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Cochrane anaesthesia

Anthony G Messina, Michael Wang, Marshall J Ward, Chase C Wilker, Brett B Smith, Daniel P Vezina, Nathan Leon Pace
BACKGROUND: General anaesthesia is usually associated with unconsciousness. 'Awareness' is when patients have postoperative recall of events or experiences during surgery. 'Wakefulness' is when patients become conscious during surgery, but have no postoperative recollection of the period of consciousness. OBJECTIVES: To evaluate the efficacy of two types of anaesthetic interventions in reducing clinically significant awareness:- anaesthetic drug regimens; and- intraoperative anaesthetic depth monitors...
October 18, 2016: Cochrane Database of Systematic Reviews
James K Hamill, Jamie-Lee Rahiri, Gamage Gunaratna, Andrew G Hill
BACKGROUND: No enhanced recovery after surgery protocol has been published for laparoscopic appendectomy. This was a review of evidence-based interventions that could optimize recovery after appendectomy. METHODS: Interventions for the review Clinical pathway, fast-track or enhanced recovery protocols; needlescopic approach; single incision laparoscopic (SIL) approach; natural orifice transluminal endoscopic surgery (NOTES); regional nerve blocks; intraperitoneal local anaesthetic (IPLA); drains...
October 17, 2016: Surgical Endoscopy
Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon
BACKGROUND: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Small bleeding areas can reduce operative visibility and result in destruction of surrounding structures. Deliberate hypotension (lowering the mean arterial blood pressure to between 50 and 65 mm Hg in normotensive patients) using a range of pharmacological agents during general anaesthesia reduces blood loss in many operations. This review was originally published in 2013 and updated in February 2016...
October 12, 2016: Cochrane Database of Systematic Reviews
Patrick B Murphy, Kerollos Wanis, Christopher M Schlachta, Nawar A Alkhamesi
: INTRODUCTION; Surgical management of external rectal prolapse (ERP) remains a challenge with the breadth of choices available and varies on the international, national, regional and locoregional level. Significant innovation has led to new techniques to manage ERP including changes to both abdominal and perineal approaches. EVIDENCE ACQUISITION; A systematic, English-language search of major databases was conducted from 2006-2016. From 636 papers two reviewers identified 24 studies which compared two or more surgical techniques in adult patients with rectal prolapse and reported on complications, quality of life or recurrence...
October 6, 2016: Minerva Chirurgica
Alessandro Montedori, Iosief Abraha, Massimiliano Orso, Potito Giuseppe D'Errico, Stefano Pagano, Guido Lombardo
BACKGROUND: Despite considerable improvements in oral health, dental caries continue to be a public health issue. The most frequently used, and universally accepted technique, to remove caries is through mechanical ablation of decayed tissues by means of rotating drills (diamond or tungsten carbide, or both). In the past few decades, the introduction of adhesive filling materials (resin composites) has affected cavity filling procedures by reducing its retention needs, with advantages for dental tissue conservation...
September 26, 2016: Cochrane Database of Systematic Reviews
Ana Licina, Sharan Sidhu, Jing Xie, Crispin Wan
BACKGROUND: Vitrectomy surgery is one of the commonest ophthalmic procedures performed across the world. It may be performed using general or local anaesthesia encompassing regional or topical anaesthesia depending on a number of factors, including patient suitability, and patient, surgeon or anaesthetist preference. There have so far been no evidence-based recommendations on the best form of anaesthesia for this intervention. There is no clear collated evidence base as to the best type of anaesthesia to reduce harm, and provide best surgical conditions and optimal outcome for patients...
September 19, 2016: Cochrane Database of Systematic Reviews
Wai-Tat Wong, Veronica Kw Lai, Yee Eot Chee, Anna Lee
BACKGROUND: Fast-track cardiac care is a complex intervention involving several components of care during cardiac anaesthesia and in the postoperative period, with the ultimate aim of early extubation after surgery, to reduce length of stay in the intensive care unit and in the hospital. Safe and effective fast-track cardiac care may reduce hospital costs. This is an update of a Cochrane review first published in 2003, updated in 2012 and updated now in 2016. OBJECTIVES: To determine the safety and effectiveness of fast-track cardiac care compared with conventional (not fast-track) care in adult patients undergoing cardiac surgery...
September 12, 2016: Cochrane Database of Systematic Reviews
Hemanshu Prabhakar, Gyaninder Pal Singh, Charu Mahajan, Indu Kapoor, Mani Kalaivani, Vidhu Anand
BACKGROUND: Brain tumour surgery usually is carried out with the patient under general anaesthesia. Over past years, both intravenous and inhalational anaesthetic agents have been used, but the superiority of one agent over the other is a topic of ongoing debate. Early and rapid emergence from anaesthesia is desirable for most neurosurgical patients. With the availability of newer intravenous and inhalational anaesthetic agents, all of which have inherent advantages and disadvantages, we remain uncertain as to which technique may result in more rapid early recovery from anaesthesia...
September 9, 2016: Cochrane Database of Systematic Reviews
Ki Jinn Chin, Javier E Cubillos, Husni Alakkad
BACKGROUND: Regional anaesthesia comprising axillary block of the brachial plexus is a common anaesthetic technique for distal upper limb surgery. This is an update of a review first published in 2006 and previously updated in 2011 and 2013. OBJECTIVES: To compare the relative effects (benefits and harms) of three injection techniques (single, double and multiple) of axillary block of the brachial plexus for distal upper extremity surgery. We considered these effects primarily in terms of anaesthetic effectiveness; the complication rate (neurological and vascular); and pain and discomfort caused by performance of the block...
