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[PMID]: 29368823 [Au] Autor: Ritchie MK; Ellison M; Ranganathan P; Sizemore D; Vallejo MC [Ti] Título: Aprepitant: A Novel Medicaton in the Prevention of Postoperative Nausea and Vomiting. [So] Source: W V Med J;112(6):20-4, 2016 Nov-Dec. [Is] ISSN: 0043-3284 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Antieméticos/uso terapêutico Morfolinas/uso terapêutico Náusea e Vômito Pós-Operatório/tratamento farmacológico Náusea e Vômito Pós-Operatório/prevenção & controle [Mh] Termos MeSH secundário: Antieméticos/farmacologia Seres Humanos Incidência Morfolinas/farmacologia Náusea e Vômito Pós-Operatório/epidemiologia Medição de Risco Fatores de Risco West Virginia/epidemiologia [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (Antiemetics); 0 (Morpholines); 1NF15YR6UY (aprepitant) [Em] Mês de entrada: 1803 [Cu] Atualização por classe: 180301 [Lr] Data última revisão: 180301 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 180126 [St] Status: MEDLINE

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[PMID]: 29254317 [Au] Autor: Wang J; Ren LJ; Chen XL; Ma L; Chen BJ; Ran SJ; Lu S [Ad] Endereço: Department of General Surgery, The Third Affiliated Hospital of Qiqihar Medical University, Qiqihar, China. [Ti] Título: Quick rehabilitation nursing improves the recovery of colon cancer patients after laparoscopy. [So] Source: J Biol Regul Homeost Agents;31(4):1073-1079, 2017 Oct-Dec. [Is] ISSN: 0393-974X [Cp] País de publicação: Italy [La] Idioma: eng [Ab] Resumo: Colon cancer is a common malignant tumor with particularly high morbidity and mortality. The aim of this study was to compare the effect of quick rehabilitation nursing and routine nursing in postoperative recovery of patients with colon cancer after laparoscopic surgery. Two hundred forty patients with colon cancer were classified into four random groups (A, B, C and D, with 60 patients in each group). All patients underwent surgery to remove the colon tumor by laparoscopy under general anesthesia. Patients in groups A and B received quick rehabilitation nursing for post-surgery recovery. In group C patients, local anesthesia associated with quick rehabilitation nursing for post-surgery recovery was used. Group D was used as control group and the patients were treated based on routine nursing. Time to get out of bed, first bowel movement time and the average time of hospitalisation in group A was lower than group D (p less than 0.05), postoperative leukocyte level as well as the occurrence rate of nausea and vomiting, ankylenteron and pelvic adhesion was decreased in group A compared to group D (p less than 0.05), but the postoperative albumin and total protein level was higher than group D (p less than 0.05). The serum level of C-Reactive Protein (CRP) and interleukin 6 (IL-6) in group A was decreased compared to group D several days after surgery (p less than 0.05); group B had 4 cases of intestinal obstruction after surgery that could be cured through conservative treatment, while group D had 10 cases of intestinal obstruction, 8 of which could be cured through conservative treatment and two needed surgery (p less than 0.05); VAS for pain degree of group C in active state was clearly lower at 1h, 5h, 7h, 15h, 30h and 42h after surgery, and side effects of postoperative analgesia were clearly reduced. Time to get out of bed was obviously decreased, while there was no evident effect on postoperative dosage, chronic pain and complications. Adopting quick rehabilitation nursing can effectively reduce occurrence of complications and postoperative pain, speed up the recovery of gastrointestinal function, shorten the length of stay, and improve patients’ satisfaction. [Mh] Termos MeSH primário: Neoplasias do Colo/reabilitação Obstrução Intestinal/diagnóstico Laparoscopia/reabilitação Dor Pós-Operatória/prevenção & controle Náusea e Vômito Pós-Operatório/prevenção & controle Enfermagem em