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general surgery randomised controlled trial

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https://www.readbyqxmd.com/read/29305324/real-world-outcomes-in-patients-with-neovascular-age-related-macular-degeneration-treated-with-intravitreal-vascular-endothelial-growth-factor-inhibitors
#1
REVIEW
Hemal Mehta, Adnan Tufail, Vincent Daien, Aaron Lee, Vuong Nguyen, Mehmet Ozturk, Daniel Barthelmes, Mark C Gillies
Clinical trials identified intravitreal vascular endothelial growth factor inhibitors (anti-VEGF agents) have the potential to stabilise or even improve visual acuity outcomes in neovascular age-related macular degeneration (AMD), a sight-threatening disease. Real-world evidence allows us to assess whether results from randomised controlled trials can be applied to the general population. We describe the development of global registries, in particular the Fight Retinal Blindness! registry that originated in Australia, the United Kingdom AMD Electronic Medical Records User Group and the IRIS registry in the USA...
January 2, 2018: Progress in Retinal and Eye Research
https://www.readbyqxmd.com/read/29304735/effect-of-single-dose-dexmedetomidine-on-postoperative-recovery-after-ambulatory-ureteroscopy-and-ureteric-stenting-a-double-blind-randomized-controlled-study
#2
I I Shariffuddin, W H Teoh, S Wahab, C Y Wang
BACKGROUND: Ambulatory surgery has recently gain popularity, as it is a good method of optimizinghospital resources utilization. To support ambulatory surgery, anaesthetic goals nowrevolve around patients' early recovery with minimal pain and nausea, expedientdischarge home and prompt resumption of activities of daily living. In this study, weevaluated the effect of a single pre-induction dose of dexmedetomidine on anaestheticrequirements, postoperative pain and clinical recovery after ambulatory ureteroscopy andureteric stenting under general anaesthesia...
January 5, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29227351/impact-of-pectoral-nerve-block-on-postoperative-pain-and-quality-of-recovery-in-patients-undergoing-breast-cancer-surgery-a-randomised-controlled-trial
#3
Yoshinori Kamiya, Miki Hasegawa, Takayuki Yoshida, Misako Takamatsu, Yu Koyama
BACKGROUND: In recent years, thoracic wall nerve blocks, such as the pectoral nerve (PECS) block and the serratus plane block have become popular for peri-operative pain control in patients undergoing breast cancer surgery. The effect of PECS block on quality of recovery (QoR) after breast cancer surgery has not been evaluated. OBJECTIVES: To evaluate the ability of PECS block to decrease postoperative pain and anaesthesia and analgesia requirements and to improve postoperative QoR in patients undergoing breast cancer surgery...
December 8, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29222203/type-and-frequency-of-side-effects-during-pc6-acupuncture-observations-from-therapists-and-patients-participating-in-clinical-efficacy-trials-of-acupuncture
#4
Anna Enblom, Anna Johnsson
BACKGROUND: Many therapists practise PC6 acupuncture for emesis (nausea and vomiting) during pregnancy, different cancer therapies, palliative care, after surgery, or to induce relaxing effects in general. Knowledge of side effects is central to shared decision-making. AIM: To describe the type and frequency of side effects and the level of needle-induced pain during PC6 acupuncture. METHODS: We included 1298 PC6 acupuncture treatments, delivered to 221 participants (77% women, mean age 52...
December 2017: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://www.readbyqxmd.com/read/29214645/recovery-characteristics-of-patients-receiving-either-sugammadex-or-neostigmine-and-glycopyrrolate-for-reversal-of-neuromuscular-block-a-randomised-controlled-trial
#5
M J Paech, R Kaye, C Baber, E A Nathan
Sugammadex more rapidly and reliably reverses rocuronium-induced neuromuscular block compared with neostigmine, but it is not known if subsequent patient outcomes, including nausea, vomiting and other aspects of recovery are modified. In this study, we compared the recovery characteristics of sugammadex and neostigmine/glycopyrrolate following reversal of neuromuscular block. This was a single-centre, randomised, blinded, parallel-group clinical trial in women undergoing elective day-surgical laparoscopic gynaecological surgery, with a standardised general anaesthesia regimen that included rocuronium...
