Articles: anesthetics.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisMedicinal and injection therapies for mechanical neck disorders.
Controversy persists regarding medicinal therapies and injections. ⋯ The major limitations are the lack of replication of the findings and sufficiently large trials. There is moderate evidence for the benefit of intravenous methylprednisolone given within eight hours of acute whiplash, from a single trial. Lidocaine injection into myofascial trigger points appears effective in two trials. There is moderate evidence that Botulinum toxin A is not superior to saline injection for chronic MND. Muscle relaxants, analgesics and NSAIDs had limited evidence and unclear benefits.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisSub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery.
Local anaesthesia for cataract surgery can be provided by either sub-Tenon or topical anaesthesia. Although there is some work suggesting advantages to both techniques, there has been no recent systematic attempt to compare both techniques for all relevant outcomes. ⋯ Sub-Tenon anaesthesia provides better pain relief than topical anaesthesia for cataract surgery.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisBispectral index for improving anaesthetic delivery and postoperative recovery.
The use of clinical signs may not be reliable to measure the hypnotic component of anaesthesia. The use of bispectral index to guide the dose of anaesthetics may have certain advantages over clinical signs. ⋯ Anaesthesia guided by BIS within the recommended range (40 to 60) could improve anaesthetic delivery and postoperative recovery from relatively deep anaesthesia. In addition, BIS-guided anaesthesia has a significant impact on reduction of the incidence of intraoperative recall in surgical patients with high risk of awareness.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisTopical lidocaine for the treatment of postherpetic neuralgia.
The cause of postherpetic neuralgia is damage to peripheral neurons, dorsal root ganglia, and the dorsal horn of the spinal cord, secondary to herpes zoster infection (shingles). In postherpetic neuralgia, peripheral neurons discharge spontaneously and have lowered activation thresholds, and exhibit an exaggerated response to stimuli. Topical lidocaine dampens peripheral nociceptor sensitisation and central nervous system hyperexcitability, and may benefit patients with postherpetic neuralgia. ⋯ There is insufficient evidence to recommend topical lidocaine as a first-line agent in the treatment of postherpetic neuralgia with allodynia. Further research should be undertaken on the efficacy of topical lidocaine for other chronic neuropathic pain disorders, and also to compare different classes of drugs (e.g. topical anaesthetics versus anti-epileptics).