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Anesthesia and analgesia · Dec 2024
Review Meta Analysis Comparative StudyComparison of Phenylephrine Bolus and Infusion Regimens on Maternal and Fetal Outcomes During Cesarean Delivery: A Systematic Review and Meta-Analysis.
Prophylactic phenylephrine infusion is superior to bolus dosing in avoiding maternal hypotension in women receiving neuraxial anaesthesia for caesarean section, although is also associated with more hypertension and bradycardia.
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Review Meta Analysis
Does anaesthesia with nitrous oxide affect mortality or cardiovascular morbidity? A systematic review with meta-analysis and trial sequential analysis.
Available evidence does not support the claim that nitrous oxide affects mortality or cardiovascular morbidity.
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Meta Analysis
Nitrous Oxide-related Postoperative Nausea and Vomiting Depends on Duration of Exposure.
Post-op nausea & vomiting incidence is related to duration of nitrous oxide exposure, but is clinically insignificant at under 1 hour exposure.
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Cochrane Db Syst Rev · Jan 2009
Review Meta AnalysisSugammadex, a selective reversal medication for preventing postoperative residual neuromuscular blockade.
Abrishami et al.'s Cochrane review of 18 RCTs totalling 1,300 patients confirmed the superiority of sugammadex compared with neostigmine at all studied levels of blockade. They identified sugammadex dosing of:
- 2 mg/kg - for reversal of rocuronium neuromuscular blockade at TOF-T2 reappearance.
- 4 mg/kg - for reversal at post-tetanic count of 1 to 2.
- 16 mg/kg - for reversal 3 to 5 minutes after a rocuronium intubating dose.
Importantly there was similar frequency of adverse events compared to neostigmine (< 1%), although overall small sample sizes mean no conclusion can be made regarding rare serious adverse events.
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Review Meta Analysis
Perioperative systemic magnesium to minimize postoperative pain: a meta-analysis of randomized controlled trials.
Peri-operative systemic magnesium reduces postoperative pain and opioid consumption, although it is of uncertain clinical significance.
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