scholarly journals Perineural Dexamethasone to Improve Postoperative Analgesia with Peripheral Nerve Blocks: A Meta-Analysis of Randomized Controlled Trials

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Gildasio S. De Oliveira ◽  
Lucas J. Castro Alves ◽  
Autoun Nader ◽  
Mark C. Kendall ◽  
Rohit Rahangdale ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Postoperative Analgesia ◽  
Weighted Mean Difference ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Pain Outcomes

Background. The overall effect of perineural dexamethasone on postoperative analgesia outcomes has yet to be quantified. The main objective of this quantitative review was to evaluate the effect of perineural dexamethasone as a nerve block adjunct on postoperative analgesia outcomes. Methods. A systematic search was performed to identify randomized controlled trials that evaluated the effects of perineural dexamethasone as a block adjunct on postoperative pain outcomes in patients receiving regional anesthesia. Meta-analysis was performed using a random-effect model. Results. Nine randomized trials with 760 subjects were included. The weighted mean difference (99% CI) of the combined effects favored perineural dexamethasone over control for analgesia duration, 473 (264 to 682) minutes, and motor block duration, 500 (154 to 846) minutes. Postoperative opioid consumption was also reduced in the perineural dexamethasone group compared to control, −8.5 (−12.3 to −4.6) mg of IV morphine equivalents. No significant neurological symptoms could have been attributed to the use of perineural dexamethasone. Conclusions. Perineural dexamethasone improves postoperative pain outcomes when given as an adjunct to brachial plexus blocks. There were no reports of persistent nerve injury attributed to perineural administration of the drug.

Effects of melatonin supplementation on oxidative stress: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 41 (4) ◽  
Author(s):  
Parivash Ghorbaninejad ◽  
Fatemeh Sheikhhossein ◽  
Farhang Djafari ◽  
Aliyu Jibril Tijani ◽  
Saba Mohammadpour ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Protein Carbonyl ◽  
Considerable Effect ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Total Antioxidant

AbstractObjectivesPrevious studies showed that melatonin supplementation may suppress oxidative stress, however, the results have not been consistent. So, we conducted this meta-analysis to assess the precise relationship between melatonin supplementation and oxidative stress.MethodsPubMed and Scopus were searched for randomized controlled trials that investigated the effect of melatonin supplementation on oxidative stress up to March 2020. Heterogeneity was assessed by Cochran’s Q test and I-square (I2) statistic. Data were pooled using the random effect model and standardized mean difference (SMD) was considered as the summary effect size. Also, standard methods were used for assessment of sensitivity analysis and publication bias.ResultsWe included 15 related articles and our findings indicated that melatonin supplementation significantly increased total antioxidant capacity (TAC) level (SMD: 1.03, 95% CI: 0.24, 1.81, p=0.011) and reduced protein carbonyl (PCO) (SMD: −1.78, 95% CI: −2.97, −0.58, p=0.004) and malondialdehyde (MDA) levels (SMD: −0.94, 95% CI: −1.48, −0.40, p=0.001). Additionally, there was considerable effect on TAC level by using ≥20 mg/d melatonin and in people under 35 years old. MDA level also decreased using dosage of below 20 mg/d and in people ≥35 years old.ConclusionsThe present study showed a promising effect of melatonin administration for reducing MDA, PCO, and increasing TAC levels. However, further studies especially with more attention to PCO level assessment are needed to confirm the findings of the present study in larger samples on different populations.

scholarly journals Different Dosage Regimens of Eptinezumab for the Treatment of Migraine: A Meta-Analysis from Randomized Controlled Trials

2020 ◽  
Author(s):  
Zeya Yan ◽  
Tao Xue ◽  
Shujun Chen ◽  
Xin Wu ◽  
Xingyu Yang ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Neurological Diseases ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Standard Mean Difference ◽  
Significant Efficacy

