Articles: pain.
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Review Meta Analysis
Meta-analysis of epidural analgesia versus parenteral opioid analgesia after colorectal surgery.
Epidural analgesia (EA) with local anaesthetic is considered to play a key role after colorectal surgery. However, its effect on postoperative recovery is still a matter of debate. ⋯ Despite improved analgesia and a decrease in ileus, EA has some adverse effects and does not shorten the duration of hospital stay after colorectal surgery.
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Review Meta Analysis Comparative Study
[Coblation tonsillectomy: a review of the literature].
Controversy surrounds the question of which technique should be preferred for tonsillectomy in order to reduce postoperative morbidity in terms of pain, bleeding, activity and return to normal diet. This study reviews the current literature on coblation tonsillectomy (CTE). ⋯ The design of the current studies varies in size, age distribution, indications for surgery, the surgical techniques compared and follow-up. The results are heterogenous and further evidence is still required to show that CTE is a safe alternative. Therefore, calculation of cost-effectiveness of a commonly performed expensive CTE as a new standard technique is currently impossible.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisEffects of nonsteroidal anti-inflammatory drugs on postoperative renal function in adults with normal renal function.
Nonsteroidal anti-inflammatory drugs (NSAIDs) can play a major role in the management of acute pain in the peri-operative period. However, there are conflicting views on whether NSAIDs are associated with adverse renal effects. ⋯ NSAIDs caused a clinically unimportant transient reduction in renal function in the early postoperative period in patients with normal preoperative renal function. NSAIDs should not be withheld from adults with normal preoperative renal function because of concerns about postoperative renal impairment.
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Cochrane Db Syst Rev · Apr 2007
Review Meta AnalysisPiracetam for reducing the incidence of painful sickle cell disease crises.
Sickle cell disease is one of the most common genetic disorders. Sickle cell crises in which irregular and dehydrated cells contribute to blocking of blood vessels are characterised by episodes of pain. Treatment is mainly supportive and symptomatic. In vitro studies with piracetam indicate that it has the potential for inhibition and a reversal of the process of sickling of erythrocytes. ⋯ The small number of included trials and their poor methodological quality provided insufficient reliable evidence to support the routine use of this medication for preventing the incidence of painful sickle cell disease crises.
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Previous meta-analyses described moderate to large benefits of chondroitin in patients with osteoarthritis. However, recent large-scale trials did not find evidence of an effect. ⋯ Large-scale, methodologically sound trials indicate that the symptomatic benefit of chondroitin is minimal or nonexistent. Use of chondroitin in routine clinical practice should therefore be discouraged.