scholarly journals Dexmedetomidine Use in the Pediatric Postoperative Patient with Emergence Agitation: A Systemic Review

2020 ◽  
Author(s):  
Elizabeth Kittredge
Keyword(s):  
Systematic Review ◽  
Critical Appraisal ◽  
Pediatric Patients ◽  
Meta Analysis ◽  
Inhibitory Neurons ◽  
Systemic Review ◽  
Emergence Agitation ◽  
Postoperative Patient ◽  
Comprehensive Literature Review ◽  
Randomized Control

Emergence Agitation is a frequent complication in the pediatric postoperative population; with up to 80% incidence (Stamper, Hawks, Taicher, Bonta & Brandon, 2014). These patients will present with crying, overexcitement, thrashing, agitation and is seen within the first 30 minutes of emergence of general anesthesia (Mohkamkar, Farhoudie, Alam-Sahebpour, Mousavi, Khani & Shamomhammadi, 2014). Dexmedetomidine, a selective alpha 2 agonist, reduces norepinephrine output, initiates firing of inhibitory neurons such as the gama aminobutric acid system and reduces release of substance P and other catecholamines. These actions provide the patient with sedation, analgesia, and anesthesia (Nagelhout & Elisha, 2018). Due to the mechanism of action of dexmedetomidine, bradycardia and hypotension have been seen in pediatric patients. This has put a limit on the use of dexmedetomidine in this population. The purpose of this systematic review was to examine efficacy and side effects of various doses of dexmedetomidine to prevent emergence agitation in the pediatric postoperative patient. A comprehensive literature review was completed with the use of CINAHL Plus with full text, PubMed and Google Scholar. Preferred Reporting Items for Systematic Meta-Analysis (PRISMA), was used as guidelines to assist in proper identification of articles. The quality and critical appraisal of each randomized control trial was determined by the Critical Appraisal for Summaries of Evidence (CASE) worksheet. A cross study analysis table was created and used to analyze results of all studies. The findings of this systematic review determined dexmedetomidine was beneficial in emergence agitation prevention. Dexmedetomidine dosed at 0.5 mcg/kg-1mcg IV boluses and 1 mcg/kg – 2 mcg/kg intranasal sprays provided good relief with limited adverse effects.

scholarly journals Optimal Application of Forced Air Warming to Prevent Peri-Operative Hypothermia during Abdominal Surgery: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (5) ◽  
pp. 2517
Author(s):  
Yoonyoung Lee ◽  
Kisook Kim
Keyword(s):  
Systematic Review ◽  
Abdominal Surgery ◽  
Critical Appraisal ◽  
Meta Analysis ◽  
Upper Body ◽  
Cochrane Library ◽  
Randomized Controlled ◽  
Forced Air Warming ◽  
Forced Air ◽  
Full Body

Patients who undergo abdominal surgery under general anesthesia develop hypothermia in 80–90% of the cases within an hour after induction of anesthesia. Side effects include shivering, bleeding, and infection at the surgical site. However, the surgical team applies forced air warming to prevent peri-operative hypothermia, but these methods are insufficient. This study aimed to confirm the optimal application method of forced air warming (FAW) intervention for the prevention of peri-operative hypothermia during abdominal surgery. A systematic review and meta-analysis were conducted to provide a synthesized and critical appraisal of the studies included. We used PubMed, EMBASE, CINAHL, and Cochrane Library CENTRAL to systematically search for randomized controlled trials published through March 2020. Twelve studies were systematically reviewed for FAW intervention. FAW intervention effectively prevented peri-operative hypothermia among patients undergoing both open abdominal and laparoscopic surgery. Statistically significant effect size could not be confirmed in cases of only pre- or peri-operative application. The upper body was the primary application area, rather than the lower or full body. These findings could contribute detailed standards and criteria that can be effectively applied in the clinical field performing abdominal surgery.

A preliminary systematic review and meta-analysis on the effects of heart rate variability biofeedback on heart rate variability and respiration of athletes

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jeffrey Cayaban Pagaduan ◽  
Yung-Sheng Chen ◽  
James William Fell ◽  
Sam Shi Xuan Wu
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Web Of Science ◽  
Meta Analysis ◽  
Academic Research ◽  
Experimental Studies ◽  
Quantitative Review ◽  
Heart Rate Variability Biofeedback ◽  
Randomized Control

Abstract To date, there is no quantitative review examining the influence of heart rate variability biofeedback (HRV BFB) on the athlete population. Such an undertaking may provide valuable information on the autonomic and respiration responses of athletes when performing HRV BFB. Thus, purpose of this preliminary systematic review and meta-analysis on the effects of HRV BFB on HRV and respiration of athletes. Searches of Springerlink, SportDiscus, Web of Science, PROQUEST Academic Research Library, Google Scholar, and ScienceDirect were conducted for studies that met the following criteria: (1) experimental studies involving athletes that underwent randomized control trial; (2) availability of HRV BFB as a treatment compared with a control (CON)/placebo (PLA); (3) any pre and post HRV variable and/or breathing frequency as dependent variable/s; and, (4) peer-reviewed articles written in English. Four out of 660 studies involving 115 athletes (25 females and 90 males) ages 16–30 years old were assessed in this review. Preliminary findings suggest the promising ability of HRV BFB to improve respiratory mechanics in athlete population. More work is needed to determine the autonomic modulatory effect of HRV BFB in athletes.

Trauma-Sensitive Yoga Interventions and Posttraumatic Stress and Depression Outcomes Among Women: A Systematic Review and Analysis of Randomized Control Trials

2021 ◽  
Author(s):  
Ashleigh Kysar-Moon ◽  
Matthew Vasquez ◽  
Tierra Luppen
Keyword(s):  
Systematic Review ◽  
Posttraumatic Stress ◽  
Traumatic Event ◽  
Meta Analysis ◽  
Depression Symptoms ◽  
Randomized Control Trials ◽  
Methodological Rigor ◽  
History Of ◽  
Randomized Control ◽  
Analysis Models

Abstract Research shows that most people experience at least one traumatic event in their lifetimes, and between 6% and 8% of those with a history of trauma will develop posttraumatic stress disorder (PTSD) and/or related mental health conditions. Women face a greater threat of trauma exposure and have a higher risk of PTSD and depression than men. Trauma-Sensitive Yoga (TSY), a body-based adjunctive therapy, has shown potential in several studies as an effective method for reducing PTSD and depression symptoms. However, existing research and systematic reviews vary widely in their methodological rigor and comparison samples. Thus, in this systematic review we examined the effectiveness of TSY among women with a history of trauma and depression who had participated in randomized control trials with clear control and experimental groups. Findings in fixed- and mixed-effects meta-analysis models suggest marginally significant to no effects of TSY on PTSD and depression outcomes. Our systematic review highlights critical questions and significant gaps in the existing literature about the rationale and best practices of TSY intervention duration.

Sign in / Sign up

Export Citation Format

Share Document