Reabilitação/métodos [Mh] Termos MeSH secundário: Adulto Idoso Albuminúria/sangue Albuminúria/diagnóstico Albuminúria/fisiopatologia Anestesia Geral/métodos Anestesia Local/métodos Proteína C-Reativa/metabolismo Neoplasias do Colo/sangue Neoplasias do Colo/patologia Neoplasias do Colo/cirurgia Feminino Seres Humanos Interleucina-6/sangue Obstrução Intestinal/sangue Obstrução Intestinal/patologia Obstrução Intestinal/cirurgia Tempo de Internação Masculino Meia-Idade Dor Pós-Operatória/sangue Dor Pós-Operatória/diagnóstico Dor Pós-Operatória/fisiopatologia Satisfação do Paciente/estatística & dados numéricos Náusea e Vômito Pós-Operatório/sangue Náusea e Vômito Pós-Operatório/diagnóstico Náusea e Vômito Pós-Operatório/fisiopatologia Período Pós-Operatório Estudos Prospectivos [Pt] Tipo de publicação: JOURNAL ARTICLE [Nm] Nome de substância: 0 (IL6 protein, human); 0 (Interleukin-6); 9007-41-4 (C-Reactive Protein) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180222 [Lr] Data última revisão: 180222 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171220 [St] Status: MEDLINE

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[PMID]: 29381983 [Au] Autor: Yang Q; Zhang Z; Xin W; Li A [Ti] Título: Preoperative intravenous glucocorticoids can decrease acute pain and postoperative nausea and vomiting after total hip arthroplasty: A PRISMA-compliant meta-analysis. [So] Source: Medicine (Baltimore);96(47):e8804, 2017 Nov. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: A systematic review and meta-analysis of published randomized controlled trials (RCTs) were performed to assess the efficacy and safety of preoperative intravenous glucocorticoids versus controls for the prevention of postoperative acute pain and postoperative nausea and vomiting (PONV) after primary total hip arthroplasty (THA). METHODS: A computer literature search of electronic databases, including PubMed, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, China National Knowledge Infrastructure (CNKI), and China Wanfang database, was conducted to identify the relevant RCTs comparing preoperative intravenous glucocorticoids versus placebos for reducing acute pain and PONV in THA patients. The primary outcomes included the use of the visual analog scale (VAS) with rest or mobilization at 6, 24, 48, and 72 hours and the occurrence of PONV. The secondary outcome was total morphine consumption. We calculated the risk ratio (RR) with a 95% confidence interval (95% CI) for dichotomous outcomes, and the weighted mean difference (WMD) with a 95% CI for continuous outcomes. RESULTS: Pooled data from 7 RCTs (411 THAs) favored preoperative intravenous glucocorticoids against acute pain intensity at 4, 24, and 48 hours (P < .05). There was no significant difference between the VAS with rest or mobilization at 72 hours (P > .05). Subsequently, preoperative intravenous glucocorticoids provided a total morphine-sparing effect of 9.36 mg (WMD = -9.36, 95% CI = -12.33 to -6.38, P = .000). In addition, preoperative intravenous glucocorticoids were associated with a significant reduction of the occurrence of PONV (RR = 0.41, 95% CI = 0.30-0.57, P = .000). CONCLUSION: Intravenous glucocorticoids can decrease early pain intensity and PONV after THA. However, the low number of studies and variation in dosing regimens limits the evidence for its use. Thus, more high-quality RCTs are still needed to identify the optimal drug and the safety of intravenous glucocorticoids. [Mh] Termos MeSH primário: Artroplastia de Quadril/efeitos adversos Glucocorticoides/administração & dosagem Dor Pós-Operatória/tratamento farmacológico Náusea e Vômito Pós-Operatório/tratamento farmacológico Cuidados Pré-Operatórios/métodos [Mh] Termos MeSH secundário: Administração Intravenosa Idoso Analgésicos Opioides/administração & dosagem Artroplastia de Quadril/métodos Feminino Seres Humanos Masculino Meia-Idade Morfina/administração & dosagem Medição da Dor Dor Pós-Operatória/etiologia Náusea e Vômito Pós-Operatório/etiologia Ensaios Clínicos Controlados Aleatórios como Assunto Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Nm] Nome de substância: 0 (Analgesics, Opioid); 0 (Glucocorticoids); 76I7G6D29C (Morphine) [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180208 [Lr] Data última revisão: 180208 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 180201 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008804

