Articles: anesthesia.
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Meta Analysis
Regional Analgesia Techniques Following Thoracic Surgery: A Systematic Review and Network Meta-analysis.
Regional analgesia techniques have become the basis of multimodal analgesia for acute and chronic pain. They are widely used in thoracic surgery, but the best treatment is still uncertain. ⋯ The cTEA and cSAPB techniques are more likely to reduce the cumulative opioid consumption within 24 hours. The cTEA, cSAPB, ESPB techniques were more likely to improve pain at postoperative 6, 12, and 24 hours. Therefore, cTEA, cSAPB, and ESPB are the first choices for pain relief post thoracic surgery, whereas wound infiltration, intercostal block, continuous wound infiltration, and continuous intercostal block were less likely to be effective. We need more high-quality randomized controlled trials with larger sample sizes to validate our results and to determine the ideal regional analgesia technique and the optimal drug formula.
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Postoperative neurocognitive disorders (PNDs) frequently occur following orthopedic surgery and are closely associated with adverse prognosis. PNDs are an emerging concept that includes both postoperative cognitive dysfunction (POCD) and postoperative delirium (POD). The prevention of combined use of peripheral nerve block (PNB) and general anesthesia (GA) on POCD and/or POD incidence following orthopedic surgery remains unknown. We aimed to investigate the effect of this combined anesthesia method on POCD/POD incidence after orthopedic surgery, compared with GA. ⋯ The combined use of PNB and GA decreases the incidence of POCD but not POD following orthopedic surgery.
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Minerva anestesiologica · Oct 2024
Meta Analysis Comparative StudyComparison between hemodynamic effects of remimazolam and propofol during general anesthesia: a systematic review and meta-analysis.
The need for safe anesthetic agents with minimal side effects has led to the development of remimazolam, a new benzodiazepine designed to be an alternative to the commonly used drug propofol, which has significant hemodynamic effects. This study aims to compare the hemodynamic effects of remimazolam with propofol during general anesthesia. ⋯ This study provides evidence that remimazolam induces fewer cardiorespiratory depressant effects and has a more favorable side effect profile compared to propofol during general anaesthesia.
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Meta Analysis Comparative Study
Remimazolam vs. propofol for general anaesthesia in elderly patients: a meta-analysis with trial sequential analysis.
Elderly patients comprise an increasing proportion of patients undergoing surgery, and they require special attention due to age-related physiological changes. Propofol is the traditional agent for anaesthesia, and recently, remimazolam, a novel ultra-short-acting benzodiazepine, has emerged as an alternative to propofol in general anaesthesia. ⋯ Remimazolam significantly reduced the risk of hypotension, bradycardia and injection pain, despite an increase in the time to loss of consciousness. Remimazolam appears to be an effective and well tolerated alternative to propofol in elderly patients undergoing general anaesthesia.
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Anesthesia and analgesia · Oct 2024
Meta AnalysisPerioperative Regional Anesthesia on Persistent Opioid Use and Chronic Pain after Noncardiac Surgery: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
Whether regional anesthesia impacts the development of chronic postsurgical pain is currently debateable, and few studies have evaluated an effect on prolonged opioid use. We sought to systematically review the effect of regional anesthesia for adults undergoing noncardiac elective surgery on these outcomes. ⋯ The results of this study suggest that regional anesthesia potentially reduces chronic postsurgical pain up to 6 months after surgery. Our findings also suggest a potential decrease in the development of persistent opioid use.