Inicio
Detalle del título uniforme
Cochrane Database of Systematic Reviews
Tipo de obra :
Autre
Naturaleza de la obra :
Oeuvre
|
Documentos disponibles con este título uniforme (6)
Clasificado(s) por (Año de edición descendente) Refinar búsquedaAmphotericin B deoxycholate versus liposomal amphotericin B: effects on kidney function / Juan Pablo Botero Aguirre ; Alejandra María Restrepo Hamid
Título : Amphotericin B deoxycholate versus liposomal amphotericin B: effects on kidney function Tipo de documento : documento electrónico Autores : Juan Pablo Botero Aguirre, ; Alejandra María Restrepo Hamid, Fecha de publicación : 2015 Títulos uniformes : Cochrane Database of Systematic Reviews Idioma : Inglés (eng) Resumen : Background: The incidence of invasive fungal infections has increased globally as a result of several factors. Conventional amphotericin B (sodium deoxycholate) has been used as standard therapy for the treatment of invasive fungal infections; however, it is associated with adverse drug reactions, including acute kidney injury (AKI). New formulations of amphotericin B have aimed to improve the safety profile of the conventional formulation. Objectives: This review aimed to assess the effects of amphotericin B deoxycholate versus liposomal amphotericin B on kidney function. Search methods: We searched Cochrane Kidney and Transplant's Specialised Register to 10 March 2015 through contact with the Trials' Search Co‐ordinator using search terms relevant to this review. Selection criteria: We included randomised controlled trials (RCTs) that compared amphotericin B sodium deoxycholate with liposomal amphotericin B. Data collection and analysis: Two authors independently assessed studies for eligibility and conducted risk of bias evaluation. Main results: We included 12 studies (2298 participants) in this review. Of these, 10 were meta‐analysed (2172 participants). Liposomal amphotericin B was found to be significantly safer than conventional amphotericin B in terms of serum creatinine increase (RR 0.49, 95% CI 0.40 to 0.59). There was significant decrease in all infusion‐related reactions in the liposomal group compared with the conventional group: fever (4 studies, 1092 participants): RR 0.39, 95% CI 0.28 to 0.55; I2 = 32%); chills and/or rigours (5 studies, 1081 participants): RR 0.27, 95% CI 0.15 to 0.48; I2 = 75%); fever and/or rigours (2 studies, 720 participants): RR 0.68, 95% CI 0.52 to 0.90; I2 = 58%); nausea (6 studies, 1187 participants): RR 0.50, 95% CI 0.35 to 0.72; I2 = 0%); and vomiting (3 studies, 1019 participants): RR 0.51, 95% CI 0.27 to 0.95; I2 = 61%). Overall, risk of bias in included studies was low or unclear for most domains. However, blinding of participants and personnel, blinding of outcome assessment and other bias (funding) tended to have a high risk of bias. The sensitivity analysis performed did not change the significance of difference in favour of the liposomal formulation. Assessment for publication bias found that review results were robust. Authors' conclusions: Current evidence suggests that liposomal amphotericin B is less nephrotoxic than conventional amphotericin B (when the effect on kidney function is measured as an increase in serum creatinine level equal to or greater than two‐fold from the baseline level). We also found that there were fewer infusion‐related reactions associated with the liposomal formulation. Mención de responsabilidad : Juan Pablo Botero Aguirre, Alejandra Maria Restrepo Hamid Referencia : Cochrane Database Syst Rev. 2015 Nov 23;(11):CD010481. DOI (Digital Object Identifier) : 10.1002/14651858.CD010481.pub2 PMID : 26595825 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010481.pub2/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3933 Amphotericin B deoxycholate versus liposomal amphotericin B: effects on kidney function [documento electrónico] / Juan Pablo Botero Aguirre, ; Alejandra María Restrepo Hamid, . - 2015.
