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Randomized controlled trial in general surgery

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https://www.readbyqxmd.com/read/28079825/the-utility-of-bispectral-index-monitoring-for-prevention-of-rocuronium-induced-withdrawal-movement-in-children-a-randomized-controlled-trial
#1
Byung Gun Lim, Il Ok Lee, Young Sung Kim, Young Ju Won, Heezoo Kim, Myoung Hoon Kong
BACKGROUND: This study was designed to determine whether a deep hypnotic state with a bispectral index (BIS) value less than 40 could alleviate withdrawal movement (WM) upon rocuronium injection during anesthesia induction in children. METHODS: Finally, 135 healthy children (3-12 years) scheduled for minor elective surgery were studied. Without premedication, anesthesia was induced with thiopental sodium 5 mg/kg. Patients were randomized into 2 groups (control vs experimental) and then by virtue of rocuronium injection time, patients in the experimental group were allocated into 2 groups, as follows: in the control group (group C; n = 45), rocuronium 0...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072805/anatomical-variants-of-the-pudendal-nerve-observed-during-a-transgluteal-surgical-approach-in-a-population-of-patients-with-pudendal-neuralgia
#2
Stephane Ploteau, Marie-Aimee Perrouin-Verbe, Jean-Jacques Labat, Thibault Riant, Amelie Levesque, Roger Robert
BACKGROUND: Several studies have described the course and anatomical relations of the pudendal nerve. Several surgical nerve decompression techniques have been described, but only the transgluteal approach has been validated by a prospective randomized clinical trial. The purpose of this study was to describe the course of the nerve and its variants in a population of patients with pudendal neuralgia in order to guide the surgeon in the choice of surgical approach for pudendal nerve decompression...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28069021/preoperative-optimization-of-patient-expectations-improves-long-term-outcome-in-heart-surgery-patients-results-of-the-randomized-controlled-psy-heart-trial
#3
Winfried Rief, Meike C Shedden-Mora, Johannes A C Laferton, Charlotte Auer, Keith J Petrie, Stefan Salzmann, Manfred Schedlowski, Rainer Moosdorf
BACKGROUND: Placebo effects contribute substantially to outcome in most fields of medicine. While clinical trials typically try to control or minimize these effects, the potential of placebo mechanisms to improve outcome is rarely used. Patient expectations about treatment efficacy and outcome are major mechanisms that contribute to these placebo effects. We aimed to optimize these expectations to improve outcome in patients undergoing coronary artery bypass graft (CABG) surgery. METHODS: In a prospective three-arm randomized clinical trial with a 6 month follow-up, 124 patients scheduled for CABG surgery were randomized to either a brief psychological pre-surgery intervention to optimize outcome expectations (EXPECT); or a psychological control intervention focusing on emotional support and general advice, but not on expectations (SUPPORT); or to standard medical care (SMC)...
January 10, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28067075/perioperative-humoral-stress-response-to-laparoscopic-versus-open-aortobifemoral-bypass-surgery
#4
Anne H Krog, Per M Thorsby, Mehdi Sahba, Erik M Pettersen, Irene Sandven, Jørgen J Jørgensen, Jon O Sundhagen, Syed S H Kazmi
Minimally invasive surgery seems to reduce hormonal stress response to surgery, but has not previously been examined in major abdominal vascular surgery. Aortic cross-clamping time and operation time is known to be longer in the totally laparoscopic aortobifemoral bypass (LABF) as compared to open aortobifemoral bypass (OABF). The main objective of our study was to measure the hormonal stress response during surgery and aortic cross-clamping in patients undergoing a totally laparoscopic versus an open aortobifemoral bypass...
January 9, 2017: Scandinavian Journal of Clinical and Laboratory Investigation
https://www.readbyqxmd.com/read/28039245/chewing-gum-for-the-treatment-of-postoperative-nausea-and-vomiting-a-pilot-randomized-controlled-trial
#5
J N Darvall, M Handscombe, K Leslie
BACKGROUND: A novel treatment, chewing gum, may be non-inferior to ondansetron in inhibiting postoperative nausea and vomiting (PONV) in female patients after laparoscopic or breast surgery. In this pilot study, we tested the feasibility of a large randomized controlled trial. METHODS: We randomized 94 female patients undergoing laparoscopic or breast surgery to ondansetron 4 mg i.v. or chewing gum if PONV was experienced in the postanaesthesia care unit (PACU)...