December 7, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29210845/does-a-hypnosis-session-reduce-the-required-propofol-dose-during-closed-loop-anaesthesia-induction-a-randomised-controlled-trial
#6
Aurélien Bataille, Avit Guirimand, Barbara Szekely, Mireille Michel-Cherqui, Virginie Dumans, Ngai Liu, Thierry Chazot, Marc Fischler, Morgan Le Guen
BACKGROUND: Hypnosis has a positive effect on peri-operative anxiety and pain. OBJECTIVE: The objective of this study was to assess the impact of a formal deep hypnosis session on the consumption of propofol for anaesthetic induction using automated administration of propofol guided by the bispectral index (BIS) in a closed loop. DESIGN: A 1 : 1 randomised, usual-care-controlled, single-centre trial. SETTING: Tertiary care centre in France from April 2014 to December 2015...
November 27, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29193009/do-perioperative-antibiotics-reduce-the-risk-of-surgical-site-infections-following-excision-of-ulcerated-skin-cancers-a-critically-appraised-topic
#7
S A Chan, A G H Wernham, N Stembridge, N Harper, S Verykiou, G A Fremlin, R A Abbott, R N Matin
AIM: To review the efficacy of perioperative antibiotics in reducing the risk of surgical site infections (SSI) following excision of ulcerated skin cancers. SETTING AND DESIGN: Study selection, data extraction and analysis were carried out independently by four authors. Only randomised controlled trials (RCTs) reported in the English Language were included. INCLUDED STUDIES: Randomised controlled trials (RCTs) in the English language in which patients received perioperative topical, intralesional, or oral antibiotics for dermatological surgery including Mohs micrographic surgery in General Practice, Dermatology or Plastic Surgery Departments were included...
November 28, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/29189318/standardised-noxious-stimulation-guided-individual-adjustment-of-remifentanil-target-controlled-infusion-to-prevent-haemodynamic-responses-to-laryngoscopy-and-surgical-incision-a-randomised-controlled-trial
#8
Aline Defresne, Luc Barvais, François Clement, Vincent Bonhomme
BACKGROUND: The surgical plethysmographic index (SPI) is one of the available indexes of the nociception-antinociception (NAN) balance. Individually adjusting the NAN balance to prevent somatic responses to noxious stimulation remains a challenge. OBJECTIVES: To assess whether guiding remifentanil administration according to the SPI response to a calibrated noxious stimulus (NANCAL) can blunt the haemodynamic response to tracheal intubation and surgical incision...
November 18, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29187413/impact-of-inhalational-versus-intravenous-anaesthesia-on-early-delirium-and-long-term-survival-in-elderly-patients-after-cancer-surgery-study-protocol-of-a-multicentre-open-label-and-randomised-controlled-trial
#9
Yue Zhang, Hui-Juan Li, Dong-Xin Wang, Hui-Qun Jia, Xu-De Sun, Ling-Hui Pan, Qing-Shan Ye, Wen Ouyang, Zhen Jia, Fang-Xiang Zhang, Yong-Qing Guo, Yan-Qiu Ai, Bin-Jiang Zhao, Xu-Dong Yang, Qin-Gong Zhang, Ning Yin, Hong-Yu Tan, Zhi-Heng Liu, Jian-Bo Yu, Daqing Ma
INTRODUCTION: Elderly patients who have solid organ cancer often receive surgery. Some of them may develop delirium after surgery and delirium development is associated with worse outcomes. Furthermore, despite all of the advances in medical care, the long-term survival in cancer patients is far from optimal. Evidences suggest that choice of anaesthetics during surgery, that is, either inhalational or intravenous anaesthetics, may influence outcomes. However, the impact of general anaesthesia type on the occurrence of postoperative delirium is inconclusive...
November 28, 2017: BMJ Open
https://www.readbyqxmd.com/read/29177062/validity-of-studies-suggesting-postsurgical-chemotherapy-for-resectable-gastric-cancer-critical-appraisal-of-randomised-trials
#10
Giulia Manzini, Doris Henne-Bruns, Michael Kremer
Background and aim: In 2013, Diaz-Nieto et al published a Cochrane review to summarise the impact of postsurgical chemotherapy versus surgery alone on survival for resectable gastric cancer. The authors concluded that postsurgical chemotherapy showed an improvement in overall survival. The aim of this article was to assess the validity of four studies included in the Cochrane review and to investigate the impact of an exclusion of these four studies on the result of the meta-analysis...