Obra : Cochrane Database of Systematic Reviews
Idioma : Inglés (eng)
Resumen : Background: The incidence of invasive fungal infections has increased globally as a result of several factors. Conventional amphotericin B (sodium deoxycholate) has been used as standard therapy for the treatment of invasive fungal infections; however, it is associated with adverse drug reactions, including acute kidney injury (AKI). New formulations of amphotericin B have aimed to improve the safety profile of the conventional formulation. Objectives: This review aimed to assess the effects of amphotericin B deoxycholate versus liposomal amphotericin B on kidney function. Search methods: We searched Cochrane Kidney and Transplant's Specialised Register to 10 March 2015 through contact with the Trials' Search Co‐ordinator using search terms relevant to this review. Selection criteria: We included randomised controlled trials (RCTs) that compared amphotericin B sodium deoxycholate with liposomal amphotericin B. Data collection and analysis: Two authors independently assessed studies for eligibility and conducted risk of bias evaluation. Main results: We included 12 studies (2298 participants) in this review. Of these, 10 were meta‐analysed (2172 participants). Liposomal amphotericin B was found to be significantly safer than conventional amphotericin B in terms of serum creatinine increase (RR 0.49, 95% CI 0.40 to 0.59). There was significant decrease in all infusion‐related reactions in the liposomal group compared with the conventional group: fever (4 studies, 1092 participants): RR 0.39, 95% CI 0.28 to 0.55; I2 = 32%); chills and/or rigours (5 studies, 1081 participants): RR 0.27, 95% CI 0.15 to 0.48; I2 = 75%); fever and/or rigours (2 studies, 720 participants): RR 0.68, 95% CI 0.52 to 0.90; I2 = 58%); nausea (6 studies, 1187 participants): RR 0.50, 95% CI 0.35 to 0.72; I2 = 0%); and vomiting (3 studies, 1019 participants): RR 0.51, 95% CI 0.27 to 0.95; I2 = 61%). Overall, risk of bias in included studies was low or unclear for most domains. However, blinding of participants and personnel, blinding of outcome assessment and other bias (funding) tended to have a high risk of bias. The sensitivity analysis performed did not change the significance of difference in favour of the liposomal formulation. Assessment for publication bias found that review results were robust. Authors' conclusions: Current evidence suggests that liposomal amphotericin B is less nephrotoxic than conventional amphotericin B (when the effect on kidney function is measured as an increase in serum creatinine level equal to or greater than two‐fold from the baseline level). We also found that there were fewer infusion‐related reactions associated with the liposomal formulation. Mención de responsabilidad : Juan Pablo Botero Aguirre, Alejandra Maria Restrepo Hamid Referencia : Cochrane Database Syst Rev. 2015 Nov 23;(11):CD010481. DOI (Digital Object Identifier) : 10.1002/14651858.CD010481.pub2 PMID : 26595825 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010481.pub2/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3933 Reserva
Reservar este documentoEjemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000517 AC-2015-070 Archivo digital Producción Científica Artículos científicos Disponible
Título : Amphotericin B deoxycholate versus liposomal amphotericin B: effects on kidney function Tipo de documento : documento electrónico Autores : Juan Pablo Botero Aguirre, ; Alejandra María Restrepo Hamid, Fecha de publicación : 2013 Títulos uniformes : Cochrane Database of Systematic Reviews Idioma : Inglés (eng) Resumen : This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to assess the effects of amphotericin B deoxycholate versus liposomal amphotericin B on kidney function. Mención de responsabilidad : Juan Pablo Botero Aguirre, Alejandra Maria Restrepo Hamid Referencia : Cochrane Database Syst Rev. 2013 Apr 30;(4):CD010481. DOI (Digital Object Identifier) : 10.1002/14651858.CD010481 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010481/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3668 Amphotericin B deoxycholate versus liposomal amphotericin B: effects on kidney function [documento electrónico] / Juan Pablo Botero Aguirre, ; Alejandra María Restrepo Hamid, . - 2013.
