Articles: analgesics.
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Review Meta Analysis
Opioid versus non-opioid analgesia for spine surgery: a systematic review and meta-analysis of randomized controlled trials.
Opioids are the primary analgesics used in patients undergoing spine surgery. Postoperative pain is common despite their liberal use and so are opioid-associated side effects. Non-opioid analgesics are gaining popularity as alternative to opioids in spine surgery. ⋯ The certainty of evidence on GRADE assessment is low for studied outcomes. Available evidence supports intraoperative non-opioid analgesia for overall postoperative pain outcomes in spine surgery. More research is needed to find the best drug combination and dosing regimen. Prospero Registration: CRD42020209042.
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Minerva anestesiologica · Jan 2023
Meta AnalysisUsefulness of Analgesia Nociception Index for guiding intraoperative opioid administration: a systematic review and meta-analysis.
This study primarily aimed at investigating the efficacy of Analgesia Nociception Index (ANI) for guiding intraoperative opioid administration in patients receiving surgery under general anesthesia. ⋯ Analgesia nociception index-guided analgesia was unable to reduce intraoperative opioid administration compared to monitoring using conventional clinical parameters. Further studies are required to support our findings.
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To estimate the acute analgesic efficacy of combined Pregabalin and Celecoxib after operation via a systematic review and meta-analysis. ⋯ This work suggested that combined Pregabalin and Celecoxib were efficacious in reduction of postoperative pain and narcotic requirements after surgery, whereas more trials are needed to further identify the efficacy of combined Pregabalin and Celecoxib in the management of acute postoperative pain.
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J Pain Palliat Care Pharmacother · Dec 2022
Meta AnalysisSuperior Hypogastric Plexus Block for Pain Management Post-Hysterectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.
We aimed to evaluate the efficacy of superior hypogastric plexus (SHP) block in pain relief among women undergoing hysterectomy. Cochrane Library, PubMed, ISI web of science, and Scopus were searched from inception to May 2021 for the available randomized clinical trials (RCTs). We included RCTs that compared SHP block (intervention group) to saline (control group) in hysterectomy. ⋯ However, no significant difference was reported in VAS pain score 1 day postoperatively between intervention and control groups. Moreover, SHP block significantly reduced the postoperative opioid consumption and incidence of nausea and vomiting (p = 0.03 & p = 0.003). In conclusion, superior hypogastric plexus block effectively reduces postoperative pain, opioid consumption, and incidence of nausea and vomiting post-hysterectomy.
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Meta Analysis
Prolonged Opioid Use After Lumbar Fusion Surgery: A Meta-Analysis of Prevalence and Risk Factors.
Persistent opioid utilization after spine surgery is a rising complication among both preoperatively opioid-naïve and opioid-tolerant patients. To our knowledge, this is the first meta-analysis to determine the prevalence and characterize the risk factors that predispose patients to prolonged opioid use (≥3 months) after lumbar fusion. ⋯ The high prevalence of prolonged opioid use after lumbar fusion underscores the importance of screening patients for comorbidities and implementing targeted strategies to minimize opioid misuse.