Articles: pain.
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Review Meta Analysis
Efficacy and safety of intrathecal diamorphine: a systematic review and meta-analysis with meta-regression and trial sequential analysis.
Intrathecal diamorphine is believed to provide postoperative analgesia but is associated with adverse effects such as nausea and vomiting. There is little evidence of synthesis regarding intrathecal diamorphine in the contemporary literature. We performed a systematic review, meta-analysis with meta-regression and trial sequential analysis to determine the magnitude of intrathecal diamorphine efficacy and safety. ⋯ There is very low level of evidence that intrathecal diamorphine provides effective analgesia after surgery, while increasing postoperative nausea and vomiting with doses > 200 μg.
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Review Meta Analysis
Enhanced Recovery After Surgery Pathways in Pediatric Spinal Surgery: A Systematic Review and Meta-Analysis.
Pediatric spinal fusion surgery is a complex procedure that poses challenges in perioperative management. The enhanced recovery after surgery (ERAS) approach is an evidence-based, multidisciplinary strategy to optimize patient care in an individualized, multidisciplinary way. Despite the benefits of ERAS protocol implementation, the role of ERAS in pediatric spine surgery remains understudied. This systematic review and meta-analysis aims to evaluate the current literature regarding pediatric spinal surgery ERAS protocols and their ability to decrease the length of stay, pain, time-to-stand, and complications. ⋯ ERAS protocol implementation can significantly enhance outcomes for pediatric patients receiving spinal surgery. Consequently, ERAS protocols have the potential to lower healthcare expenses, increase access, and set a new standard of care. Future research should be conducted to expand pediatric ERAS protocols to a diverse range of spinal pathologies and assess the long-term advantages of this practice.
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Review Meta Analysis
Cervical-Level Regional Paraspinal Nerve Block in Cervical Spine Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Regional paraspinal nerve block techniques have shown promise in cervical spine surgery pain relief and opioid reduction. The study aims to evaluate cervical-level regional paraspinal nerve block techniques in cervical spine surgery. ⋯ Cervical-level regional paraspinal nerve block effectively reduces postoperative pain and opioid usage, particularly with a dosage exceeding 10 mL, utilizing ESPB and ISPB techniques, administered posteriorly, bilaterally, and under ultrasound guidance.
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Meta Analysis
A meta-analysis of ultrasound-guided stellate ganglion block on the quality of recovery after cancer surgery.
Pain is a prevalent symptom among patients with cancer, significantly impacting their health and quality of life. Stellate ganglion block (SGB) has been employed as a diagnostic, prognostic, or therapeutic intervention for various pain syndromes. This systematic review and meta-analysis aimed to examine the effects of ultrasound-guided SGB on postoperative recovery quality and other functional indicators following cancer surgery. ⋯ This systematic review and meta-analysis suggests that ultrasound-guided SGB therapy is effective in reducing pain levels and improving mobility and quality of life compared to conventional treatments. Therefore, clinicians should consider administering SGBs to patients with chronic cancer pain, emphasizing sensory exercise to achieve a balance between movement and rest.
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Review Meta Analysis
Preoperative pain sensitivity and its correlation with postoperative acute and chronic pain: a systematic review and meta-analysis.
Preoperative pain sensitivity (PPS) can be associated with postsurgical pain. However, estimates of this association are scarce. Confirming this correlation is essential to identifying patients at high risk for severe postoperative pain and for developing analgesic strategy. This systematic review and meta-analysis summarises PPS and assessed its correlation with postoperative pain. ⋯ PROSPERO (CRD42023465727).