Obra : Cochrane Database of Systematic Reviews
Idioma : Inglés (eng)
Resumen : This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: This review aims to assess the effects of amphotericin B deoxycholate versus liposomal amphotericin B on kidney function. Mención de responsabilidad : Juan Pablo Botero Aguirre, Alejandra Maria Restrepo Hamid Referencia : Cochrane Database Syst Rev. 2013 Apr 30;(4):CD010481. DOI (Digital Object Identifier) : 10.1002/14651858.CD010481 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD010481/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3668 Reserva
Reservar este documentoEjemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000241 AC-2013-009 Archivo digital Producción Científica Artículos científicos Disponible
Título : Laparoscopic repair for perforated peptic ulcer disease Tipo de documento : documento electrónico Autores : Álvaro Enrique Sanabria Quiroga, Fecha de publicación : 2013 Títulos uniformes : Cochrane Database of Systematic Reviews Idioma : Inglés (eng) Resumen : Background: Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery has changed the way to treat such abdominal surgical emergencies. The results of some clinical trials suggest that laparoscopic surgery could be a better strategy than open surgery in the correction of perforated peptic ulcer but the evidence is not strongly in favour for or against this intervention.Objectives: To measure the effect of laparoscopic surgical treatment versus open surgical treatment in patients with a diagnosis of perforated peptic ulcer in relation to abdominal septic complications, surgical wound infection, extra‐abdominal complications, hospital length of stay and direct costs. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (2004, Issue 2), PubMed/MEDLINE (1966 to July 2004), EMBASE (1985 to November 2004) and LILACS (1988 to November 2004) as well as the reference lists of relevant articles. Searches in all databases were updated in December 2009 and January 2012. We did not confine our search to English language publications. Selection criteria :Randomized clinical trials comparing laparoscopic surgery versus open surgery for the repair of perforated peptic ulcer using any mechanical method of closure (suture, omental patch or fibrin sealant). Data collection and analysis Primary outcome measures included proportion of septic and other abdominal complications (surgical site infection, suture leakage, intra‐abdominal abscess, postoperative ileus) and extra‐abdominal complications (pulmonary). Secondary outcomes included mortality, time to return to normal diet, time of nasogastric aspiration, hospital length‐of‐stay and costs. Outcomes were summarized by reporting odds ratios (ORs) and 95% confidence intervals (CIs), using the fixed‐effect model. Main results: We included three randomized clinical trials of acceptable quality. We found no statistically significant differences between laparoscopic and open surgery in the proportion of abdominal septic complications (OR 0.66; 95% CI 0.30 to 1.47), pulmonary complications (OR 0.52; 95% CI 0.08 to 3.55) or number of septic abdominal complications (OR 0.60; 95% CI 0.32 to 1.15). Heterogeneity was significant for pulmonary complications and operating time. Authors' conclusions: This review suggests that a decrease in septic abdominal complications may exist when laparoscopic surgery is used to correct perforated peptic ulcer. However, it is necessary to perform more randomized controlled trials with a greater number of patients to confirm such an assumption, guaranteeing a long learning curve for participating surgeons. With the information provided it could be said that laparoscopic surgery results are not clinically different from those of open surgery. Mención de responsabilidad : Alvaro Sanabria, Maria Isabel Villegas, Carlos Hernando Morales Uribe Referencia : Cochrane Database Syst Rev. 2013 Feb 28;(2):CD004778. DOI (Digital Object Identifier) : 10.1002/14651858.CD004778.pub3 PMID : 23450555 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004778.pub3/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3709 Laparoscopic repair for perforated peptic ulcer disease [documento electrónico] / Álvaro Enrique Sanabria Quiroga, . - 2013.
