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Randomized controlled trial in general surgery

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https://www.readbyqxmd.com/read/28810091/preoperative-chest-radiography-in-elective-surgery-review-and-update
#1
Ethan M Young, Joel D Farmer
INTRODUCTION: The preoperative evaluation is designed to identify factors that may predispose a patient to perioperative complications in an effort to ensure patient safety. The use of chest radiography in the preoperative evaluation has progressed from routine testing to a more selective approach based on evidence that routine testing is low yield. However, preoperative chest radiography (POCR) may still be utilized more frequently than necessary as guidelines provide varying recommendations and providers continue to order the test by convention...
February 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28803601/ultrasound-guided-transversus-abdominis-plane-block-improves-postoperative-analgesia-and-early-recovery-in-patients-undergoing-retroperitoneoscopic-urologic-surgeries-a-randomized-controlled-double-blinded-trial
#2
Ge Qu, Xu-Lei Cui, Hong-Ju Liu, Zhi-Gang Ji, Yu-Guang Huang
Objective To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. Methods This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28802606/comparison-of-lma-supreme%C3%A2-with-i-gel%C3%A2-and-lma-proseal%C3%A2-in-children-for-airway-management-during-general-anaesthesia-a-meta-analysis-of-randomized-controlled-trials
#3
Sulagna Bhattacharjee, Anirban Som, Souvik Maitra
STUDY OBJECTIVE: A few randomized trials have compared LMA Supreme™ with LMA ProSeal™ and i-gel™ in children but their conclusions varied widely. This systematic review and meta analysis has compared the former device with the latter two devices. DESIGN: Meta-analysis and systematic review using the Mantel-Haenszel method and pooled mean difference using inverse variance method. SETTING: Meta-analysis of published prospective randomized controlled trials...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28800778/effects-of-intraoperative-peep-optimization-on-postoperative-pulmonary-complications-and-the-inflammatory-response-study-protocol-for-a-randomized-controlled-trial
#4
Zoltán Ruszkai, Erika Kiss, Ildikó László, Fanni Gyura, Erika Surány, Péter Töhötöm Bartha, Gergely Péter Bokrétás, Edit Rácz, István Buzogány, Zoltán Bajory, Erzsébet Hajdú, Zsolt Molnár
BACKGROUND: Patients undergoing general anesthesia and mechanical ventilation during major abdominal surgery commonly develop pulmonary atelectasis and/or hyperdistention of the lungs. Recent studies show benefits of lung-protective mechanical ventilation with the use of low tidal volumes, a moderate level of positive end-expiratory pressure (PEEP) and regular alveolar recruitment maneuvers during general anesthesia, even in patients with healthy lungs. The purpose of this clinical trial is to evaluate the effects of intraoperative lung-protective mechanical ventilation, using individualized PEEP values, on postoperative pulmonary complications and the inflammatory response...
August 11, 2017: Trials
https://www.readbyqxmd.com/read/28794836/comparing-epidural-surgical-anesthesia-and-spinal-anesthesia-following-epidural-labor-analgesia-for-intrapartum-cesarean-section-a-prospective-randomized-controlled-trial
#5
Hea-Jo Yoon, Sang-Hwan Do, Yeo Jin Yun
BACKGROUND: The conversion of epidural labor analgesia (ELA) to epidural surgical anesthesia (ESA) for intrapartum cesarean section (CS) often fails, resulting in intraoperative pain. Spinal anesthesia (SA) can provide a denser sensory block than ESA. The purpose of this prospective, non-blinded, parallel-arm, randomized trial was to compare the rate of pain-free surgery between ESA and SA following ELA for intrapartum CS. METHODS: Both groups received continuous epidural infusions for labor pain at a rate of 10 ml/h...
August 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28764777/betamethasone-gel-compared-with-lidocaine-jelly-to-reduce-tracheal-tube-related-postoperative-airway-symptoms-a-randomized-controlled-trial
#6
Parineeta Thapa, Ravi Ram Shrestha, Sangeeta Shrestha, Gautam Ratna Bajracharya
BACKGROUND AND OBJECTIVES: Post-operative airway symptoms can be troublesome to patients following an uneventful general anesthesia with endotracheal intubation. In this study, we compared the effectiveness of lubricating an endotracheal tube with betamethasone gel or lidocaine jelly with using an unlubricated tube in reducing the incidence and severity of postoperative sore throat, hoarseness and cough. METHODS: This was a prospective, randomized, single-blind comparative study carried out among 120 ASA I and II patients aged 18-65 years undergoing elective surgery under general anesthesia with endotracheal intubation...