January 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28028979/a-controlled-trial-of-the-efficacy-of-a-training-walking-program-in-patients-recovering-from-abdominal-aortic-aneurysm-surgery
#6
Bartosz R Wnuk, Jacek Durmała, Krzysztof Ziaja, Przemysław Kotyla, Marek Woźniewski, Edward Błaszczak
BACKGROUND: Major surgical procedures as well as general anesthesia contribute to muscle weakness and posture instability and may result in increased postoperative complications and functional disorders resulting from an elective operation. OBJECTIVES: We aim to state the significance of backward walking as a form of interval march training with patients after abdominal aortic aneurysm surgery. MATERIAL AND METHODS: Sixty-five patients were randomly divided into three subgroups and three various models of physiotherapy were applied...
November 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/28017174/benefit-of-general-anesthesia-monitored-by-bispectral-index-compared-with-monitoring-guided-only-by-clinical-parameters-systematic-review-and-meta-analysis
#7
Carlos Rogério Degrandi Oliveira, Wanderley Marques Bernardo, Victor Moisés Nunes
BACKGROUND: The bispectral index parameter is used to guide the titration of general anesthesia; however, many studies have shown conflicting results regarding the benefits of bispectral index monitoring. The objective of this systematic review with meta-analysis is to evaluate the clinical impact of monitoring with the bispectral index parameter. METHODS: The search for evidence in scientific information sources was conducted during December 2013 to January 2015, the following primary databases: Medline/PubMed, LILACS, Cochrane, CINAHL, Ovid, SCOPUS and TESES...
January 2017: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/28012165/stem-cell-therapy-for-chronic-ischaemic-heart-disease-and-congestive-heart-failure
#8
REVIEW
Sheila A Fisher, Carolyn Doree, Anthony Mathur, David P Taggart, Enca Martin-Rendon
BACKGROUND: A promising approach to the treatment of chronic ischaemic heart disease and congestive heart failure is the use of stem cells. The last decade has seen a plethora of randomised controlled trials developed worldwide, which have generated conflicting results. OBJECTIVES: The critical evaluation of clinical evidence on the safety and efficacy of autologous adult bone marrow-derived stem/progenitor cells as a treatment for chronic ischaemic heart disease and congestive heart failure...
24, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28007690/deep-brain-stimulation-for-tremor-tractographic-versus-traditional-distinct-study-protocol-of-a-randomized-controlled-feasibility-trial
#9
Bastian Elmar Alexander Sajonz, Florian Amtage, Peter Christoph Reinacher, Carolin Jenkner, Tobias Piroth, Jürgen Kätzler, Horst Urbach, Volker Arnd Coenen
BACKGROUND: Essential tremor is a movement disorder that can result in profound disability affecting the quality of life. Medically refractory essential tremor can be successfully reduced by deep brain stimulation (DBS) traditionally targeting the thalamic ventral intermediate nucleus (Vim). Although this structure can be identified with magnetic resonance (MR) imaging nowadays, Vim-DBS electrodes are still implanted in the awake patient with intraoperative tremor testing to achieve satisfactory tremor control...
December 22, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/28007033/efficacy-of-therapeutic-suggestions-under-general-anesthesia-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#10
Jenny Rosendahl, Susan Koranyi, Davina Jacob, Nina Zech, Ernil Hansen
BACKGROUND: General anesthesia does not block central nervous processing of auditive information. Therefore, positive suggestions even given during surgery might have the potential to encourage well-being and recovery of patients. Aim of this review was to summarize the evidence on the efficacy of therapeutic suggestions under general anesthesia in adults undergoing surgery compared to an attention control (i.e. white noise). METHODS: We included randomized controlled trials that investigated therapeutic suggestions presented during general anesthesia to adult patients undergoing surgery or medical procedures...
December 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/28004310/high-body-mass-index-and-use-of-fentanyl-iontophoretic-transdermal-system-in-postoperative-pain-management-results-of-a-pooled-analysis-of-six-phase-3-3b-trials
#11
Eugene R Viscusi, Li Ding, J Bradley Phipps, Loretta M Itri, Philip R Schauer
INTRODUCTION: Postoperative pain management can be challenging in patients with a high body mass index (BMI) especially as a result of poor venous access and delayed ambulation that can result in serious complications. Fentanyl iontophoretic transdermal system (ITS) is a needle-free, patient-controlled analgesic method available for use in acute postoperative pain. The primary objective of these analyses was to determine if there were any differences between patients with high BMI (>40 kg/m(2)) and lower BMIs (<30 kg/m(2) and 35-40 kg/m(2)) in terms of efficacy or safety...