Obra : Cochrane Database of Systematic Reviews
Idioma : Inglés (eng)
Resumen : Background: Perforated peptic ulcer is a common abdominal disease that is treated by surgery. The development of laparoscopic surgery has changed the way to treat such abdominal surgical emergencies. The results of some clinical trials suggest that laparoscopic surgery could be a better strategy than open surgery in the correction of perforated peptic ulcer but the evidence is not strongly in favour for or against this intervention.Objectives: To measure the effect of laparoscopic surgical treatment versus open surgical treatment in patients with a diagnosis of perforated peptic ulcer in relation to abdominal septic complications, surgical wound infection, extra‐abdominal complications, hospital length of stay and direct costs. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library (2004, Issue 2), PubMed/MEDLINE (1966 to July 2004), EMBASE (1985 to November 2004) and LILACS (1988 to November 2004) as well as the reference lists of relevant articles. Searches in all databases were updated in December 2009 and January 2012. We did not confine our search to English language publications. Selection criteria :Randomized clinical trials comparing laparoscopic surgery versus open surgery for the repair of perforated peptic ulcer using any mechanical method of closure (suture, omental patch or fibrin sealant). Data collection and analysis Primary outcome measures included proportion of septic and other abdominal complications (surgical site infection, suture leakage, intra‐abdominal abscess, postoperative ileus) and extra‐abdominal complications (pulmonary). Secondary outcomes included mortality, time to return to normal diet, time of nasogastric aspiration, hospital length‐of‐stay and costs. Outcomes were summarized by reporting odds ratios (ORs) and 95% confidence intervals (CIs), using the fixed‐effect model. Main results: We included three randomized clinical trials of acceptable quality. We found no statistically significant differences between laparoscopic and open surgery in the proportion of abdominal septic complications (OR 0.66; 95% CI 0.30 to 1.47), pulmonary complications (OR 0.52; 95% CI 0.08 to 3.55) or number of septic abdominal complications (OR 0.60; 95% CI 0.32 to 1.15). Heterogeneity was significant for pulmonary complications and operating time. Authors' conclusions: This review suggests that a decrease in septic abdominal complications may exist when laparoscopic surgery is used to correct perforated peptic ulcer. However, it is necessary to perform more randomized controlled trials with a greater number of patients to confirm such an assumption, guaranteeing a long learning curve for participating surgeons. With the information provided it could be said that laparoscopic surgery results are not clinically different from those of open surgery. Mención de responsabilidad : Alvaro Sanabria, Maria Isabel Villegas, Carlos Hernando Morales Uribe Referencia : Cochrane Database Syst Rev. 2013 Feb 28;(2):CD004778. DOI (Digital Object Identifier) : 10.1002/14651858.CD004778.pub3 PMID : 23450555 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004778.pub3/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3709 Reserva
Reservar este documentoEjemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000282 AC-2013-050 Archivo digital Producción Científica Artículos científicos Disponible
Título : Opioids compared to placebo or other treatments for chronic low-back pain Tipo de documento : documento electrónico Autores : Luis Enrique Chaparro Gómez, Fecha de publicación : 2013 Títulos uniformes : Cochrane Database of Systematic Reviews Idioma : Inglés (eng) Resumen : Background: The use of opioids in the long‐term management of chronic low‐back pain (CLBP) has increased dramatically. Despite this trend, the benefits and risks of these medications remain unclear. This review is an update of a Cochrane review first published in 2007. Objectives: To determine the efficacy of opioids in adults with CLBP. Search methods: We electronically searched the Cochrane Back Review Group's Specialized Register, CENTRAL, CINAHL and PsycINFO, MEDLINE, and EMBASE from January 2006 to October 2012. We checked the reference lists of these trials and other relevant systematic reviews for potential trials for inclusion. Selection criteria: We included randomized controlled trials (RCTs) that assessed the use of opioids (as monotherapy or in combination with other therapies) in adults with CLBP that were at least four weeks in duration. We included trials that compared non‐injectable opioids