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[PMID]: 29222203 [Au] Autor: Enblom A; Johnsson A [Ad] Endereço: Region of Östergötland and Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Sweden. [Ti] Título: Type and frequency of side effects during PC6 acupuncture: observations from therapists and patients participating in clinical efficacy trials of acupuncture. [So] Source: Acupunct Med;35(6):421-429, 2017 Dec. [Is] ISSN: 1759-9873 [Cp] País de publicação: England [La] Idioma: eng [Ab] Resumo: BACKGROUND: Many therapists practise PC6 acupuncture for emesis (nausea and vomiting) during pregnancy, different cancer therapies, palliative care, after surgery, or to induce relaxing effects in general. Knowledge of side effects is central to shared decision-making. AIM: To describe the type and frequency of side effects and the level of needle-induced pain during PC6 acupuncture. METHODS: We included 1298 PC6 acupuncture treatments, delivered to 221 participants (77% women, mean age 52.5, range 18-91 years). The subjects had received genuine PC6 acupuncture, in one of two previous randomised controlled trials, aimed at inducing antiemetic (n=100, with 100 providing data on side effects and 94 on needle-induced pain, respectively) or relaxing (n=121, with 120 providing data) effects. Side effects during and after the acupuncture treatments were registered in structured treatment protocols and study diaries. RESULTS: No serious complications occurred. Side effects during the acupuncture sessions included minor bleeding in 5.0%, tiredness in 4.9%, numbness in 4.5% and dizziness in 1.4% of the 1298 treatments. After treatment, the mean proportions of participants reporting side effects each week were: tiredness 25.8%; feeling cold 17.8%; dizziness 9.7%; sweating 9.3%; haematoma 8.8%; and soreness at the needling sites 4.3%. Participants perceived the needling to be not painful (47.4% of participants), or mildly (39.1%), moderately (11.6%) or very painful (1.4%). CONCLUSIONS: Few side effects occurred and those that did were mild. Nearly 90% found PC6 acupuncture to be not painful or only mildly painful. Healthcare professionals may consider the observed levels of side effects when informing patients about side effects of PC6 acupuncture. [Mh] Termos MeSH primário: Pontos de Acupuntura Terapia por Acupuntura/efeitos adversos Dor/etiologia Avaliação de Sintomas [Mh] Termos MeSH secundário: Adulto Idoso Idoso de 80 Anos ou mais Feminino Seres Humanos Masculino Meia-Idade Satisfação do Paciente Náusea e Vômito Pós-Operatório/prevenção & controle Adulto Jovem [Pt] Tipo de publicação: JOURNAL ARTICLE [Em] Mês de entrada: 1802 [Cu] Atualização por classe: 180201 [Lr] Data última revisão: 180201 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171210 [St] Status: MEDLINE [do] DOI: 10.1136/acupmed-2016-011270

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[PMID]: 29280884 [Au] Autor: Manahan MA; Johnson DJ; Gutowski KA; Bonawitz SC; Ellsworth WA; Zielinski M; Thomsen RW; Basu CB [Ad] Endereço: Baltimore, Md.; Sacramento, Calif.; Chicago and Arlington Heights, Ill.; and Houston, Texas From Johns Hopkins Plastic and Reconstructive Surgery; Sacramento Plastic and Reconstructive Surgery Medical Group, Inc.; Chicago Cosmetic Institute and University; The Johns Hopkins Outpatient Clinic; Houston Methodist West Hospital; the American Society of Plastic Surgeons; The Johns Hopkins University School of Medicine; and the Basu Center for Aesthetics and Plastic