Background: Bariatric surgery is associated with significant postoperative challenges, including pain and nausea. Dexmedetomidine (Dex), an alpha-2 adrenergic agonist, is commonly used to manage pain and postoperative nausea and vomiting (PONV) in various surgical settings. This meta-analysis evaluates the efficacy of Dex in bariatric surgery patients, focusing on postoperative pain intensity, opioid consumption, and PONV. Methods: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) published between 2010 and 2023, assessing Dex use during or after bariatric surgery. Studies comparing Dex to placebo or standard care were included. Data extraction was performed independently by two reviewers, and statistical analysis was conducted using a random-effects model. Study quality was assessed using the Cochrane Risk of Bias tool. Results: Six RCTs (485 participants) met the inclusion criteria. Dex significantly reduced intraoperative fentanyl use (SMD −1.33, 95% CI [−2.19, −0.47], p = 0.002). Pain scores showed mixed results, with some studies reporting lower pain intensity in the Dex group, while others found no significant difference compared to morphine or placebo. PONV scores were generally lower in the Dex group (p = 0.01) compared to placebo and morphine. No significant differences were found in morphine consumption (SMD −1.13, 95% CI [−2.24, 0.01], p = 0.05) or recovery time. Conclusions: Dexmedetomidine appears to reduce opioid requirements and postoperative nausea in bariatric surgery patients. However, the variability in pain management outcomes suggests that further well-designed RCTs are needed to confirm its overall efficacy. The findings are based on moderate-quality evidence, and further research should aim to standardize dosing protocols and patient populations.

Background: Whole blood is a product that contains all three blood components (plasma, red blood cells, and platelets). This systemic review and meta-analysis was conducted to identify barriers and obstacles to establishing whole blood transfusion protocols in civilian hospitals. Methods: The study was conducted using PRISMA guidelines with PROSPERO registration No. CRD42024519898. Traumatic patients who needed or received whole blood transfusion were included. A systematic literature review employed a comprehensive search strategy through the PubMed, Google Scholar, Web of Science, ScienceDirect, and ProQuest databases. Meta-analysis was utilized to analyze the outcomes. The risk of bias was assessed using the Newcastle–Ottawa Scale. Results: In total, 310 studies were identified, and 11 studies met the inclusion criteria. The following intervals were used to assess the prevalence of mortality: 6 h 12.15% (0.081, 95% CI [0.023, 0.139]), 24 h 14.08% (0.141, 95% CI [0.111, 0.171]), delayed mortality (28–30 days) 22.89% (0.284, 95% CI [0.207, 0.360]), and in-hospital 18.72%, with relative risk (0.176, 95% CI [0.114,0.238]). Conclusions: Traumatic patients can be effectively resuscitated and stabilized with whole blood transfusion (WBT), but it is essential to provide ongoing critical care, address logistical challenges, and prevent blood product wastage. We recommend utilizing WBT in the early stages of resuscitation for adult civilian trauma patients.

Background: Post-operative pain management is essential for optimizing recovery, patient comfort, and satisfaction. Peripheral nerve blockade, or lumbar plexus block (LPB), has been widely used for analgesia and regional anesthesia. This study explored the existing literature to determine the efficacy of continuous lumbar plexus blockade in managing post-operative pain following hip or femur surgery. Methods: Reviewers comprehensively searched electronic databases to identify peer-reviewed scholarly articles reporting the efficacy of lumbar plexus block in managing post-operative pain after orthopedic surgery. The potential articles were carefully selected and assessed for the risk of bias using the Cochrane Collaboration Risk of Bias assessment tool. Data were systematically extracted and analyzed. Results: The literature search yielded 206 articles, 20 of which were randomized controlled trials. Lumbar plexus block demonstrated superior pain relief compared to conventional pain management approaches like general anesthetics. In addition, LPB reduced patients’ overall opioid consumption compared to controls, reduced adverse effects, and enhanced functional recovery, which underlines the broader positive impact of meticulous pain management. More patients could walk more than 40 feet after the second day post-operatively among the lumbar plexus group (14.7%) compared to the continuous femoral group (1.3%). Other parameters, including cortisol levels and hemodynamic stability, were evaluated, showing comparable outcomes. Conclusions: Lumbar plexus block is effective in pain management after orthopedic surgery, as shown by the lower pain scores and less opioid consumption. Additionally, patient satisfaction was relatively higher in LPB-treated patients compared to other approaches like general anesthesia.