December 21, 2016: Pain and Therapy
https://www.readbyqxmd.com/read/28003177/substitution-of-usual-perioperative-care-by-ehealth-to-enhance-postoperative-recovery-in-patients-undergoing-general-surgical-or-gynecological-procedures-study-protocol-of-a-randomized-controlled-trial
#12
Eva van der Meij, Judith Af Huirne, Esther Va Bouwsma, Johanna M van Dongen, Caroline B Terwee, Peter M van de Ven, Chantal M den Bakker, Suzan van der Meij, W Marchien van Baal, Wouter Kg Leclercq, Peggy Maj Geomini, Esther Cj Consten, Steven E Schraffordt Koops, Paul Jm van Kesteren, Hein Bac Stockmann, A Dorien Ten Cate, Paul Hp Davids, Petrus C Scholten, Baukje van den Heuvel, Frederieke G Schaafsma, Wilhelmus Jhj Meijerink, H Jaap Bonjer, Johannes R Anema
BACKGROUND: Due to the strong reduction in the length of hospital stays in the last decade, the period of in-hospital postoperative care is limited. After discharge from the hospital, guidance and monitoring on recovery and resumption of (work) activities are usually not provided. As a consequence, return to normal activities and work after surgery is hampered, leading to a lower quality of life and higher costs due to productivity loss and increased health care consumption. OBJECTIVE: With this study we aim to evaluate whether an eHealth care program can improve perioperative health care in patients undergoing commonly applied abdominal surgical procedures, leading to accelerated recovery and to a reduction in costs in comparison to usual care...
December 21, 2016: JMIR Research Protocols
https://www.readbyqxmd.com/read/27998859/-effect-of-magnesium-sulphate-infusion-on-emergence-agitation-in-patients-undergoing-esophageal-carcinoma-with-general-anesthesia-a-randomized-double-blind-controlled-trial
#13
Min Xie, Xiang-Kui Li, Jie Chen
OBJECTIVE: To evaluate the safety and effectiveness of magnesium sulphate for reducing the incidence of the emergence agitation in patients undergoing surgery for esophageal carcinoma with general anesthesia. METHODS: This randomized, double-blind, controlled clinical trial was conducted in patients undergoing elective radical resection of esophageal carcinoma in Sichuan Provincial People's Hospital between October, 2015 and March, 2016. The patients underwent surgeries under general intravenous anesthesia, and after anesthesia induction, the patients were infused with magnesium sulphate at the rate of 0...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/27988164/effects-of-a-single-dose-interscalene-block-on-pain-and-stress-biomarkers-in-patients-undergoing-arthroscopic-rotator-cuff-repair-a-randomized-controlled-trial
#14
Xiao Ning Liu, Young-Min Noh, Cheol-Jung Yang, Jung Uk Kim, Mi Hwa Chung, Kyu Cheol Noh
PURPOSE: To compare the effects of a single-dose interscalene block and general anesthesia (SISB/GA) with the effects of GA only in the early postoperative period after arthroscopic rotator cuff repair by evaluating subjective pain visual analog scale scores and objective pain-related stress biomarkers. METHODS: Patients refractory to conservative treatment of the affected shoulder were enrolled in this prospective, randomized endpoint study. Patients diagnosed with a rotator cuff tear (1-4 cm) based on magnetic resonance imaging were included...
December 14, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/27976517/warmed-humidified-co2-insufflation-benefits-intraoperative-core-temperature-during-laparoscopic-surgery-a-meta-analysis
#15
Meara Dean, Robert Ramsay, Alexander Heriot, John Mackay, Richard Hiscock, A Craig Lynch
BACKGROUND: Intraoperative hypothermia is linked to postoperative adverse events. The use of warmed, humidified CO2 to establish pneumoperitoneum during laparoscopy has been associated with reduced incidence of intraoperative hypothermia. However, the small number and variable quality of published studies have caused uncertainty about the potential benefit of this therapy. This meta-analysis was conducted to specifically evaluate the effects of warmed, humidified CO2 during laparoscopy...
