Knowledge

Collections of articles, notes and knowledge from the metajournal community.

Does perioperative pregabalin reduce postoperative pain?

Pain Pregabalin
- Review
  
  Impact of pregabalin on acute and persistent postoperative pain: a systematic review and meta-analysis.
  
  Br J Anaesth. 2015 Jan 1; 114 (1): 10-31.
  
  Perioperative pregabalin may improve postoperative analgesia, nausea and vomiting, though increases sedation and visual disturbances
  pearl
- Randomized Controlled Trial
  
  A randomized placebo-controlled trial of two doses of pregabalin for postoperative analgesia in patients undergoing abdominal hysterectomy.
  
  Can J Anaesth. 2014 Jun 1;61(6):551-7.
- Review
  
  Efficacy of pregabalin in acute postoperative pain: a meta-analysis.
  
  Br J Anaesth. 2011 Apr 1;106(4):454-62.
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Post-operative awareness monitoring & prevention

Anesthesia Awareness Monitoring
- Randomized Controlled Trial
  
  Bispectral index monitoring to prevent awareness during anaesthesia: the B-Aware randomised controlled trial.
  
  Lancet. 2004 May 29;363(9423):1757-63.
  
  BIS monitoring significantly reduces the risk of awareness under general anesthesia in high-risk adult surgical patients.
  pearl
- Randomized Controlled Trial
  
  Prevention of intraoperative awareness in a high-risk surgical population.
  
  N. Engl. J. Med. 2011 Aug 18;365(7):591-600.
- Randomized Controlled Trial
  
  The effect of bispectral index monitoring on long-term survival in the B-aware trial.
  
  Anesth. Analg. 2010 Mar 1;110(3):816-22.
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Perioperative Gabapentin and Pregabalin

Analgesia Anesthesia Gaba agents
- Randomized Controlled Trial
  
  Clinical Study Evaluating Pregabalin Efficacy and Tolerability for Pain Management in Patients Undergoing Laparoscopic Cholecystectomy.
  
  Clin J Pain. 2014 Nov 1;30(11):944-52.
- Randomized Controlled Trial
  
  A randomized placebo-controlled trial of two doses of pregabalin for postoperative analgesia in patients undergoing abdominal hysterectomy.
  
  Can J Anaesth. 2014 Jun 1;61(6):551-7.
- Randomized Controlled Trial
  
  Perioperative gabapentin reduces 24 h opioid consumption and improves in-hospital rehabilitation but not post-discharge outcomes after total knee arthroplasty with peripheral nerve block.
  
  Br J Anaesth. 2014 Nov 1;113(5):855-64.
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Sinus surgery, intravenous anaesthesia and bleeding

Anesthesia Hemorrhage Total intravenous anesthesia
- Randomized Controlled Trial
  
  Blood loss during endoscopic sinus surgery with propofol or sevoflurane: a randomized clinical trial.
  
  JAMA Otolaryngol Head Neck Surg. 2013 May 1;139(5):510-4.
- Review
  
  Systematic review and meta-analysis of total intravenous anesthesia and endoscopic sinus surgery.
  
  Int Forum Allergy Rhinol. 2013 Oct 1;3(10):848-54.
- Randomized Controlled Trial
  
  Effects of three different types of anaesthesia on perioperative bleeding control in functional endoscopic sinus surgery.
  
  Eur Arch Otorhinolaryngol. 2013 Jul 1;270(7):2045-50.
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Left-lateral tilt, aortocaval compression and caesarean section

Obstetric anesthesia
Is the conventional assumption that left-lateral tilt and uterine displacement avoids aortocaval compression during Caesarean section actually valid?

50 years of assumed orthodoxy is challenged by studies showing that:
- True aortal compression is relatively uncommon (Higuchi 2015, Lee 2012).
- Caval compression is probably near-universal, but also usually not improved by a mere 15 degree tilt. (An impractical 30 degrees is more likely required for meaningful impact!) (Palmer 2015).
- Caval compression probably has limited haemodynamic or fetal consequences in the fit, well, term parturient (Higuchi 2015; Lee 2012).
- Judicious use of vasopressor infusions may obviate the need for traditional uterine displacement (Lee 2017; Farber 2017).
Time to change practice then?

Not quite yet...
summary
- Randomized Controlled Trial
  
  Left Lateral Table Tilt for Elective Cesarean Delivery under Spinal Anesthesia Has No Effect on Neonatal Acid-Base Status: A Randomized Controlled Trial.
  
  Anesthesiology. 2017 Aug 1; 127 (2): 241-249.
  
  Left-lateral tilt has no effect on neonatal acid-base status when maternal blood pressure is maintained with crystalloid coload & phenylephrine infusion during elective cesarean delivery.
  pearl
- Editorial
  
  Phenylephrine Infusion: Driving a Wedge in Our Practice of Left Uterine Displacement?
  
  Anesthesiology. 2017 Aug 1; 127 (2): 212-214.
- Editorial
  
  Tilting at aortocaval compression.
  
  Anesthesiology. 2015 Feb 1;122(2):231-2.
expand and show 6 more articles

Knowledge

Does perioperative pregabalin reduce postoperative pain?

Post-operative awareness monitoring & prevention

Perioperative Gabapentin and Pregabalin

Sinus surgery, intravenous anaesthesia and bleeding

Left-lateral tilt, aortocaval compression and caesarean section

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