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Randomized controlled trial in general surgery

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https://www.readbyqxmd.com/read/29121294/low-dose-buprenorphine-infusion-to-prevent-postoperative-hyperalgesia-in-patients-undergoing-major-lung-surgery-and-remifentanil-infusion-a-double-blind-randomized-active-controlled-trial
#1
Marco Mercieri, Stefano Palmisani, Roberto A De Blasi, Antonio D'Andrilli, Alessia Naccarato, Barbara Silvestri, Sara Tigano, Domenico Massullo, Monica Rocco, Roberto Arcioni
Background: Postoperative secondary hyperalgesia arises from central sensitization due to pain pathways facilitation and/or acute opioid exposure. The latter is also known as opioid-induced hyperalgesia (OIH). Remifentanil, a potent μ-opioid agonist, reportedly induces postoperative hyperalgesia and increases postoperative pain scores and opioid consumption. The pathophysiology underlying secondary hyperalgesia involves N-methyl-D-aspartate (NMDA)-mediated pain pathways. In this study, we investigated whether perioperatively infusing low-dose buprenorphine, an opioid with anti-NMDA activity, in patients receiving remifentanil infusion prevents postoperative secondary hyperalgesia...
October 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29119559/preoperative-methylprednisolone-increases-plasma-pentraxin-3-early-after-total-knee-arthroplasty-a-randomized-double-blind-placebo-controlled-trial
#2
V Lindberg-Larsen, H Kehlet, K Pilely, J Bagger, M L Rovsing, P Garred
Preoperative glucocorticoid administration reduces the systemic inflammatory response. Pentraxin 3 (PTX3) is a novel inflammatory marker belonging to the humoral arm of innate immunity exerting a potentially protective host response. This study evaluated PTX3 and other complement marker changes after preoperative methylprednisolone (MP) early after total knee arthroplasty (TKA). Seventy patients were randomized (1 : 1) to preoperative intravenous (i.v.) MP 125 mg (group MP) or isotonic saline i.v. (group C)...
October 14, 2017: Clinical and Experimental Immunology
https://www.readbyqxmd.com/read/29119239/safety-and-efficacy-of-dexamethasone-intravitreal-implant-for-treatment-of-macular-edema-secondary-to-retinal-vein-occlusion-in-chinese-patients-randomized-sham-controlled-multicenter-study
#3
Xiaoxin Li, Ningli Wang, Xiaoling Liang, Gezhi Xu, Xiao-Yan Li, Jenny Jiao, Jean Lou, Yehia Hashad
PURPOSE: The purpose of this study was to evaluate the safety and efficacy of dexamethasone intravitreal implant 0.7 mg (DEX) for treatment of macular edema associated with retinal vein occlusion (RVO). METHODS: This study was a six-month, randomized, double-masked, sham-controlled, multicenter, phase 3 clinical trial with a 2-month open-label study extension. Patients with branch or central RVO received DEX (n = 129) or sham procedure (n = 130) in the study eye at baseline; all patients who met re-treatment criteria received DEX at month 6...
November 8, 2017: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29112565/a-randomized-control-trial-of-preoperative-oral-antibiotics-as-adjunct-therapy-to-systemic-antibiotics-for-preventing-surgical-site-infection-in-clean-contaminated-contaminated-and-dirty-type-of-colorectal-surgeries
#4
RANDOMIZED CONTROLLED TRIAL
Nadeem Anjum, Jianan Ren, Gefei Wang, Guanwei Li, Xiuwen Wu, Hu Dong, Qin Wu, Jieshou Li
BACKGROUND: Preoperative bowel preparation with or without oral antibiotics is controversial in terms of postoperative surgical site infections. OBJECTIVE: This study aimed to evaluate the efficacy of oral antibiotics as adjunct therapy to systemic antibiotics with mechanical bowel preparation for preventing surgical site infections in clean contaminated, contaminated, and dirty colorectal procedures. DESIGN: This was a single-center, prospective randomized study...
December 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/29108405/gabapentin-given-before-laparoscopic-sleeve-gastrectomy-reduces-postoperative-oxycodone-consumption-in-obese-patients-a-randomized-double-blind-placebo-controlled-trial
#5
Anna Rupniewska-Ladyko, Małgorzata Malec-Milewska, Ewa Kraszewska, Michal Pirozynski
BACKGROUND: Post-operative pain can be prevented. Gabapentin may be effective in this role. Our primary objective was to test the hypothesis that a prophylactic administration of gabapentin in obese patients before surgery has an opioid-sparing effect and reduces postoperative oxycodone consumption more efficiently than placebo. METHODS: The study enrolled 113 patients undergoing laparoscopic sleeve-gastrectomy under general anesthesia. The patients were randomly allocated to the control or gabapentin group and received a single oral dose of gabapentin 1200 mg or a matching placebo 1 h before surgery...