to placebo or other treatments. We excluded trials that compared different opioids only. Data collection and analysis: Two authors independently assessed the risk of bias and extracted data onto a pre‐designed form. We pooled results using Review Manager (RevMan) 5.2. We reported on pain and function outcomes using standardized mean difference (SMD) or risk ratios with 95% confidence intervals (95% CI). We used absolute risk difference (RD) with 95% CI to report adverse effects. Main results: We included 15 trials (5540 participants). Tramadol was examined in five trials (1378 participants); it was found to be better than placebo for pain (SMD ‐0.55, 95% CI ‐0.66 to ‐0.44; low quality evidence) and function (SMD ‐0.18, 95% CI ‐0.29 to ‐0.07; moderate quality evidence). Transdermal buprenorphine (two trials, 653 participants) may make little difference for pain (SMD ‐2.47, 95%CI ‐2.69 to ‐2.25; very low quality evidence), but no difference compared to placebo for function (SMD ‐0.14, 95%CI ‐0.53 to 0.25; very low quality evidence). Strong opioids (morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol), examined in six trials (1887 participants), were better than placebo for pain (SMD ‐0.43, 95%CI ‐0.52 to ‐0.33; moderate quality evidence) and function (SMD ‐0.26, 95% CI ‐0.37 to ‐0.15; moderate quality evidence). One trial (1583 participants) demonstrated that tramadol may make little difference compared to celecoxib (RR 0.82, 95% CI 0.76 to 0.90; very low quality evidence) for pain relief. Two trials (272 participants) found no difference between opioids and antidepressants for either pain (SMD 0.21, 95% CI ‐0.03 to 0.45; very low quality evidence), or function (SMD ‐0.11, 95% ‐0.63 to 0.42; very low quality evidence). The included trials in this review had high drop‐out rates, were of short duration, and had limited interpretability of functional improvement. They did not report any serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid‐induced hyperalgesia, hypogonadism). In general, the effect sizes were medium for pain and small for function. Authors' conclusions: There is some evidence (very low to moderate quality) for short‐term efficacy (for both pain and function) of opioids to treat CLBP compared to placebo. The very few trials that compared opioids to non‐steroidal anti‐inflammatory drugs (NSAIDs) or antidepressants did not show any differences regarding pain and function. The initiation of a trial of opioids for long‐term management should be done with extreme caution, especially after a comprehensive assessment of potential risks. There are no placebo‐RCTs supporting the effectiveness and safety of long‐term opioid therapy for treatment of CLBP. Mención de responsabilidad : Luis Enrique Chaparro, Andrea D Furlan, Amol Deshpande, Angela Mailis-Gagnon, Steven Atlas, Dennis C Turk Referencia : Cochrane Database Syst Rev. 2013 Aug 27;(8):CD004959. DOI (Digital Object Identifier) : 10.1002/14651858.CD004959.pub4 PMID : 23983011 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004959.pub4/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3723 Opioids compared to placebo or other treatments for chronic low-back pain [documento electrónico] / Luis Enrique Chaparro Gómez, . - 2013.
Obra : Cochrane Database of Systematic Reviews
Idioma : Inglés (eng)
Resumen : Background: The use of opioids in the long‐term management of chronic low‐back pain (CLBP) has increased dramatically. Despite this trend, the benefits and risks of these medications remain unclear. This review is an update of a Cochrane review first published in 2007. Objectives: To determine the efficacy of opioids in adults with CLBP. Search methods: We electronically searched the Cochrane Back Review Group's Specialized Register, CENTRAL, CINAHL and PsycINFO, MEDLINE, and EMBASE from January 2006 to October 2012. We checked the reference lists of these trials and other relevant systematic reviews for potential trials for inclusion. Selection criteria: We included randomized controlled trials (RCTs) that assessed the use of opioids (as monotherapy or in combination with other therapies) in adults with CLBP that were at least four weeks in duration. We included trials that compared non‐injectable opioids to placebo or other treatments. We excluded trials that compared different opioids only. Data collection and analysis: Two authors independently assessed the risk of bias and extracted data onto a pre‐designed form. We pooled results using Review Manager (RevMan) 5.2. We reported on pain and function outcomes using standardized mean difference (SMD) or risk ratios with 