Use of Laser in Sleep Disorders: A Review on Low Laser Uvulopalatoplasty

Study Objective. The objective of this study is to find the effectiveness of the low laser therapy on uvulopalatoplasty/soft palate in sleep apnea patients and snoring. Also, this study aims to touch base on the effectiveness of the Er:YAG and combined use of Er:YAG and Nd:YAG lasers for the uvulopalatoplasty. Methods. A comprehensive and systematic literature review was conducted using PubMed, Google Scholar, Cochrane Central Register of Controlled Trials, Embase, Web of Science, the US National Institutes of Health Trials Registry, WHO Library, and Medline. The search strategies were developed to cover publications from January 2010 through March 2020. The past 10 years of the search were performed to report the data following systematic review and meta-analysis protocol (PRISMA-P) 2015 statement. Results. With the help of keywords, the total number of abstracts identified was 946. These abstracts were further reviewed as per inclusion and exclusion criteria, and 106 abstracts were identified to match the selection criteria. Further review of full articles resulted in 12 articles that matched the inclusion criteria for the study. Conclusion. Er:YAG can be a good alternative and least invasive therapy for managing snoring and obstructive sleep apnea. Er:YAG therapy is considered to nonsurgical intervention with minimum side effects and can be performed chairside.

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Validation of the STOP-Bang questionnaire for screening of obstructive sleep apnea in the general population and commercial drivers: a systematic review and meta-analysis

Sleep And Breathing ◽

10.1007/s11325-021-02299-y ◽

2021 ◽

Author(s):

Lina Chen ◽

Bianca Pivetta ◽

Mahesh Nagappa ◽

Aparna Saripella ◽

Sazzadul Islam ◽

...

Keyword(s):

Systematic Review ◽

Obstructive Sleep Apnea ◽

Sleep Apnea ◽

General Population ◽

Meta Analysis ◽

Health Concern ◽

Cochrane Central Register ◽

Effective Manner ◽

Obstructive Sleep ◽

Commercial Drivers

Abstract Purpose Obstructive sleep apnea (OSA) is a critical occupational health concern, but is often undiagnosed in the general population and commercial drivers. The STOP-Bang questionnaire is a simple, reliable tool to screen for OSA, which could improve public health in a cost-effective manner. The objective of this systematic review and meta-analysis is to assess the validity of the STOP-Bang questionnaire to detect OSA in these key populations. Methods We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, PsycINFO, Journals @ Ovid, Web of Science, Scopus, and CINAHL for relevant articles from 2008 to March 2020. The quality of studies was appraised using Cochrane Methods criteria. To calculate pooled predictive parameters, we created 2 × 2 contingency tables and performed random-effects meta-analyses. Results Of 3871 citations, five studies that evaluated STOP-Bang in the general population (n = 8585) and two in commercial drivers (n = 185) were included. In the general population, prevalence of all OSA (AHI ≥ 5), moderate-to-severe OSA (AHI ≥ 15), and severe OSA (AHI ≥ 30) was 57.6%, 21.3%, and 7.8% respectively. In commercial drivers, the prevalence of moderate-to-severe OSA was 37.3%. The trends of high sensitivity and negative predictive value of a STOP-Bang score ≥ 3 illustrates that the questionnaire helps detect and rule out clinically significant OSA in the general population and commercial drivers. Conclusion This meta-analysis demonstrates that the STOP-Bang questionnaire is a valid and effective screening tool for OSA in the general population and commercial drivers. Trial registration PROSPERO No. CRD42020200379; 08/22/2020

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Pharmacological interventions for preventing rocuronium-induced pain responses and rocuronium-induced withdrawal responses: a systematic review and network meta-analysis

10.22514/sv.2020.16.0108 ◽

2020 ◽

Keyword(s):

Systematic Review ◽

General Anesthesia ◽

Meta Analysis ◽

Controlled Trials ◽

Pain Response ◽

Cochrane Central Register ◽

Pharmacological Interventions ◽

Study Objective ◽

Central Register ◽

Withdrawal Response

Study objective: Rocuronium is widely used during the induction of general anesthesia. However, it is associated with rocuronium-induced pain response, which can appear as a rocuronium-induced withdrawal response. The purpose of this study was to compare the effectiveness of pharmacological interventions in preventing rocuronium-induced pain response and rocuronium-induced withdrawal response using a network meta-analysis. Design: Systematic review and network meta-analysis (NMA) of RCTs. Setting: Pharmacological interventions to prevent rocuronium-induced pain response and rocuronium-induced pain response and rocuronium-induced withdrawal. Data sources: MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar were systematically searched from its inception until Mar 2020. Methods: We searched multiple databases and extracted randomized controlled trials that compared two or more pharmacological interventions to prevent rocuronium-induced pain response and rocuronium-induced withdrawal response in adult patients who received rocuronium injections for general anesthesia. We conducted network meta-analysis and used surface under the cumulative ranking curve values and rankograms to present the hierarchy of the pharmacological interventions evaluated. Results: In total, 43 studies (5,291 patients) were included in this network meta-analysis and 31 pharmacological interventions were evaluated. The rankogram and cumulative ranking plot showed that oxycodone followed by a combination of lidocaine and sodium bicarbonate (NaHCO3), esmolol, alfentanil, and rocuronium mixed with NaHCO3 had the lowest frequency of rocuronium-induced withdrawal response. In terms of rocuronium-induced pain response, NaHCO3 mixed with rocuronium showed the lowest frequency, followed by a combination of lidocaine and NaHCO3, a combination of lidocaine and nitrous oxide, rocuronium mixed with lidocaine, and lidocaine. Conclusions: Lidocaine administration has been shown to reduce the incidence of rocuronium-induced pain response regardless of the method of injection or drug combination. The combination of lidocaine and NaHCO3 or mixing NaHCO3with rocuronium was effective at reducing rocuronium-induced withdrawal response. In particular, oxycodone was shown to be more effective than the other opioids evaluated and esmolol was also found to be effective at reducing rocuronium-induced withdrawal response.

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The Role of Orthodontics in the Management of Obstructive Sleep Apnea OSA in Children: Systematic Review

10.21203/rs.2.12596/v1 ◽

2019 ◽

Author(s):

Norah Alotaibi ◽

Amani alkhamees ◽

Rabia Bilal

Keyword(s):

Meta Analysis ◽

Oral Appliance ◽

Included Study ◽

Cochrane Central Register ◽

Oral Appliances ◽

Ovid Medline ◽

Study Selection ◽

Central Register ◽

Obstructive Sleep ◽

Reported Data

Abstract Objective review the effectiveness of the use of different orthodontic oral appliance as a primary or adjective treatment of OSAS in children. methods: systemic search of online databases (PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), international Registry Platform for ongoing trials and clinical trails.gov, Embase Ovid, Medline complete) for randomized control trail and non-randomized prospective or retrospective clinical studies published in 2000-2019 that uses oral appliances for the treatment of OSA in children. Study selection was done by 2 reviews. Results 9 studies were included in the review. Based on the limited evidence oral appliances improve OSA in children measured by the reduction of AHI. Due to heterogeneity of included study designs and reported data meta-analysis was not possible. Limitation limited number of studies and study populations. High risk of bias. Conclusion oral appliances show a promising improvement in AHI and should be considered as a treatment option for OSA in children

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