December 14, 2016: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/27967333/more-complications-with-uncemented-than-cemented-femoral-stems-in-total-hip-replacement-for-displaced-femoral-neck-fractures-in-the-elderly
#16
Ghazi Chammout, Olle Muren, Evaldas Laurencikas, Henrik Bodéns, Paula Kelly-Pettersson, Helene Sjöö, André Stark, Olof Sköldenberg
Background and purpose - Total hip replacement (THR) is the preferred method for the active and lucid elderly patient with a displaced femoral neck fracture (FNF). Controversy still exists regarding the use of cemented or uncemented stems in these patients. We compared the effectiveness and safety between a modern cemented, and a modern uncemented hydroxyapatite-coated femoral stem in patients 65-79 years of age who were treated with THR for displaced FNF. Patients and methods - In a single-center, single-blinded randomized controlled trial, we included 69 patients, mean age 75 (65-79) and with a displaced FNF (Garden III-IV)...
December 14, 2016: Acta Orthopaedica
https://www.readbyqxmd.com/read/27935990/hyperalgesia-and-persistent-pain-after-breast-cancer-surgery-a-prospective-randomized-controlled-trial-with-perioperative-cox-2-inhibition
#17
Noud van Helmond, Monique A Steegers, Gertie P Filippini-de Moor, Kris C Vissers, Oliver H Wilder-Smith
BACKGROUND: Persistent pain is a challenging clinical problem after breast cancer treatment. After surgery, inflammatory pain and nociceptive input from nerve injury induce central sensitization which may play a role in the genesis of persistent pain. Using quantitative sensory testing, we tested the hypothesis that adding COX-2 inhibition to standard treatment reduces hyperalgesia after breast cancer surgery. A secondary hypothesis was that patients developing persistent pain would exhibit more postoperative hyperalgesia...
2016: PloS One
https://www.readbyqxmd.com/read/27932240/surgery-versus-5-imiquimod-for-nodular%C3%A2-and-superficial-basal-cell-carcinoma-5-year-results-of-the-sins%C3%A2-randomized-controlled-trial
#18
Hywel C Williams, Fiona Bath-Hextall, Mara Ozolins, Sarah J Armstrong, Graham B Colver, William Perkins, Paul S J Miller
We previously reported modest clinical 3-year benefit for topical imiquimod compared with surgery for superficial or nodular basal cell carcinoma at low-risk sites in our noninferiority randomized controlled SINS trial. Here we report 5-year data. Participants were randomized to imiquimod 5% cream once daily (superficial basal cell carcinoma, 6 weeks; nodular basal cell carcinoma, 12 weeks) or excisional surgery (4-mm margin). The primary outcome was clinical absence of initial failure or signs of recurrence at the 3-year dermatology review...
November 23, 2016: Journal of Investigative Dermatology
https://www.readbyqxmd.com/read/27906934/can-unilateral-kyphoplasty-replace-bilateral-kyphoplasty-in-treatment-of-osteoporotic-vertebral-compression-fractures-a-systematic-review-and-meta-analysis
#19
Han Sun, Pei-Pei Lu, Yi-Jie Liu, Xu Yang, Ping-Hui Zhou, Xiao-Feng Shen, Si-Wei Sun, Huilin Yang
BACKGROUND: Kyphoplasty has been proven to be an efficient method to relieve patient suffering from osteoporotic vertebral compression fractures (OVCFs). Because of its technological superiority, unilateral kyphoplasty consumes less operative time and bone cement than traditional bilateral kyphoplasty. However, there is controversy about which method is most efficient in the treatment of OVCFs. Thus, an overall analysis should be performed to shed light on the facts corroborating both procedures...
November 2016: Pain Physician
https://www.readbyqxmd.com/read/27902493/intravenous-amisulpride-for-the-prevention-of-postoperative-nausea-and-vomiting-two-concurrent-randomized-double-blind-placebo-controlled-trials
#20
Tong J Gan, Peter Kranke, Harold S Minkowitz, Sergio D Bergese, Johann Motsch, Leopold Eberhart, David G Leiman, Timothy I Melson, Dominique Chassard, Anthony L Kovac, Keith A Candiotti, Gabriel Fox, Pierre Diemunsch
BACKGROUND: Two essentially identical, randomized, double-blind, placebo-controlled, parallel-group phase III studies evaluated the efficacy of intravenous amisulpride, a dopamine D2/D3 antagonist, in the prevention of postoperative nausea and vomiting in adult surgical patients. METHODS: Adult inpatients undergoing elective surgery during general anesthesia and having at least two of the four Apfel risk factors for postoperative nausea and vomiting were enrolled at 9 U...
November 30, 2016: Anesthesiology
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