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Type of anaesthesia for acute ischaemic stroke endovascular treatment
CONCLUSIONS: In early outcomes, general anaesthesia improves target artery revascularisation compared to non-general anaesthesia with moderate-certainty evidence. General anaesthesia may improve adverse events (haemodynamic instability) compared to non-general anaesthesia with low-certainty evidence. We found no evidence of a difference in neurological impairment, stroke-related mortality, all intracranial haemorrhage and haemodynamic instability adverse events between groups with low-certainty evidence. We are uncertain whether general anaesthesia improves functional outcomes and time to revascularisation because the cert...
Source: Cochrane Database of Systematic Reviews - July 20, 2022 Category: General Medicine Authors: Renato Tosello Rachel Riera Giuliano Tosello Caroline Nb Clezar Jorge E Amorim Vladimir Vasconcelos Benedito B Joao Ronald Lg Flumignan Source Type: research

Local versus general anaesthesia for carotid endarterectomy
CONCLUSIONS: The incidence of stroke and death were not convincingly different between local and general anaesthesia for people undergoing carotid endarterectomy. The current evidence supports the choice of either approach. Further high-quality studies are still needed as the evidence is of limited reliability.PMID:34642940 | DOI:10.1002/14651858.CD000126.pub5
Source: Cochrane Database of Systematic Reviews - October 13, 2021 Category: General Medicine Authors: Amaraporn Rerkasem Saritphat Orrapin Dominic Pj Howard Sothida Nantakool Kittipan Rerkasem Source Type: research

Local versus general anaesthesia for carotid endarterectomy.
CONCLUSIONS: The proportion of patients who had a stroke or died within 30 days of surgery did not differ significantly between the two types of anaesthetic techniques used during carotid endarterectomy. This systematic review provides evidence to suggest that patients and surgeons can choose either anaesthetic technique, depending on the clinical situation and their own preferences. PMID: 24353155 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - December 19, 2013 Category: Journals (General) Authors: Vaniyapong T, Chongruksut W, Rerkasem K Tags: Cochrane Database Syst Rev Source Type: research

Routine or selective carotid artery shunting for carotid endarterectomy (and different methods of monitoring in selective shunting)
CONCLUSIONS: This review concluded that the data available were too limited to either support or refute the use of routine or selective shunting in carotid endarterectomy when performed under general anaesthesia. Large-scale randomised trials of routine shunting versus selective shunting are required. No method of monitoring in selective shunting has been shown to produce better outcomes.PMID:35731671 | DOI:10.1002/14651858.CD000190.pub4
Source: Cochrane Database of Systematic Reviews - June 22, 2022 Category: General Medicine Authors: Busaba Chuatrakoon Sothida Nantakool Amaraporn Rerkasem Saritphat Orrapin Dominic Pj Howard Kittipan Rerkasem Source Type: research

Perioperative beta-blockers for preventing surgery-related mortality and morbidity.
CONCLUSIONS: According to our findings, perioperative application of beta-blockers still plays a pivotal role in cardiac surgery , as they can substantially reduce the high burden of supraventricular and ventricular arrhythmias in the aftermath of surgery. Their influence on mortality, AMI, stroke, congestive heart failure, hypotension and bradycardia in this setting remains unclear.In non-cardiac surgery, evidence from low risk of bias trials shows an increase in all-cause mortality and stroke with the use of beta-blockers. As the quality of evidence is still low to moderate, more evidence is needed before a definitive co...
Source: Cochrane Database of Systematic Reviews - September 18, 2014 Category: Journals (General) Authors: Blessberger H, Kammler J, Domanovits H, Schlager O, Wildner B, Azar D, Schillinger M, Wiesbauer F, Steinwender C Tags: Cochrane Database Syst Rev Source Type: research

Cooling for cerebral protection during brain surgery.
CONCLUSIONS: We found no evidence that the use of induced hypothermia was associated with a significant reduction in mortality or severe neurological disability, or an increase in harm in patients undergoing neurosurgery. PMID: 25626888 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - February 3, 2015 Category: Journals (General) Authors: Galvin IM, Levy R, Boyd JG, Day AG, Wallace MC Tags: Cochrane Database Syst Rev Source Type: research

