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Randomized controlled trial in general surgery

Bin Yu, Miao He, Guang-Yu Cai, Tian-Xiao Zou, Na Zhang
BACKGROUND: Continuous femoral nerve block and fascia iliaca compartment block are 2 traditional anesthesia methods in orthopedic surgeries, but it is controversial which method is better. The objective of this study was to compare the practicality, efficacy, and complications of the 2 modalities in hip replacement surgery in the elderly and to assess the utility of a novel cannula-over-needle set. METHODS: In this prospective, randomized controlled clinical investigation, 60 elderly patients undergoing hip replacement were randomly assigned to receive either continuous femoral nerve block or continuous fascia iliaca compartment block...
October 2016: Medicine (Baltimore)
Marian Wiegersma, Chantal M C R Panman, Marjolein Y Berger, Henrica C W De Vet, Boudewijn J Kollen, Janny H Dekker
BACKGROUND: The Pelvic Floor Distress Inventory-20 is used to evaluate symptoms and treatment effects in women with pelvic floor disorders. To interpret changes in the scores of this inventory, information is needed on what patients and clinicians perceive as the minimal important (meaningful) change. Although this change in the inventory score has previously been investigated in women undergoing pelvic floor surgery, the results could not be generalized to women with milder symptoms (i...
October 14, 2016: American Journal of Obstetrics and Gynecology
Dafna Willner, Valeria Spennati, Shelly Stohl, Giulia Tosti, Simone Aloisio, Federico Bilotta
Spine surgery has been growing rapidly as a neurosurgical operation, with an increase of 220% over a 15-year period. Intraoperative blood transfusion is a major outcome determinant of spine procedures. Various approaches, including pharmacologic and nonpharmacologic therapies, have been tested to decrease both intraoperative and postoperative blood loss. The aim of this systematic review is to report clinical evidence on the relationship between intraoperative blood loss (primary outcome) and on transfusion requirements and postoperative complications (secondary outcomes) in patients undergoing spine surgery...
October 3, 2016: Anesthesia and Analgesia
Abhyuday Kumar, Anita Seth, Smita Prakash, Mangilal Deganwa, Anoop Raj Gogia
BACKGROUND: The present study was undertaken to compare and evaluate the efficacy of intravenous (IV) fentanyl and lignocaine airway nebulization and a combination of both in attenuating the hemodynamic response to laryngoscopy and tracheal intubation. MATERIALS AND METHODS: Ninety-six patients of either sex aged between 18 and 65 years of age, belonging to the American Society of Anesthesiologists (ASA) health status Classes I and II, undergoing elective surgery requiring general anesthesia with endotracheal intubation were included in the study...
September 2016: Anesthesia, Essays and Researches
P Rani, V R Hemanth Kumar, M Ravishankar, T Sivashanmugam, R Sripriya, M Trilogasundary
BACKGROUND: Fentanyl and dexmedetomidine have been tried to attenuate airway and circulatory reflexes during emergence and extubation individually but have not been compared with respect to the level of sedation to evolve a reliable technique for rapid and smooth extubation. AIM: To compare the effects of fentanyl and dexmedetomidine in attenuating airway and circulatory reflexes during emergence and extubation of the endotracheal tube. SETTING AND DESIGN: This double-blind, randomized, controlled study was done in patients undergoing surgery under general anesthesia belonging to the American Society of Anesthesiologists physical status 1 or 2...
September 2016: Anesthesia, Essays and Researches
Rasmus Gregersen, Laura Quitzau Mortensen, Jakob Burcharth, Hans-Christian Pommergaard, Jacob Rosenberg
PURPOSE: This study aimed to systematically review the literature and present the evidence on outcomes after treatment for acute diverticulitis with abscess formation. Secondly, the paper aimed to compare different treatment options. METHODS: PubMed, EMBASE and the Cochrane Library were searched. Two authors screened the records independently, initially on title and abstract and subsequently on full-text basis. Articles describing patients treated acutely for Hinchey Ib and II were included...