2017: BMJ Open Gastroenterology
https://www.readbyqxmd.com/read/29168575/cuffed-vs-uncuffed-tracheal-tubes-in-children-a-randomised-controlled-trial-comparing-leak-tidal-volume-and-complications
#11
N A Chambers, A Ramgolam, D Sommerfield, G Zhang, T Ledowski, M Thurm, M Lethbridge, M Hegarty, B S von Ungern-Sternberg
Cuffed tracheal tubes are increasingly used in paediatric anaesthetic practice. This study compared tidal volume and leakage around cuffed and uncuffed tracheal tubes in children who required standardised mechanical ventilation of their lungs in the operating theatre. Children (0-16 years) undergoing elective surgery requiring tracheal intubation were randomly assigned to receive either a cuffed or an uncuffed tracheal tube. Assessments were made at five different time-points: during volume-controlled ventilation 6 ml...
November 23, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29161465/neuromuscular-electrical-stimulation-for-the-prevention-of-venous-thromboembolism
#12
REVIEW
Shahab Hajibandeh, Shahin Hajibandeh, George A Antoniou, James Rh Scurr, Francesco Torella
BACKGROUND: Venous thromboembolism (VTE) is a serious but preventable cause of morbidity and mortality. Neuromuscular electrical stimulation systems (NMES) for the prevention of VTE may be beneficial for patients in whom pharmacological or standard mechanical prophylaxis methods are contraindicated or are regarded as unsafe or impractical. Although findings of experimental studies suggest that NMES reduce venous stasis, the clinical utility and effectiveness of NMES in VTE prevention remain controversial...
November 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29150922/prospective-evaluation-of-a-nonsurgical-device-for-rhinoplasty
#13
M A Deggeller, D Holzmann, M B Soyka
BACKGROUND: Rhinoplasty represents one of the most challenging and frequently performed procedures in plastic surgery and non-surgical rhinoplasty is rarely considered. The aim of this study was to investigate whether the Nasella Nose Former (NNF), a newly developed non-surgical rhinoplasty device, could improve objective and subjective results following surgical rhinoplasty and even correct the shape of the nose without any surgery at all. METHODOLOGY: In this prospective, monocentric, two-armed, non-blinded randomized, controlled clinical trial, a total of 43 participants were included...
November 18, 2017: Rhinology
https://www.readbyqxmd.com/read/29131754/perioperative-local-and-systemic-warming-in-surgical-site-infection-a-systematic-review-and-meta-analysis
#14
K Ousey, K-L Edward, S Lui, J Stephenson, K Walker, J Duff, D Leaper
OBJECTIVE: Surgical site infection (SSI) is a common cause of postoperative morbidity. Perioperative hypothermia may contribute to surgical complications including increased risk of SSI. In this systematic review and meta-analysis, the effectiveness of active and passive perioperative warming interventions to prevent SSI was compared with standard (non-warming) care. METHOD: Ovid MEDLINE; Ovid EMBASE; EBSCO CINAHL Plus; The Cochrane Wounds Specialised Register, and The Cochrane Central Register of Controlled Trials were searched, with no restrictions on language, publication date or study setting for randomised controlled trials (RCTs) and cluster RCTs...
November 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/29083473/intracavity-lavage-and-wound-irrigation-for-prevention-of-surgical-site-infection
#15
REVIEW
Gill Norman, Ross A Atkinson, Tanya A Smith, Ceri Rowlands, Amber D Rithalia, Emma J Crosbie, Jo C Dumville
BACKGROUND: Surgical site infections (SSIs) are wound infections that occur after an operative procedure. A preventable complication, they are costly and associated with poorer patient outcomes, increased mortality, morbidity and reoperation rates. Surgical wound irrigation is an intraoperative technique, which may reduce the rate of SSIs through removal of dead or damaged tissue, metabolic waste, and wound exudate. Irrigation can be undertaken prior to wound closure or postoperatively...