November 6, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29104871/smoking-gender-and-overweight-are-important-influencing-factors-on-monocytic-hla-dr-before-and-after-major-cancer-surgery
#6
Gunnar Lachmann, Clarissa von Haefen, Johannes Kurth, Fatima Yuerek, Klaus-Dieter Wernecke, Claudia Spies
Background: Monocytic human leukocyte antigen D related (mHLA-DR) is essential for antigen-presentation. Downregulation of mHLA-DR emerged as a general biomarker of impaired immunity seen in patients with sepsis and pneumonia and after major surgery. Influencing factors of mHLA-DR such as age, overweight, diabetes, smoking, and gender remain unclear. Methods: We analyzed 20 patients after esophageal or pancreatic resection of a prospective, randomized, placebo-controlled, double-blind trial (placebo group)...
2017: BioMed Research International
https://www.readbyqxmd.com/read/29095259/comparison-of-hydrophobic-and-hydrophilic-intraocular-lens-in-preventing-posterior-capsule-opacification-after-cataract-surgery-an-updated-meta-analysis
#7
Yang Zhao, Ke Yang, Jiaxin Li, Yang Huang, Siquan Zhu
BACKGROUND: Posterior capsular opacification (PCO) is a common long-term complication of cataract surgery. Intraocular lens design and material have been implicated in influencing the development of PCO. This study evaluated the association of hydrophobic and hydrophilic intraocular lenses on preventing PCO. METHODS: Medline, Cochrane, EMBASE, and Google Scholar databases were searched until August 3, 2016, using the following search terms: cataract, posterior capsule opacification, and intraocular lens...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29094418/total-intravenous-anesthesia-vs-single-pharmacological-prophylaxis-to-prevent-postoperative-vomiting-in-children-a-systematic-review-and-meta-analysis
#8
REVIEW
Maximilian S Schaefer, Peter Kranke, Stephanie Weibel, Robert Kreysing, Janika Ochel, Peter Kienbaum
BACKGROUND: Postoperative nausea and postoperative vomiting are frequent but often missed complications after general anesthesia in pediatric patients. Because inhaled anesthetics are known to trigger postoperative vomiting, total intravenous anesthesia is often administered in high-risk children to avoid the use of inhalational anesthesia. Since inhalational anesthesia might be advantageous in some situations, the question is raised whether administration of pharmacological prophylaxis offers equal protection from postoperative vomiting compared with total intravenous anesthesia alone...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29090265/postoperative-analgesic-efficiency-of-transversus-abdominis-plane-block-after-ventral-hernia-repair-a-prospective-randomized-controlled-clinical-trial
#9
Ion Chesov, Adrian Belîi
BACKGROUND AND AIMS: Effective postoperative analgesia is a key element in reducing postoperative morbidity, accelerating recovery and avoiding chronic postoperative pain. The aim of this study was to evaluate the effectiveness of ultrasound-guided Transversus Abdominis Plane (TAP) block, performed before surgical incision, in providing postoperative analgesia for patients undergoing open ventral hernia repair under general anaesthesia. METHODS: Seventy elective patients scheduled for open ventral hernia repair surgery under general anaesthesia were divided randomly into two equal groups: Group I received bilateral TAP block performed before surgical incision (n = 35); Group II received systemic postoperative analgesia with parenteral opioid (morphine) alone (n = 35)...
October 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/29077818/evaluation-of-postoperative-recovery-in-day-surgery-patients-using-a-mobile-phone-application-a-multicentre-randomized-trial
#10
M Jaensson, K Dahlberg, M Eriksson, U Nilsson
Background: Many patients undergoing anaesthesia and surgery experience postoperative complications. Our aim was to investigate whether a systematic follow-up smartphone-based assessment, using recovery assessment by phone points (RAPP) compared with standard care, had a positive effect on day surgery patients' postoperative recovery. We also investigated whether there were differences in women and men's recovery and recovery scores. Methods: The study was a single-blind, multicentre randomized controlled trial...
