scholarly journals Effect of perioperative goal-directed hemodynamic therapy on postoperative recovery following major abdominal surgery—a systematic review and meta-analysis of randomized controlled trials

Critical Care ◽  
2017 ◽  
Vol 21 (1) ◽  
Author(s):  
Yanxia Sun ◽  
Fang Chai ◽  
Chuxiong Pan ◽  
Jamie Lee Romeiser ◽  
Tong J. Gan
Medicines ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 73
Author(s):  
Joanna Dietzel ◽  
Mike Cummings ◽  
Kevin Hua ◽  
Klaus Hahnenkamp ◽  
Benno Brinkhaus ◽  
...  

Background: Preoperative anxiety causes profound psychological and physiological reactions that may lead to a worse postoperative recovery, higher intensity of acute and persistent postsurgical pain and impaired quality of life in the postoperative period. Previous randomized controlled trials (RCTs) suggest that auricular acupuncture (AA) is safe and effective in the treatment of preoperative anxiety; however there is a lack of systematic evidence on this topic. Therefore, this protocol was developed following the PRISMA guidelines to adequately evaluate the existing literature regarding the value of AA for the reduction in anxiety in patients in a preoperative setting, compared to other forms of acupuncture, pharmacological, or no control interventions and measured with questionnaires regarding anxiety and fear. Methods: The following databases will be searched: MEDLINE (PubMed), EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science, and Scopus Database. RCTs will be included if an abstract is available in English. Data collection and analysis will be conducted by two reviewers independently. Quality and risk assessment of included studies will be done using the Cochrane 5.1.0 handbook criteria and meta-analysis of effectiveness and symptom scores will be conducted using the statistical software RevMan V.5.3. Conclusions: This systematic review will evaluate the efficacy and safety of AA for preoperative anxiety. Since all data used in this systematic review and meta-analysis have been published, this review does not require ethical approval. The results may be published in a peer-reviewed journal or be presented in relevant conferences. Registration number: PROSPERO ID CRD42020.


2021 ◽  
Author(s):  
Yu Xiang Tan ◽  
Miny Samuel ◽  
Ning Qi Pang

Abstract Introduction Multimodal prehabilitation has been touted as a potential strategy to better prepare our elderly and frail patients for major surgery. While randomized controlled trials and systematic reviews have been done to investigate the effect of prehabilitation on various surgical cohorts, most of these studies have focused on single modality prehabilitation and without an emphasis on the elderly. This systematic review aims to assess the effect of a multimodal prehabilitation program on elderly patients undergoing major abdominal surgery. MethodsThis protocol has been written according to the PRISMA-P statement and is registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number 250281). MEDLINE, EMBASE, CENTRAL, CINAHL and PsychINFO databases will be searched. Only randomized controlled trials with an average study population age ≥65 that has undergone major abdominal operation with at least two components (physical, nutritional, psychological) of prehabilitation will be included. Clinical outcomes that will be collected include post-operative morbidity and mortality, length of stay, 30-day readmission and peri-operative 6-minute walking distance. The risk of bias in included studies will be assessed. Data will be pooled where possible. DiscussionThis systematic review will evaluate and establish the effectiveness of multimodal prehabilitation for the elderly, who represents the group of patients most likely to benefit from prehabilitation. This review with its focus on the elderly will provide us with fresh insight into the utility of prehabilitation that will better inform policy makers in its implementation.PROSPERO Registration: On 20/04/2021, ID 250281


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