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161. Liver Disease and Pregnancy

recommendation, low level of evidence). Computed tomography scans carry a risk of teratogenesis and childhood hematologic malignancies but may be used judiciously with minimized radiation protocols (2–5 rads; conditional recommendation, very low level of evidence). Endoscopy in pregnancy Endoscopy is safe in pregnancy but should be deferred until the second trimester if possible (strong recommendation, low level of evidence). Meperidine and propofol can be used for endoscopic sedation (strong recommendation (...) trimester if possible (strong recommendation, low level of evidence). 6. Meperidine and propofol can be used for endoscopic seda- tion (strong recommendation, moderate level of evidence). Although clinical studies on the safety and eff ectiveness of endoscopy for the pregnant patient have been limited, endo- scopy can be safe and eff ective if careful assessment of the risks, benefi ts, and clinical rationale is performed. One of the most important clinical issues in endoscopy of the pregnant patient

2016 American College of Gastroenterology

162. Clinical Practice Guidelines for Sustained Neuromuscular Blockade in the Adult Critically Ill Patient

. However, related research in other populations may be extrapolated to the setting of therapeutic hypothermia following cardiac arrest. In an open-label randomized study of 20 patients following hypothermic cardiopulmonary bypass, vecuronium (0.1 mg/kg bolus followed by 1 µg·kg –1 ·min –1 for 4 hr) eliminated shivering in 100% of patients, compared with 50% of patients who received meperidine (25 mg every 15 min until no shivering was observed or a total dose of 75 mg was administered) ( p < 0.05 (...) ) ( ). Vecuronium eliminated shivering without lowering systolic blood pressure, as occurred with meperidine ( p < 0.02), and eliminated shivering in the five patients whose shivering was uncontrolled by meperidine. As was noted in nonrandomized studies involving pancuronium for the prevention of shivering in patients following cardiopulmonary bypass ( , ), vecuronium administration was associated with consistent and statistically significant decreases in oxygen consumption and CO 2 production, effects not seen

2016 Society of Critical Care Medicine

169. Enhanced Recovery After Surgery (ERAS) for gastrointestinal surgery, part 2: consensus statement for anaesthesia practice Full Text available with Trip Pro

(forced air warming systems, circulating water garments or warmed i.v. solutions). Combined strategies, and among the others preoperative warming, should be considered in vulnerable groups such as older patients with cardiorespiratory diseases, and surgery of long duration. Rewarming should be performed to a core temperature of 35.5–36.0°C before emergence from anaesthesia, and every effort should be made to avoid shivering by using meperidine 0.25–0.5 mg/kg. Alternatively clonidine 1–2 μg/kg i.v. can

2015 ERAS Society

172. Risk factors for postoperative delirium in patients undergoing lower extremity joint arthroplasty: a retrospective population-based cohort study. (Abstract)

data from the all-payer Premier Healthcare database containing detailed billing information from >25% nationwide hospitalizations. Patients undergoing elective total hip/knee arthroplasty surgery (2006-2016) were included.The primary outcome was postoperative delirium, while potential risk factors included age, gender, race, insurance type, and modifiable exposures including anesthesia type, opioid prescription dose (low/medium/high), benzodiazepines, meperidine, non-benzodiazepine hypnotics

2019 Regional Anesthesia and Pain Medicine

173. Effects of preincisional analgesia with surgical site infiltration of ketamine or levobupivacaine in patients undergoing abdominal hysterectomy under general anesthesia; A randomized double blind study. Full Text available with Trip Pro

score in ketamine group was significantly lower than that in the levobupivacaine group 8, 10, and 24 h postoperatively. Ketamine group showed delayed request of additional opioid analgesia (P < 0.001) with significantly less opioid consumption (P < 0.001) as compared to levobupivacaine. The total dose of meperidine consumed during the 24 postoperative h was significantly smaller in ketamine group (P < 0.001).Surgical site infiltration of ketamine is a promising preemptive analgesic method

2019 Saudi journal of anaesthesia Controlled trial quality: uncertain

174. Opioid Management in Older Adults with Chronic Kidney Disease: A Review. (Abstract)

, transdermal buprenorphine, transdermal fentanyl, and oral hydromorphone are the most tolerable opioids in these patients; hydrocodone, oxycodone, and methadone are useful but require careful monitoring; and tramadol, codeine, morphine, and meperidine should be avoided due to risk of accumulation and adverse events. Because older adults with nondialysis chronic kidney disease are at increased risk for adverse events, vigilant monitoring of opioid prescription is critical. Lastly, collaboration among

