Cochrane Db Syst Rev
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisBispectral index for improving anaesthetic delivery and postoperative recovery.
The use of clinical signs may not be reliable to measure the hypnotic component of anaesthesia. The use of bispectral index to guide the dose of anaesthetics may have certain advantages over clinical signs. ⋯ Anaesthesia guided by BIS within the recommended range (40 to 60) could improve anaesthetic delivery and postoperative recovery from relatively deep anaesthesia. In addition, BIS-guided anaesthesia has a significant impact on reduction of the incidence of intraoperative recall in surgical patients with high risk of awareness.
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Cochrane Db Syst Rev · Jan 2007
Review Meta AnalysisPostnatal thyroid hormones for respiratory distress syndrome in preterm infants.
Preterm infants with respiratory distress syndrome are at increased risk of adverse neonatal and developmental outcomes. In animal research, thyroid hormones stimulate surfactant production and reduce the incidence and severity of respiratory distress when given antenatally. ⋯ There is no evidence from controlled clinical trials that postnatal thyroid hormone treatment reduces the severity of respiratory distress syndrome, neonatal morbidity or mortality in preterm infants with respiratory distress syndrome.
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Cochrane Db Syst Rev · Jan 2007
ReviewScopolamine (hyoscine) for preventing and treating motion sickness.
Motion sickness - the discomfort experienced when perceived motion disturbs the organs of balance - may include symptoms such as nausea, vomiting, pallor, cold sweats, hypersalivation, hyperventilation and headaches. The control and prevention of these symptoms have included pharmacological, behavioural and complementary therapies. Although scopolamine (hyoscine) has been used in the treatment and prevention of motion sickness for decades, there have been no systematic reviews of its effectiveness. ⋯ The use of scopolamine versus placebo in preventing motion sickness has been shown to be effective. No conclusions can be made on the comparative effectiveness of scopolamine and other agents such as antihistamines and calcium channel antagonists. In addition, no randomised controlled trials were identified that examined the effectiveness of scopolamine in the treatment of established symptoms of motion sickness.
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Fetal movement counting is a method by which a woman quantifies the movements she feels to assess the condition of the baby. The purpose is to try to reduce perinatal mortality by alerting caregivers when the baby might have become compromised. This method may be used routinely, or only in women who are considered at increased risk of complications in the baby. Some clinicians believe that fetal movement counting is a good method as it allows the clinician to make appropriate interventions in good time. On the other hand, fetal movement counting may cause anxiety to women. ⋯ This review does not provide enough evidence to influence practice. In particular, no trials compared fetal movement counting with no fetal movement counting. Robust research is needed in this area.
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Pain is a major issue for patients suffering from many different types of wounds in particular those with burn injuries. Prompt, aggressive use of opioid analgesics such as morphine has been suggested as critical to avert the cycle of pain and anxiety, but side effects are encountered. It is proposed that newer agents such as lidocaine could be effective in reducing pain and alleviating the escalating opioid dosage requirements in patients with burn injury. ⋯ No information is available from the published RCTs or CCTs on clinically relevant primary outcome measures which can influence current burns care practice and management. Therefore, since current clinical evidence is subject to the inherent weaknesses of case series or reports, intravenous lidocaine must be considered a pharmacological agent under investigation in burns care whose effectiveness is yet to be determined in well-designed and conducted clinical trials.