Articles: anesthesia.
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Review Meta Analysis
Epidemiological, methodological, and statistical characteristics of network meta-analysis in anaesthesia: a systematic review.
Network meta-analyses (NMAs) combine direct and indirect estimates to provide mixed (or network) estimates of effect sizes. The scientific rigour of the conduct and reporting of anaesthesia NMAs is unknown. This review assessed the epidemiological, methodological, and statistical characteristics of anaesthesia NMAs. ⋯ PROSPERO CRD42021227608.
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Anesthesia and analgesia · Mar 2023
Meta AnalysisHigh-Flow Nasal Cannula for Apneic Oxygenation in Obese Patients for Elective Surgery: A Systematic Review and Meta-Analysis.
Obese patients desaturate rapidly during the apneic period after induction of anesthesia for elective surgery. Administration of oxygen using high-flow nasal cannulae (HFNCs) may prevent desaturation in nonobese patients compared to facemask (FM) preoxygenation. The aim of this meta-analysis was to compare the effectiveness of HFNC to FM preoxygenation techniques in reducing preintubation desaturation in obese patients undergoing elective surgery. ⋯ There may be no difference between HFNC and FM preoxygenation in preventing oxygen desaturation <92% or the lowest oxygen saturation before intubation. Preparation remains important to prevent and manage desaturation during induction of obese patients.
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Epidural injection (EI) has been used to manage lower back and radicular leg pain caused by a herniated lumbar disc. There are 3 types of EI techniques currently being used: transforaminal (TFEI), interlaminar (ILEI), and caudal epidural injections (CEI). ⋯ TFEI had the best potential of the 3 EI techniques to reduce pain and improve function in patients with a herniated lumbar disc. Further qualified trials comparing the effects of these 3 techniques are warranted to derive definitive conclusions.
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It is important to reduce the hemodynamic response during tracheal intubation. We performed a systematic review and meta-analysis of the Airway Scope and Macintosh laryngoscope to determine whether they reduce the hemodynamic responses of heart rate (HR) and mean blood pressure (MBP) after tracheal intubation under general anesthesia. ⋯ Our finding suggested that the Airway Scope attenuated hemodynamic responses at 60 seconds after tracheal intubation in comparison with that of the Macintosh laryngoscope. However, the MBP sample size is small and further research is needed.
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Review Meta Analysis
Depth of anaesthesia and mortality after cardiac or noncardiac surgery: a systematic review and meta-analysis of randomised controlled trials.
Recent randomised controlled trials have failed to show a benefit in mortality by using processed electroencephalography (pEEG) to guide lighter anaesthesia. We performed a meta-analysis of mortality data from randomised trials of pEEG monitoring to assess the evidence of any protective effect of pEEG-guided light anaesthesia compared with deep anaesthesia in adults aged ≥18 yr. ⋯ CRD42022285195 (PROSPERO).