2019 American Journal of Medicine

175. Usage of Intravenous Lidocaine Infusion with Enhanced Recovery Pathway in Patients Scheduled for Open Radical Cystectomy: A Randomized Trial. (Abstract)

%. Postoperative pain scores, rescue analgesic consumption, times to return of bowel sounds, first flatus, first defecation, resuming of regular diet, length of hospital stay, in-hospital complications, and patient satisfaction were recorded.Patients in the lidocaine group experienced significantly lower pain scores after surgery at 6 hours (P = 0.005) and 12 hours (P = 0.001) at rest, and in the first 18 hours during mobilization (P < 0.05), with less paracetamol (P = 0.04) and meperidine (P = 0.02

2019 Pain physician Controlled trial quality: predicted high

176. Comparison of Effects of Hemostatic Gelatin Sponge Impregnated with Ropivacaine versus Normal Saline Applied on the Transverse Process of the Operated Vertebrae on Postoperative Pain in Patients Undergoing Spinal Instrumentation Surgery: A Randomized Clin (Abstract)

postoperatively in the 2 groups (ropivacaine vs. normal saline). The total amount of postoperative opioid use was also recorded.The VAS score was significantly lower in patients receiving hemostatic gelatin sponge impregnated with local anesthetics as compared with patients receiving gelatin sponge impregnated with normal saline 48 hours postoperatively; the mean total dose of meperidine given in the first 48 hours postoperatively was significantly lower (53.5 ± 51.0 mg) in patients receiving gelatin sponge

2019 World neurosurgery Controlled trial quality: uncertain

177. Comparison of intraperitoneal versus intravenous dexamethasone on postoperative nausea and vomiting after gynecological laparoscopy: a randomized clinical trial. Full Text available with Trip Pro

common side effects in the IV dexamethasone group. The groups did not differ significantly in terms of mean VAS score for pain and total meperidine consumption during the first 24 h postoperatively.Intraperitoneal dexamethasone at a dose of 8 mg at the end of gynecological laparoscopy reduces the incidence of postoperative nausea.

2019 Korean journal of anesthesiology Controlled trial quality: uncertain

178. The effects of novel α Full Text available with Trip Pro

The effects of novel α Objective: Meperidine used to control shivering during perioperative period has associated side effects. The present study compared the safety of selective α2-adrenoreceptor agonist dexmedetomidine and meperidine for anti-shivering in primiparas after caesarean delivery under combined spinal-epidural anesthesia (CSEA).Methods: 100 primiparas scheduled for caesarean delivery were randomly allocated to dexmedetomidine group (Group D, n=50) and meperidine positive control (...) group (Group M, n=50). Primiparas experienced shivering that continued to cord clamping were treated with dexmedetomidine (0.5 μg/kg) or meperidine (0.5 mg/kg) after cord clamping. The primary outcome measures were incidence of nausea, vomiting, and respiratory depression. Secondary outcome measures were shivering score, vital signs including blood pressure, heart rate and O2 saturation, tympanic temperature, and sedation score.Results: Dexmedetomidine provided similar anti-shivering effects

2019 Bioscience reports Controlled trial quality: uncertain

179. Sedative techniques for endoscopic retrograde cholangiopancreatography. (Abstract)

sedation using midazolam and meperidine with deep sedation using propofol in patients undergoing ERCP procedures. All sedation was administered by non-anaesthetic personnel. Due to the clinical heterogeneity of the studies we decided to review the papers from a narrative perspective as opposed to a full meta-analysis. Our primary outcome measures included mortality, major complications and inability to complete the procedure due to sedation-related problems. Secondary outcomes encompassed sedation (...) considerably. The studies showed either moderate or high risk of bias.Results from individual studies suggested that patients have a better recovery profile after propofol sedation for ERCP procedures than after midazolam and meperidine sedation. As there was no difference between the two sedation techniques as regards safety, propofol sedation is probably preferred for patients undergoing ERCP procedures. However, in all of the studies that were identified only non-anaesthesia personnel were involved

2012 Cochrane

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