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https://www.readbyqxmd.com/read/28899891/effect-of-anesthesia-depth-on-postoperative-clinical-outcome-in-patients-with-supratentorial-tumor-depth-study-protocol-for-a-randomized-controlled-trial
#1
Qianyu Cui, Yuming Peng, Xiaoyuan Liu, Bo Jia, Jia Dong, Ruquan Han
INTRODUCTION: Recent studies have shown that deep anaesthesia is associated with poor outcomes. However, no randomised controlled trials have been conducted to test the causality in patients undergoing brain tumour resection. METHODS AND ANALYSIS: DEPTH is a multicenter, randomised, parallel-group, blind trial. The depth of general anaesthesia will be monitored using the bispectral index (BIS). Patients elected for supratentorial tumour resection will be randomly allocated to the deep or the light anaesthesia group in which the target BIS value is 35 or 50, respectively...
September 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28882741/tracheal-extubation-with-suction-vs-positive-pressure-during-emergence-from-general-anaesthesia-in-adults-a-randomised-controlled-trial
#2
Joël L'Hermite, Olivier Wira, Chritel Castelli, Jean-Emmanuel de La Coussaye, Jacques Ripart, Philippe Cuvillon
BACKGROUND: After general anaesthesia (GA) in adults, the optimal tracheal extubation technique (positive pressure or suctioning) remains debated. The primary endpoint of this study was to assess the effects of these techniques on onset time of desaturation (SpO2 < 92%). METHODS: Sixty-nine patients with a body mass index < 30 scheduled for elective orthopaedic surgery were allocated to positive pressure (PP) or suctioning (SUC) group. GA was standardised with propofol and remifentanil via target-controlled infusion...
September 4, 2017: Anaesthesia, Critical Care & Pain Medicine
https://www.readbyqxmd.com/read/28859943/population-screening-and-intervention-for-vascular-disease-in-danish-men-viva-a-randomised-controlled-trial
#3
Jes S Lindholt, Rikke Søgaard
BACKGROUND: Abdominal aortic aneurysm is the only cardiovascular disease targeted by population screening. In this study, we test the effect of screening and subsequent intervention for abdominal aortic aneurysm, peripheral arterial disease, and hypertension combined. METHODS: In this randomised controlled trial, we randomly allocated (1:1) all men aged 65-74 years living in the Central Denmark Region to screening for abdominal aortic aneurysm, peripheral arterial disease, and hypertension, or to no screening...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28851399/a-mixed-methods-feasibility-and-external-pilot-study-to-inform-a-large-pragmatic-randomised-controlled-trial-of-the-effects-of-surgical-wound-dressing-strategies-on-surgical-site-infections-bluebelle-phase-b-study-protocol-for-a-randomised-controlled-trial
#4
Barnaby C Reeves, Lazaros Andronis, Jane M Blazeby, Natalie S Blencowe, Melanie Calvert, Joanna Coast, Tim Draycott, Jenny L Donovan, Rachael Gooberman-Hill, Robert J Longman, Laura Magill, Jonathan M Mathers, Thomas D Pinkney, Chris A Rogers, Leila Rooshenas, Andrew Torrance, Nicky J Welton, Mark Woodward, Kate Ashton, Katarzyna D Bera, Gemma L Clayton, Lucy A Culliford, Jo C Dumville, Daisy Elliott, Lucy Ellis, Hannah Gould-Brown, Rhiannon C Macefield, Christel McMullan, Caroline Pope, Dimitrios Siassakos, Sean Strong, Helen Talbot
BACKGROUND: Surgical site infections (SSIs) are common, occurring in up to 25% of > 4 million operations performed in England each year. Previous trials of the effect of wound dressings on the risk of developing a SSI are of poor quality and underpowered. METHODS/DESIGN: This study is a feasibility and pilot trial to examine the feasibility of a full trial that will compare simple dressings, no dressing and tissue-glue as a dressing. It is examining the overall acceptability of trial participation, identifying opportunities for refinement, testing the feasibility of and validating new outcome tools to assess SSI, wound management issues and patients' wound symptom experiences...
