Articles: nerve-block.
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Meta Analysis Comparative Study
Effects of perioperative central neuraxial analgesia on outcome after coronary artery bypass surgery: a meta-analysis.
Perioperative central neuraxial analgesia may improve outcome after coronary artery bypass surgery due to attenuation of stress response and superior analgesia. ⋯ There were no differences in the rates of mortality or myocardial infarction after coronary artery bypass grafting with central neuraxial analgesia. There were associated improvements in faster time until tracheal extubation, decreased pulmonary complications and cardiac dysrhythmias, and reduced pain scores.
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Meta Analysis
[Ultrasound and local anaesthesia. Part III: ultrasound and neuroaxial local anaesthesia].
The use of ultrasound as a diagnostic tool for the visualisation of the epidural space has effects on the quality and the performance of epidural anesthesia. This work presents an overview of the recent experiences with ultrasound for epidural anesthesia and on the possibilities for ultrasound imaging techniques. The results of visualisation of the epidural space and its limiting structures obtained by various working groups are presented. ⋯ The ultrasound-guided puncture allowed an ideal needle trajectory and a more precise application of the catheter. A significant improvement of analgesia quality ( p<0.035) and patient satisfaction ( p<0.006) could be achieved. The metaanalysis of the different studies regarding puncture quality by ultrasound-guided peridural anaesthesia showed a clear advantage for the use of imaging techniques.
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Anesthesia and analgesia · May 2000
Meta AnalysisNovel analgesic adjuncts for brachial plexus block: a systematic review.
This article reviews current evidence for the efficacy of adding novel analgesic adjuncts to brachial plexus block, the goal of which is to prolong analgesic effect without the disadvantage of systemic side effects or prolonged motor block. It may also allow for a reduction in the total dose of local anesthetic used. Novel adjuncts studied to date include opioids, clonidine, neostigmine, and tramadol. ⋯ Evidence regarding the analgesic benefit of opioid adjuncts remains equivocal and more evidence is required before their routine use can be recommended. Clonidine appears to have significant analgesic benefit and to cause minimal adverse effects when used in doses up to 150 microg. Data regarding other drugs, such as tramadol and neostigmine, are not sufficient to allow for any recommendations, and further studies are required.
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Anesthesia and analgesia · Feb 1995
Meta AnalysisNeurolytic celiac plexus block for treatment of cancer pain: a meta-analysis.
We performed a meta-analysis of the efficacy and safety of neurolytic celiac plexus block (NCPB) for cancer pain. A literature search yielded 59 papers, but data on NCPB in two or more patients was available in only 24 papers. Twenty-one studies were retrospective, one was prospective, and two were randomized and controlled. ⋯ Patients with pancreatic cancer responded similarly to those with other intraabdominal malignancies. Common adverse effects were transient, including local pain (96%), diarrhea (44%), and hypotension (38%); complications occurred in 2%. This analysis suggests that: 1) NCPB has long-lasting benefit for 70%-90% of patients with pancreatic and other intraabdominal cancers, regardless of the technique used; 2) adverse effects are common but transient and mild; and 3) severe adverse effects are uncommon.