Articles: nerve-block.
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A combination of bilateral superficial cervical plexus block (BSCPB) and general anesthesia is recommended for thyroid surgery. Proof of the efficacy of this combination remains weak. Furthermore, data on the safety of this regimen are lacking. Therefore, a meta-analysis of randomized controlled trials (RCT) to evaluate the efficacy and safety of BSCPB as an adjunct to general anesthesia in patients receiving thyroid surgery was performed. ⋯ The combination of BSCPB and general anesthesia has a significant benefit in reducing pain 6 and 24 hours after thyroid surgery. However, the effect on pain reduction is too small to be of clinical relevance. Although it is a safe procedure, the existing evidence allows for no recommendation concerning the application of BSCPB in thyroid surgery. Further trials should evaluate a dose-response relationship and the incidence of PONV with this regimen.
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J Plast Reconstr Aesthet Surg · Oct 2011
Meta Analysis Comparative StudyGeneral anaesthesia versus thoracic paravertebral block for breast surgery: a meta-analysis.
Thoracic paravertebral block (TPVB) offers an attractive alternative to general anaesthesia (GA) for ambulatory breast surgery. The aim of this meta-analysis was first to evaluate the safety and efficacy of TPVB for breast surgery, and second to compare TPVB with GA with regard to postoperative pain, nausea and vomiting, opioid consumption and length of hospital stay. ⋯ TPVB provides effective anaesthesia for ambulatory breast surgery and can result in significant benefits over GA. However, further studies are required to determine whether these advantages would still be present if an optimal technique for outpatient GA is employed. Adjunctive ultrasonography may contribute to improve the safety of TPVB in breast surgery and requires further investigation.
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Meta Analysis Comparative Study
Analgesic efficacy of ultrasound-guided regional anesthesia: a meta-analysis.
To determine if the use of ultrasound guidance (vs non-ultrasound techniques) improves the success rate of nerve blocks. ⋯ Ultrasound-guided peripheral nerve block is associated with an increased overall success rate when compared with nerve stimulation or other methods. Ultrasound-guided techniques also increase the success rate of some specific blocks.
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Review Meta Analysis
A meta-analysis on the clinical effectiveness of transversus abdominis plane block.
To study the efficacy of the transversus abdominal plane (TAP) block. ⋯ TAP block reduces the need for postoperative opioid use, it increases the time first request for further analgesia, it provides more effective pain relief, and it reduces opioid-associated side effects.
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Cochrane Db Syst Rev · Jan 2011
Review Meta AnalysisSingle, double or multiple-injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery in adults.
Regional anaesthesia comprising axillary block of the brachial plexus is a common anaesthetic technique for distal upper limb surgery. This is an update of a review first published in 2006. ⋯ This review provides evidence that multiple injection techniques using nerve stimulation for axillary plexus block produce more effective anaesthesia than either double or single injection techniques. However, there was insufficient evidence for a significant difference in other outcomes, including safety.