Surgery. [Ti] Título: Postoperative Nausea and Vomiting with Plastic Surgery: A Practical Advisory to Etiology, Impact, and Treatment. [So] Source: Plast Reconstr Surg;141(1):214-222, 2018 01. [Is] ISSN: 1529-4242 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: Ambulatory surgery is common in plastic surgery, where many aesthetic and reconstructive procedures can be performed in hospitals, ambulatory surgery centers, or office-based surgery facilities. Outpatient surgery offers advantages to both the patient and the surgeon by increasing accessibility, flexibility, and convenience; lowering cost; and maintaining high-quality care. To optimize a patient's experience and comfort, postoperative nausea and vomiting (PONV) should be prevented. However, in those patients who develop PONV, it must be appropriately managed and treated. The incidence of PONV is variable. It is often difficult to accurately predict those patients who will develop PONV or how they will manifest symptoms. There are a variety of recommended "cocktails" for PONV prophylaxis and treatments that are potentially effective. The decision regarding the type of treatment given is often more related to provider preference and determination of side-effect profile, rather than targeted to specific patient characteristics, because of the absence of large volumes of reliable data to support specific practices over others. Fortunately, there are several tenets for the successful prevention and treatment of PONV we have extracted from the literature and summarize here. The following is a summary for the practicing plastic surgeon of the current state of the literature regarding PONV cause, risk factors, prophylaxis, and treatment that may serve as a guide for further study and practice management. [Mh] Termos MeSH primário: Antieméticos/uso terapêutico Náusea e Vômito Pós-Operatório/tratamento farmacológico Náusea e Vômito Pós-Operatório/prevenção & controle Procedimentos Cirúrgicos Reconstrutivos/efeitos adversos Cirurgia Plástica/efeitos adversos [Mh] Termos MeSH secundário: Procedimentos Cirúrgicos Ambulatórios/efeitos adversos Procedimentos Cirúrgicos Ambulatórios/métodos Feminino Seguimentos Seres Humanos Masculino Procedimentos Cirúrgicos Reconstrutivos/métodos Índice de Gravidade de Doença Cirurgia Plástica/métodos Fatores de Tempo Resultado do Tratamento [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Antiemetics) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180117 [Lr] Data última revisão: 180117 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171228 [St] Status: MEDLINE [do] DOI: 10.1097/PRS.0000000000003924

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[PMID]: 29280885 [Au] Autor: Lalonde DH [Ad] Endereço: Saint John, New Brunswick, Canada From the Division of Plastic Surgery, Dalhousie University. [Ti] Título: Discussion: Postoperative Nausea and Vomiting with Plastic Surgery: A Practical Advisory to Etiology, Impact, and Treatment. [So] Source: Plast Reconstr Surg;141(1):223-224, 2018 01. [Is] ISSN: 1529-4242 [Cp] País de publicação: United States [La] Idioma: eng [Mh] Termos MeSH primário: Náusea e Vômito Pós-Operatório Cirurgia Plástica [Mh] Termos MeSH secundário: Antieméticos Método Duplo-Cego Seres Humanos Procedimentos Cirúrgicos Reconstrutivos [Pt] Tipo de publicação: JOURNAL ARTICLE; COMMENT [Nm] Nome de substância: 0 (Antiemetics) [Em] Mês de entrada: 1801 [Cu] Atualização por classe: 180108 [Lr] Data última revisão: 180108 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171228 [St] Status: MEDLINE [do] DOI: 10.1097/PRS.0000000000003925