November 1, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29076419/intraoperative-seizures-anesthetic-drugs-and-antiepileptic-drugs
#11
Alberto Uribe, Alix Zuleta-Alarcon, Mahmoud Kassem, Gurneet S Sandhu, Sergio D Bergese
BACKGROUND: Epilepsy is a common condition with up to 1% prevalence in the general population. In the perioperative course of neurologic surgery patients, the use of prophylactic and therapeutic antiepileptic drugs is a common practice. Nonetheless, there is limited evidence supporting the use of prophylactic antiepileptics to prevent perioperative seizures and there are no guidelines for which anesthetic technique is preferred. OBJECTIVE: To discuss the seizurogenic potential of anesthetic drugs and to discuss intraoperative seizures in neurosurgical patients...
October 24, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/29073928/safety-of-tubal-ligation-by-minilaparotomy-provided-by-clinical-officers-versus-assistant-medical-officers-study-protocol-for-a-noninferiority-randomized-controlled-trial-in-tanzanian-women
#12
Mark A Barone, Zuhura Mbuguni, Japhet Ominde Achola, Carmela Cordero, Joseph Kanama, Projestine S Muganyizi, Jamilla Mwanga, Caitlin Shannon, Leopold Tibyehabwa
BACKGROUND: Female sterilization by tubal ligation is a safe, extremely effective, and permanent way to limit childbearing. It is the most popular modern contraceptive method worldwide. The simplest way to provide tubal ligation is by a procedure called minilaparotomy, generally performed with the client under local anesthesia with systemic sedation and analgesia. In Tanzania, unmet need for family planning is high and has declined little in the past decade. Access to tubal ligation is limited throughout the country, in large part because of a lack of trained providers...
October 26, 2017: Trials
https://www.readbyqxmd.com/read/29071382/hydroxyethyl-starch-130-0-4-versus-crystalloid-co-loading-during-general-anesthesia-induction-a-randomized-controlled-trial
#13
Takashi Juri, Koichi Suehiro, Shigemune Kuwata, Sayaka Tsujimoto, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
PURPOSE: Hypotension and decreased cardiac output (CO) are common adverse effects during anesthesia induction depending on the patient's pre-anesthetic cardiac condition. The aim of this study was to assess the ability of hydroxyethyl starch (HES) 130/0.4 to prevent hypotension and decreased CO during the induction of general anesthesia. METHODS: Ninety patients undergoing laparoscopic surgery were randomly divided into a HES group and a crystalloid group. Following the insertion of an intravenous line, fluid was administered to each patient at a rate of 25 ml/min using either crystalloid or HES 130/0...
December 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/29065020/personalized-video-feedback-and-repeated-task-practice-improve-laparoscopic-knot-tying-skills-two-controlled-trials
#14
RANDOMIZED CONTROLLED TRIAL
Eduardo F Abbott, Whitney Thompson, T K Pandian, Benjamin Zendejas, David R Farley, David A Cook
PURPOSE: Compare the effect of personalized feedback (PF) vs. task demonstration (TD), both delivered via video, on laparoscopic knot-tying skills and perceived workload; and evaluate the effect of repeated practice. METHOD: General surgery interns and research fellows completed four repetitions of a simulated laparoscopic knot-tying task at one-month intervals. Midway between repetitions, participants received via e-mail either a TD video (demonstration by an expert) or a PF video (video of their own performance with voiceover from a blinded senior surgeon)...
November 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/29062459/comparison-of-the-effects-of-spinal-epidural-and-general-anesthesia-on-coagulation-and-fibrinolysis-in-laparoscopic-cholecystectomy-a-randomized-controlled-trial-vsj-competition-2-nd-place
#15
Suleyman Demiryas, Turgut Donmez, Vuslat Muslu Erdem, Duygu Ayfer Erdem, Engin Hatipoglu, Sina Ferahman, Oguzhan Sunamak, Lale Yoldas Zengin, Ahmet Kocakusak
INTRODUCTION: Laparoscopic cholecystectomy (LC) is usually performed under general anesthesia. Recently, laparoscopic cholecystectomy under regional anesthesia has become popular, but this creates a serious risk of thromboembolism because of pneumoperitoneum, anesthesia technique, operative positioning, and patient-specific risk factors. AIM: This randomized controlled trial compares the effects of two different anesthesia techniques in laparoscopic cholecystectomy on coagulation and fibrinolysis...
