Articles: nerve-block.
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Perioperative hypothermia is a common complication of anesthesia that can result in negative outcomes. The purpose of this review is to answer the question: Does the type of warming intervention influence the frequency or severity of inadvertent perioperative hypothermia (IPH) in surgical patients receiving neuraxial anesthesia? ⋯ During neuraxial anesthesia, AW reduces IPH more effectively than PW. Even with AW, IPH persists in some patients. Continued innovation in AW technology and additional comparative effectiveness research studying different AW methods are needed.
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Review Meta Analysis Comparative Study
Comparison of local infiltration analgesia and sciatic nerve block as an adjunct to femoral nerve block for pain control after total knee arthroplasty: A systematic review and meta-analysis.
To perform a meta-analysis to assess the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) for pain control following total knee arthroplasty (TKA). ⋯ FNB combined with SNB provided decreased VAS scores and less morphine consumption at 12 and 24 hours compared with FNB combined with LIA in total knee arthroplasty. In addition, it was associated with lower risks of nausea and vomiting. We assessed the quality of the evidence as low to very low; therefore, our confidence in the effect estimate is limited, and the true effect may be substantially different from our estimates. Further studies should focus on surgeries that are known to be associated with significant postoperative pain, particularly surgeries where improved pain control may deliver significant clinical benefits through reduced morbidity, or cost-effectiveness benefits through faster rehabilitation and discharge. The present meta-analysis has the following limitations: (1) only 5 studies were included in the meta-analysis. Although all of them are recently published studies, the sample sizes are relatively small; (2) Functional outcome is an important parameter; however, owing to the insufficiency of relevant data, we failed to perform a meta-analysis on functional outcome; (3) The doses of anesthetics and the concomitant pain management regimes varied between the studies, which may have influenced the results; (4) The duration of follow-up was relatively short, which might have led to an underestimating of complications; and (5) publication bias present in the meta-analysis may have influenced the results.
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Int J Obstet Anesth · May 2017
Review Meta AnalysisCranial nerve palsy following central neuraxial block in obstetrics - a review of the literature and analysis of 43 case reports.
Cranial nerve palsy is a rarely reported complication of central neuraxial block in obstetrics. The aetiology is diverse and includes both decreased and increased intracranial pressure. ⋯ Intracranial hypotension is the most common aetiology of cranial nerve palsy after central neuraxial block in obstetrics. Neuroimaging is recommended in every case, to exclude other neurological causes. Epidural blood patch was the most utilised treatment for post-dural puncture cranial nerve palsy, but outcomes were variable. The majority of cranial nerve palsies resolved over the subsequent weeks and months.
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Review Meta Analysis
Evaluation of Transversus Abdominis Plane (TAP) Block in Hernia Surgery: A Meta-analysis.
Transversus abdominis plane (TAP) block reduces opiate requirements and pain scores in abdominal surgery, but the effect has not been evaluated in hernia surgery. The aim of this study was to evaluate the efficacy of TAP block in hernia surgery. ⋯ Within a heterogeneous group of RCTs, TAP block reduces postoperative morphine requirements and the severity of pain after hernia surgery.
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Review Meta Analysis Comparative Study
Adductor Canal Block versus Femoral Nerve Block for Analgesia after Total Knee Arthroplasty: A Systematic Review and Meta-analysis.
The efficacy and safety of adductor canal block (ACB) as compared with femoral nerve block (FNB) for postoperative pain management in total knee arthroplasty (TKA) remains controversial. We therefore performed a meta-analysis of randomized-controlled trials (RCTs) to compare ACB with FNB in TKA. ⋯ ACB may achieve faster mobilization ability recovery for patients after TKA without a reduction in analgesia when compared with FNB in the early postoperative period. However, due to the variations in the included studies, additional studies are needed to validate these conclusions.