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[PMID]: 28455599 [Au] Autor: Cao X; White PF; Ma H [Ad] Endereço: First Hospital of China Medical University, Shenyang, China. [Ti] Título: An update on the management of postoperative nausea and vomiting. [So] Source: J Anesth;31(4):617-626, 2017 Aug. [Is] ISSN: 1438-8359 [Cp] País de publicação: Japan [La] Idioma: eng [Ab] Resumo: Postoperative nausea and vomiting (PONV) and postdischarge nausea and vomiting (PDNV) remain common and distressing complications following surgery. PONV and PDNV can delay discharge and recovery and increase medical costs. The high incidence of PONV has persisted in part because of the tremendous growth in ambulatory surgery and the increased emphasis on earlier mobilization and discharge after both minor and major operations. Pharmacological management of PONV should be tailored to the patients' risk level using the PONV and PDNV scoring systems to minimize the potential for these adverse side effects in the postoperative period. A combination of prophylactic antiemetic drugs should be administered to patients with moderate-to-high risk of developing PONV in order to facilitate the recovery process. Optimal management of perioperative pain using opioid-sparing multimodal analgesic techniques and preventing PONV using prophylactic antiemetics are key elements for achieving an enhanced recovery after surgery. Strategies that include reductions of the baseline risk (e.g., adequate hydration, use of opioid-sparing analgesic techniques) as well as a multimodal antiemetic regimen will improve the likelihood of preventing both PONV and PDNV. [Mh] Termos MeSH primário: Procedimentos Cirúrgicos Ambulatórios/métodos Antieméticos/uso terapêutico Náusea e Vômito Pós-Operatório/tratamento farmacológico [Mh] Termos MeSH secundário: Anestesia/métodos Seres Humanos [Pt] Tipo de publicação: JOURNAL ARTICLE; REVIEW [Nm] Nome de substância: 0 (Antiemetics) [Em] Mês de entrada: 1712 [Cu] Atualização por classe: 171207 [Lr] Data última revisão: 171207 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 170430 [St] Status: MEDLINE [do] DOI: 10.1007/s00540-017-2363-x

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[PMID]: 29019899 [Au] Autor: Guo W; Ding J; Jin X; Li G [Ad] Endereço: Department of Anesthesiology, Wannan Medical College, First Affiliated Hospital, Yijishan Hospital, Wuhu, Anhui, China. [Ti] Título: Effect of cerebral oxygen saturation on postoperative nausea and vomiting in female laparoscopic surgery patients. [So] Source: Medicine (Baltimore);96(41):e8275, 2017 Oct. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: The purpose of this study was to investigate effect of cerebral oxygen saturation (SCTO2) on postoperative nausea and vomiting (PONV) in female patients who underwent laparoscopic surgery. METHODS: This study included 90 female patients who underwent laparoscopic surgery (60 cases of gynecological operations and 30 cases of gallbladder operations). All patients were allocated into 3 groups of 30 patients each: group A (gynecological laparoscopic surgery), group B (gynecological laparoscopic surgery with mannitol treatment) and group C (laparoscopic cholecystectomy surgery). Perioperative SCTO2, mean blood flow velocity of vertebral artery (VM), vascular resistance index of vertebral artery (RI), and PONV (within 48 hours after surgery) were investigated. RESULTS: No differences in age, body weight, operation time, and hemoglobin levels were observed among the patients (P > .05). The SCTO2 values for groups B and C were lower than those for group A in both brain hemispheres at T4 and T5 (P < .05). The VM was higher in group B than in groups A and C at T3 (P < .05), but differences in VM were not observed between groups B and C at T4 or T5. However, the VM of group A was still lower than the other groups (P < .05), and no difference in VM was observed among the 3 groups at T6 (P > .05). The RI was higher in group C than in groups A and B at T4 (P < .05). The incidence of PONV within 48 hours after surgery was significantly higher in group A than in the other 2 groups (P < .05). CONCLUSION: Strategies that maintain normal SCTO2 may reduce the incidence of PONV in female patients who underwent laparoscopy surgery by reducing perioperative intracranial pressure. [Mh] Termos