95% confidence intervals (95% CI). We used absolute risk difference (RD) with 95% CI to report adverse effects. Main results: We included 15 trials (5540 participants). Tramadol was examined in five trials (1378 participants); it was found to be better than placebo for pain (SMD ‐0.55, 95% CI ‐0.66 to ‐0.44; low quality evidence) and function (SMD ‐0.18, 95% CI ‐0.29 to ‐0.07; moderate quality evidence). Transdermal buprenorphine (two trials, 653 participants) may make little difference for pain (SMD ‐2.47, 95%CI ‐2.69 to ‐2.25; very low quality evidence), but no difference compared to placebo for function (SMD ‐0.14, 95%CI ‐0.53 to 0.25; very low quality evidence). Strong opioids (morphine, hydromorphone, oxycodone, oxymorphone, and tapentadol), examined in six trials (1887 participants), were better than placebo for pain (SMD ‐0.43, 95%CI ‐0.52 to ‐0.33; moderate quality evidence) and function (SMD ‐0.26, 95% CI ‐0.37 to ‐0.15; moderate quality evidence). One trial (1583 participants) demonstrated that tramadol may make little difference compared to celecoxib (RR 0.82, 95% CI 0.76 to 0.90; very low quality evidence) for pain relief. Two trials (272 participants) found no difference between opioids and antidepressants for either pain (SMD 0.21, 95% CI ‐0.03 to 0.45; very low quality evidence), or function (SMD ‐0.11, 95% ‐0.63 to 0.42; very low quality evidence). The included trials in this review had high drop‐out rates, were of short duration, and had limited interpretability of functional improvement. They did not report any serious adverse effects, risks (addiction or overdose), or complications (sleep apnea, opioid‐induced hyperalgesia, hypogonadism). In general, the effect sizes were medium for pain and small for function. Authors' conclusions: There is some evidence (very low to moderate quality) for short‐term efficacy (for both pain and function) of opioids to treat CLBP compared to placebo. The very few trials that compared opioids to non‐steroidal anti‐inflammatory drugs (NSAIDs) or antidepressants did not show any differences regarding pain and function. The initiation of a trial of opioids for long‐term management should be done with extreme caution, especially after a comprehensive assessment of potential risks. There are no placebo‐RCTs supporting the effectiveness and safety of long‐term opioid therapy for treatment of CLBP. Mención de responsabilidad : Luis Enrique Chaparro, Andrea D Furlan, Amol Deshpande, Angela Mailis-Gagnon, Steven Atlas, Dennis C Turk Referencia : Cochrane Database Syst Rev. 2013 Aug 27;(8):CD004959. DOI (Digital Object Identifier) : 10.1002/14651858.CD004959.pub4 PMID : 23983011 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD004959.pub4/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3723 Reserva
Reservar este documentoEjemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000296 AC-2013-064 Archivo digital Producción Científica Artículos científicos Disponible
Título : Pharmacotherapy for the prevention of chronic pain after surgery in adults Tipo de documento : documento electrónico Autores : Luis Enrique Chaparro Gómez, Fecha de publicación : 2013 Títulos uniformes : Cochrane Database of Systematic Reviews Idioma : Francés (fre) Resumen : Background: Chronic pain can often occur after surgery, substantially impairing patients’ health and quality of life. It is caused by complex mechanisms that are not yet well understood. The predictable nature of most surgical procedures has allowed for the conduct of randomized controlled trials of pharmacological interventions aimed at preventing chronic postsurgical pain. Objectives: The primary objective was to evaluate the efficacy of systemic drugs for the prevention of chronic pain after surgery by examining the proportion of patients reporting pain three months or more after surgery. The secondary objective was to evaluate the safety of drugs administered for the prevention of chronic pain after surgery. Search methods: We identified randomized controlled trials (RCTs) of various systemically administered drugs for the prevention of chronic pain after surgery from CENTRAL, MEDLINE, EMBASE and handsearches of other reviews and trial registries. The most recent search was performed on 17 July 2013. Selection criteria: Included studies were double‐blind, placebo‐controlled, randomized trials involving adults and evaluating one or more drugs administered systemically before, during or after surgery, or both, which measured pain three months or more after surgery. Data collection and analysis: Data collected from each study included the study drug name, dose, route, timing