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Randomized controlled trial in general surgery

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https://www.readbyqxmd.com/read/28207529/comparison-of-the-pro-postoperative-analgesia-of-intraoperative-dexmedetomidine-with-and-without-loading-dose-following-general-anesthesia-a-prospective-randomized-controlled-clinical-trial
#1
Wei Fan, Haikou Yang, Yong Sun, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Intraoperative dexemdetomidine (DEX) with or without loading dose is well-established to improve postoperative pain control in patient-controlled analgesia (PCA). This study was designed to compare the pro-analgesia effect between the 2 in patients received general anesthesia.Seventy patients shceduced abdominal surgery under general anesthesia were randomly assigned into 3 groups which were maintained using propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/dexmedetomidine with (PRDw) or without (PRDo) a loading dose of dexmedetomidine before induction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28205034/laparoscopic-surgery-for-pancreatic-neoplasms-the-european-association-for-endoscopic-surgery-clinical-consensus-conference
#2
Bjørn Edwin, Mushegh A Sahakyan, Mohammad Abu Hilal, Marc G Besselink, Marco Braga, Jean-Michel Fabre, Laureano Fernández-Cruz, Brice Gayet, Song Cheol Kim, Igor E Khatkov
BACKGROUND: Introduced more than 20 years ago, laparoscopic pancreatic surgery (LAPS) has not reached a uniform acceptance among HPB surgeons. As a result, there is no consensus regarding its use in patients with pancreatic neoplasms. This study, organized by the European Association for Endoscopic Surgery (EAES), aimed to develop consensus statements and clinical recommendations on the application of LAPS in these patients. METHODS: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreatic surgery...
February 15, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28199805/bariatric-surgery-versus-intensive-medical-therapy-for-diabetes-5-year-outcomes
#3
Philip R Schauer, Deepak L Bhatt, John P Kirwan, Kathy Wolski, Ali Aminian, Stacy A Brethauer, Sankar D Navaneethan, Rishi P Singh, Claire E Pothier, Steven E Nissen, Sangeeta R Kashyap
Background Long-term results from randomized, controlled trials that compare medical therapy with surgical therapy in patients with type 2 diabetes are limited. Methods We assessed outcomes 5 years after 150 patients who had type 2 diabetes and a body-mass index (BMI; the weight in kilograms divided by the square of the height in meters) of 27 to 43 were randomly assigned to receive intensive medical therapy alone or intensive medical therapy plus Roux-en-Y gastric bypass or sleeve gastrectomy. The primary outcome was a glycated hemoglobin level of 6...
16, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28197774/popliteal-block-for-lower-limb-surgery-in-children-with-cerebral-palsy-effect-on-sevoflurane-consumption-and-postoperative-pain-a-randomized-double-blinded-controlled-trial
#4
Derya Ozkan, Emel Gonen, Taylan Akkaya, Mesut Bakir
PURPOSE: The aim of this study was to evaluate the effects of a preoperative popliteal block on sevoflurane consumption, postoperative pain, and analgesic consumption in children with cerebral palsy (CP) following lower limb surgery. METHODS: Fifty-four patients undergoing lower limb surgery were randomized to receive either a popliteal block + general anaesthesia (group P, n = 27) or general anaesthesia without a popliteal block (group C, n = 27). After anesthesia induction with 50% N2O, O2, and 8% sevoflurane, a popliteal block was given to group P patients with ultrasound guidance as a single dose of 0...