MeSH primário: Encéfalo Colecistectomia Laparoscópica/efeitos adversos Procedimentos Cirúrgicos em Ginecologia/efeitos adversos Laparoscopia/efeitos adversos Consumo de Oxigênio/fisiologia Náusea e Vômito Pós-Operatório Artéria Vertebral/fisiopatologia [Mh] Termos MeSH secundário: Adulto Velocidade do Fluxo Sanguíneo Encéfalo/irrigação sanguínea Encéfalo/metabolismo Diuréticos Osmóticos/uso terapêutico Feminino Procedimentos Cirúrgicos em Ginecologia/métodos Seres Humanos Laparoscopia/métodos Manitol/uso terapêutico Meia-Idade Assistência Perioperatória/métodos Náusea e Vômito Pós-Operatório/diagnóstico Náusea e Vômito Pós-Operatório/metabolismo Náusea e Vômito Pós-Operatório/fisiopatologia Náusea e Vômito Pós-Operatório/prevenção & controle Estatística como Assunto Resistência Vascular [Pt] Tipo de publicação: JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL [Nm] Nome de substância: 0 (Diuretics, Osmotic); 3OWL53L36A (Mannitol) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171122 [Lr] Data última revisão: 171122 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 171012 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008275

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[PMID]: 28977021 [Au] Autor: Yokoi A; Mihara T; Ka K; Goto T [Ad] Endereço: Department of Anesthesiology, Kanagawa Children's Medical Center, Minami-ku, Yokohama, Japan. [Ti] Título: Comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting: An updated systematic review and meta-analysis with trial sequential analysis. [So] Source: PLoS One;12(10):e0186006, 2017. [Is] ISSN: 1932-6203 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: Postoperative nausea and vomiting is a distressing complication of surgery, and 5-HT3 receptor antagonists are often prescribed to prevent it. Ondansetron is the agent typically administered to prevent postoperative nausea and vomiting. Although ramosetron has a longer duration of action than ondansetron, it remains unclear whether ramosetron is the more effective medication. We performed an updated meta-analysis on the comparative efficacy of ramosetron and ondansetron in preventing postoperative nausea and vomiting. METHODS: We searched six databases for all trials that randomly assigned patients to ramosetron or ondansetron groups. The primary outcome was postoperative nausea or vomiting in the early, late, and next-day periods. The secondary outcomes were side effects of the medications. We used the random-effects model to combine the results. Trial sequential analyses were performed to correct for repetitive testing in the updated meta-analysis. RESULTS: Twenty-seven randomized controlled trials with 3,811 patients were included in the meta-analysis. The combined results of ramosetron vs. ondansetron efficacy in preventing postoperative nausea and vomiting were as follows: Risk ratio [95% confidence interval] = 0.82 [0.69-0.98] for early postoperative nausea, 0.76 [0.65-0.89] for late postoperative nausea, 0.69 [0.57-0.84] for next-day postoperative nausea, 0.78 [0.63-0.98] for early postoperative vomiting, 0.57 [0.45-0.72] for late postoperative vomiting, and 0.61 [0.43-0.86] for next-day postoperative vomiting. Dizziness was significantly lower in ramosetron groups than in ondansetron groups (risk ratio [95% confidence interval] = 0.81 [0.66-0.98]). Trial sequential analysis revealed that the results for late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea were conclusive. CONCLUSIONS: Ramosetron is more effective in preventing late postoperative nausea, late postoperative vomiting, and next-day postoperative nausea than ondansetron. The incidence of dizziness may be lower in patients receiving ramosetron than in patients receiving ondansetron. TRIAL REGISTRATION: University hospital Medical Information Network Clinical Trials Registry: UMIN000022980. [Mh] Termos MeSH primário: Antieméticos/uso terapêutico Benzimidazóis/uso terapêutico Ondansetron/uso terapêutico Náusea e Vômito Pós-Operatório/prevenção & controle [Mh] Termos MeSH secundário: Seres Humanos [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Nm] Nome de substância: 0 (Antiemetics); 0 (Benzimidazoles); 4AF302ESOS (Ondansetron); 7ZRO0SC54Y (ramosetron) [Em] Mês de entrada: 1711 [Cu] Atualização por classe: 171102 [Lr] Data última revisão: 171102 [Sb] Subgrupo de revista: IM [Da] Data de entrada para processamento: 171005 [St] Status: MEDLINE [do] DOI: 10.1371/journal.pone.0186006

