British journal of anaesthesia
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Review Meta Analysis Comparative Study
The analgesic efficacy of local infiltration analgesia vs femoral nerve block after total knee arthroplasty: a systematic review and meta-analysis.
Many consider femoral nerve block the gold standard in pain management following knee arthroplasty. Local infiltration analgesia is an alternate approach that applies the concept of surgical wound infiltration with local anaesthetics. This meta-analysis aims to compare both analgesic treatments for analgesia and functional outcomes after total knee arthroplasty. ⋯ Complication rates were captured by three trials or fewer with exception of knee infection, which was sought by eight trials. Local infiltration analgesia provides similar postoperative analgesia after total knee arthroplasty to femoral nerve block. Although this meta-analysis did not capture any difference in rates of complications, the low number of trials that specifically sought these outcomes dictates caution.
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Review Meta Analysis
Ultrasound-guided radial artery cannulation in adult and paediatric populations: a systematic review and meta-analysis.
Ultrasound is a well-validated adjunct to central venous cannulation; however, previous reviews of ultrasound-guided radial artery cannulation have been inconclusive. The aim of this study was to assess the use of ultrasound in radial artery cannulation in adult and paediatric populations. ⋯ This is the first level one systematic review to demonstrate strong evidence for the use of ultrasound guidance in radial artery cannulation in adult and paediatric populations. In the adult population, ultrasound use significantly increased first-attempt success rate, which subsequently resulted in a significant reduction in the number of attempts. The benefits of ultrasound were also shown in the paediatric population, with a significant increase in first-attempt success rate and reduction in the number of attempts. The use of ultrasound as an adjunct to radial arterial cannulation should now be considered best practice.
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Letter Meta Analysis
Aspirin and coronary artery surgery: an updated meta-analysis.
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Review Meta Analysis
Are neuromuscular blocking agents being misused in laboratory pigs?
The literature (2012-4) describing experimental pig surgery was reviewed to estimate the extent to which neuromuscular block (NMB) is used, to examine methods for ensuring unconsciousness, and to identify the rationale for use of NMB and establish the anaesthetist's training. In the first stage of a two-stage review, NMB use was estimated using Web of Knowledge to identify articles describing NMB during pig surgeries. In the second stage, PubMed and Google Scholar were used to increase the number of articles for determining measures taken to prevent accidental awareness during general anaesthesia (AAGA). ⋯ Medical or veterinary anaesthetists supervised anaesthesia in 70% of studies; non-anaesthetists provided NMB, unsupervised, in 23. Nine respondents prioritized experimental expediency over pig welfare. In laboratory pig studies, AAGA may be prevalent; reported details of its attempted prevention are woefully inadequate.
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Review Meta Analysis
Alternative intubation techniques vs Macintosh laryngoscopy in patients with cervical spine immobilization: systematic review and meta-analysis of randomized controlled trials.
Immobilization of the cervical spine worsens tracheal intubation conditions. Various intubation devices have been tested in this setting. Their relative usefulness remains unclear. ⋯ In situations where the spine is immobilized, the Airtraq device reduces the risk of intubation failure. There is a lack of evidence for the usefulness of other intubation devices.