August 29, 2017: Trials
https://www.readbyqxmd.com/read/28838644/laparoscopic-ileocaecal-resection-versus-infliximab-for-terminal-ileitis-in-crohn-s-disease-a-randomised-controlled-open-label-multicentre-trial
#5
Cyriel Y Ponsioen, E Joline de Groof, Emma J Eshuis, Tjibbe J Gardenbroek, Patrick M M Bossuyt, Ailsa Hart, Janindra Warusavitarne, Christianne J Buskens, Ad A van Bodegraven, Menno A Brink, Esther C J Consten, Bart A van Wagensveld, Marno C M Rijk, Rogier M P H Crolla, Casper G Noomen, Alexander P J Houdijk, Rosalie C Mallant, Maarten Boom, Willem A Marsman, Hein B Stockmann, Bregje Mol, A Jeroen de Groof, Pieter C Stokkers, Geert R D'Haens, Willem A Bemelman
BACKGROUND: Treatment of patients with ileocaecal Crohn's disease who have not responded to conventional therapy is commonly scaled up to biological agents, but surgery can also offer excellent short-term and long-term results. We compared laparoscopic ileocaecal resection with infliximab to assess how they affect health-related quality of life. METHODS: In this randomised controlled, open-label trial, in 29 teaching hospitals and tertiary care centres in the Netherlands and the UK, adults with non-stricturing, ileocaecal Crohn's disease, in whom conventional therapy has failed were randomly allocated (1:1) by an internet randomisation module with biased-coin minimisation for participating centres and perianal fistula to receive laparoscopic ileocaecal resection or infliximab...
August 21, 2017: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28782746/comparison-of-single-port-and-conventional-laparoscopic-abdominoperineal-resection
#6
Nikolaj Nerup, Steffen Rosenstock, Orhan Bulut
BACKGROUND: Within the last two decades, surgical treatment of colorectal cancer has changed dramatically from large abdominal incisions to minimal access surgery. In the recent years, single port (SP) surgery has spawned from conventional laparoscopic surgery. The purpose of this study was to compare conventional with SP laparoscopic abdominoperineal resection (LAPR) for rectal cancer. PATIENTS AND METHODS: This was a single-center non-randomised retrospective comparative study of prospectively collected data on 53 patients who underwent abdominoperineal resection for low rectal cancer; 41 with conventional laparoscopy and 12 with SP surgery...
August 1, 2017: Journal of Minimal Access Surgery
https://www.readbyqxmd.com/read/28763316/effects-of-calcium-chloride-coadministered-with-neostigmine-on-neuromuscular-blockade-recovery-a-double-blind-randomised-study
#7
Jae-Woo Ju, Hyun-Chang Kim, Sehee Yoon, Deok Man Hong, Hee-Pyoung Park
BACKGROUND: Ionised calcium plays an important role in neuromuscular transmission, but its effects on the reversal of nondepolarising neuromuscular blockade have not been fully evaluated. OBJECTIVE: We examined whether calcium chloride coadministered with neostigmine could enhance the rate of neuromuscular recovery. DESIGN: Randomised double-blind trial. SETTING: A tertiary teaching hospital. PATIENTS: In total, 53 patients undergoing elective surgery under general anaesthesia with neuromuscular monitoring by acceleromyography using a TOF-Watch SX monitor...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28743315/tight-intra-operative-blood-pressure-control-versus-standard-care-for-patients-undergoing-hip-fracture-repair-hip-fracture-intervention-study-for-prevention-of-hypotension-hip-hop-trial-study-protocol-for-a-randomised-controlled-trial
#8
Iain Keith Moppett, Stuart White, Richard Griffiths, Donal Buggy
BACKGROUND: Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control...
July 25, 2017: Trials
https://www.readbyqxmd.com/read/28741303/open-retropubic-colposuspension-for-urinary-incontinence-in-women
#9
REVIEW
Marie Carmela M Lapitan, June D Cody, Atefeh Mashayekhi
BACKGROUND: Urinary incontinence is a common and potentially debilitating problem. Stress urinary, incontinence as the most common type of incontinence, imposes significant health and economic burdens on society and the women affected. Open retropubic colposuspension is a surgical treatment which involves lifting the tissues near the bladder neck and proximal urethra in the area behind the anterior pubic bones to correct deficient urethral closure to correct stress urinary incontinence...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28738443/urethral-injection-therapy-for-urinary-incontinence-in-women
#10
REVIEW
Vivienne Kirchin, Tobias Page, Phil E Keegan, Kofi Om Atiemo, June D Cody, Samuel McClinton, Patricia Aluko
BACKGROUND: Urinary incontinence imposes a significant health and economic burden to society. Periurethral or transurethral injection of bulking agents is a minimally invasive surgical procedure used as one the surgical treatments of stress urinary incontinence (SUI) in adult women. OBJECTIVES: To assess the effects of periurethral or transurethral injection therapy on the cure or improvement of urinary incontinence in women. SEARCH METHODS: We searched the Cochrane Incontinence Group Specialised Trials Register (searched 8 November 2010) and the reference lists of relevant articles...
