International journal of clinical and experimental medicine
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Dexmedetomidine, as a sole or combinable sedative, has served in pediatric sedation undergoing MRI. However, clinical effects of dexmedetomidine are still controversial. This meta-analysis was to assess the effects between dexmedetomidine and propofol in children undergoing MRI, especially outcomes and adverse events of patients. ⋯ There were statistically significant increased in the pediatric anesthesia emergence Delirium scores of 5-min after awakening (WMD: 2.40; 95% CI: 1.00 to 3.81; P = 0.0008) and 10-min after awakening (WMD: 3.06; 95% CI: 1.81 to 4.31; P < 0.00001) in patients who were treated with dexmedetomidine than propofol. Improved the prognosis of patients, nonetheless, dexmedetomidine must have an indispensable role to undergoing pediatric MRI scanning. Compared with propofol, however, dexmedetomidine did not induce the duration of sedation and might lead to a longer recovery time.
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The purpose of this systematic review was to evaluate the predictive validity of the Identification of Seniors at Risk (ISAR) Tool in identifying elderly patients at risk of adverse outcomes after a visit to the emergency department (ED). Since older adults are frequently sent to the ED, screening for risk of adverse outcomes in elderly patients is increasingly important in the ED. Also it is a way to ensure that interventions based on a comprehensive geriatric assessment (CGA) are provided to patients identified at risk to reduce the risk of adverse outcomes. ⋯ With a cutoff score at least 2, the ISAR was proved to have poor validity related to revisiting the ED (AUC: 0.59-0.60) and hospital readmission (AUC: 0.59-0.60). The predictive validity of the ISAR related to mortality and composite outcomes was graded as poor to fair. It is not suitable to use the ISAR alone for identifying seniors at risk for adverse outcomes in the ED.
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To evaluate the efficacy of in-patient comprehensive geriatric care for elderly patients with hip fracture. ⋯ Comprehensive geriatric care promoted the functional improvement for elderly patients with hip fracture. Meanwhile, the proportion of patients who were discharged from hospital to the same place as before fracture in intervention group was higher as compared to control. However, our finding showed no significant difference on in-patients mortality, follow-up mortality and length of stay between both groups.
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Chronic low back and lower extremity pain is mainly caused by lumbar disc herniation (LDH) and radiculitis. Various surgery and nonsurgical modalities, including epidural injections, have been used to treat LDH or radiculitis. Therefore, we conducted this meta-analysis to assess the effects of the two interventions in managing various chronic low and lower extremity pain. ⋯ This meta-analysis confirms that epidural injections of local anesthetic with or without steroids have beneficial but similar effects in the treatment of patients with chronic low back and lower extremity pain.
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To investigate and compared the efficacy and safety of epidural analgesia with different concentrations of bupivacaine plus fentanyl on pain in patients undergoing thoracic surgery. ⋯ 0.25%~0.375% bupivacaine plus fentanyl 0.4 mg using in epidural analgesia in patients undergoing thoracic surgery can lead to safe and effective analgesic effect.