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dc.contributor.authorVlassakov, Kamen V.en_US
dc.contributor.authorKissin, Igoren_US
dc.date.accessioned2017-11-21T20:40:17Z
dc.date.issued2017en_US
dc.identifier.citationVlassakov, Kamen V., and Igor Kissin. 2017. “Assessing advances in regional anesthesia by their portrayals in meta-analyses: an alternative view on recent progress.” BMC Anesthesiology 17 (1): 112. doi:10.1186/s12871-017-0406-3. http://dx.doi.org/10.1186/s12871-017-0406-3.en
dc.identifier.issnen
dc.identifier.urihttp://nrs.harvard.edu/urn-3:HUL.InstRepos:34375042
dc.description.abstractBackground: The aim of this study was to delineate research reflecting advances in regional/local anesthesia where recent clinical progress was clearly defined by meta-analysis. Methods: We conducted a search to identify all articles with meta-analyses of randomized clinical trials related to the field of regional/local anesthesia. From 279 titles, after multiple exclusions, 16 meta-analyses on important clinical practice developments with high potential for a positive conclusion on the effectiveness of the treatment were left for the assessment. The assessment was performed in two steps. The first step was related to verification of proof-of-concept: the effect is statistically reliable (p-value, effect size, heterogeneity across different RCTs) and the risk of bias not too high. The second step was devoted to attempts to form an opinion on the real clinical benefits of a new development. Results: The assessment revealed that seven recent developments passed the proof-of-concept step. At the same time, positive conclusion on real clinical benefits was reached only by one of these seven developments: ultrasound guidance for peripheral nerve blocks (at least with some of the blocks). Meaningful clinical improvements with other developments remains uncertain. The assessment of the relationships between analyzed advancements over the past 30 years and earlier similar developments indicated that their evolution was usually incremental. The most original advancement was found to be the introduction of the transversus abdominis plane block. Conclusion: The assessment of recent advances in regional/local anesthesia, based on the evaluation of related meta-analyses, revealed only incremental progress with mostly marginal benefits. The progress was the most notable with ultrasound guidance for some of peripheral nerve blocks.en
dc.language.isoen_USen
dc.publisherBioMed Centralen
dc.relation.isversionofdoi:10.1186/s12871-017-0406-3en
dc.relation.hasversionhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC5576355/pdf/en
dash.licenseLAAen_US
dc.subjectEpidural anesthesiaen
dc.subjectSpinal anesthesiaen
dc.subjectNerve blocksen
dc.subjectMinimal clinically important differenceen
dc.subjectReal-world evidenceen
dc.titleAssessing advances in regional anesthesia by their portrayals in meta-analyses: an alternative view on recent progressen
dc.typeJournal Articleen_US
dc.description.versionVersion of Recorden
dc.relation.journalBMC Anesthesiologyen
dash.depositing.authorVlassakov, Kamen V.en_US
dc.date.available2017-11-21T20:40:17Z
dc.identifier.doi10.1186/s12871-017-0406-3*
dash.contributor.affiliatedVlassakov, Kamen
dash.contributor.affiliatedKissin, Igor


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