M R Tramer

..Randomized trials have reached different conclusions as to whether magnesium is a useful adjuvant to postoperative analgesia...

..We set out to estimate the proportion of abstracts submitted to meetings that are eventually published as full reports, and to explore factors that are associated with meeting acceptance and successful publication...

..Better treatment is likely to have reduced mortality. An estimate of mortality is helpful in explaining to patients the risks of therapy, especially with NSAIDs...

..The authors reviewed efficacy and safety data for ondansetron for preventing postoperative nausea and vomiting (PONV)...

..The lack of relevant paediatric PONV data remains a major drawback and is highly unsatisfactory. Hopefully, future research will further improve the control of PONV not only in adults but also in children...

..Unless more reliable risk scores are developed, aggressive treatment of established PONV symptoms may be more useful and more cost-effective than prophylaxis for many patients...

..Previous studies have suggested that magnesium may be a useful adjuvant to postoperative analgesia...

..To review the efficacy of pharmacological prevention of serious reactions to iodinated contrast media...

..Absolute risk reduction and number needed to treat should become standard summary estimates in randomized controlled trials...

..The optimal dose of lignocaine to prevent magnesium-induced aching of the treated limb needs to be established. Bier's block with magnesium-lignocaine may provide a possible treatment alternative in these patients...

..For patients who are identified as high-risk patients, all measurements should be simultaneously initiated (multimodal anti-emesis)...

..There is no evidence of dose-responsiveness for efficacy with droperidol, but the risk of adverse effects is dose-dependent. There is a lack of evidence for other antiemetics...

..On average 1 in 1200 patients taking NSAIDs for at least 2 months will die from gastroduodenal complications who would not have died had they not taken NSAIDs. This extrapolates to about 2000 deaths each year in the UK...

..To quantify the antiemetic efficacy and adverse effects of cannabis used for sickness induced by chemotherapy...

..Oculocardiac reflex (OCR) and postoperative vomiting are major complications of paediatric strabismus surgery...

..Morphine-sparing is more pronounced after abdominal than after cardiac-thoracic surgery. Respiratory depression remains a major safety concern...

..Intravenous lidocaine is increasingly used in surgical patients. As it has neuromuscular blocking effects, we tested the impact of an intravenous lidocaine infusion on the time course of a rocuronium-induced neuromuscular block...

..A previously published study suggested that pre-treatment with magnesium sulphate (MgSO(4)) had no impact on the speed of onset of rocuronium-induced neuromuscular block. We set out to verify this assumption...

..05 (0.01-0.25)]. In conclusion, oral magnesium does not prevent AMS. In subjects with established AMS, intravenous magnesium reduces the severity of symptoms to some extent, but this effect is of no clinical importance...

..Implications: The duration of adequate sedation time is longer with propofol compared with midazolam. In postoperative patients with sedation < 36 h, weaning is faster with propofol...

..To quantify efficacy and harm of pharmacological prevention of acute mountain sickness...

..The usefulness of intravenous patient-controlled analgesia (PCA) with opioids for postoperative analgesia is not well defined...

..Credible estimates of clinical efficacy are only likely to come from large trials or from pooling multiple trials of conventional (small) size...

..04. The hypnotic efficacy of propofol is reduced when used at low effect-site concentrations in smokers. This phenomenon may have some impact on the management of smokers undergoing sedation using target controlled infusion systems...

..Propofol-rocuronium is thought to be superior to thiopental-rocuronium for rapid sequence intubation (RSI). The role of the intubation model per se has never been investigated...

..Implementation of guidelines for rational analgesia and sedation would help to reduce patients' length of stay in the intensive care unit...

..The aim of this systematic review is to quantify beneficial and harmful effects of clonidine when used as an adjuvant to intrathecal local anesthetics for surgery...

..These data suggest that in males undergoing elective minor surgery, BDNF plasma concentrations show a specific pattern that is influenced by the anesthetic technique and, possibly, by the duration of surgery...

..In this Review we examine the analytical strengths of, and the main problems encountered by, both systematic reviews and meta-analyses, focusing on how to best assess the validity of each for the practicing clinician...

..e. a multimodal approach including the combination of strong opioids, non-opioid analgesics, and peripheral or neuraxial local anaesthetics that act at different sites of the pain pathways...

..To compare the detection rate of genital human papillomavirus (HPV) infection in self- and physician-obtained samples...

..To examine the efficacy of respiratory physiotherapy for prevention of pulmonary complications after abdominal surgery...

..Dexamethasone is widely used to prevent postoperative nausea and vomiting (PONV) in pediatric tonsillectomy...

..There is evidence that the combination of nonsteroidal antiinflammatory drugs with patient-controlled analgesia morphine offers some advantages over morphine alone...

..Does this mean meta-analyses should be restricted to trials with large sample sizes?..

..The association between the degree of neurological deficit and cardiopulmonary dysfunction in patients with spontaneous subarachnoid hemorrhage (SAH) is poorly understood...

..There is empirical evidence that smokers are less likely to suffer from postoperative nausea and vomiting (PONV). We sought to investigate whether transcutaneus nicotine prevents PONV...

..4). There were no reports on cardiac toxicity. Postoperatively and in gastroenterology, haloperidol is antiemetic, with minimal toxicity. For other clinical settings and for children, valid data are unavailable...

..Jet with lidocaine is effective, but its application is not painless. Costs to achieve one patient with no more than moderate pain (numerical verbal scale < or =3 of 10) on insertion of an IV cannula are $10...

..To confirm this hypothesis, to estimate the prevalence of propofol-related SLP, and to identify patients at risk, data of higher quality are needed...

..s(-1) before compared with 67 +/- 16 cm.s(-1) after rescue medication; P=0.79). MCAv was increased in subjects who received magnesium, but was not affected by exposure to high altitude or by severe AMS...

..There was no difference in patient satisfaction. The optimal antiemetic dose of droperidol is 15-50 micro g/mg of morphine. Larger doses may have more antivomiting efficacy but are likely to be unacceptably sedating...

..To assess whether respiratory physiotherapy prevents pulmonary complications after cardiac surgery...

..49 (95%CI 0.18-12.6), NNH 286. Despite many published randomised trials, the role of ketamine, as a component of perioperative analgesia, remains unclear...

..The most common adverse effect was bradycardia, which occurred in 24.5% of patients receiving a beta adrenergic blocker versus 9.1% of controls (OR 3.76 [95% CI, 2.45-5.77], NNH 6)...

..The ideal ventilation strategy is expected to optimize gas exchange and pulmonary mechanics and to reduce the risk of respiratory complications...

..Our aim was to evaluate both the accuracy of TCD compared with angiography and its usefulness as a screening method in this setting...

..In the specific settings of perioperative medicine the number of systematic reviews has become so important that recommendations for evidenced-based strategies of prevention and therapy can be formulated...

..Dr. Scott Reuben allegedly fabricated data. The authors of the current article examined the impact of Reuben reports on conclusions of systematic reviews...

..However, dose responsiveness and adverse effect profile remain unclear, and the role of nefopam as part of multimodal analgesia needs to be established. Data in children are lacking...

..Since the EEG is changing with increasing age, we investigated the impact of advanced age on BIS, SE, and RE indices during induction...

..Authorship was an unreliable criterion. Duplicates were published in journals with similar impact factors and were cited as frequently as main articles...

..For silver-impregnated collagen cuffs, there is evidence of lack of effect for both short- and long-term insertion...

..The risk of catheter colonization is not decreased. Although these conclusions are based on limited data, single-lumen catheters should be used whenever feasible...