Orthopedic joint replacement procedures, including total hip and knee arthroplasty, are crucial interventions for managing degenerative joint diseases and enhancing patients’ quality of life. Postoperative pain management remains a critical challenge affecting recovery and outcomes. Recognizing pain management as pivotal in patient care, this systematic review evaluates the effectiveness of patient-controlled analgesia (PCA) in orthopedic surgeries. This systematic review synthesizes the current literature to assess PCA’s role in orthopedic joint replacements. Studies focusing on pain relief, opioid consumption, hospital stays, rehabilitation outcomes, and patient satisfaction were analyzed. Significant findings were extracted from statistical analyses to evaluate PCA’s efficacy compared to traditional pain management methods. PCA significantly improves postoperative pain relief (p < 0.05), leading to a 30% reduction in opioid consumption and a 20% shorter hospital stay on average compared to traditional methods. Additionally, patients using PCA reported higher satisfaction scores (85% vs. 65%) and demonstrated improved rehabilitation outcomes, enhancing overall recovery and quality of life post surgery. This review underscores PCA’s effectiveness as a superior strategy for postoperative pain management in orthopedic joint replacements. By reducing pain, opioid use, and hospitalization duration and enhancing rehabilitation outcomes, PCA contributes significantly to improving patient outcomes and healthcare efficiency.

Background/Objectives: Pelvic floor dysfunction (PFD) encompasses urinary incontinence (UI), anorectal disorders (ARDs), and other related conditions that frequently coexist. Evidence on the prevalence and determinants of ARD among patients with UI, particularly in Middle Eastern populations, remains limited. This study aimed to assess the prevalence of ARD in UI patients and identify key clinical and demographic factors associated with anorectal disorders. Methods: A retrospective cohort study was conducted between January 2017 and June 2025. Consecutive adult patients diagnosed with UI were included. Demographic, clinical, obstetric, and surgical characteristics were extracted from medical records. Categorical comparisons were performed using chi-square and Fisher’s exact tests, while predictors of ARD were analyzed using multivariable logistic regression. Results: Among 494 patients with UI, ARD was present in 115 cases, yielding a prevalence of 23.3%. The most frequent ARD diagnoses were hemorrhoids (29.8%), obstructive defecation syndrome (19.3%), and fecal incontinence (18.1%). Patients with ARD more often had stress UI (25.2% vs. 18.5%) and overflow UI (4.3% vs. 2.1%) compared with those without ARD. Chronic constipation was significantly associated with ARD (39.7% vs. 10.7%, p < 0.001), as were hypothyroidism (31.8% vs. 21.4%, p = 0.037), psychological conditions (37.1% vs. 21.0%, p = 0.003), and sexual dysfunction (64.7% vs. 19.0%, p < 0.001). Logistic regression identified rectocele (aOR = 6.54, 95% CI: 3.18–13.45, p < 0.001) and previous pelvic surgery (aOR = 2.27, 95% CI: 1.17–4.41, p = 0.016) as independently associated with ARD. Increasing age was inversely associated with ARD (aOR = 0.98, 95% CI: 0.96–0.99, p = 0.014). Conclusions: Our findings underscore the need to incorporate anorectal and sexual health screening in UI patients. Early recognition, coupled with multidisciplinary team-based management, may help optimize outcomes, enhance treatment compliance, improve quality of life, and reduce the long-term burden associated with PFD.

Intrauterine devices (IUDs) are highly effective long-acting contraceptives. However, pain associated with insertion deters some women and impacts satisfaction. This systematic review critically evaluates the effectiveness of local anesthetics, misoprostol, nonsteroidal anti-inflammatory drugs (NSAIDs), and conscious sedation for managing pain associated with IUD insertion. A comprehensive database search including PubMed, Web of Science, Google Scholar, ClinicalTrials.gov, and ProQuest was conducted from inception to July 2023 for randomized controlled trials (RCTs). RCTs assessing interventions for IUD insertion pain were included. Case reports, non-randomized studies, and non-English papers were excluded. Two independent reviewers extracted data on pain outcomes and adverse effects. The risk of bias was assessed using Cochrane tools. Thirty-nine RCTs (n = 12,345 women) met the inclusion criteria. Topical lidocaine effectively reduced pain on consistent findings across multiple high-quality RCTs. Misoprostol pretreatment facilitated easier insertions through cervical ripening. However, evidence for NSAIDs was inconclusive, with some RCTs finding no additional benefits versus placebo. Results also remained unclear for nitrous oxide conscious sedation due to variability in protocols. Nulliparity predicted higher reported pain consistently. Lidocaine and misoprostol show promise for minimizing IUD insertion pain and difficulty. Further optimization is required to standardize conscious sedation and fully evaluate NSAIDs. Improving pain management may increase favorable experiences and uptake of this reliable method.