September 2, 2016: Cochrane Database of Systematic Reviews
Jahan Che Penny-Dimri, Andrew D Cochrane, Luke A Perry, Julian A Smith
BACKGROUND: The role of perioperative erythropoietin (EPO) for preventing cardiac surgery associated acute kidney injury (CSA-AKI) remains uncertain with published trials producing conflicting results. Perspective into the factors at work is needed, due to ongoing uncertainty. METHODS: We undertook the systematic review and meta-analysis of randomised-controlled trials (RCTs) using random-effects modelling. The primary outcome was safety and efficacy of perioperative EPO to prevent CSA-AKI and the secondary outcomes were change in serum creatinine, urinary neutrophil gelatinase-associated lipocalin, time in ICU, rates of postoperative transfusions, haemodialysis, and mortality...
November 2016: Heart, Lung & Circulation
Juliet Hounsome, Amanda Nicholson, Janette Greenhalgh, Tim M Cook, Andrew F Smith, Sharon R Lewis
BACKGROUND: Accidental awareness during general anaesthesia (AAGA) is when a patient unintentionally becomes conscious during a procedure performed with general anaesthesia and subsequently has explicit recall of this event. Incidence estimates for AAGA vary, with the most common estimate being one to two cases per 1000 general anaesthetics. Evidence linking nitrous oxide use and an increased risk of AAGA has come from observational studies data but the literature is contradictory, with some studies finding a protective effect of nitrous oxide...
2016: Cochrane Database of Systematic Reviews
Paul F Ashley, Susan Parekh, David R Moles, Prabhleen Anand, Laura C I MacDonald
BACKGROUND: Fear of dental pain is a major barrier to treatment for children who need dental care. The use of preoperative analgesics has the potential to reduce postoperative discomfort and intraoperative pain. We reviewed the available evidence to determine whether further research is warranted and to inform the development of prescribing guidelines. This is an update of a Cochrane review published in 2012. OBJECTIVES: To assess the effects of preoperative analgesics for intraoperative or postoperative pain relief (or both) in children and adolescents undergoing dental treatment without general anaesthesia or sedation...
2016: Cochrane Database of Systematic Reviews
Theresa A Lawrie, Regina Kulier, Juan Manuel Nardin
BACKGROUND: This is an update of a review that was first published in 2002. Female sterilisation is the most popular contraceptive method worldwide. Several techniques exist for interrupting the patency of fallopian tubes, including cutting and tying the tubes, damaging the tube using electric current, applying clips or silicone rubber rings, and blocking the tubes with chemicals or tubal inserts. OBJECTIVES: To compare the different tubal occlusion techniques in terms of major and minor morbidity, failure rates (pregnancies), technical failures and difficulties, and women's and surgeons' satisfaction...
2016: Cochrane Database of Systematic Reviews
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
2016: Cochrane Database of Systematic Reviews
Kate Leslie, Ornella Clavisi, Joshua Hargrove
No abstract text is available yet for this article.
2016: Cochrane Database of Systematic Reviews
Polpun Boonmak, Suhattaya Boonmak, Porjai Pattanittum
BACKGROUND: Sevoflurane induction for general anaesthesia has been reported to be safe, reliable and well accepted by patients. Sevoflurane induction uses either low or high initial concentrations. The low initial concentration technique involves initially administering a low concentration of sevoflurane and gradually increasing the concentration of the dose until the patient is anaesthetized. The high initial concentration technique involves administering high concentrations from the beginning, then continuing with those high doses until the patient is anaesthetized...
2016: Cochrane Database of Systematic Reviews
Eunice K Erhaze, Maura Dowling, Declan Devane
This systematic review assessed the effectiveness of parental presence for children undergoing surgical or diagnostic procedures under general anaesthesia (such as bronchoscopy, laryngoscopy and laparoscopy). Randomized and quasi randomized trials with healthy children scheduled for elective diagnostic and surgical procedures under general anaesthesia (age range 0-16 years) where the intervention was parental presence at anaesthesia induction were included. A comprehensive literature search was conducted using electronic databases and the reference lists of included studies...
August 2016: International Journal of Nursing Practice
E K Badenoch-Jones, T Lincoln
There is a growing body of work examining whether a palatal injection is necessary for the extraction of maxillary teeth with contemporary local anaesthetics. The available literature was reviewed systematically by conducting a search of the PubMed, EMBASE, and Cochrane CENTRAL databases for trials examining outcomes of maxillary tooth extraction where buccal injection of local anaesthetic only was used for one or more test groups. The selected studies were reviewed for study type, sample size, quality, participant characteristics and methodology, outcome variables, and findings...
October 2016: International Journal of Oral and Maxillofacial Surgery
Anje J Scarfe, Susanne Schuhmann-Hingel, Joanna K Duncan, Ning Ma, Yasoba N Atukorale, Alun L Cameron
A continuous paravertebral block is used when pain relief is required beyond the duration of a single-injection paravertebral block. Surgical procedures requiring an incision into the pleural cavity are some of the most painful procedures postoperatively and, if not managed appropriately, can lead to chronic pain. The current gold standard for post-cardiothoracic surgery pain management is epidural analgesia, which has contraindications, a failure rate of up to 12% and risk of complications such as epidural abscess and spinal haematoma...
May 30, 2016: European Journal of Cardio-thoracic Surgery
Hsiao-Chi Nieh, Shu-Fen Su
AIM: The aim of this study was to evaluate the effectiveness of forced-air warming for preventing perioperative hypothermia. BACKGROUND: Perioperative hypothermia commonly occurs in patients receiving anaesthesia during surgeries. However, the effectiveness of warming systems requires verification. DESIGN: Systematic review incorporating meta-analysis. DATA SOURCES: We searched OVID, PubMed, Cochrane Library, Medline, CINAHL, CETD and CEPS databases (2001-2015) for randomized controlled trials published in English and Chinese...
October 2016: Journal of Advanced Nursing
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