August 1, 2017: BMC Research Notes
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/28759502/quadratus-lumborum-block-versus-transversus-abdominis-plane-block-in-children-undergoing-low-abdominal-surgery-a-randomized-controlled-trial
#8
Gözen Öksüz, Bora Bilal, Yavuz Gürkan, Aykut Urfalioğlu, Mahmut Arslan, Gökçe Gişi, Hafize Öksüz
BACKGROUND AND OBJECTIVES: Truncal blocks have a place within multimodal analgesia techniques in abdominal surgery. The quadratus lumborum block is a new abdominal truncal block used for somatic analgesia of both the upper and lower abdomen. In this prospective, double-blind, randomized study, we aimed to compare quadratus lumborum block and transversus abdominis plane block in pediatric patients undergoing lower abdominal surgery. METHODS: Fifty-three children undergoing unilateral inguinal hernia repair or orchiopexy surgery were randomized into 2 groups: transversus abdominis plane block and quadratus lumborum block...
July 27, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28750481/aqueous-shunts-for-glaucoma
#9
REVIEW
Victoria L Tseng, Anne L Coleman, Melinda Y Chang, Joseph Caprioli
BACKGROUND: Aqueous shunts are employed to control intraocular pressure (IOP) for people with primary or secondary glaucomas who fail or are not candidates for standard surgery. OBJECTIVES: To assess the effectiveness and safety of aqueous shunts for reducing IOP in glaucoma compared with standard surgery, another type of aqueous shunt, or modification to the aqueous shunt procedure. SEARCH METHODS: We searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 8), MEDLINE Ovid (1946 to August 2016), Embase...
July 28, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28743341/-effect-of-external-abdominal-aorta-compression-on-circulation-during-anesthesia-induction-in-elderly-patients
#10
Xiuman Li, Lixiang Wang
OBJECTIVE: To investigate the effect of external abdominal aorta compression on circulation during anesthetic induction in elderly patients. METHODS: A prospective randomized controlled trial was conducted. Patients with age of 60-75 years old, requiring a general anesthesia for non-abdominal surgery, and with II-III class of American Society of Anesthesiologists (ASA) physical status classification, and admitted to General Hospital of Chinese People's Armed Police Forces from January to April in 2017 were enrolled...
July 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28742771/perioperative-amino-acid-infusion-for-preventing-hypothermia-and-improving-clinical-outcomes-during-surgery-under-general-anesthesia-a-systematic-review-and-meta-analysis
#11
Yoshitaka Aoki, Yukie Aoshima, Kazuyuki Atsumi, Ryo Kaminaka, Rintaro Nakau, Kyoko Yanagita, Makiko Kora, Shunsuke Fujii, Junichiro Yokoyama
Amino acid (AA) infusion is sometimes selected to avoid hypothermia during general anesthesia. However, the widespread clinical use of AA infusion therapy has not been established. This study aimed to clarify the evidence that AA infusion can increase patient body temperature and improve clinical outcomes using the Grading of Recommendations Assessment, Development, and Evaluation system. We searched MEDLINE (PubMed), Cochrane Central Register of Controlled Trials, and Igaku Chuo Zasshi (Japana Centra Revuo Medicina) in November 2015...
July 24, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28740417/efficacy-and-safety-of-0-75-ropivacaine-instillation-into-subinguinal-wound-in-patients-after-bilateral-microsurgical-varicocelectomy-a-bi-center-randomized-double-blind-placebo-controlled-trial
#12
Wan Shou Cui, Yu Seob Shin, Jae Hyung You, A Ram Doo, Kiran Kumar Soni, Jong Kwan Park
OBJECTIVE: To evaluate the efficacy and safety of 0.75% ropivacaine instillation into inguinal wound in patients who have undergone bilateral microsurgical varicocelectomy. PATIENTS AND METHODS: Eighty-five men who were screened for bilateral varicoceles from March 2015 to July 2016 were randomized for the treatment. All patients underwent inguinal varicocelectomy by general anesthesia. After ligation of the internal spermatic veins from the spermatic cord, additional delivery of testis through inguinal incision site was done to ligate external spermatic veins and gubernacular veins...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28732521/retroclavicular-approach-vs-infraclavicular-approach-for-plexic-bloc-anesthesia-of-the-upper-limb-study-protocol-randomized-controlled-trial
#13
P L Langlois, A F Gil-Blanco, D Jessop, Y Sansoucy, F D'Aragon, N Albert, P Echave
BACKGROUND: The coracoid approach is recognized as the simplest approach to perform brachial plexus anaesthesia, but needle visualization needs to be improved. With a different needle entry point, the retroclavicular approach confers a perpendicular angle between the ultrasound and the needle, which theoretically enhances needle visualization. This trial compares these two techniques. The leading hypothesis is that the retroclavicular approach is comparable to the infraclavicular coracoid approach in general aspects, but needle visualization is better with this novel approach...
