anaesthesia technique (general vs. neuraxial anaesthesia). There is a dearth of evidence from randomised studies regarding to the optimal anaesthesia technique. However, several large non-randomised studies addressing this question have been published from the onset of 2010. ⋯ Neuraxial anaesthesia is associated with a reduced in-hospital mortality and length of hospitalisation. However, type of anaesthesia did not influence the 30-day mortality. In future there is a need for large randomised studies to examine the association between the type of anaesthesia, post-operative complications and mortality.