Background Common complications of pediatric strabismus surgery, including emergence agitation (EA), postoperative nausea and vomiting (PONV), and postoperative pain, may be prevented using dexmedetomidine, which is an anxiolytic and analgesic. This systematic review and meta-analysis assessed the effects of dexmedetomidine in patients who had undergone pediatric strabismus surgery. Method Five databases were searched for randomized controlled trials published from database inception to April 2020 that compared dexmedetomidine use with placebo or active comparator use and evaluated EA, PONV, or postoperative pain incidence (main outcomes) in patients who had undergone pediatric strabismus surgery. Oculocardiac reflex (OCR) incidence and postanesthesia care unit (PACU) stay duration were considered as safety outcomes. All meta-analyses were performed using a random-effects model. Results In the nine studies meeting our inclusion criteria, compared with placebo use, dexmedetomidine use reduced EA incidence [risk ratio (RR): 0.

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A 73-year-old woman receiving warfarin presented to the emergency department with vague abdominal pain, 4 episodes of bilious vomiting, and melena stool. Physical examination showed diffuse abdominal tenderness without peritoneal signs. Blood testing demonstrated an international normalized ratio of 17.4 and a serum creatinine level of 2.79 mg/dL. The emergency physician performed bedside ultrasonography (Figures 1 and 2, Video) and confirmed with computed tomography (CT) (Figure 3).For the diagnosis and teaching points, see page e8. To view the entire collection of Images in Emergency Medicine, visit www.annemergmed.com