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Randomized controlled trial in general surgery

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https://www.readbyqxmd.com/read/29351243/awake-versus-asleep-deep-brain-stimulation-surgery-technical-considerations-and-critical-review-of-the-literature
#1
REVIEW
Ryan B Kochanski, Sepehr Sani
Advancements in neuroimaging have led to a trend toward direct, image-based targeting under general anesthesia without the use of microelectrode recording (MER) or intraoperative test stimulation, also referred to as "asleep" deep brain stimulation (DBS) surgery. Asleep DBS, utilizing imaging in the form of intraoperative computed tomography (iCT) or magnetic resonance imaging (iMRI), has demonstrated reliable targeting accuracy of DBS leads implanted within the globus pallidus and subthalamic nucleus while also improving clinical outcomes in patients with Parkinson's disease...
January 19, 2018: Brain Sciences
https://www.readbyqxmd.com/read/29345011/effectiveness-of-a-patient-education-plan-on-knowledge-ofpost-op-venous-thromboembolism-survival-skills
#2
Julie Green, Esther I Bernhofer
AIMS AND OBJECTIVES: To investigate the effectiveness of a multi-method venous thromboembolism prevention patient education plan on participants' knowledge retention. BACKGROUND: A potential complication of surgery requiring general anesthesia, worldwide, is the development of life-threatening venous thromboembolism. Patients need education on preventing, recognizing, and immediately responding to a suspected thromboembolism. Written instructional materials given to patients at discharge may be inadequate...
January 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29344905/management-of-nfas-medical-treatment
#3
REVIEW
Naomi Even-Zohar, Yona Greenman
INTRODUCTION: Non-functioning pituitary adenomas (NFPAs) are in general large tumors that present with symptoms secondary to local pressure on adjacent structures. Transsphenoidal surgery is the first line of treatment but residual tumor mass is often detected post-operatively. Medical therapy, in any stage of tumor management, is not well established. METHODS: A literature search was performed to review the available data on medical treatment of NFPAs. RESULTS: Medications investigated for the treatment of NFPAs include dopamine receptor agonists (DA) and somatostatin receptor ligands...
January 17, 2018: Pituitary
https://www.readbyqxmd.com/read/29343448/optimizing-the-dose-of-local-infiltration-analgesia-and-gabapentin-for-total-knee-arthroplasty-a-randomized-single-blind-trial-in-128-patients
#4
Maurik H M van Haagen, Hennie Verburg, Brechtje Hesseling, Lauri Coors, Nick T van Dasselaar, Pim N J Langendijk, Nina M C Mathijssen
BACKGROUND AND PURPOSE: Effective analgesia is essential for postoperative recovery and rehabilitation in TKA. The challenge of analgesic regimes is to obtain adequate pain relief and maximum muscle control to mobilize and rehabilitate patients early. However, the optimal dose and best composition are not known. We hypothesized that there would be no differences in reported postoperative pain on the day of the TKA surgery as well as the first day after surgery when different combinations of ropivacain for LIA and gabapentin are given...
January 14, 2018: Knee
https://www.readbyqxmd.com/read/29340825/laparoscopic-surgery-in-colon-cancer-patients-treated-with-chronic-anti-thrombotic-therapy
#5
Hiroaki Nozawa, Takahide Shinagawa, Kazushige Kawai, Keisuke Hata, Toshiaki Tanaka, Takeshi Nishikawa, Kensuke Otani, Kazuhito Sasaki, Manabu Kaneko, Shigenobu Emoto, Koji Murono
BACKGROUND: Anti-thrombotic medications are commonly used for the treatment and prevention of cardiovascular diseases. Laparoscopic resection of colon cancer has generally been accepted with favorable outcomes being reported in randomized control trials. However, the safety and efficacy of laparoscopic surgery for colon cancer patients receiving chronic anti-thrombotic therapy (AT) remain unclear. METHODS: We identified 951 patients who underwent elective resection for colon cancer between 2009 and 2016 from our database...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29337175/minimally-invasive-versus-extensile-lateral-approach-for-saners-type-ii-and-iii-calcaneal-fractures-a-meta-analysis-of-randomized-controlled-trials
#6
REVIEW
Zhikui Zeng, Lingmei Yuan, Shengpeng Zheng, Youqiang Sun, Feng Huang
BACKGROUND: The use of less-invasive techniques in the treatment of displaced intra-articular calcaneal fractures (DIACFs) remains controversial. No prior meta-analysis has considered the influence of differences in the fracture type. Thus, our meta-analysis aimed to investigate the efficacy and safety of minimally invasive (MI) in Sanders type II and III fractures. MATERIALS AND METHODS: A comprehensive search was performed to identify RCTs comparing MI using sinus tarsi approach (STA) or percutaneous reduction (PR) to open reduction (OR) via extensile lateral approach (ELA) from the Cochrane Library, PubMed, Embase and CNKI...
