Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Sep 2014
Randomized Controlled Trial Comparative StudyThe effects of propofol vs. sevoflurane on post-operative pain and need of opioid.
Maintaining anesthesia with either sevoflurane or propofol for laparoscopic gynaecology surgery has no differential effect on post-operative pain.
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Acta Anaesthesiol Scand · Sep 2014
Review Meta AnalysisDefinition, prevalence, and outcome of feeding intolerance in intensive care: a systematic review and meta-analysis.
Clinicians and researchers frequently use the phrase 'feeding intolerance' (FI) as a descriptive term in enterally fed critically ill patients. We aimed to: (1) determine what is the most accepted definition of FI; (2) estimate the prevalence of FI; and (3) evaluate whether FI is associated with important outcomes. Systematic searches of peer-reviewed publications using PubMed, MEDLINE, and Web of Science were performed with studies reporting FI extracted. ⋯ In summary, FI is inconsistently defined but appears to occur frequently. There are preliminary data indicating that FI is associated with adverse outcomes. A standard definition of FI is required to determine the accuracy of these preliminary data.
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Acta Anaesthesiol Scand · Sep 2014
Randomized Controlled Trial Comparative StudyContinuous wound infiltration with ropivacaine for analgesia after caesarean section: a randomised, placebo-controlled trial.
We evaluated the analgesic effect of ropivacaine infiltration into the surgical wound after caesarean section. ⋯ Continuous wound infiltration with ropivacaine did not decrease the need for opioids and had no impact on pain scores or patient satisfaction after caesarean section.
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Acta Anaesthesiol Scand · Sep 2014
Review Comparative StudyRecovery of gastrointestinal function with thoracic epidural vs. systemic analgesia following gastrointestinal surgery.
The objective of this review was to systematically assess the effect of thoracic epidural analgesia (TEA) vs. systemic analgesia (SA) on the recovery of gastrointestinal (GI) function in patients following GI surgery. We performed a comprehensive literature search to identify randomized controlled trials of adult patients undergoing GI surgery, comparing the effect of two postoperative analgesia regimens. Patients postoperatively receiving local anesthesia-based TEA with or without opioids were compared to patients receiving opioid-based SA. ⋯ The occurrence of postoperative hypotension was relatively higher in the TEA group, risk ratio: 7.9, 95% CIs: 2.4 to 26.5, P = 0.001; other side effects (such as pruritus and vomiting) were similar in the two groups. There is evidence that TEA (compared to SA) improves the recovery of GI function after GI procedures without any increased risk of GI complications. To further confirm these effects, larger, better quality randomized controlled trials with standard outcome measurements are needed.