February 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28184264/heated-carrier-fluids-in-decreasing-propofol-injection-pain-a-randomized-controlled-trial
#5
Ann Misun Youn, Tzung-Min Hsu
BACKGROUND: Propofol is a commonly used intravenous drug during anesthetic induction because of its rapid onset and short duration. However, the injection pain that patients experience is so severe that they recall the induction of anesthesia as the most painful part of the perioperative period. Therefore, the objective of this study was to determine the effect of heated carrier fluids (40℃) in decreasing propofol injection pain. METHODS: A randomized, controlled clinical trial was conducted in 90 patients aged 18 to 65 who were scheduled for either elective or urgent surgery under general anesthesia classified as American Society of Anesthesiologists physical status I or II...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183546/sevoflurane-preserves-regional-cerebral-oxygen-saturation-better-than-propofol-randomized-controlled-trial
#6
Tomislav Ružman, Tatjana Šimurina, Danijela Gulam, Nataša Ružman, Maja Miškulin
STUDY OBJECTIVE: To investigate possible effects of volatile induction and maintenance anesthesia with sevoflurane (VIMA) and total intravenous anesthesia with propofol (TIVA) on regional cerebral oxygen saturation (rcSo2) during laparoscopic cholecystectomy. DESIGN: Randomized, prospective and single-blinded study. SETTING: Academic hospital. PATIENTS: ASA physical status of I and II surgical patients, scheduled for elective laparoscopic cholecystectomy from March 2013 to October 2014...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183345/robot-assisted-single-site-compared-with-laparoscopic-single-incision-cholecystectomy-for-benign-gallbladder-disease-protocol-for-a-randomized-controlled-trial
#7
Lukasz Filip Grochola, Christopher Soll, Adrian Zehnder, Roland Wyss, Pascal Herzog, Stefan Breitenstein
BACKGROUND: Recent advances in robotic technology suggest that the utilization of the da Vinci Single-Site™ platform for cholecystectomy is safe, feasible and results in a shorter learning curve compared to conventional single-incision laparoscopic cholecystectomy. Moreover, the robot-assisted technology has been shown to reduce the surgeon's stress load compared to standard single-incision laparoscopy in an experimental setup, suggesting an important advantage of the da Vinci platform...
February 9, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28178175/the-effect-of-nicardipine-on-the-surgical-pleth-index-during-thyroidectomy-under-general-anesthesia-a-prospective-double-blind-randomized-controlled-trial
#8
Young Ju Won, Byung Gun Lim, Gwi Eun Yeo, Min Ki Lee, Dong Kyu Lee, Heezoo Kim, Il Ok Lee, Myoung Hoon Kong
BACKGROUND: The effectiveness of surgical pleth index (SPI) for managing nociception-antinociception balance during general anesthesia with vasodilators, including nicardipine has not been demonstrated. We aimed to compare the time course during surgery in SPI values in patients receiving nicardipine or remifentanil infusion during thyroidectomy. METHODS: Forty patients undergoing thyroidectomy were randomly assigned to receive nicardipine (group N; n = 19) or remifentanil (group R; n = 21) along with induction (propofol, fentanyl, and rocuronium) and maintenance (50% desflurane/nitrous oxide in oxygen) anesthesia (goal bispectral index [BIS] ∼50)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28178149/combination-of-general-anesthesia-and-peripheral-nerve-block-with-low-dose-ropivacaine-reduces-postoperative-pain-for-several-days-after-outpatient-arthroscopy-a-randomized-controlled-clinical-trial
#9
Benedikt Büttner, Ashham Mansur, José Hinz, Joachim Erlenwein, Martin Bauer, Ingo Bergmann
BACKGROUND: Effective methods for postoperative pain relief are an important concern in outpatient surgery. For arthroscopies we combine a single-shot peripheral nerve block using low-volume, low-concentration ropivacaine with general anesthesia. We hypothesized that the patients would have less postoperative pain and be more rapidly home ready than after general anesthesia alone. METHODS: Patients (American Society of Anesthesiologists I-III, 18-80 years old) scheduled for outpatient arthroscopy on the upper or lower extremity were randomized to have either a combination of peripheral nerve block and general anesthesia (NB + GA, study group) or general anesthesia alone (GA, control group)...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28177565/the-impact-of-capnography-monitoring-among-children-and-adolescents-in-the-postanesthesia-care-unit-a-randomized-controlled-trial
#10
Melissa L Langhan, Fang-Yong Li, J Lance Lichtor
BACKGROUND: Pulse oximetry does not reliably recognize respiratory depression, particularly in the presence of supplemental oxygen. Capnography frequently detects hypoventilation and apnea among children recovering from anesthesia. Although children are routinely monitored with capnography during anesthesia, reducing the rate of adverse events, it is not routinely used in the postanesthesia care unit (PACU), where patients remain at risk for respiratory depression. AIM: We hypothesized that children monitored with capnography would have more frequent staff interventions and fewer adverse events than children monitored with pulse oximetry alone...