Abstract BackgroundMigraine is one of the most common neurological diseases around the world and calcitonin gene-related peptide（CGRP）plays an important role in its pathophysiology. Therefore, in the present study, we evaluated the efficacy of monoclonal antibodies blocking the CGRP ligand or receptor in episodic and chronic migraine. ObjectiveThe objective of our study is implementing a meta-analysis to systematically evaluate the efficacy and safety of eptinezumab for the treatment of migraine compared with placebo.MethodWe searched the Medline, Embase, Cochrane Library and Clinicaltrials.gov for randomized controlled trials (RCTs) which were performed to evaluate eptinezumab versus placebo for migraine up to September 2020. The data was assessed by Review Manager 5.3 software. The risk ratio (RR) and standard mean difference (SMD) were analyzed using dichotomous outcomes and continuous outcomes respectively with a random effect model.ResultWe collected 2,739 patients from 4 RCTs: the primary endpoint of efficacy was the change from baseline to week 12 in mean monthly migraine days (MMDs). We found that eptinezumab (30mg，100mg，300mg) led to a significant reduction in MMDs (P=0.0001,P < 0.00001, P < 0.00001) during 12 weeks compared with placebo, especially with 300mg. For the safety, we compared and concluded the treatment emergent adverse events (TEAEs) of the 4 RCTs. This indicated no evident statistical difference between eptinezumab and placebo.ConclusionsIn the present study, we found that eptinezumab is safe and has significant efficacy in the treatment of migraine, especially the dose of 300 mg.

scholarly journals Quadratus lumborum block versus transversus abdominis plane block for postoperative analgesia in patients undergoing abdominal surgeries: A systematic review and meta-analysis of randomized controlled trials

2019 ◽  
Author(s):  
Xiancun Liu ◽  
Tingting Song ◽  
Xuejiao Chen ◽  
Jingjing Zhang ◽  
Conghui Shan ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Abdominal Surgery ◽  
Randomized Controlled Trials ◽  
Postoperative Analgesia ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Tap Block ◽  
Randomized Controlled ◽  
Quadratus Lumborum

Abstract Background Abdominal surgery is common and associated with severe postoperative pain. Transverse abdominal plane (TAP) block is considered an effective means for pain control in such cases. Quadratus lumborum (QL) block is another option for the management of postoperative pain. The aim of this study was to conduct a meta-analysis and thereby evaluate the efficacy and safety of QL block and TAP block for pain management after abdominal surgery. Methods We comprehensively searched PubMed, Embase, EBSCO, the Cochrane Library, Web of Science and CNKI for randomized controlled trials (RCTs) that compared QL block and TAP block for pain management in patients undergoing abdominal surgery. All of the data were screened and evaluated by two researchers. RevMan5.3 was applied to perform the meta-analysis. Results A total of 8 RCTs involving564 patients were included. The meta-analysis showed statistically significant differences between the two groups with respect to postoperative pain scores at 2 hours (standardized mean difference [Std.MD]=-1.76; 95% confidence interval [CI]=-2.63 to -0.89; p<.001), 4 hours (Std.MD=-0.77; 95% CI=-1.36 to -0.18; p=.01),6 hours (Std.MD=-1.24; 95% CI=-2.31 to -0.17; p=.02),12 hours (Std.MD=-0.70; 95% CI=-1.27 to -0.13; p=.02) and 24hours (Std.MD=-0.65; 95% CI=-1.29 to -0.02; p=.04) ; postoperative opioid consumption at 24 h (Std.MD=-1.39; 95% CI=-1.83 to -0.95; p<.001); and duration of postoperative analgesia (Std.MD=2.30; 95% CI=1.85 to 2.75; p<.001). There was no statistically significant difference between the two groups regarding postoperative nausea and vomiting (PONV) incidence (RR=0.55; 95% CI=0.27 to 1.14; p=.11). Conclusion QL block provides better pain management with less opioid consumption than TAP block after abdominal surgery. In addition, there are no differences between TAP block and QL block with respect to PONV.

