Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jan 2020
Review Meta Analysis Comparative StudyLow- versus high-dose intraoperative opioids: a systematic review with meta-analyses and trial sequential analyses.
Opioid-induced hyperalgesia is a state of nociceptive sensitisation secondary to opioid administration. The objective of this meta-analysis was to test the hypothesis that high-dose intraoperative opioids contribute to increased post-operative pain and hyperalgesia when compared with a low-dose regimen in patients under general anaesthesia. ⋯ There is low certainty of evidence that high-dose intraoperative opioid administration increases pain scores in the post-operative period, when compared with a low-dose regimen.
-
Acta Anaesthesiol Scand · Jan 2020
ReviewEffects of magnesium, phosphate and zinc supplementation in ICU patients - protocol for a systematic review.
Depletion of the trace elements magnesium, phosphate and zinc is common in patients admitted to the intensive care unit (ICU). Observational studies have suggested worse outcome in patients with hypomagnesaemia, hypophosphataemia or hypozincaemia, but also inverse associations with worse outcome with too high serum levels. However, it is unclear whether data from randomised clinical trials (RCTs) confirm this. Accordingly, we plan to assess the balance between benefits and harms of supplementation as compared with placebo or no supplementation in adult ICU patients. ⋯ The benefits and harms of supplementation therapy with magnesium, phosphate and zinc in general ICU patients are unknown. This outlined systematic review will provide data on the evidence, on which future recommendations for supplementation may be founded.
-
Acta Anaesthesiol Scand · Jan 2020
Experience with a "Feed and swaddle" Program In Infants up to Six Months of Age.
Feed and swaddle is a technique in which an infant is fed and allowed to fall asleep to facilitate diagnostic imaging. This study reviews our experience and diagnostic success in premature and term infants up to 6 months old undergoing brain magnetic resonance imaging (MRI) using a feed and swaddle technique and with comparable patients imaged under anesthesia. ⋯ Given the high rate of success and absence of complications with feed and swaddle in children ≤6 months for brain MRI and the presence of anesthesia-related complications, most infants should undergo a trial of feed and swaddle prior to undergoing brain MRI with anesthesia.
-
Acta Anaesthesiol Scand · Jan 2020
Review Meta AnalysisPreoperative femoral nerve block for hip fracture - A systematic review with meta-analysis.
Pre-operative pain management of hip fracture patients is complex. Femoral nerve block (FNB) is used for hip fractures to reduce pain and demand for systematic analgesia. The objective of the study was to systematically investigate the efficacy of single-shot FNB for hip fracture patients. ⋯ The quantity of evidence supporting pre-operative single-shot FNB for hip fractures is very low, and the certainty of evidence supporting pre-operative single-shot FNB for hip fractures is low. No studies using ultrasound guided technique were identified. Data on non-ultrasound guided FNB's suggest a decreased pain score compared to the use of systemic analgesia.
-
Acta Anaesthesiol Scand · Jan 2020
Patient-controlled sedation with propofol for endoscopic procedures - a cost-analysis.
Patient-controlled sedation (PCS) with propofol accompanied by a bedside nurse anaesthetist is an alternative sedation method for endoscopic procedures compared with midazolam administered by a nurse or endoscopist. Increasing costs in health care demands an economic perspective when introducing alternative methods. We applied a hospital perspective on a cost analysis comparing different methods of sedation and the resource use that were expected to affect cost differences related to the sedation. ⋯ Propofol PCS with a bedside nurse anaesthetist reduces the direct sedation costs for ERCP and bronchoscopy procedures compared with midazolam sedation.