February 8, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28160217/a-randomized-controlled-trial-of-nabilone-for-the-prevention-of-acute-postoperative-nausea-and-vomiting-in-elective-surgery
#11
David Neville Levin, Zachary Dulberg, An-Wen Chan, Gregory M T Hare, C David Mazer, Aaron Hong
PURPOSE: Nabilone is a synthetic cannabinoid with properties that make it an appealing candidate as a postoperative nausea and vomiting (PONV) prophylactic adjunct. Nabilone has proven clinical utility in chemotherapy-related nausea and vomiting but has not been adequately tested for PONV. The purpose of this study was to evaluate the effectiveness of a single dose of nabilone for the prevention of PONV. METHODS: This was a pragmatic single-centre randomized-controlled trial comparing oral nabilone vs placebo for the prevention of PONV...
February 3, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28158901/long-term-symptom-control-of-gastro-oesophageal-reflux-disease-12-years-after-laparoscopic-nissen-or-180%C3%A2-anterior-partial-fundoplication-in-a-randomized-clinical-trial
#12
D J Roks, J A Broeders, R J Baigrie
BACKGROUND: Laparoscopic 180° anterior fundoplication has been shown to achieve similar reflux control to Nissen fundoplication, with fewer side-effects, up to 5 years. However, there is a paucity of long-term follow-up data on this technique and antireflux surgery in general. This study reports 12-year outcomes of a double-blind RCT comparing laparoscopic Nissen versus 180° laparoscopic anterior fundoplication for gastro-oesophageal reflux disease (GORD). METHODS: Patients with proven GORD were randomized to laparoscopic Nissen or 180° anterior fundoplication...
February 3, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28149479/prophylaxis-and-antibiotic-therapy-in-management-protocols-of-patients-treated-with-oral-and-intravenous-bisphosphonates
#13
REVIEW
Elena-Beatriz Bermúdez-Bejarano, María-Ángeles Serrera-Figallo, Aida Gutiérrez-Corrales, Manuel-María Romero-Ruiz, Raquel Castillo-de-Oyagüe, José-Luis Gutiérrez-Pérez, Daniel Torres-Lagares
INTRODUCTION: Osteonecrosis of the jaw (MRONJ) linked to bisphosphonate treatment has specific characteristics that render its therapeutic management challenging for clinicians. Poor response to standard treatment makes it essential to take special precautions when treating this type of disease; therefore, antibiotic prophylaxis and/or antibiotic therapy have been proposed as effective and helpful tools in these situations. OBJECTIVES: This article seeks to assess published evidence in order to evaluate the different protocols used for antibiotic prophylaxis and/or antibiotic therapy in the general context of patients treated with bisphosphonates...
January 2017: Journal of Clinical and Experimental Dentistry
https://www.readbyqxmd.com/read/28143430/a-multicenter-randomized-open-label-active-comparator-trial-to-determine-the-efficacy-safety-and-pharmacokinetics-of-intravenous-ibuprofen-for-treatment-of-fever-in-hospitalized-pediatric-patients
#14
Samia N Khalil, Barry J Hahn, Corrie E Chumpitazi, Amy D Rock, Byron A Kaelin, Charles G Macias
BACKGROUND: Oral antipyretics are commonly used to treat pediatric patients who develop fevers. However, patients presenting to the emergency department or undergoing surgery are frequently unable to tolerate oral antipyretics. Rectal formulations are available; however, this route of administration is unpredictable. The main objectives of this randomized controlled study was to evaluate the efficacy and safety of single or multiple doses of intravenous ibuprofen to acetaminophen (oral or suppository) in pediatric patients with fever and to assess plasma ibuprofen concentrations...
February 1, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28141603/prevention-and-management-of-postoperative-delirium-in-elderly-patients-following-elective-spinal-surgery
#15
Alireza K Nazemi, Anirudh K Gowd, Jonathan J Carmouche, Stephen L Kates, Todd J Albert, Caleb J Behrend
STUDY DESIGN: This study is a systematic review. OBJECTIVE: Propose an evidence-based algorithm for prevention, diagnosis, and management of postoperative delirium in geriatric patients undergoing elective spine surgery. SUMMARY OF BACKGROUND DATA: Delirium is associated with longer stays after elective surgery, increased risk of readmission, and $6.9 billion annually in medical costs. Early diagnosis and treatment of delirium can reduce length of stay (LOS), in-hospital morbidity, and health care costs...