July 21, 2017: Trials
https://www.readbyqxmd.com/read/28727896/proseal-versus-classic-laryngeal-mask-airway-lma-for-positive-pressure-ventilation-in-adults-undergoing-elective-surgery
#14
REVIEW
Muhammad Qamarul Hoda, Khalid Samad, Hameed Ullah
BACKGROUND: The development of supraglottic airway devices has revolutionized airway management during general anaesthesia. Two devices are widely used in clinical practice to facilitate positive pressure ventilation: the ProSeal laryngeal mask airway (pLMA) and the Classic laryngeal mask airway (cLMA). It is not clear whether these devices have important clinical differences in terms of efficacy or complications. OBJECTIVES: To compare the effectiveness of the ProSeal laryngeal mask airway (pLMA) and the Classic LMA (cLMA) for positive pressure ventilation in adults undergoing elective surgery...
July 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#15
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727632/a-prospective-randomized-controlled-trial-comparing-quality-of-life-following-endoscopic-totally-extraperitoneal-tep-versus-open-stoppa-inguinal-hernioplasty
#16
Jitendra K Kushwaha, Loreno E Enny, Akshay Anand, Abhinav A Sonkar, Awanish Kumar, Harvinder S Pahwa
In inguinal hernia surgery, quality of life (QOL) has emerged as a striking issue. Evidence suggests better QOL of patients operated with laparoscopic procedure as compared with open anterior hernia repairs. However data are scarce with relation to open posterior repair in terms of QOL issues. A prospective randomized single-blind study from November 2014 to October 2015 including all patients who underwent elective primary endoscopic [totally extraperitoneal (TEP)] or open Stoppa inguinal hernia repair was undertaken...
August 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28722299/cost-and-health-care-utilization-implications-of-bariatric-surgery-versus-intensive-lifestyle-and-medical-intervention-for-type-2-diabetes
#17
Souvik Banerjee, Louis P Garrison, David R Flum, David E Arterburn
OBJECTIVE: The aim of this study was to compare the cost and health care utilization of patients with obesity and type 2 diabetes mellitus (T2DM) randomized into either Roux-en-Y gastric bypass (RYGB) surgery or an intensive lifestyle and medical intervention (ILMI). METHODS: This analysis (N = 745) is based on 2-year follow-up of a small randomized controlled trial (RCT); adult patients with obesity and T2DM were recruited between 2011 and 2012 from Kaiser Permanente Washington...
July 19, 2017: Obesity
https://www.readbyqxmd.com/read/28721690/pre-or-postoperative-interscalene-block-and-or-general-anesthesia-for-arthroscopic-shoulder-surgery-a-retrospective-observational-study
#18
Laura Bosco, Cheng Zhou, John A C Murdoch, Ryan Bicknell, Wilma M Hopman, Rachel Phelan, Vidur Shyam
PURPOSE: Arthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery. METHODS: Charts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n = 124), or pre- vs postoperative ISBPB combined with GA (ISBPB + GA [n = 72] vs GA + ISBPB [n = 52], respectively)...
July 18, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28720423/undergraduate-clinical-teaching-in-orthopedic-surgery-a-randomized-control-trial-comparing-the-effect-of-case-based-teaching-and-bedside-teaching-on-musculoskeletal-osce-performance
#19
Martin Kelly, Iain Feeley, Fiona Boland, John M O'Byrne
INTRODUCTION: Musculoskeletal (MSK) complaints are the second most common reason for a hospital outpatient appointment in the US, and account for 19.5% of general practice consultations. Previous studies have shown that passive teaching in medical school does not imbue students with an adequate degree of confidence in MSK evaluation. The aim of this study was to conduct a randomized control trial to compare the effect of the gold standard small group tutorial of bedside teaching against case-based teaching (CBT) in relation to orthopedic surgery in medical students...
July 15, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28718727/effects-of-palonosetron-and-ondansetron-on-preventing-nausea-and-vomiting-after-laparoscopic-surgery
#20
Qili Liu, Chengmao Zhou, Zeqing Bao, Yu Zhu
Background This meta-analysis was performed to evaluate the efficacy and safety of palonosetron and ondansetron in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic surgery with general anesthesia. Methods We searched for randomized controlled clinical trials in PubMed, Embase, and The Cochrane Library. Results Nine studies were enrolled in this meta-analysis and showed no statistically significant difference between palonosetron and ondansetron in the prevention of PONV in the first 24 hours after surgery (relative risk [RR], 0...
January 1, 2017: Journal of International Medical Research
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