Journal of anesthesia
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Journal of anesthesia · Oct 2016
Review Meta AnalysisFiner gauge of cutting but not pencil-point needles correlate with lower incidence of post-dural puncture headache: a meta-regression analysis.
Post-dural puncture headache (PDPH) is a well-known neurological outcome caused by leakage of cerebrospinal fluid during neuraxial anesthesia. Studies aimed at assessing the efficacy of finer gauged spinal needles to reduce the incidence of PDPH have produced conflicting results. We have therefore examined the effect of the gauge of cutting needles and pencil-point needles, separately, on the incidence of PDPH. ⋯ A significant relationship between needle gauge and subsequent rate of PDPH was noted in cutting needles, but not pencil-point needles.
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Journal of anesthesia · Feb 2016
Review Meta Analysis Comparative StudyCuffed versus uncuffed endotracheal tubes in children: a meta-analysis.
Cuffed endotracheal tubes (ETTs) have increasingly been used in small children. However, the use of cuffed ETTs in small children is still controversial. The goal of this meta-analysis is to assess the current evidence regarding the postextubation morbidity and tracheal tube (TT) exchange rate of cuffed ETTs compared to uncuffed ETTs in children. ⋯ Our study demonstrates that cuffed ETTs reduce the need for TT exchanges and do not increase the risk for postextubation stridor compared with uncuffed ETTs.
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Journal of anesthesia · Dec 2015
Review Meta AnalysisBeta-adrenergic antagonists during general anesthesia reduced postoperative pain: a systematic review and a meta-analysis of randomized controlled trials.
We have performed a systematic literature review and a meta-analysis investigating the effect of beta-adrenergic antagonist on perioperative pain in randomized clinical trials (RCTs). The search included the CENTRAL, CINAHL, EMBASE, and MEDLINE databases (from inception to 10 February 2015). From the retrieved full texts, we hand-searched the references and PubMed related citations. ⋯ However, in two opioid-controlled studies, one in knee arthroscopy and another in tubal ligation patients, the proportion of patients needing rescue analgesia was two-times higher in esmolol-treated patients: 52-57 vs. 23-34%, p < 0.05. Adverse effects were rarely reported, and as reported were mostly cardiovascular alterations. In conclusion, intra-operative beta-adrenergic antagonists' administration may decrease postoperative pain and analgesic consumption when given as an adjuvant to general anesthesia.
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Journal of anesthesia · Oct 2015
Review Meta AnalysisAssociation between childhood exposure to single general anesthesia and neurodevelopment: a systematic review and meta-analysis of cohort study.
Many studies have been done to seek the relationship between general anesthesia and neurodevelopment in pediatrics. However, there is no unified conclusion, especially single anesthesia affecting a child before 3 and 4 years. The association between anesthesia and neurodevelopment is studied using a meta-analysis. ⋯ The current evidence suggests a modestly elevated risk of neurodevelopmental disorders exists in children near 3 years of age. A single general anesthesia is relatively safe after 3 years, as the outcome is very close before 3 and 4 years old.
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Journal of anesthesia · Aug 2015
Meta Analysis Comparative StudyEffects of volatile vs. propofol-based intravenous anesthetics on the alveolar inflammatory responses to one-lung ventilation: a meta-analysis of randomized controlled trials.
The aim of this meta-analysis is to compare the potential effects of inhalation anesthetics with total intravenous anesthetics on alveolar cytokine expression and lung-related clinical outcomes in patients undergoing one-lung ventilation (OLV) for thoracic surgery. ⋯ Inhalation anesthetics might be preferable in patients undergoing OLV for thoracic surgery and their protective effects might work via attenuating inflammatory responses.