January 30, 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28138973/medical-treatments-for-incomplete-miscarriage
#16
REVIEW
Caron Kim, Sharmani Barnard, James P Neilson, Martha Hickey, Juan C Vazquez, Lixia Dou
BACKGROUND: Miscarriage occurs in 10% to 15% of pregnancies. The traditional treatment, after miscarriage, has been to perform surgery to remove any remaining placental tissues in the uterus ('evacuation of uterus'). However, medical treatments, or expectant care (no treatment), may also be effective, safe, and acceptable. OBJECTIVES: To assess the effectiveness, safety, and acceptability of any medical treatment for incomplete miscarriage (before 24 weeks). SEARCH METHODS: We searched Cochrane Pregnancy and Childbirth's Trials Register (13 May 2016) and reference lists of retrieved papers...
January 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28137255/the-norwegian-dietary-guidelines-and-colorectal-cancer-survival-crc-nordiet-study-a-food-based-multicentre-randomized-controlled-trial
#17
Hege Berg Henriksen, Hanna Ræder, Siv Kjølsrud Bøhn, Ingvild Paur, Ane Sørlie Kværner, Siv Åshild Billington, Morten Tandberg Eriksen, Gro Wiedsvang, Iris Erlund, Arne Færden, Marit Bragelien Veierød, Manuela Zucknick, Sigbjørn Smeland, Rune Blomhoff
BACKGROUND: Colorectal cancer survivors are not only at risk for recurrent disease but also at increased risk of comorbidities such as other cancers, cardiovascular disease, diabetes, hypertension and functional decline. In this trial, we aim at investigating whether a diet in accordance with the Norwegian food-based dietary guidelines and focusing at dampening inflammation and oxidative stress will improve long-term disease outcomes and survival in colorectal cancer patients. METHODS/DESIGN: This paper presents the study protocol of the Norwegian Dietary Guidelines and Colorectal Cancer Survival study...
January 30, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28108822/the-feasibility-of-local-anesthesia-for-the-surgical-treatment-of-umbilical-hernia-a-systematic-review-of-the-literature
#18
REVIEW
A P Jairam, R Kaufmann, F Muysoms, J Jeekel, J F Lange
BACKGROUND: Yearly approximately 4500 umbilical hernias are repaired in The Netherlands, mostly under general anesthesia. The use of local anesthesia has shown several advantages in groin hernia surgery. Local anesthesia might be useful in the treatment of umbilical hernia as well. However, convincing evidence is lacking. We have conducted a systematic review on safety, feasibility, and advantages of local anesthesia for umbilical hernia repair. METHODS: A systematic review was conducted according to the PRISMA guidelines...
January 20, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28108076/safety-and-effectiveness-of-alveolar-recruitment-maneuvers-and-positive-end-expiratory-pressure-during-general-anesthesia-for-cesarean-section-a-prospective-randomized-trial
#19
D Aretha, F Fligou, P Kiekkas, C Messini, E Panteli, E Zintzaras, M Karanikolas
INTRODUCTION: During cesarean section, the supine position reduces functional residual capacity and worsens lung compliance. We tested the hypothesis that alveolar recruitment maneuvers and positive end-expiratory pressure improve lung compliance in women undergoing general anesthesia for cesarean section. METHODS: Ninety women undergoing cesarean section were randomly assigned to one of two groups in a prospective, double-blind trial. In the alveolar recruitment maneuver group, pressure-control ventilation was used and inspiratory time was increased to 50% after delivery; positive end-expiratory pressure was increased to 20cmH2O and peak airway inspiratory pressure gradually increased to 45-50cmH2O...
December 23, 2016: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28108038/the-effect-of-endotracheal-tubes-versus-laryngeal-mask-airways-on-perioperative-respiratory-adverse-events-in-infants-a-randomised-controlled-trial
#20
Thomas F E Drake-Brockman, Anoop Ramgolam, Guicheng Zhang, Graham L Hall, Britta S von Ungern-Sternberg
BACKGROUND: Perioperative respiratory adverse events (PRAE) are the most common critical incidents in paediatric anaesthesia and occur more often in infants. Use of laryngeal mask airways (LMAs) is associated with reduced PRAE compared with endotracheal tubes in older children (>1 year). We aimed to evaluate the effect of these devices on the incidence of PRAE in infants. METHODS: We did a randomised controlled trial at the Princess Margaret Hospital for Children in Perth (WA, Australia) by recruiting infants (aged 0-12 months) undergoing general (with or without regional or local) anaesthesia with anticipated fentanyl dose 1 μg/kg or lower for minor elective surgery...
January 17, 2017: Lancet
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