January 11, 2018: International Journal of Surgery
https://www.readbyqxmd.com/read/29306497/short-and-long-term-risks-of-cardiovascular-disease-following-radiotherapy-in-rectal-cancer-in-four-randomized-controlled-trials-and-a-population-based-register
#7
Lingjing Chen, Sandra Eloranta, Anna Martling, Ingrid Glimelius, Martin Neovius, Bengt Glimelius, Karin E Smedby
AIM: A population-based cohort and four randomized trials enriched with long-term register data were used to clarify if radiotherapy in combination with rectal cancer surgery is associated with increased risks of cardiovascular disease (CVD). METHODS: We identified 14,901 rectal cancer patients diagnosed 1995-2009 in Swedish nationwide registers, of whom 9227 were treated with preoperative radiotherapy. Also, we investigated 2675 patients with rectal cancer previously randomized to preoperative radiotherapy or not followed by surgery in trials conducted 1980-1999...
January 3, 2018: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/29305792/analgesic-effect-of-intraperitoneal-bupivacaine-hydrochloride-after-laparoscopic-sleeve-gastrectomy-a-randomized-clinical-trial
#8
Nasser Malekpour Alamdari, Mahmood Bakhtiyari, Barmak Gholizadeh, Catrine Shariati
BACKGROUND: The indications for sleeve gastrectomy as a primary procedure for the surgical treatment of morbid obesity have increased worldwide. Pain is the most common complaint for patients on the first day after laparoscopic sleeve gastrectomy. There are various methods for decreasing pain after laparoscopic sleeve gastrectomy such as the use of intraperitoneal bupivacaine hydrochloride. This clinical trial was an attempt to discover the effects of intraperitoneal bupivacaine hydrochloride on alleviating postoperative pain after laparoscopic sleeve gastrectomy...
January 5, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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
#9
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/29296829/safety-pharmacokinetics-and-reversal-of-apixaban-anticoagulation-with-andexanet-alfa
#10
Deborah Siegal, Genmin Lu, Janet M Leeds, Mark Karbarz, Janice Castillo, Vandana Mathur, Athiwat Hutchaleelaha, Uma Sinha, Michael Kitt, Matt McClure, Stanley J Hollenbach, John T Curnutte, Pamela B Conley, Mark Crowther
Direct factor Xa (FXa) inhibitors lack a specific reversal agent for emergencies such as major bleeding or urgent surgery. Andexanet alfa, a modified, catalytically inactive, recombinant human FXa derivative, reverses anticoagulant effect by binding and sequestering FXa inhibitors. This original report of safety and dose-finding, phase 1 and 2 randomized, double-blind, placebo-controlled studies, investigated various doses of andexanet in healthy volunteers. Phase 1 evaluated the safety and pharmacokinetics of andexanet (n = 24) or placebo (n = 8)...
