Journal of clinical anesthesia
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Review Meta Analysis
Effect of dexmedetomidine on hemodynamic responses to tracheal intubation: A meta-analysis with meta-regression and trial sequential analysis.
An uncontrolled adrenergic response during tracheal intubation may lead to life-threatening complications. Dexmedetomidine binds to α2-receptors and may attenuate this response. The primary aim of our meta-analysis is to investigate dexmedetomidine efficacy in attenuating sympathetic response to tracheal intubation, compared with placebo or no dexmedetomidine, in terms of heart rate and blood pressure at intubation. ⋯ Patients receiving premedication with dexmedetomidine for tracheal intubation, compared with no dexmedetomidine, have a lower blood pressure and heart rate, however, the risk of bradycardia and hypotension is relevant and its use during daily practice should be cautiously evaluated for each patient.
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Meta Analysis
The analgesic efficacy of iPACK after knee surgery: A systematic review and meta-analysis with trial sequential analysis.
The novel infiltration between the popliteal artery and the capsule of the posterior knee (iPACK) has been described to relieve posterior knee pain after knee surgery. The study objective is to determine whether iPACK provides analgesia after knee surgery when compared with a control group. ⋯ There is moderate level evidence that iPACK might provide analgesia for posterior pain after total knee arthroplasty when compared with a control group at 12 h, but was not associated with any other meaningful benefits. Based on these results, there is currently limited evidence supporting the use of iPACK as a complement to adductor canal block for analgesia after total knee arthroplasty.
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Randomized Controlled Trial
Effect of combined versus sequential injection of 2% lidocaine and 0.5% bupivacaine on the onset and duration of supraclavicular brachial plexus block: A double blinded randomised controlled trial.
To assess whether sequential (one after the other with a delay of 120 s) or combined (freshly prepared mixture) administration of 2% lidocaine and 0.5% bupivacaine in supraclavicular brachial plexus block (SCBPB) provides faster onset and prolonged duration of block. ⋯ There was no advantage of sequential administration of 2% lidocaine and 0.5% bupivacaine over the administration of combination of both LAs in terms of onset and duration of block.