British journal of anaesthesia
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Review Meta Analysis
Targeted temperature management in cardiac surgery: a systematic review and meta-analysis on postoperative cognitive outcomes.
Postoperative cognitive decline occurs commonly after cardiac surgery. The available literature is inconclusive on the role of intraoperative causal or protective factors. ⋯ CRD42019140844.
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Review Meta Analysis
The potential for autonomic neuromodulation to reduce perioperative complications and pain: a systematic review and meta-analysis.
Autonomic dysfunction promotes organ injury after major surgery through numerous pathological mechanisms. Vagal withdrawal is a key feature of autonomic dysfunction, and it may increase the severity of pain. We systematically evaluated studies that examined whether vagal neuromodulation can reduce perioperative complications and pain. ⋯ Indirect vagal neuromodulation improves physiological measures associated with limiting organ dysfunction, although studies are of low quality, are susceptible to bias and lack specific focus on perioperative patients.
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Review Meta Analysis Comparative Study
Selective serotonin reuptake inhibitors and serotonin-norepinephrine reuptake inhibitors as adjuncts for postoperative pain management: systematic review and meta-analysis of randomised controlled trials.
Postoperative adjunct use of serotonin-norepinephrine reuptake inhibitors (SNRIs) shows a small beneficial effect to reduce acute & chronic post-operative pain and opioid consumption.
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Randomized Controlled Trial Comparative Study
High-dose steroids in high pain responders undergoing total knee arthroplasty: a randomised double-blind trial.
Total knee arthroplasty (TKA) is associated with moderate-to-severe postoperative pain despite multimodal opioid-sparing analgesia. Pain catastrophising or preoperative opioid therapy is associated with increased postoperative pain. Preoperative glucocorticoid improves pain after TKA, but dose-finding studies and benefit in high pain responders are lacking. ⋯ NCT03763734.