July 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28734705/a-proficiency-based-stepwise-endovascular-curricular-training-prospect-program-enhances-operative-performance-in-real-life-a-randomised-controlled-trial
#11
H Maertens, R Aggarwal, N Moreels, F Vermassen, I Van Herzeele
OBJECTIVES: Healthcare evolution requires optimisation of surgical training to provide safe patient care. Operating room performance after completion of proficiency based training in vascular surgery has not been investigated. DESIGN: A randomised controlled trial evaluated the impact of a Proficiency based Stepwise Endovascular Curricular Training program (PROSPECT) on the acquisition of endovascular skills and the transferability of these skills to real life interventions...
July 19, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28731925/thoracic-paravertebral-block-for-postoperative-pain-management-after-renal-surgery-a-randomised-controlled-trial
#12
Maja Copik, Szymon Bialka, Andrzej Daszkiewicz, Hanna Misiolek
BACKGROUND: Thoracic paravertebral block (ThPVB) combined with general anaesthesia is used in thoracic and general surgery. It provides effective analgesia, reduces surgical stress response and the incidence of chronic postoperative pain. OBJECTIVE: To assess the efficacy of ThPVB in reducing opioid requirements and decreasing the intensity of pain after renal surgery. DESIGN: A randomised, open label study. SETTING: A single university hospital...
September 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28673215/the-effect-of-a-perioperative-ketamine-infusion-on-the-incidence-of-chronic-postsurgical-pain-a-pilot-study
#13
RANDOMIZED CONTROLLED TRIAL
P J Peyton, C Wu, T Jacobson, M Hogg, F Zia, K Leslie
Chronic postsurgical pain (CPSP) is a common and debilitating complication of major surgery. We undertook a pilot study at three hospitals to assess the feasibility of a proposed large multicentre placebo-controlled randomised trial of intravenous perioperative ketamine to reduce the incidence of CPSP. Ketamine, 0.5 mg/kg pre-incision, 0.25 mg/kg/hour intraoperatively and 0.1 mg/kg/hour for 24 hours, or placebo, was administered to 80 patients, recruited over a 15-month period, undergoing abdominal or thoracic surgery under general anaesthesia...
July 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/28668558/early-rehabilitation-after-lumbar-disc-surgery-is-not-effective-or-cost-effective-compared-to-no-referral-a-randomised-trial-and-economic-evaluation
#14
Teddy Oosterhuis, Raymond W Ostelo, Johanna M van Dongen, Wilco C Peul, Michiel R de Boer, Judith E Bosmans, Carmen L Vleggeert-Lankamp, Mark P Arts, Maurits W van Tulder
QUESTION: Is referral for early rehabilitation after lumbar disc surgery effective and cost-effective compared to no referral? DESIGN: Multicentre, randomised, controlled trial, and economic evaluation with concealed allocation and intention-to-treat-analysis. PARTICIPANTS: Adults who underwent discectomy for a herniated lumbar disc, confirmed by magnetic resonance imaging, and signs of nerve root compression corresponding to the herniation level...
July 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/28659127/general-vs-neuraxial-anaesthesia-in-hip-fracture-patients-a-systematic-review-and-meta-analysis
#15
Julia Van Waesberghe, Ana Stevanovic, Rolf Rossaint, Mark Coburn
BACKGROUND: Hip fracture is a trauma of the elderly. The worldwide number of patients in need of surgery after hip fracture will increase in the coming years. The 30-day mortality ranges between 4 and 14%. Patients' outcome may be improved by anaesthesia technique (general vs. neuraxial anaesthesia). There is a dearth of evidence from randomised studies regarding to the optimal anaesthesia technique. However, several large non-randomised studies addressing this question have been published from the onset of 2010...