Pectoral nerve blocks and postoperative pain outcomes after mastectomy: a meta-analysis of randomized controlled trials

2019 ◽  
Vol 44 (10) ◽  
pp. 923-928 ◽  
Author(s):  
Danielle Lovett-Carter ◽  
Mark C Kendall ◽  
Zachary L McCormick ◽  
Edward I Suh ◽  
Alexander D Cohen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Postoperative Analgesia ◽  
Meta Analysis ◽  
Opioid Consumption ◽  
Controlled Trials ◽  
Nerve Blocks ◽  
Randomized Controlled ◽  
Pectoral Nerve

Background and objectivesSeveral studies have evaluated the effect of pectoral nerve blocks to improve postoperative analgesia following breast cancer surgery resulting in contradictory findings. The aim of this study was to examine the effect of Pecs blocks on postoperative analgesia in women following mastectomies.MethodsWe performed a quantitative systematic review in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Articles of randomized controlled trials that compared Pecs block (types I and II) to a control group in patients undergoing mastectomy were included. The primary outcome was total opioid consumption 24 hours after surgery. Secondary outcomes included pain scores and side effects. Meta-analysis was performed using the random effect model.Results7 randomized controlled trials with 458 patients were included in the analysis. The effect of pectoral nerve blocks on postoperative opioid consumption compared with control revealed a significant effect, weighted mean difference (WMD) (95% CI) of -−4.99 (−7.90 to −2.08) mg intravenous morphine equivalents (p=0.001). In addition, postoperative pain compared with control was reduced at 6 hours after surgery: WMD (95% CI) of −0.72 (−1.37 to −0.07), p=0.03, and at 24 hours after surgery: WMD (95% CI) of −0.91 (−1.81 to −0.02), p=0.04.DiscussionThis quantitative analysis of randomized controlled trials demonstrates that the Pecs block is effective for reducing postoperative opioid consumption and pain in patients undergoing mastectomy. The Pecs block should be considered as an effective strategy to improve analgesic outcomes in patients undergoing mastectomies for breast cancer treatment.

scholarly journals The effect of magnesium added to bupivacaine for arthroscopy: a meta-analysis of randomized controlled trials

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Weineng Xiang ◽  
Lin Jiang ◽  
Langtao Shi ◽  
Chengming Jiang ◽  
Yun Zhou ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Magnesium Sulphate ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Analgesic Efficacy ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Analgesic Requirement ◽  
Randomized Controlled

Abstract Introduction The analgesic efficacy of magnesium sulphate added to bupivacaine for arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the efficacy of magnesium sulphate in combination with bupivacaine for arthroscopy. Methods We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through July 2020 for randomized controlled trials (RCTs) assessing the effect of magnesium sulphate plus bupivacaine versus bupivacaine for arthroscopy. This meta-analysis is performed using the random-effect model. Results Six RCTs were included in the meta-analysis. Overall, compared with bupivacaine for arthroscopy, combination analgesia using magnesium plus bupivacaine was associated with significantly prolonged duration of analgesia (SMD=0.93; 95% CI=0.27 to 1.60; P=0.006) and first time to analgesic requirement (SMD=196.57; 95% CI=13.90 to 379.24; P=0.03), reduced pain scores (SMD=-1.71; 95% CI=-2.96 to -0.46; P=0.007) and analgesic consumption (SMD=-1.04; 95% CI=-1.49 to -0.60; P<0.00001), but showed no remarkable influence on nausea or vomiting (OR=1.54; 95% CI=0.60 to 3.97; P=0.37). Conclusions Magnesium sulphate added to bupivacaine may significantly improve the analgesic efficacy for arthroscopy.

scholarly journals The analgesic evaluation of gabapentin for arthroscopy: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Feiri Huang ◽  
Hifan Yang ◽  
Zhongliang Su ◽  
Xiaosheng Gao
Keyword(s):  
Randomized Controlled Trials ◽  
Pain Control ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Pain Scores

Abstract Introduction: The efficacy of gabapentin for pain management of arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of gabapentin versus placebo on the postoperative pain intensity of arthroscopy. Methods We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through April 2020 for randomized controlled trials (RCTs) assessing the effect of gabapentin versus placebo on pain control of arthroscopy. This meta-analysis is performed using the random-effect model. Results Five RCTs are included in the meta-analysis. Overall, compared with control group for arthroscopy, gabapentin remarkably decreases pain scores at 24 h (Std. MD=-0.68; 95% CI=-1.15 to -0.02; P = 0.21), analgesic consumption (Std. MD=-18.24; 95% CI=-24.61 to -11.88; P < 0.00001), nausea and vomiting (OR = 0.42; 95% CI = 0.21 to 0.84; P = 0.01), but has no obvious influence on pain scores at 6 h (Std. MD=-1.30; 95% CI=-2.92 to 0.31; P = 0.11) or dizziness (OR = 1.12; 95% CI = 0.56 to 2.24; P = 0.75). Conclusions Gabapentin is effective for pain control after arthroscopy.