September 2017: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
https://www.readbyqxmd.com/read/29045567/individualized-positive-end-expiratory-pressure-in-obese-patients-during-general-anaesthesia-a-randomized-controlled-clinical-trial-using-electrical-impedance-tomography
#16
C Nestler, P Simon, D Petroff, S Hammermüller, D Kamrath, S Wolf, A Dietrich, L M Camilo, A Beda, A R Carvalho, A Giannella-Neto, A W Reske, H Wrigge
Background: General anaesthesia leads to atelectasis, reduced end-expiratory lung volume (EELV), and diminished arterial oxygenation in obese patients. We hypothesized that a combination of a recruitment manoeuvre (RM) and individualized positive end-expiratory pressure (PEEP) can avoid these effects. Methods: Patients with a BMI ≥35 kg m-2 undergoing elective laparoscopic surgery were randomly allocated to mechanical ventilation with a tidal volume of 8 ml kg-1 predicted body weight and (i) an RM followed by individualized PEEP titrated using electrical impedance tomography (PEEPIND) or (ii) no RM and PEEP of 5 cm H2O (PEEP5)...
October 16, 2017: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29043600/effects-of-ultrasound-guided-stellate-ganglion-block-on-sleep-and-regional-cerebral-oxygen-saturation-in-patients-undergoing-breast-cancer-surgery-a-randomized-controlled-double-blinded-trial
#17
Feng Jin, Xiao-Qian Li, Wen-Fei Tan, Hong Ma, Bo Fang, A-Yong Tian, Huang-Wei Lu
Numerous factors could contribute to sleep disturbances in women with breast cancer. We hypothesized that stellate ganglion block (SGB) during surgery would preserve sleep after surgery and increase intraoperative regional cerebral oxygen saturation (rSO2) on the blocked side in patients undergoing breast cancer surgery. A randomized, double-blinded, controlled trial was conducted at the First Hospital of China Medical University from January 2016 to September 2016. Ninety-six patients who underwent radical breast cancer surgery requiring general anaesthesia were randomly assigned to one of two study groups: a control group that received a saline SGB and a block group that received a 0...
October 17, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/29034961/a-randomized-trial-of-automated-intermittent-ropivacaine-administration-vs-continuous-infusion-in-an-interscalene-catheter
#18
J Oxlund, A H Clausen, S Venø, M D Nielsen, M Pall, T Strøm, P Toft
BACKGROUND: Ultrasound-guided interscalene nerve block with ropivacaine as local anesthetic agent given as boluses or continuous infusion is the preferred pain management after major shoulder surgery. The use of automated intermittent boluses has been shown to be superior to continuous infusion in sciatic and epidural nerve block. HYPOTHESIS: Automated intermittent boluses reduce pain after major shoulder surgery. METHODS: Seventy patients aged 18-75 years, scheduled for major shoulder surgery under general anesthesia with interscalene nerve block were included in this randomized controlled trial...
October 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29033716/transdermal-fentanyl-as-an-adjuvant-to-paravertebral-block-for-pain-control-after-breast-cancer-surgery-a-randomized-double-blind-controlled-trial
#19
Ahmed H Bakeer, Nasr M Abdallah
OBJECTIVE: The aim of this study is to investigate the effect of transdermal fentanyl (TDF) as an adjuvant to paravertebral block (PVB) for pain control after breast cancer surgery. PATIENTS AND METHODS: This randomized, double-blind trial included fifty females with breast cancer scheduled for surgery. They were randomly allocated into one of two equal groups. The TDF group used transdermal fentanyl patches (TFPs) 25 μg/h applied 10 h preoperative then PVB with 20 mL of bupivacaine 0...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29032916/combination-of-magnesium-sulphate-and-ropivacaine-epidural-analgesia-for-hip-arthroplasty-in-dogs
#20
Elena Lardone, Bruno Peirone, Chiara Adami
OBJECTIVE: The aim of this study was to determine whether lumbosacral epidural administration of magnesium sulphate added to ropivacaine prolongs and improves perioperative analgesia, without adverse effects on motor block duration or hind limb neurological function, in dogs undergoing hip arthroplasty. STUDY DESIGN: Investigator-blind, controlled, randomized, prospective clinical trial. ANIMALS: A group of 20 client-owned dogs undergoing hip arthroplasty were allocated randomly to either group C (control, 1 mg kg(-1)epidural ropivacaine) or group M (magnesium, epidural injection of 1 mg kg(-1) ropivacaine and 2 mg kg(-1)magnesium sulphate)...
June 16, 2017: Veterinary Anaesthesia and Analgesia
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