Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis Comparative Study
Is sciatic nerve block advantageous when combined with femoral nerve block for postoperative analgesia following total knee arthroplasty? a meta-analysis.
Total knee arthroplasty (TKA) is associated with moderate-to-severe postoperative pain despite the use of femoral nerve block (FNB). The analgesic benefits of adding sciatic nerve block (SNB) to FNB following TKA are unclear. The aim of this meta-analysis was to quantify the analgesic effects of adding SNB to FNB following TKA. ⋯ The available evidence supporting the analgesic benefits of adding SNB to FNB following TKA is marked by significant heterogeneity. With this challenge in mind, our meta-analysis suggests that SNB can significantly reduce postoperative opioid consumption and diminish knee pain following TKA compared to no SNB in the setting of FNB.
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Randomized Controlled Trial Comparative Study
Prewarming neurosurgical patients to minimize hypotension on induction of anesthesia: a randomized trial.
Prewarming prior to surgery is effective in preventing perioperative hypothermia. There is a paucity of evidence, however, regarding the hemodynamic effects of prewarming. We hypothesized that the nadir mean arterial pressure during anesthesia induction would be higher after prewarming than after no prewarming. ⋯ Prewarming with convective forced air for one hour prior to intravenous anesthetic induction did not prevent hypotension during the induction period (Australian New Zealand Clinical Trials Registry [ANZCTR] ACTRN12615000431527).
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Randomized Controlled Trial
Dexmedetomidine during total knee arthroplasty performed under spinal anesthesia decreases opioid use: a randomized-controlled trial.
It remains unclear whether the opioid-sparing effects of dexmedetomidine seen in patients undergoing general anesthesia are reproducible in patients undergoing spinal anesthesia. We hypothesized that the administration of intravenous dexmedetomidine for sedation during total knee arthroplasty under spinal anesthesia would decrease postoperative morphine consumption in the first 24 hr following surgery. ⋯ Dexmedetomidine was associated with a significant decrease in morphine use in the first 24 hr following total knee arthroplasty. Our study shows that an intraoperative infusion of dexmedetomidine for sedation in patients receiving spinal anesthesia can produce postoperative analgesic effects. This offers another potential adjunct in the multimodal pain management of these patients. This trial was registered at ClinicalTrials.gov (identifier NCT02026141).