ObjectiveTo systematically review the efficacy and safety of intranasal lidocaine spray before nasogastric tube insertion. MethodsWe searched PubMed, EMbase, The Cochrane Library, WanFang Data, VIP, CBM and CNKI databases concerning randomized controlled trial (RCT) of the efficacy and safety of intranasal lidocaine spray before nasogastric tube insertion from their inception to January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Meta-analysis was then conducted using RevMan 5.2 software. ResultsSix RCTs involving 384 patients were included. The results of meta-analysis showed that there were no significant differences between the lidocaine group and the saline group in pain and discomfort scores (MD=-25.35, 95%CI -30.37 to -24.33) and first successful insertion rate (RR=1.38, 95%CI 1.21 to 1.57). ConclusionIntranasal lidocaine spray before nasogastric tube insertion could reduce patient pain and discomforts related to the procedure, and improve the first successful insertion rate.
ObjectiveTo systematically review the effect of pre-treating the catheters with dexamethasone for preventing PICC-associated phlebitis. MethodsWe electronically searched PubMed, EMbase, The Cochrane Library (Issue 4, 2012), CNKI, CBM, WanFang Data and CQVIP for studies about pre-treating the catheters with dexamethasone to prevent PICC-associated phlebitis from inception to March 2013. Relevant studies including grey literature were also manually searched. Two reviewers independently screened studies according to the inclusion and exclusion criteria, extracted data and evaluated the methodological quality of the included studies. Then meta-analysis was performed using the software RevMan 5.0. ResultsA total of 13 studies involving 1 965 cases (1 025 cases in the dexamethasone group, and 940 cases in the control group) were included. The results of meta-analysis showed that pre-treating the catheters with dexamethasone could significantly decrease the incidence of PICC-associated phlebitis (RR=0.29, 95%CI=0.22 to 0.39, P < 0.000 1). However, no significant difference was found for the PICC-associated other complications, such as pipe blockage, bleeding, swelling of puncture site, allergy and atopic catheter. ConclusionPre-treating the catheters with dexamethasone soltion before inserting could reduce the incidence of PICC-associated phlebitis. The aforementioned conclusion needs to be further validated by more high-quality and large-scale randomized controlled trials.