Knowledge

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

Does ondansetron prevent post-operative shivering?

Ondansetron Postoperative complications
- Meta Analysis
  
  Efficacy and safety of ondansetron in preventing postanesthesia shivering: a meta-analysis of randomized controlled trials.
  
  BMC Anesthesiol. 2014 Mar 3; 14: 12.
- Review
  
  Efficacy spectrum of antishivering medications: meta-analysis of randomized controlled trials.
  
  Crit. Care Med.. 2012 Nov 1;40(11):3070-82.
- Randomized Controlled Trial
  
  Ondansetron given before induction of anesthesia reduces shivering after general anesthesia.
  
  Anesth. Analg. 2000 Jun 1;90(6):1423-7.
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Does ketamine reduce persistent post-surgical pain?

Ketamine Pain
- Randomized Controlled Trial
  
  Ketamine infusion for 96 hr after thoracotomy: Effects on acute and persistent pain.
  
  Eur J Pain. 2019 May 1; 23 (5): 985-993.
- Article
  
  Does perioperative ketamine have a role in the prevention of chronic postsurgical pain: the ROCKet trial.
  
  Br J Pain. 2017 Nov 1; 11 (4): 166-168.
- Randomized Controlled Trial
  
  Chronic postthoracotomy pain and perioperative ketamine infusion.
  
  J Pain Palliat Care Pharmacother. 2014 Jun 1;28(2):117-21.
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Is preoperative ranitidine effective at reducing induction aspiration?

Airway Complications
- Randomized Controlled Trial
  
  The effect of intravenous pantoprazole and ranitidine for improving preoperative gastric fluid properties in adults undergoing elective surgery.
  
  Anesth. Analg. 2003 Nov 1;97(5):1360-3.
- Randomized Controlled Trial
  
  A comparison of the effects of ranitidine and omeprazole on volume and pH of gastric contents in elective surgical patients.
  
  Eur J Anaesthesiol. 2004 Apr 1;21(4):260-4.
- Randomized Controlled Trial
  
  Effects of metoclopramide and ranitidine on preoperative gastric contents in day-case surgery.
  
  Yonsei Med. J. 2006 Jun 30; 47 (3): 315-8.
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Interesting obstetric spinal anesthesia articles

Intrathecal Obstetric anesthesia
- Randomized Controlled Trial
  
  Spinal anaesthesia for caesarean section: an ultrasound comparison of two different landmark techniques.
  
  Int J Obstet Anesth. 2014 Aug 1;23(3):206-12.
- Review
  
  Hyperbaric versus plain bupivacaine for spinal anesthesia for cesarean delivery.
  
  Anesth. Analg. 2015 Jan 1; 120 (1): 132-140.
  
  There is limited evidence supporting superiority between plain or hyperbaric spinal bupivacaine for spinal cesarean section.
  pearl
- Randomized Controlled Trial
  
  Synergistic Interaction between Fentanyl and Bupivacaine Given Intrathecally for Labor Analgesia.
  
  Anesthesiology. 2014 May 1;120(5):1126-36.
  
  Intrathecal fentanyl synergistically improves labour analgesia when given in combination with bupivacaine.
  pearl
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Breastfeeding and epidural fentanyl

Epidural Obstetric anesthesia
Although there remains much conflicting evidence, largely of a low-quality observational nature, the highest quality evidence to date refutes assertions that epidural fentanyl reduces breastfeeding rates.

Notably Lee et al.’s 2017 RCT of over 300 women showed no effect of epidural fentanyl up to 2 mcg/mL and successful maternal breastfeeding up to 6 weeks.
summary
- Randomized Controlled Trial
  
  Epidural Labor Analgesia-Fentanyl Dose and Breastfeeding Success: A Randomized Clinical Trial.
  
  Anesthesiology. 2017 Oct 1; 127 (4): 614-624.
  
  Epidural fentanyl at concentrations up to 2 mcg/mL does not effect breastfeeding rates in women who have previously successfully breastfed.
  pearl
- Randomized Controlled Trial
  
  A Randomized Control Trial of Bupivacaine and Fentanyl versus Fentanyl-only for Epidural Analgesia during the Second Stage of Labor.
  
  Anesthesiology. 2015 Jan 1; 122 (1): 172-7.
  
  Fentanyl-only epidural infusion shows no benefit over fentanyl/bupiv in respect to duration of labor, motor block, delivery, analgesia, or outcomes.
  pearl
- Review
  
  Labor Epidural Analgesia and Breastfeeding: A Systematic Review.
  
  J Hum Lact. 2016 Aug 1; 32 (3): 507-20.
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