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[PMID]: 28953626 [Au] Autor: Cao X; Pan F [Ad] Endereço: aDepartment of Anesthesiology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University bDepartment of Anesthesiology and Pain Medicine, Peking University People's Hospital, Peking University, Beijing, China. [Ti] Título: Comparison of liposomal bupivacaine infiltration versus interscalene nerve block for pain control in total shoulder arthroplasty: A meta-analysis of randomized control trails. [So] Source: Medicine (Baltimore);96(39):e8079, 2017 Sep. [Is] ISSN: 1536-5964 [Cp] País de publicação: United States [La] Idioma: eng [Ab] Resumo: BACKGROUND: This meta-analysis aimed to compare the efficiency and safety of liposomal bupivacaine infiltration and interscalene nerve block for pain control after total shoulder arthroplasty. METHODS: A systematic search was performed in Medline (1966 to May 2017), PubMed (1966 to May 2017), Embase (1980 to May 2017), ScienceDirect (1985 to May 2017) and the Cochrane Library. Only randomized controlled trials (RCTs) were included. Reported surgical outcomes, including visual analogue scale (VAS) scores, opioid consumption, length of stay, and postoperative adverse effects including the risk of nausea and vomiting. Meta-analysis was performed using Stata 11.0 software. RESULTS: Four RCTs including 510 patients met the inclusion criteria. The present meta-analysis indicated that there were no significant differences between groups in terms of VAS score at 12 hours (standard mean difference [SMD] = 0.272, 95% CI: -0.150 to 0.695, P = .207), 24 hours (SMD = -0.056, 95% CI: -0.458 to 0.346, P = 0.785), and 48 hours (SMD = 0.183, 95% CI: -0.148 to 0.513, P = .278). Liposomal bupivacaine infiltration groups required an equivalent amount of opioids at postoperative 12 hours (SMD = -0.039, 95% CI: -0.222 to 0.143, P = .672), 24 hours (SMD = 0.046, 95% CI: -0.136 to 0.228, P = .618) and 48 hours (SMD = -0.025, 95% CI: -0.207 to 0.157, P = .785). CONCLUSION: Liposomal bupivacaine infiltration provides equivalent postoperative pain control compared with interscalene nerve block following total shoulder arthroplasty. Both of them can reduce the consumption of opioids without severe adverse effects. More high-quality RCTs with long follow-up period are necessary for proper comparisons of the efficacy and safety of liposomal bupivacaine infiltration with interscalene nerve block. [Mh] Termos MeSH primário: Anestésicos Locais/uso terapêutico Artroplastia do Ombro/efeitos adversos Bupivacaína/uso terapêutico Bloqueio Nervoso/métodos Dor Pós-Operatória/prevenção & controle [Mh] Termos MeSH secundário: Analgésicos Opioides/efeitos adversos Analgésicos Opioides/uso terapêutico Anestésicos Locais/efeitos adversos Bupivacaína/efeitos adversos Seres Humanos Tempo de Internação Músculos do Pescoço Bloqueio Nervoso/efeitos adversos Medição da Dor Náusea e Vômito Pós-Operatório/diagnóstico Ensaios Clínicos Controlados Aleatórios como Assunto [Pt] Tipo de publicação: COMPARATIVE STUDY; JOURNAL ARTICLE; META-ANALYSIS; REVIEW [Nm] Nome de substância: 0 (Analgesics, Opioid); 0 (Anesthetics, Local); Y8335394RO (Bupivacaine) [Em] Mês de entrada: 1710 [Cu] Atualização por classe: 171013 [Lr] Data última revisão: 171013 [Sb] Subgrupo de revista: AIM; IM [Da] Data de entrada para processamento: 170928 [St] Status: MEDLINE [do] DOI: 10.1097/MD.0000000000008079

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