Articles: anesthetics.
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J. Cardiothorac. Vasc. Anesth. · Feb 2024
Meta AnalysisPeripheral Regional Anesthetic Techniques in Cardiac Surgery: A Systematic Review and Meta-Analysis.
The aim of this systematic review was to investigate postoperative pain outcomes and adverse events after peripheral regional anesthesia (PRA) compared to no regional anesthesia (RA), placebo, or neuraxial anesthesia in children and adults undergoing cardiac surgery. ⋯ Compared to no RA or placebo, PRA may reduce pain intensity at rest and during movement. However, these results should be interpreted cautiously because the certainty of evidence is only very low.
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This meta-analysis aimed to compare the risk of brain swelling during craniotomy between propofol-based and volatile-based anesthesia. ⋯ By reviewing the available evidence, our results demonstrate the beneficial effects of propofol on the risk of brain swelling, ICP, PONV, and intraoperative tachycardia. In emergency craniotomy for traumatic brain injury and subarachnoid hemorrhage, brain swelling showed no significant difference between propofol and volatile agents. Further large-scale studies are warranted for verification.
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To summarize and appraise the use of dexmedetomidine in epidural labor analgesia, we conducted a systematic review and meta-analysis of randomized controlled trials (RCTs). ⋯ Dexmedetomidine combined with local anesthetic for epidural labor analgesia can improve the VAS score of parturients. Except for the increased incidence of maternal bradycardia, it seems to be safe for the parturients and fetuses.
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Review Meta Analysis
General anesthesia versus conscious sedation for acute ischemic stroke endovascular therapy: A Meta Analysis of Randomized Controlled Trials.
Endovascular thrombectomy (E.V.T.) is the primary treatment for acute ischemic stroke (AIS). Nevertheless, the optimal choice of anesthetic modality during E.V.T. remains uncertain. This systematic review and meta-analysis aim to summarize existing literature from randomized controlled trials (RCTs) to guide the selection of the most appropriate anesthetic modality for AIS patients undergoing E.V.T. ⋯ G.A. had superior recanalization rates in AIS patients undergoing endovascular therapy, but functional outcomes, mortality, and NIHSS scores were similar. Secondary outcomes showed no significant differences, except for a higher risk of hypotension with G.A. More trials are required to determine the optimal anesthesia approach for thrombectomy in AIS patients.
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J. Cardiothorac. Vasc. Anesth. · Jan 2024
Meta AnalysisComparison of Volatile Anesthetics Versus Propofol on Postoperative Cognitive Function After Cardiac Surgery: A Systematic Review and Meta-analysis.
To compare the effects of volatile anesthetics and propofol on neurocognitive function after cardiac surgery. ⋯ Unlike noncardiac surgery, there are no differences between volatile anesthetics and propofol regarding postoperative neurocognitive dysfunction after cardiac surgery.