and duration of dosing; surgical procedure; proportion of patients reporting any pain three months or more after surgery, reporting at least 4/10 or moderate to severe pain three months or more after surgery; and proportion of participants dropping out of the study due to treatment‐emergent adverse effects. Main results: We identified 40 RCTs of various pharmacological interventions including intravenous ketamine (14 RCTs), oral gabapentin (10 RCTs), oral pregabalin (5 RCTs), non‐steroidal anti‐inflammatories (3 RCTs), intravenous steroids (3 RCTs), oral N‐methyl‐D‐aspartate (NMDA) blockers (3 RCTs), oral mexiletine (2 RCTs), intravenous fentanyl (1 RCT), intravenous lidocaine (1 RCT), oral venlafaxine (1 RCT) and inhaled nitrous oxide (1 RCT). Meta‐analysis suggested a modest but statistically significant reduction in the incidence of chronic pain after surgery following treatment with ketamine but not gabapentin or pregabalin. Results with ketamine should be viewed with caution since most of the included trials were small (that is Mención de responsabilidad : Chaparro LE, Smith SA, Moore RA, Wiffen PJ, Gilron I Referencia : Cochrane Database Syst Rev. 2013 Jul 24;(7):CD008307. DOI (Digital Object Identifier) : 10.1002/14651858.CD008307.pub2 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008307.pub2/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3718 Pharmacotherapy for the prevention of chronic pain after surgery in adults [documento electrónico] / Luis Enrique Chaparro Gómez, . - 2013.
Obra : Cochrane Database of Systematic Reviews
Idioma : Francés (fre)
Resumen : Background: Chronic pain can often occur after surgery, substantially impairing patients’ health and quality of life. It is caused by complex mechanisms that are not yet well understood. The predictable nature of most surgical procedures has allowed for the conduct of randomized controlled trials of pharmacological interventions aimed at preventing chronic postsurgical pain. Objectives: The primary objective was to evaluate the efficacy of systemic drugs for the prevention of chronic pain after surgery by examining the proportion of patients reporting pain three months or more after surgery. The secondary objective was to evaluate the safety of drugs administered for the prevention of chronic pain after surgery. Search methods: We identified randomized controlled trials (RCTs) of various systemically administered drugs for the prevention of chronic pain after surgery from CENTRAL, MEDLINE, EMBASE and handsearches of other reviews and trial registries. The most recent search was performed on 17 July 2013. Selection criteria: Included studies were double‐blind, placebo‐controlled, randomized trials involving adults and evaluating one or more drugs administered systemically before, during or after surgery, or both, which measured pain three months or more after surgery. Data collection and analysis: Data collected from each study included the study drug name, dose, route, timing and duration of dosing; surgical procedure; proportion of patients reporting any pain three months or more after surgery, reporting at least 4/10 or moderate to severe pain three months or more after surgery; and proportion of participants dropping out of the study due to treatment‐emergent adverse effects. Main results: We identified 40 RCTs of various pharmacological interventions including intravenous ketamine (14 RCTs), oral gabapentin (10 RCTs), oral pregabalin (5 RCTs), non‐steroidal anti‐inflammatories (3 RCTs), intravenous steroids (3 RCTs), oral N‐methyl‐D‐aspartate (NMDA) blockers (3 RCTs), oral mexiletine (2 RCTs), intravenous fentanyl (1 RCT), intravenous lidocaine (1 RCT), oral venlafaxine (1 RCT) and inhaled nitrous oxide (1 RCT). Meta‐analysis suggested a modest but statistically significant reduction in the incidence of chronic pain after surgery following treatment with ketamine but not gabapentin or pregabalin. Results with ketamine should be viewed with caution since most of the included trials were small (that is Mención de responsabilidad : Chaparro LE, Smith SA, Moore RA, Wiffen PJ, Gilron I Referencia : Cochrane Database Syst Rev. 2013 Jul 24;(7):CD008307. DOI (Digital Object Identifier) : 10.1002/14651858.CD008307.pub2 En línea : https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008307.pub2/full Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3718 Reserva
Reservar este documentoEjemplares(1)
Código de barras Número de Ubicación Tipo de medio Ubicación Sección Estado DD000291 AC-2013-059 Archivo digital Producción Científica Artículos científicos Disponible Permalink