September 26, 2017: Blood Advances
https://www.readbyqxmd.com/read/29284858/the-influence-of-two-different-doses-of-magnesium-sulfate-on-intraocular-pressure-variations-after-injection-of-succinylcholine-and-endotracheal-intubation-a-prospective-randomized-parallel-three-arm-double-blind-placebo-controlled-clinical-trial
#11
Hany Mahmoud Yassin, Ahmed Tohamy Abdel Moneim, Ahmed Sherin Mostafa Bayoumy, Hasan Metwally Bayoumy, Sameh Galal Taher
Background: The use of succinylcholine for rapid sequence induction in patients with open globe injuries may be detrimental to the eye. Aim: The aim of this study is to determine if the premedication with magnesium sulfate (MgSO4) could attenuate the increase in intraocular pressure (IOP) associated with succinylcholine injection and intubation. Setting: Operation theaters in a tertiary care University Hospital between December 2014 and July 215...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284847/evaluation-of-preoperative-flupirtine-in-ambulatory-functional-endoscopic-sinus-surgery-a-prospective-double-blind-randomized-controlled-trial
#12
Anjan Das, Hirak Biswas, Anindya Mukherjee, Sandip Roy Basunia, Subinay Chhaule, Tapobrata Mitra, Partha Sarathi Halder, Subrata Kumar Mandal
Background: Functional endoscopic sinus surgery (FESS) is the mainstay therapeutic management for nasal pathologies. We evaluated flupirtine, a centrally acting analgesic, for producing perfect perioperative conditions in FESS for adults in a day-care setting. Materials and Methods: Sixty-two patients (25-40 years) scheduled for FESS under general anesthesia were randomly divided into Group F (n = 31) receiving preoperative flupirtine (100 mg) and Group C (n = 31) receiving identical-looking placebo capsule per oral 60 min before induction of anesthesia...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284835/to-evaluate-the-efficacy-of-intravenous-infusion-of-dexmedetomidine-as-premedication-in-attenuating-the-rise-of-intraocular-pressure-caused-by-succinylcholine-in-patients-undergoing-rapid-sequence-induction-for-general-anesthesia-a-randomized-study
#13
Raj Bahadur Singh, Sanjay Choubey, Saurabh Mishra
Context: Laryngoscopy and intubation performed during RSI lead to choroidal blood volume increase and an eventual rise in intraocular pressure (IOP). Use of succinylcholine (SCh) causes an undesirable rise in IOP which is further aggravated by laryngoscopy and endotracheal intubation. Dexmedetomidine is a highly selective centrally acting α2 adrenergic agonist that has IOP lowering properties. Aims: This study aims to evaluate the efficacy of intravenous (i.v.) infusion of dexmedetomidine (0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29282145/parenteral-nutrition-during-neoadjuvant-chemotherapy-for-patients-with-non-metastatic-gastric-or-esophago-gastric-cancer-to-reduce-postoperative-morbidity-percog-study-protocol-for-a-randomized-controlled-trial
#14
Tara C Mueller, Rebekka Schirren, Victoria Kehl, Helmut Friess, Daniel Reim, Marc E Martignoni
BACKGROUND: The majority of patients with gastric or esophago-gastric cancer are at risk for malnutrition. Preoperative malnutrition was shown to increase the incidence of postoperative complications following abdominal surgery. However, it remains unclear if preoperative parenteral nutritional support during neoadjuvant chemotherapy (NACT) may be effective to reduce the rate of postoperative complications in these patients. METHODS/DESIGN: The PERCOG trial is a randomized controlled multicenter observer-blinded trial, investigating if the improvement of the general condition of patients with non-metastasized gastric cancer or cancer of the esophago-gastric junction during NACT by supplemental parenteral nutrition can decrease the postoperative Comprehensive Complication Index (CCI)...
December 28, 2017: Trials
https://www.readbyqxmd.com/read/29280239/on-line-preparatory-information-for-children-and-their-families-undergoing-dental-extractions-under-general-anesthesia-a-phase-iii-randomized-controlled-trial
#15
Corinne Huntington, Christina Liossi, Ana Nora Donaldson, Jonathan Timothy Newton, Patricia A Reynolds, Reham Alharatani, Marie Therese Hosey
BACKGROUND: Family-centered interactive on-line games are increasingly popular in healthcare, but their effectiveness for preoperative preparation needs further research. www.scottga.org is the new on-line version of a proven nonweb-based game for children and parents/caregivers. AIMS: The aim of this study was to evaluate if www.scottga.org improved children's anxiety and families' satisfaction compared with controls. METHODS: In this phase III double-blind randomized controlled trial, children/parents/caregivers received (i) www...
