Search

Although the positive effects of acupuncture in the treatment of hiccups following a stroke may be seen in actual clinical practice, no systematic reviews exist that describe the use of acupuncture to treat hiccups after stroke. The aim of this study is to analyse the available literature and trial data to determine the efficacy of acupuncture in the treatment of hiccups following stroke. We will search MEDLINE, EMBASE, CENTERAL, CINAHL, and four Chinese medical databases up to June 1, 2015. Randomised controlled trials (RCTs) will be included if acupuncture is assessed as the sole treatment or as an adjunct treatment for alleviating hiccups after stroke. The primary outcome of our analysis is cessation of hiccups within a specified time period following intervention; secondary outcome will include adverse events. Study selection, data extraction, and quality assessment will be conducted by two reviewers. Any disagreement will be resolved through discussion with a third reviewer. The Cochrane risk-of-bias criteria will be used to assess the methodological quality of the trials. The systematic review will be published through a peer-reviewed journal or presented at a relevant conference. We believe that the findings of our review will inform and guide healthcare practice and policy. Trial registration number: PROSPERO CRD42014015481.

This study aims to assess the effectiveness and safety of acupuncture for the treatment of urinary retention (UR) after stroke. The Medical Literature Analysis and Retrieval System Online (MEDLINE; 1950 to present), Excerpta Medica Database (EMBASE; 1980 to present), the Cochrane Central Register of Controlled Trials (CENTRAL; 1980 to present), Chinese Biomedical Literature Database (CBM; 1980 to present), China National Knowledge Infrastructure (which includes the database China Academic Journals) (CNKI; 1980 to present), VIP Information (VIP; 1980 to present), and Wanfang Data (WANFANG;1980 to present). The dataset will include randomised controlled trials (RCTs) and quasi-randomised controlled trials (Q-RCTs), which compare the efficacy and safety of acupuncture with no acupuncture in stroke patients with urinary retention. The primary outcome will be determined using postvoid residual or void volume. The secondary outcomes will be assessed using Short Form 36 Health Survey Questionnaire (SF36), clinical efficacy assessment (curative rate), and adverse events. The study selection, data extraction, and study quality assessment will be conducted independently by two authors. The methodological quality of included studies will be evaluated with Cochrane risk of bias criteria. This systematic review does not need ethical approval because our study will not involve individual patient data. The findings of this study will be disseminated through a peer-reviewed publication or presented at a relevant conference. Trial registration number: PROSPERO CRD42015017179.

Pain management after thoracic surgery in children presents the challenge of providing adequate analgesia without excessive sedation, and maintaining adequate respiratory function in the face of compromise resulting from existing pathology, surgical trauma, single-lung ventilation and postoperative ventilation-perfusion abnormalities. In the pediatric population, pain assessment and reporting present additional challenges. The number and complexity of surgical procedures, including video-assisted thoracoscopic procedures, is increasing in the pediatric population. There is a need to explore pain management for these types of patients.There are effective and safe strategies whereby analgesia can be provided to this pediatric population. This review will outline the progress that has been made in this field, including the use of regional techniques. The routine use of caudal catheters in neonates and infants for thoracic surgical procedures and the use of electrical guidance of epidural catheters, the 'Tsui' technique, are reviewed.These techniques, applied within a comprehensive pain management strategy, can be extremely beneficial in the care of the pediatric thoracic patient.

Study Objective: To review anesthesia and pain management in pediatric patients with recessive dystrophic epidermolysis bullosa (RDEB). Study Design: Retrospective study. Setting: University-affiliated pediatric hospital. Patients: 25 pediatric patients with RDEB had a total of 121 surgical procedures. Measurements and Main Results: Pediatric patients with RDEB could have vesicles and bullae formation in the skin in response to trauma, friction, or pressure. The common surgical procedures for patients with RDEB were balloon dilation of esophageal strictures (38%), pseudosyndactyly release with or without skin graft (27%), postsurgical or skin care related dressing changes (21%), percutaneous endoscopic gastrostomy tube placement (8%), and circumcision (2%). Our anesthetic techniques included general inhalational anesthesia using mask (21%), general anesthesia using endotracheal tube (48%), and intravenous sedation (31%). No death or other major perioperative anesthetic complications occurred in these reported cases. Conclusions: Patients with RDEB can present considerable management issues for the anesthesiologists. Anesthesia and pain management can be carefully delivered with proper preoperative evaluation and preparation for pediatric patients with RDEB.

The past decade has brought about an explosion of knowledge about the physiology of nociception and many new techniques for pain relief, new analgesic drugs, and new applications of old analgesic drugs. These techniques include methods of opioid administration by transdermal and transmucosal absorption and the use of neuraxial analgesia for the management of pain in children. Interest in the use of regional anesthesia in children has been rekindled, and analgesic properties and pre-emptive analgesic properties of many agents not typically considered analgesics, such as clonidine and ketamine, have been recognized. Perhaps the greatest advance has been the paradigm shift in the recognition that pain not only exists in infants and children but also is a significant cause of morbidity and even mortality. Given the unprecedented interest in pain management in adults and children, physicians can now look forward to the development of new methods of drug delivery and of receptor-specific drugs that divorce analgesia from the untoward side effects of existing analgesics. Improvement in the quality of life of hospitalized children also will occur.