Journal of anesthesia
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Journal of anesthesia · Aug 2019
Review Meta AnalysisThe efficacy and safety of prophylactic use of levosimendan on patients undergoing coronary artery bypass graft: a systematic review and meta-analysis.
Prophylactic use of levosimendan in cardiac surgery remains controversial and no meta-analysis has been done exclusively about that in patients undergoing coronary artery bypass graft (CABG) surgery. We conducted this systematic review and meta-analysis of levosimendan in CABG using PubMed, Embase, Scopus, and Cochrane Library (till April 20, 2018). ⋯ Subgroup analyses revealed that such a benefit was mainly observed in the isolated CABG, the preoperative administration, with-bolus and on-pump subgroups. More high-quality and well-designed prospective studies are needed to confirm or disprove our findings in future.
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Journal of anesthesia · Aug 2019
Review Meta AnalysisThe efficacy and safety of prophylactic use of levosimendan on patients undergoing coronary artery bypass graft: a systematic review and meta-analysis.
Prophylactic use of levosimendan in cardiac surgery remains controversial and no meta-analysis has been done exclusively about that in patients undergoing coronary artery bypass graft (CABG) surgery. We conducted this systematic review and meta-analysis of levosimendan in CABG using PubMed, Embase, Scopus, and Cochrane Library (till April 20, 2018). ⋯ Subgroup analyses revealed that such a benefit was mainly observed in the isolated CABG, the preoperative administration, with-bolus and on-pump subgroups. More high-quality and well-designed prospective studies are needed to confirm or disprove our findings in future.
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Journal of anesthesia · Aug 2019
ReviewPerioperative management of patients with atrial fibrillation receiving anticoagulant therapy.
The number of patients with atrial fibrillation (AF) and the number of patients indicated for anticoagulant therapy have been increasing because AF would affect patient survival due to thromboembolism. Once AF develops, following the disappearance of pulsation, the circumstances within the atrium become prothrombotic and thrombus formation within the left atrium occurs in patients with AF. In recent years, not only warfarin but also new oral anticoagulants were introduced clinically and have become used as oral anticoagulants. ⋯ In addition, knowledge of the characteristics of each oral anticoagulant is required at drug cessation and resumption. Unlike warfarin, which has been used in the past five decades, direct oral anticoagulants (DOACs) do not have sensitive indicators such as prothrombin time-international normalized ratio. To avoid major hemorrhages and thromboembolism, quantitative assays can be implemented for DOAC monitoring and for reversal therapies in perioperative settings.
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Journal of anesthesia · Jun 2019
ReviewInfraclavicular brachial plexus block in adults: a comprehensive review based on a unified nomenclature system.
Over the last decade, considerable progress has been made regarding infraclavicular brachial plexus block (ICB) in adults, especially since the introduction of ultrasound guidance. The advancements in ICB have been attributed to the development of various approaches to improve the success rate and reduce complications. This has also necessitated a unified nomenclature system to facilitate comparison among different approaches. ⋯ For continuous ICB, the proximal approach is promising for reducing local anesthetic volume and increasing efficacy. Nevertheless, further studies are warranted in this direction. We provide practice advisories to maximize safety and minimize adverse events, and recommend designing future studies on ICB according to these findings based on the unified nomenclature system.
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Journal of anesthesia · Jun 2019
Review Meta Analysis Comparative StudyComparison of invasive and noninvasive blood hemoglobin measurement in the operating room: a systematic review and meta-analysis.
Noninvasive hemoglobin (Hb)-monitoring devices are new inventions in pulse oximeter systems that show hemoglobin levels continuously. The aim of this systematic review and meta-analysis was to evaluate the accuracy and precision of noninvasive versus standard central laboratory Hb measurements in the operating room. We systematically searched multiple databases. ⋯ A total of 28 studies on 2000 participants were included in the meta-analysis. Meta-analysis results of mean differences between noninvasive and the central laboratory Hb measurements in overall pooled random effects were - 0.27 (95% LoA (0.44, - 0.10); P value < 0.05). According to this meta-analysis, noninvasive hemoglobin measurement has acceptable accuracy in comparison with the standard invasive method.