October 11, 2016: International Journal of Surgery
Karen L Barker, David Beard, Andrew Price, Francine Toye, Martin Underwood, Avril Drummond, Gary Collins, Susan Dutton, Helen Campbell, Nicola Kenealy, Jon Room, Sarah E Lamb
BACKGROUND: The number of knee arthroplasties performed each year is steadily increasing. Although the outcome is generally favourable, up to 15 % fail to achieve a satisfactory clinical outcome which may indicate that the existing model of rehabilitation after surgery may not be the most efficacious. Given the increasing number of knee arthroplasties, the relative limited physiotherapy resources available and the increasing age and frailty of patients receiving arthroplasty surgery, it is important that we concentrate our rehabilitation resources on those patients who most need help to achieve a good outcome...
October 13, 2016: Trials
Ge Qu, Xu-Lei Cui, Hong-Ju Liu, Zhi-Gang Ji, Yu-Guang Huang
<strong>Objective</strong> To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. <strong>Methods</strong> 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
Polpun Boonmak, Suhattaya Boonmak, Malinee Laopaiboon
BACKGROUND: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Small bleeding areas can reduce operative visibility and result in destruction of surrounding structures. Deliberate hypotension (lowering the mean arterial blood pressure to between 50 and 65 mm Hg in normotensive patients) using a range of pharmacological agents during general anaesthesia reduces blood loss in many operations. This review was originally published in 2013 and updated in February 2016...
October 12, 2016: Cochrane Database of Systematic Reviews
Bing-Cheng Zhao, Tong-Yi Huang, Qi-Wen Deng, Wei-Feng Liu, Jian Liu, Wen-Tao Deng, Ke-Xuan Liu, Cai Li
BACKGROUND: Postoperative atrial fibrillation/flutter (POAF) is associated with significant morbidity and mortality after general thoracic surgery, but the need and the best agent for prophylaxis remains obscure. METHODS: A systematic literature search was performed to identify randomized controlled trials that compared regimens for POAF prophylaxis after general thoracic surgery. Random-effects meta-analyses with trial sequential analyses were performed to compare the effects of medical prophylaxis versus placebo/usual care...
October 8, 2016: Chest
Marjan de Vries, Dagmar C M van Rijckevorsel, Kris C P Vissers, Oliver H G Wilder-Smith, Harry van Goor
BACKGROUND & AIMS: Delta-9-tetrahydrocannabinol (THC) is the most abundant cannabinoid from the plant Cannabis sativa. There is only equivocal evidence that THC has analgesic effects. We performed a phase 2 controlled trial to evaluate the analgesic efficacy, pharmacokinetics, safety, and tolerability of an oral tablet containing purified THC in patients with chronic abdominal pain. METHODS: Sixty-five patients with chronic abdominal pain for 3 months or more (numeric rating scale scores of 3 or more) after surgery or due to chronic pancreatitis were randomly assigned to groups given the THC tablet or identical matching placebos for 50-52 days...
October 5, 2016: Clinical Gastroenterology and Hepatology
Mikael L Soucisse, Kerianne Boulva, Lucas Sideris, Pierre Drolet, Michel Morin, Pierre Dubé
BACKGROUND: As surgical training is evolving and operative exposure is decreasing, new, effective, and experiential learning methods are needed to ensure surgical competency and patient safety. Video coaching is an emerging concept in surgery that needs further investigation. DESIGN: In this randomized controlled trial conducted at a single teaching hospital, participating residents were filmed performing a side-to-side intestinal anastomosis on cadaveric dog bowel for baseline assessment...
October 5, 2016: Journal of Surgical Education
Patrick B Murphy, Kerollos Wanis, Christopher M Schlachta, Nawar A Alkhamesi
: INTRODUCTION; Surgical management of external rectal prolapse (ERP) remains a challenge with the breadth of choices available and varies on the international, national, regional and locoregional level. Significant innovation has led to new techniques to manage ERP including changes to both abdominal and perineal approaches. EVIDENCE ACQUISITION; A systematic, English-language search of major databases was conducted from 2006-2016. From 636 papers two reviewers identified 24 studies which compared two or more surgical techniques in adult patients with rectal prolapse and reported on complications, quality of life or recurrence...