June 28, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28639296/pathways-to-professionalism-quality-improvement-care-pathways-and-the-interplay-of-standardisation-and-clinical-autonomy
#16
Graham P Martin, David Kocman, Timothy Stephens, Carol J Peden, Rupert M Pearse
Care pathways are a prominent feature of efforts to improve healthcare quality, outcomes and accountability, but sociological studies of pathways often find professional resistance to standardisation. This qualitative study examined the adoption and adaptation of a novel pathway as part of a randomised controlled trial in an unusually complex, non-linear field - emergency general surgery - by teams of surgeons and physicians in six theoretically sampled sites in the UK. We find near-universal receptivity to the concept of a pathway as a means of improving peri-operative processes and outcomes, but concern about the impact on appropriate professional judgement...
June 21, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28635028/gases-for-establishing-pneumoperitoneum-during-laparoscopic-abdominal-surgery
#17
REVIEW
Tianwu Yu, Yao Cheng, Xiaomei Wang, Bing Tu, Nansheng Cheng, Jianping Gong, Lian Bai
BACKGROUND: This is an update of the review published in 2013.Laparoscopic surgery is now widely performed to treat various abdominal diseases. Currently, carbon dioxide is the most frequently used gas for insufflation of the abdominal cavity (pneumoperitoneum). Although carbon dioxide meets most of the requirements for pneumoperitoneum, the absorption of carbon dioxide may be associated with adverse events. People with high anaesthetic risk are more likely to experience cardiopulmonary complications and adverse events, for example hypercapnia and acidosis, which has to be avoided by hyperventilation...
June 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28617240/what-carcinoembryonic-antigen-level-should-trigger-further-investigation-during-colorectal-cancer-follow-up-a-systematic-review-and-secondary-analysis-of-a-randomised-controlled-trial
#18
Bethany Shinkins, Brian D Nicholson, Tim James, Indika Pathiraja, Sian Pugh, Rafael Perera, John Primrose, David Mant
BACKGROUND: Following primary surgical and adjuvant treatment for colorectal cancer, many patients are routinely followed up with blood carcinoembryonic antigen (CEA) testing. OBJECTIVE: To determine how the CEA test result should be interpreted to inform the decision to undertake further investigation to detect treatable recurrences. DESIGN: Two studies were conducted: (1) a Cochrane review of existing studies describing the diagnostic accuracy of blood CEA testing for detecting colorectal recurrence; and (2) a secondary analysis of data from the two arms of the FACS (Follow-up After Colorectal Surgery) trial in which CEA testing was carried out...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28604179/bolus-administration-of-intravenous-lidocaine-reduces-pain-after-an-elective-caesarean-section-findings-from-a-randomised-double-blind-placebo-controlled-trial
#19
Afshin Gholipour Baradari, Abolfazl Firouzian, Farshad Hasanzadeh Kiabi, Amir Emami Zeydi, Mohammad Khademloo, Zeinab Nazari, Masoumeh Sanagou, Maedeh Ghobadi, Ensieh Fooladi
We conducted a randomised double-blind, placebo-controlled trial to assess whether a bolus dose of lidocaine during the induction of general anaesthesia would reduce postoperative pain over 24 h. Level of satisfaction with pain control at 48 h after surgery and Apgar score were also examined. A total of 100 women aged 20-35 years, who were candidates for elective caesarean section (CS) were randomised to receive either 1.5 mg/kg lidocaine or placebo during the induction of general anaesthesia. Results showed that lidocaine decreased pain intensity over 24 h after surgery (p < ...
July 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28600373/evaluation-of-a-physiatrist-directed-prehabilitation-intervention-in-frail-patients-with-colorectal-cancer-a-randomised-pilot-study-protocol
#20
Sherman G Wong, Eugene Maida, David Harvey, Natalie Wagner, Ranil Sonnadara, Nalin Amin
INTRODUCTION: Prehabilitation interventions have shown efficacy in the orthopaedic and cardiothoracic surgical populations, but there has been limited evidence for general surgical patients. We present the protocol for a pilot trial of a novel prehabilitation intervention, consisting of a physiatrist-directed preoperative assessment and treatment programme. METHODS AND ANALYSIS: This is a single-centre pilot randomised controlled trial investigating physiatrist-directed prehabilitation for a 4 to 6-week preoperative period...
June 9, 2017: BMJ Open
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