December 27, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29279832/the-comparison-of-preventive-analgesic-effects-of-ketamine-paracetamol-and-magnesium-sulfate-on-postoperative-pain-control-in-patients-undergoing-lower-limb-surgery-a-randomized-clinical-trial
#16
Seyed Morteza Heydari, Seyed Jalal Hashemi, Shahpour Pourali
Background: In considering the importance of postoperative pain management and its consequences on its related secondary outcomes including nausea, vomiting, and operation-related complications, we aimed to compare the effectiveness of the three analgesic agents including ketamine, paracetamol, and magnesium sulfate for postoperative pain relief and associated consequences in this trial. Materials and Methods: In this double-blinded randomized control clinical trial, patients scheduled for elective lower extremity orthopedic surgery under general anesthesia were enrolled and randomized into four groups for receiving intravenous ketamine (0...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29245259/efficacy-of-pudendal-nerve-block-for-alleviation-of-catheter-related-bladder-discomfort-in-male-patients-undergoing-lower-urinary-tract-surgeries-a-randomized-controlled-double-blind-trial
#17
Li Xiaoqiang, Zhang Xuerong, Liu Juan, Bechu Shelley Mathew, Yin Xiaorong, Wan Qin, Luo Lili, Zhu Yingying, Luo Jun
BACKGROUND: Catheter-related bladder discomfort (CRBD) to an indwelling urinary catheter is defined as a painful urethral discomfort, resistant to conventional opioid therapy, decreasing the quality of postoperative recovery. According to anatomy, the branches of sacral somatic nerves form the afferent nerves of the urethra and bladder triangle, which deriving from the ventral rami of the second to fourth sacral spinal nerves, innervating the urethral muscles and sphincter of the perineum and pelvic floor; as well as providing sensation to the penis and clitoris in males and females, which including the urethra and bladder triangle...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29241077/pectoral-nerve-blocks-to-improve-analgesia-after-breast-cancer-surgery-a-prospective-randomized-and-controlled-trial
#18
Neethu M, Ravinder Kumar Pandey, Ankur Sharma, Vanlalnghaka Darlong, Jyotsna Punj, Renu Sinha, Preet Mohinder Singh, Nandini Hamshi, Rakesh Garg, Chandralekha Chandralekha, Anurag Srivastava
STUDY OBJECTIVE: To evaluate the analgesic efficacy of ultrasound guided combined pectoral nerve blocks I and II in patients scheduled for surgery for breast cancer. DESIGN: Prospective, randomized, control trial. SETTING: Operating rooms in a tertiary care hospital of Northern India. PATIENTS: Sixty American Society of Anesthesiologists status I to II adult women, aged 18-70years were enrolled in this study. INTERVENTIONS: Patients were randomized into two groups (30 patients in each group), PECS (P) group and control (C) group...
December 11, 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29225747/a-prospective-randomized-controlled-double-blind-trial-to-assess-the-effects-of-dexmedetomidine-during-cleft-palate-surgery
#19
Priyanka Surana, Devangi A Parikh, Geeta A Patkar, Bharati A Tendolkar
Background: We investigated whether the intraoperative administration of dexmedetomidine would attenuate the profound sympathoadrenal response associated with cleft palate (CP) surgery. Methods: Sixty children aged 6 months to 12 years undergoing CP surgery under general anesthesia were randomly assigned to the control (C) or dexmedetomidine (D) groups. Group C received benzodiazepine (0.05 mg/kg midazolam followed by infusion of normal saline) fentanyl isoflurane anesthesia, and Group D received dexmedetomidine (loading 1 µg/kg followed by infusion of 0...
December 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29219935/intrathecal-morphine-for-laparoscopic-segmental-colonic-resection-as-part-of-an-enhanced-recovery-protocol-a-randomized-controlled-trial
#20
Mark V Koning, Aart Jan W Teunissen, Erwin van der Harst, Elisabeth J Ruijgrok, Robert Jan Stolker
BACKGROUND AND OBJECTIVES: Management of postoperative pain after laparoscopic segmental colonic resections remains controversial. We compared 2 methods of analgesia within an Enhanced Recovery After Surgery (ERAS) program. The goal of the study was to investigate whether administration of intrathecal bupivacaine/morphine would lead to an enhanced recovery. METHODS: A single-center, randomized, double-blind controlled trial was performed (NL43488.101.13). Patients scheduled for laparoscopic segmental intestinal resections were considered...
December 6, 2017: Regional Anesthesia and Pain Medicine
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