Articles: anesthetics.
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Review Meta Analysis
[Levobupivacaine for regional anesthesia. A systematic review].
Levobupivacaine [S(-)bupivacaine], the levorotatory S-enantiomer of racemic bupivacaine, is commercially available in the U. S. and in most European countries. We performed a systematic review (MEDLINE database) and identified 88 articles on the clinical application of levobupivacaine in more than 3,000 patients. ⋯ In these regional techniques, levobupivacaine was used for all common indications in a wide range of clinical settings. Epidural levobupivacaine was combined with fentanyl, morphine, sufentanil, epinephrine, and clonidine, spinal levobupivacaine was combined with sufentanil, fentanyl, and epinephrine. In most studies, levobupivacaine was compared to bupivacaine and/or ropivacaine.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisEMLA and amethocaine for reduction of children's pain associated with needle insertion.
Children often experience pain from needle insertion procedures; therefore, several topical anaesthetics have been developed. ⋯ Although EMLA is an effective topical anaesthetic for children, amethocaine is superior in preventing pain associated with needle procedures.
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Cochrane Db Syst Rev · Jan 2006
Review Meta AnalysisSingle, double or multiple injection techniques for axillary brachial plexus block for hand, wrist or forearm surgery.
Regional anaesthesia comprising axillary block of the brachial plexus is a common anaesthetic technique for distal upper extremity surgery. ⋯ This review provided some evidence that multiple injection techniques using nerve stimulation for axillary plexus block provide more effective anaesthesia than either double or single injection techniques. However, there was insufficient evidence for other outcomes, including safety.
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Anesthesia and analgesia · Dec 2005
Review Meta AnalysisSystemic administration of local anesthetics to relieve neuropathic pain: a systematic review and meta-analysis.
We reviewed randomized controlled trials to determine the efficacy and safety of systemically administered local anesthetics compared with placebo or active drugs. Of 41 retrieved studies, 27 trials of diverse quality were included in the systematic review. Ten lidocaine and nine mexiletine trials had data suitable for meta-analysis (n = 706 patients total). ⋯ The most common adverse effects of lidocaine and mexiletine were drowsiness, fatigue, nausea, and dizziness. The adverse event rate for systemically administered local anesthetics was more than for placebo but equivalent to morphine, amitriptyline, or gabapentin (odds ratio: 1.23; 95% confidence interval: 0.22 to 6.90). Lidocaine and mexiletine produced no major adverse events in controlled clinical trials, were superior to placebo to relieve neuropathic pain, and were as effective as other analgesics used for this condition.
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Acta Anaesthesiol Scand · Nov 2005
Review Meta AnalysisPeri-operative ketamine for acute post-operative pain: a quantitative and qualitative systematic review (Cochrane review).
Post-operative pain management is usually limited by adverse effects such as nausea and vomiting. Adjuvant treatment with an inexpensive opioid-sparing drug such as ketamine may be of value in giving better analgesia with fewer adverse effects. The objective of this systematic review was to evaluate the effectiveness and tolerability of ketamine administered peri-operatively in the treatment of acute post-operative pain in adults. ⋯ In the first 24 h after surgery, ketamine reduces morphine requirements. Ketamine also reduces PONV. Adverse effects are mild or absent. These data should be interpreted with caution as the retrieved studies were heterogenous and the result of the meta-analysis can not be translated into any specific administration regimen with ketamine.