October 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29061612/comparison-of-regional-with-general-anaesthesia-on-postoperative-delirium-raga-delirium-in-the-older-patients-undergoing-hip-fracture-surgery-study-protocol-for-a-multicentre-randomised-controlled-trial
#16
Ting Li, Joyce Yeung, Jun Li, Yan Zhang, Teresa Melody, Ye Gao, Yi Wang, Qianquan Lian, Fang Gao
INTRODUCTION: Postoperative delirium (POD) is a common serious postoperative complication especially in older people and is associated with increased mortality, morbidity and healthcare costs. There is no clear consensus which anaesthesia is associated with less incidence of POD for older patients. We aim to assess whether regional anaesthesia results in lower incidence of POD comparing with general anaesthesia (GA) among older patients undergoing hip fracture surgery. METHODS AND ANALYSIS: RAGA-delirium is a pragmatic, multicentre, prospective, parallel grouped, randomised controlled clinical trial comparing RA or GA for hip fracture surgery...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29037157/gastrointestinal-motility-following-thoracic-surgery-the-effect-of-thoracic-epidural-analgesia-a-randomised-controlled-trial
#17
Argyro Zoumprouli, Aikaterini Chatzimichali, Stamatios Papadimitriou, Alexandra Papaioannou, Evaghelos Xynos, Helen Askitopoulou
BACKGROUNDS: Impairment of gastrointestinal (GI) motility is an undesirable but inevitable consequence of surgery. This prospective randomised controlled study tested the hypothesis that postoperative thoracic epidural analgesia (TEA) with ropivacaine or a combination of ropivacaine and morphine accelerates postoperative GI function and shortens the duration of postoperative ileus following major thoracic surgery compared to intravenous (IV) morphine. METHODS: Thirty patients scheduled for major thoracic surgery were randomised to three groups...
October 16, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29034449/nitrous-oxide-based-vs-nitrous-oxide-free-general-anaesthesia-and-accidental-awareness-in-surgical-patients-an-abridged-cochrane-systematic-review
#18
REVIEW
J Hounsome, J Greenhalgh, O J Schofield-Robinson, S R Lewis, T M Cook, A F Smith
Accidental awareness during general anaesthesia can arise from a failure to deliver sufficient anaesthetic agent, or from a patient's resistance to an expected sufficient dose of such an agent. Awareness is 'explicit' if the patient is subsequently able to recall the event. We conducted a systematic review into the effect of nitrous oxide used as part of a general anaesthetic on the risk of accidental awareness in people over the age of five years undergoing general anaesthesia for surgery. We included 15 randomised controlled trials, 14 of which, representing a total of 3439 participants, were included in our primary analysis of the frequency of accidental awareness events...
October 16, 2017: Anaesthesia
https://www.readbyqxmd.com/read/29028921/smartpilot%C3%A2-view-guided-anaesthesia-improves-postoperative-outcomes-in-hip-fracture-surgery-a-randomized-blinded-controlled-study
#19
D Leblanc, M Conté, G Masson, F Richard, A Jeanneteau, G Bouhours, J M Chrétien, L Rony, E Rineau, S Lasocki
Background: Both under-dosage and over-dosage of general anaesthetics can harm frail patients. We hypothesised that computer-assisted anaesthesia using pharmacokinetic/pharmacodynamic models guided by SmartPilot® View (SPV) software could optimise depth of anaesthesia and improve outcomes in patients undergoing hip fracture surgery. Methods: This prospective, randomized, single-centre, blinded trial included patients undergoing hip fracture surgery under general anaesthesia...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29019319/the-asymptomatic-carotid-surgery-trial-2-acst-2-an-ongoing-randomised-controlled-trial-comparing-carotid-endarterectomy-with-carotid-artery-stenting-to-prevent-stroke
#20
Richard Bulbulia, Alison Halliday
BACKGROUND: A successful open surgical operation to remove atheromatous carotid artery narrowing that has not yet caused a stroke (asymptomatic carotid stenosis) carries some procedural risk but, if completed successfully, halves patients' future annual stroke risk for at least 10 years. A newer, less invasive alternative is carotid stenting, which also carries some procedural risk, especially if the carotid lesion has recently given rise to a stroke (symptomatic carotid stenosis). For both surgery and stenting, improvements in technique (and in medication) have reduced risk...
October 2017: Health Technology Assessment: HTA
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