Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Feb 2020
Review Meta AnalysisHaloperidol for the treatment of delirium in critically ill patients: a systematic review with meta-analysis and Trial Sequential Analysis.
Haloperidol is the most frequently used drug to treat delirium in the critically ill patients. Yet, no systematic review has focussed on the effects of haloperidol in critically ill patients with delirium. ⋯ The evidence for the use of haloperidol to treat critically ill patients with delirium is sparse, of low quality and inconclusive. We therefore have no certainty regarding any beneficial, harmful or neutral effects of haloperidol in these patients.
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Acta Anaesthesiol Scand · Feb 2020
Randomized Controlled Trial Multicenter StudyBenefits and harm of paracetamol and ibuprofen in combination for postoperative pain: preplanned subgroup analyses of the multicenter randomized PANSAID trial.
The "Paracetamol and Ibuprofen in Combination" (PANSAID) trial showed that combining paracetamol and ibuprofen resulted in lower opioid consumption than each drug alone and we did not find an increase in risk of harm when using ibuprofen vs paracetamol. The aim of this subgroup analysis was to investigate the differences in benefits and harms of the interventions in different subgroups. We hypothesized that the intervention effects would differ in subgroups with different risk of pain or adverse events. ⋯ These pre-planned subgroup analyses did not suggest that patients in the investigated subgroups benefitted differently from a basic non-opioid analgesic regimen consisting of paracetamol and ibuprofen. Further, there was no evidence of subgroup heterogeneity regarding harm and use of ibuprofen. Because of reduced statistical power in subgroup analyses, we cannot exclude clinically relevant subgroup heterogeneity.
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Acta Anaesthesiol Scand · Feb 2020
Randomized Controlled TrialVolume of ropivacaine 0.2% and sciatic nerve block duration:a randomised, blinded trial inhealthy volunteers.
Sciatic nerve blocks are used for many orthopaedic procedures on the knee, lower leg, foot and ankle. However, as nerve block durations vary considerably, the timing of supplemental analgesia is challenging. Therefore, knowledge on the effect of local anaesthetic (LA) dose on block duration is important to outweigh the benefits of increasing LA dose against the risk of LA systemic toxicity. In this randomized, double-blind trial, we aimed to explore the relationship between the volume of ropivacaine 0.2% and sciatic nerve block duration. We hypothesized that increasing LA volume would prolong block duration. ⋯ We found no effect of increasing the volume of ropivacaine 0.2% from 5 to 30 mL on sensory sciatic nerve block duration.
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Acta Anaesthesiol Scand · Feb 2020
Randomized Controlled Trial Multicenter StudyDEX-2-TKA - DEXamethasone twice for pain treatment after Total Knee Arthroplasty. A protocol for a randomized, blinded, three-group multicentre clinical trial.
Multimodal analgesia is considered the leading principle for post-operative pain treatment, but no gold standard after total knee arthroplasty (TKA) exists. ⋯ Recruiting is planned to commence September 2018 and expected to finish March 2020.
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Acta Anaesthesiol Scand · Feb 2020
ReviewNew-onset postoperative atrial fibrillation after heart surgery.
New-onset postoperative atrial fibrillation (poAF) complicates approximately 20-60% of all cardiac surgical procedures and is associated with an increased periprocedural mortality and morbitity, prolonged hospital stay, increased costs, and worse long-term survival. Unfortunately multiple advances in surgery and perioperative care over the last two decades have not led to a reduction in the incidence of poAF or associated complications in the daily clinical practice. ⋯ Multiple strategies to prevent and manage poAF following heart surgery already exist. Our hope is that this review will facilitate more rigorous testing of prevention strategies, implementation of prophylaxis regimens as well as optimal treatment of this common and serious complication.