The Effects of Folate Supplementation on Diabetes Biomarkers Among Patients with Metabolic Diseases: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2018 ◽  
Vol 50 (02) ◽  
pp. 93-105 ◽  
Author(s):  
Maryam Akbari ◽  
Reza Tabrizi ◽  
Kamran B. Lankarani ◽  
Seyed Taghi Heydari ◽  
Maryam Karamali ◽  
...  
Keyword(s):  
Randomized Controlled Trials ◽  
Metabolic Diseases ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Model Assessment ◽  
Folate Supplementation ◽  
Randomized Controlled

AbstractAlthough several studies have evaluated the effect of folate supplementation on diabetes biomarkers among patients with metabolic diseases, findings are inconsistent. This review of randomized controlled trials (RCTs) was performed to summarize the evidence on the effects of folate supplementation on diabetes biomarkers among patients with metabolic diseases. Randomized-controlled trials (RCTs) published in PubMed, EMBASE, Web of Science and Cochrane Library databases up to 1 September 2017 were searched. Two review authors independently assessed study eligibility, extracted data, and evaluated risk of bias of included studies. Heterogeneity was measured with a Q-test and with I2 statistics. Data were pooled by using the fix or random-effect model based on the heterogeneity test results and expressed as standardized mean difference (SMD) with 95% confidence interval (CI). A total of sixteen randomized controlled trials involving 763 participants were included in the final analysis. The current meta-analysis showed folate supplementation among patients with metabolic diseases significantly decreased insulin (SMD –1.28; 95% CI, –1.99, –0.56) and homeostasis model assessment of insulin resistance (HOMA-IR) (SMD –1.28; 95% CI, –1.99, –0.56). However, folate supplementation did not affect fasting plasma glucose (FPG) (SMD –0.30; 95% CI, –0.63, 0.02) and hemoglobin A1C (HbA1c) (SMD –0.29; 95% CI, –0.61, 0.03). The results of this meta-analysis study demonstrated that folate supplementation may result in significant decreases in insulin levels and HOMA-IR score, but does not affect FPG and HbA1c levels among patients with metabolic diseases.

scholarly journals Meta-Analysis of Randomized Controlled Trials on Androgens versus Erythropoietin for Anaemia of Chronic Kidney Disease: Implications for Developing Countries

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
B. Adamu ◽  
S. M. Ma'aji ◽  
P. J. Erwin ◽  
I. M. Tleyjeh
Keyword(s):  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
A Priori ◽  
Random Effect ◽  
Random Effect Model ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Relative Risks

Androgens which are relatively cheap were used in the treatment of anaemia in dialysis patients before the advent of Erythropoietin (EPO). However, there are concerns about their efficacy and side effects.Aims. To examine the efficacy and harms of androgens for the treatment of anaemia of chronic kidney disease (CKD) compared to EPO.Settings and Design. A systematic review and meta-analysis using an a priori protocol.Methods and Materials. We searched several databases for randomized controlled trials using the key terms anaemia, chronic kidney disease, and androgens, without language restrictions. We also searched reference lists of relevant articles.Statistical Analysis Used. Data was analyzed using Review manger 5 software. We summarized treatment effects as relative risks and mean differences, with 95% confidence intervals using a random-effect model. We tested for heterogeneity with Chi2and theI2statistics.Results. We identified four eligible trials involving 114 participants, majority (83.33%) of whom were males, mostly over 50 years of age. The pooled difference in mean haemoglobin between the nandrolone and EPO arms at the end of the trials was −0.11 (CI −0.80 to 0.58) which is not statistically significant.Conclusions. This meta-analysis revealed no difference between nandrolone and EPO for the treatment of anaemia of CKD in men over 50 years. Therefore, nandrolone can be used for the treatment of anaemia of CKD in this category of patients, in resource-limited countries. However, further studies are needed to determine the long-term safety of nandrolone in men over 50 years old, as well as its effectiveness and safety in females in general, and males less than 50 years of age.

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