Articles: anesthesia.
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Review Meta Analysis
Local anaesthetic for post-tonsillectomy pain: a systematic review and meta-analysis.
Tonsillectomy is one of the most commonly performed procedures in otolaryngology. Pain is a significant aspect of post-operative patient morbidity. The use of local anaesthetic, by infiltration or topical application, has been advocated as a way of reducing post-operative pain. ⋯ Local anaesthetic does seem to provide a modest reduction in post-tonsillectomy pain. Topical local anaesthetic on swabs appears to provide a similar level of analgesia to that of infiltration without the potential adverse effects and should be the method of choice for providing additional post-operative analgesia.
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Acta Anaesthesiol Scand · Sep 2008
Review Meta AnalysisNosocomial infections and infection control in regional anesthesia.
Although rare, infectious complications from regional anesthesia and analgesia can be devastating. The literature on this topic consists primarily of surveys, case reports, case series, and studies in which used supplies were cultured. We derived infection control recommendations from the existing literature and compared these recommendations with existing guidelines. ⋯ Studies using more robust methods are necessary to define the rates of infection after different regional anesthesia procedures and to identify risk factors for infections. Data on risk factors would allow anesthesiologists to develop evidence-based guidelines for placement and care of catheters used for regional anesthesia. A multicenter surveillance system may help anesthesiologists address some of the unanswered questions and to develop evidence-based infection control recommendations.
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Review Meta Analysis
Greater incidence of emergence agitation in children after sevoflurane anesthesia as compared with halothane: a meta-analysis of randomized controlled trials.
Sevoflurane is a popular inhalational anesthetic for general anesthesia in children. The higher incidence of emergence agitation has been suspected after sevoflurane anesthesia as compared with halothane, whereas some controlled studies showed conflicting results. In this report, the authors performed a meta-analysis of randomized controlled trials to compare the incidence of emergence agitation in children after sevoflurane or halothane anesthesia. ⋯ This meta-analysis revealed that emergence agitation occurred more frequently with sevoflurane than with halothane anesthesia in children.
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Rev Esp Anestesiol Reanim · Jun 2008
Review Meta Analysis Comparative Study[Combined general-epidural anesthesia compared to general anesthesia: a systematic review and meta-analysis of morbidity and mortality and analgesic efficacy in thoracoabdominal surgery].
We performed a systematic review of randomized controlled trials to compare combined general-epidural anesthesia, followed by postoperative epidural analgesia, and general anesthesia followed by postoperative parenteral analgesia without epidural analgesia in patients undergoing thoracoabdominal surgery. Outcome measures considered were mortality, length of stay in hospital and in the intensive care unit, analgesia, and morbidity. ⋯ Combined anesthesia provides better analgesia and is associated with fewer cases of postoperative respiratory failure. No significant differences were found in mortality, length of stay in hospital, or other morbidity variables.
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Meta Analysis Comparative Study
Supplementary intracameral lidocaine for phacoemulsification under topical anesthesia. A meta-analysis of randomized controlled trials.
We consider a meta-analysis of randomized controlled trials (RCTs) comparing topical anesthesia alone with topical and intracameral anesthesia for phacoemulsification. ⋯ Intraoperative pain during cataract surgery under topical anaesthetic is reduced by intracameral lidocaine. Possible adverse effects of intracameral lidocaine cannot be excluded due to significant heterogeneity in outcome measures between different RCTs. Although a statistically significant reduction in intraoperative pain has been demonstrated, it is not yet possible to recommend this additional intervention without reservations.