Abstract:
BACKGROUND:Elective medical or surgical procedures are commonplace for neonates admitted to NICU. Agents such as opioids are commonly used for achieving sedation/analgesia/anaesthesia for such procedures; however, these agents are associated with adverse effects. Propofol is used widely in paediatric and adult populations for this purpose. The efficacy and safety of the use of propofol in neonates has not been defined. OBJECTIVES:To determine the efficacy and safety of propofol treatment compared to placebo or no treatment or alternate active agents in neonates undergoing sedation or anaesthesia for procedures. To conduct subgroup analyses according to method of propofol administration (bolus or continuous infusion), type of active control agent (neuromuscular blocking agents with or without the use of sedative, analgesics or anxiolytics), type of procedure (endotracheal intubation, eye examination, other procedure), and gestational age (preterm and term). SEARCH STRATEGY:We searched MEDLINE (1950 to September 30, 2010), EMBASE (1980 to September 30, 2010) and the Cochrane Central Register of Controlled Trials (CENTRAL, The Cochrane Library 2010, Issue 2) for eligible studies without language restriction. We searched reference lists of identified articles and abstracts submitted to Pediatric Academic Societies (2002 to 2009), and international trials registries for eligible articles. SELECTION CRITERIA:We included randomised or quasi-randomised controlled trials of propofol versus placebo, no treatment or other sedative/anaesthetic/analgesic agents in isolation or combination used in neonates for procedures. DATA COLLECTION AND ANALYSIS:We collected and analysed data in accordance with the standard methods of the Cochrane Neonatal Review Group. MAIN RESULTS:One open-label randomised controlled trial of 63 neonates was eligible for inclusion. Thirty-three neonates in the propofol group were compared to 30 infants in the morphine-atropine-suxamethonium group. There was no statistically significant difference in the number of infants who required multiple intubation attempts (39% in the propofol group versus 57% in the morphine-atropine-suxamethonium group; RR 1.40, 95% CI 0.85 to 2.29). Times required to prepare medication, to complete the procedure and for recovery to previous clinical status were shorter in the propofol group. No difference in clinically significant side effects was observed; however, the number of events was small. AUTHORS' CONCLUSIONS:No practice recommendation can be made based on the available evidence regarding the use of propofol in neonates. Further research is needed on the pharmacokinetics of propofol in neonates and once a relatively safe dose is identified, randomised controlled trials assessing the safety and efficacy of propofol are needed.
journal_name
Cochrane Database Syst Revjournal_title
The Cochrane database of systematic reviewsauthors
Shah PS,Shah VSdoi
10.1002/14651858.CD007248.pub2subject
Has Abstractpub_date
2011-03-16 00:00:00pages
CD007248issue
3issn
1469-493Xpub_type
杂志文章,评审abstract:BACKGROUND:Nonsteroidal anti-inflammatory drugs (NSAIDs) are used for pain relief following tonsillectomy in children. However, as they inhibit platelet aggregation and prolong bleeding time, they could cause increased perioperative bleeding. The overall risk remains unclear. OBJECTIVES:The primary objective of this r...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD003591.pub2
更新日期:2005-04-18 00:00:00
abstract:BACKGROUND:The benefits and risks of antibiotics for acute bronchitis remain unclear despite it being one of the most common illnesses seen in primary care. OBJECTIVES:To assess the effects of antibiotics in improving outcomes and assess adverse effects of antibiotic therapy for patients with a clinical diagnosis of a...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000245.pub3
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Leprosy causes nerve damage which may result in nerve function impairment and disability. Decompressive surgery is used for treating nerve damage, although the effect is uncertain. OBJECTIVES:To assess the effects of decompressive surgery on nerve damage in leprosy. SEARCH STRATEGY:We searched the Cochrane...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD006983.pub2
更新日期:2009-01-21 00:00:00
abstract:BACKGROUND:Sepsis is a common problem in preterm and term infants. The incidence of neonatal sepsis has declined, but mortality remains high. Recombinant human activated protein C (rhAPC) possess a broad spectrum of activity modulating coagulation and inflammation. In septic adults it may reduce mortality, but no signi...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD005385.pub3
更新日期:2012-04-18 00:00:00
abstract:BACKGROUND:Atrial fibrillation (AF) is the most frequent sustained arrhythmia. AF recurs frequently after restoration of normal sinus rhythm. Antiarrhythmic drugs have been widely used to prevent recurrence, but the effect of these drugs on mortality and other clinical outcomes is unclear. OBJECTIVES:To determine, in ...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD005049.pub3
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journal_title:The Cochrane database of systematic reviews
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abstract:BACKGROUND:Electromechanical- and robot-assisted gait-training devices are used in rehabilitation and might help to improve walking after stroke. This is an update of a Cochrane Review first published in 2007 and previously updated in 2017. OBJECTIVES:Primary • To determine whether electromechanical- and robot-assiste...
journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD006185.pub5
更新日期:2020-10-22 00:00:00
abstract:BACKGROUND:The morbidity and treatment costs associated with skin and soft tissue infections (SSTIs) are high. Linezolid and vancomycin are antibiotics that are commonly used in treating skin and soft-tissue infections, specifically those infections due to methicillin-resistant Staphylococcus aureus (MRSA). OBJECTIVES...
journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
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doi:10.1002/14651858.CD006946.pub4
更新日期:2020-09-18 00:00:00
abstract:BACKGROUND:Hallux valgus is classified as an abnormal deviation of the great toe (hallux) towards the midline of the foot. OBJECTIVES:To identify and evaluate the evidence from randomised trials of interventions used to correct hallux valgus. SEARCH STRATEGY:We searched the Cochrane Musculoskeletal Injuries Group tri...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
doi:10.1002/14651858.CD000964.pub2
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
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更新日期:2011-04-13 00:00:00
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doi:10.1002/14651858.CD007523.pub2
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000422.pub3
更新日期:2013-01-31 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD001146.pub2
更新日期:2009-01-21 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD009924.pub2
更新日期:2015-03-05 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,评审
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journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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更新日期:2010-06-16 00:00:00
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journal_title:The Cochrane database of systematic reviews
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doi:10.1002/14651858.CD003091.pub3
更新日期:2014-09-01 00:00:00
abstract:BACKGROUND:Reduced uterine blood flow from maternal hypotension may contribute to fetal heart rate changes which are common following regional analgesia (epidural or spinal or combined spinal-epidural (CSE)) during labour. Intravenous fluid preloading may help to reduce maternal hypotension but using lower doses of loc...
journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD000175.pub2
更新日期:2004-10-18 00:00:00
abstract:BACKGROUND:Therapeutic exercise is used as one modality to treat people with osteoarthritis (OA). OBJECTIVES:To evaluate the effectiveness of therapeutic exercise of differing intensities on objective and subjective measures of disease activity in people with OA. SEARCH STRATEGY:We searched MEDLINE, EMBASE, Pedro, Cu...
journal_title:The Cochrane database of systematic reviews
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更新日期:2003-01-01 00:00:00
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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更新日期:2011-12-07 00:00:00
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journal_title:The Cochrane database of systematic reviews
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journal_title:The Cochrane database of systematic reviews
pub_type: 杂志文章,meta分析,评审
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更新日期:2003-01-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
doi:10.1002/14651858.CD008870
更新日期:2010-12-08 00:00:00