International journal of clinical and experimental medicine
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Review
Local anaesthetic wound infiltration used for caesarean section pain relief: a meta-analysis.
Local anaesthetic wound infiltration techniques were reported to reduce opiate requirements and pain scores in women undergoing caesarean section (CS). However, the results were conflicting. The primary aim of this meta-analysis was to assess whether local analgesia could reduce pain intensity when injected via wound catheters. ⋯ Local anaesthetic wound infiltration can reduce morphine requirements and the rate of patients suffer nausea but not pain scores after caesarean section. Further procedure-specific RCTs were encouraged to confirm the efficacy of local anaesthetic wound infiltration techniques.
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Fentanyl-induced cough is a common phenomenon during anesthesia induction. Magnesium sulphate (MgSO4) is reported to have a powerful relaxation of airway smooth muscle. This study is to investigate the effects of prophylactic MgSO4 on the incidence and severity of fentanyl-induced cough. ⋯ Compared with the group I, both the groups II and III had lower incidence of moderate cough (P < 0.05). There were no differences in the hemodynamic data at three timepoints among the three groups. In conclusion, fentanyl-induced cough may be suppressed effectively and safely by prophylactic 30 mg/kg of MgSO4 during anesthetic induction.
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Atrial fibrillation (AF) is a quite common complication during the postoperative period after cardiac surgery. Increasing studies have reported that landiolol may be effective in prevention of AF after cardiac surgery. Its efficacy and safety are seldom explored; hence we conducted a meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of landiolol in prevention of AF after cardiac surgery. ⋯ Compared with the control group, landiolol was associated with a significant reduction of AF after cardiac surgery (RR=0.41; 95% CI 0.32-0.52; P<0.001), and the administration of landiolol seems more effective in patients who underwent coronary artery bypass grafting (CABG) (RR=0.36; 95% CI 0.25-0.52; P<0.001). Compared with placebo, no difference was detected in the incidence of major complications (RR=0.77; 95% CI 0.34-1.72; P=0.52). Landiolol is effective in prevention of AF after cardiac surgery and without increasing the risk of major complications.
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Sciatic nerve block is widely used for anesthesia and analgesia in lower limb surgery, traditional method used for sciatic nerve block is nerve stimulation guidance. Whether the use of ultrasound-guided technology can increases the success rate of sciatic nerve block and provide other benefits are not defined. This meta-analysis was aimed to clarify this issue. ⋯ Compared to traditional nerve stimulation guidance, ultrasound guidance for sciatic nerve may improve the success rate of block and reduce the risk of vascular puncture.
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The treatment of posterolateral tibial plateau fracture remains controversial and challenging. Several approaches for this fracture have been applied for direct exposure and support plate fixation. However, several structures are to be at risk via posterior approach, which may affect exposure and plate application. To solve this problem, an extended anterolateral approach was developed and reported. ⋯ The extended anterolateral approach provides excellent visualization, which can facilitate the internal fixation and reduction of posterolateral tibial plateau fractures, and shows encouraging results.