Perioperative beta-blockers for preventing surgery-related mortality and morbidity.
CONCLUSIONS: According to our findings, perioperative application of beta-blockers still plays a pivotal role in cardiac surgery, as they can substantially reduce the high burden of supraventricular and ventricular arrhythmias in the aftermath of surgery. Their influence on mortality, AMI, stroke, congestive heart failure, hypotension and bradycardia in this setting remains unclear.In non-cardiac surgery, evidence shows an association of beta-blockers with increased all-cause mortality. Data from low risk of bias trials further suggests an increase in stroke rate with the use of beta-blockers. As the quality of evidence is...
Source: Cochrane Database of Systematic Reviews - March 13, 2018 Category: General Medicine Authors: Blessberger H, Kammler J, Domanovits H, Schlager O, Wildner B, Azar D, Schillinger M, Wiesbauer F, Steinwender C Tags: Cochrane Database Syst Rev Source Type: research

Remote ischaemic preconditioning versus no remote ischaemic preconditioning for vascular and endovascular surgical procedures
CONCLUSIONS: Overall, compared with no RIPC, RIPC probably leads to little or no difference in perioperative mortality, myocardial infarction, renal impairment, stroke, hospital stay, and operating time, and may lead to little or no difference in limb loss in people undergoing elective major vascular and endovascular surgery. Adequately powered and designed randomised studies are needed, focusing in particular on the clinical endpoints and patient-centred outcomes.PMID:36645250 | DOI:10.1002/14651858.CD008472.pub3
Source: Cochrane Database of Systematic Reviews - January 16, 2023 Category: General Medicine Authors: Fuxiang Liang Shidong Liu Guangzu Liu Hongxu Liu Bing Song Liang Yao Qi Wang Source Type: research

Nitrous oxide-based techniques versus nitrous oxide-free techniques for general anaesthesia.
CONCLUSIONS: Given the evidence from this Cochrane review, the avoidance of nitrous oxide may be reasonable in participants with pre-existing poor pulmonary function or at high risk of postoperative nausea and vomiting. Since there are eight studies awaiting classification, selection bias may exist in our systematic review. PMID: 26545294 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - November 6, 2015 Category: Journals (General) Authors: Sun R, Jia WQ, Zhang P, Yang K, Tian JH, Ma B, Liu Y, Jia RH, Luo XF, Kuriyama A Tags: Cochrane Database Syst Rev Source Type: research

Fast-track cardiac care for adult cardiac surgical patients.
CONCLUSIONS: Low-dose opioid-based general anaesthesia and time-directed extubation protocols for fast-track interventions have risks of mortality and major postoperative complications similar to those of conventional (not fast-track) care, and therefore appear to be safe for use in patients considered to be at low to moderate risk. These fast-track interventions reduced time to extubation and shortened length of stay in the intensive care unit but did not reduce length of stay in the hospital. PMID: 27616189 [PubMed - as supplied by publisher]
Source: Cochrane Database of Systematic Reviews - September 11, 2016 Category: Journals (General) Authors: Wong WT, Lai VK, Chee YE, Lee A Tags: Cochrane Database Syst Rev Source Type: research

Epidural therapy for the treatment of severe pre-eclampsia in non labouring women.
CONCLUSIONS: Currently, there is insufficient evidence from randomised controlled trials to evaluate the effectiveness, safety or cost of using epidural therapy for treating severe pre-eclampsia in non-labouring women.High-quality randomised controlled trials are needed to evaluate the use of epidural agents as therapy for treatment of severe pre-eclampsia. The rationale for the use of epidural is well-founded. However there is insufficient evidence from randomised controlled trials to show that the effect of epidural translates into improved maternal and fetal outcomes. Thus, there is a need for larger, well-designed stud...
Source: Cochrane Database of Systematic Reviews - November 28, 2017 Category: General Medicine Authors: Ray A, Ray S Tags: Cochrane Database Syst Rev Source Type: research

Neuraxial anaesthesia for lower-limb revascularization.
CONCLUSIONS: Available evidence from included trials that compared neuraxial anaesthesia with general anaesthesia was insufficient to rule out clinically important differences for most clinical outcomes. Neuraxial anaesthesia may reduce pneumonia. No conclusions can be drawn with regard to mortality, myocardial infarction and rate of lower-limb amputation, or less common outcomes. PMID: 23897485 [PubMed - in process]
Source: Cochrane Database of Systematic Reviews - August 3, 2013 Category: Journals (General) Authors: Barbosa FT, Jucá MJ, Castro AA, Cavalcante JC Tags: Cochrane Database Syst Rev Source Type: research

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