Introduction:The efficacy of melatonin to improve sleep quality after laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of melatonin intervention versus placebo on sleep quality after laparoscopic cholecystectomy.Methods: We searched PubMed, EMbase, Web of Science, EBSCO, and Cochrane library databases through July 2018 for randomized controlled trials assessing the effect of melatonin intervention versus placebo on sleep quality after laparoscopic cholecystectomy. This meta-analysis is performed using the random-effect model.Results: Five randomized controlled trials involving 250 patients are included in the meta-analysis. Overall, compared with control group for laparoscopic cholecystectomy, melatonin intervention shows no substantial impact on well-being [standard mean difference (std MD) = 0.05; 95% confidence interval (CI) = −0.26 to 0.36; P = 0.76], sleepiness (std MD = −0.10; 95% CI = −0.44 to 0.23; P = 0.54), sleep quality (std MD = 0.10; 95% CI = −0.21 to 0.41; P = 0.53), pain scores after 1 hour (std MD = −0.26; 95% CI = −1.08 to 0.56; P = 0.53) and 3 hours (std MD = −0.86; 95% CI = −2.69 to 0.97; P = 0.36), headache [risk ratio (RR) = 1.25; 95% CI = 0.42-3.71; P = 0.68], depression (RR = 1.03; 95% CI = 0.15-7.21; P = 0.97), dizziness (RR = 1.09; 95% CI = 0.14-9.40; P = 0.94).Conclusions: Melatonin intervention has no significant influence on well-being, sleepiness, sleep quality, pain intensity after 1 and 3 hours, headache, depression, and dizziness for laparoscopic cholecystectomy.
Background:The impact of magnesium sulfate on hemodynamic responses during laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of magnesium sulfate on hemodynamic responses for laparoscopic cholecystectomy.Methods:We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through June 2018 for randomized controlled trials (RCTs) assessing the effect of magnesium sulfate on hemodynamic responses for laparoscopic cholecystectomy. Meta-analysis is performed using the random-effect model.Results:Four RCTs involving 208 patients are included in the meta-analysis. Overall, compared with control group in laparoscopic cholecystectomy, intravenous magnesium sulfate is associated with systolic blood pressure at 30 minutes [Std. MD = −1.34; 95% confidence interval (95% CI) = −1.86 to −0.82; P < .00001], diastolic blood pressure at 30 minutes (Std. MD = −1.40; 95% CI = −1.86 to −0.94; P < .00001), mean arterial pressure at 30 minutes (Std. MD = −1.19; 95% CI = −1.91 to −0.46; P = .001), systolic blood pressure at 10 minutes (Std. MD = −1.61; 95% CI = −2.08 to −1.13; P < .00001), diastolic blood pressure at 10 minutes (Std. MD = −1.54; 95% CI = −2.68 to −0.40; P = .008), heart rate at 30 minutes (Std. MD = −2.09; 95% CI = −2.87 to −1.32; P < .00001), but results in prolonged extubation time (Std. MD = 0.96; 95% CI = 0.18–1.74; P = .02).Conclusion:Magnesium sulfate can reduce blood pressure, but with the increase in extubation time for laparoscopic cholecystectomy.
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