October 6, 2016: Minerva Chirurgica
Laura S M Derks, Inge Wegner, Adriana L Smit, Hans G X M Thomeer, Vedat Topsakal, Wilko Grolman
INTRODUCTION: Cochlear implantation is an increasingly common procedure in the treatment of severe to profound sensorineural hearing loss (SNHL) in children and adults. It is often performed as a day-case procedure. The major drive towards day-case surgery has been from a logistical, economical and societal perspective, but we also speculate that the patient's quality of life (QoL) is at least equal to inpatient surgery if not increased as a result of rapid discharge and rehabilitation...
October 3, 2016: BMJ Open
Iman Khalil, Saad E Itani, Zeina Naja, Ahmad Salah Naja, Fouad M Ziade, Jean-Marc Ayoubi, Mariam A El-Rajab, Zoher M Naja
STUDY OBJECTIVE: Compare the effectiveness of nerve stimulator-guided pudendal nerve block (PNB) vs general anesthesia (GA) for anterior and posterior (AP) colporrhaphy in terms of pain relief and analgesic consumption within 24 and 48 hours postoperatively. DESIGN: Prospective randomized trial. PATIENTS: Fifty-seven patients whose ages ranged between 20 and 53 years scheduled to undergo AP colporrhaphy due to the presence of cystorectocele...
November 2016: Journal of Clinical Anesthesia
Alexander Torossian, Elke Van Gerven, Karin Geertsen, Bengt Horn, Marc Van de Velde, Johan Raeder
STUDY OBJECTIVE: Incidence of inadvertent perioperative hypothermia is still high; therefore, present guidelines advocate "prewarming" for its prevention. Prewarming means preoperative patient skin warming, which minimizes redistribution hypothermia caused by induction of anesthesia. In this study, we compared the new self-warming BARRIER EasyWarm blanket with passive thermal insulation regarding mean perioperative patient core body temperature. DESIGN: Multinational, multicenter randomized prospective open-label controlled trial...
November 2016: Journal of Clinical Anesthesia
Preet Mohinder Singh, Anuradha Borle, Divakara Gouda, Jeetinder Kaur Makkar, Mahesh K Arora, Anjan Trikha, Ashish Sinha, Basavana Goudra
INTRODUCTION: Palonosetron is a second-generation 5-HT3 receptor antagonist with proposed higher efficacy and sustained action for prophylaxis of postoperative nausea and vomiting (PONV). METHODS: Randomized controlled trials involving adult population undergoing elective surgery under general anesthesia comparing palonosetron to placebo, ramosetron, granisetron, and ondansetron were included. Data were extracted for vomiting incidence (VI), complete response (no nausea/vomiting; Complete Response [CR]), and rescue antiemetic need...
November 2016: Journal of Clinical Anesthesia
Junichi Ishio, Nobuyasu Komasawa, Yu Miyazaki, Haruki Kido, Toshiaki Minami
STUDY OBJECTIVE: This study aimed to test the hypothesis that insertion of the supraglottic device LMA-ProSeal (ProSeal) by novice doctors in anesthetized patients can be improved by using an intubating stylet to create a 90° bend and that better sealing pressure is achieved. DESIGN: Randomized clinical trial. SETTING: Operating room. PATIENTS: Seventy adult patients scheduled for elective surgery under general anesthesia using ProSeal with American Society of Anesthesiologists physical status 1 to 3...
November 2016: Journal of Clinical Anesthesia
Stephen King, Elizabeth S Roberts, Jonathan N King
BACKGROUND: Few pharmaceuticals are registered in cats for the management of post-operative pain and inflammation. The objective of this study was to assess the field efficacy and safety of an injectable formulation of the nonsteroidal anti-inflammatory drug robenacoxib in cats undergoing surgery. The study was a multi-center, prospective, randomized, masked, parallel-group, placebo-controlled clinical trial. A total of 349 cats were enrolled and underwent surgery comprising forelimb onychectomy, as an example of orthopedic surgery, plus either ovariohysterectomy or castration...
September 29, 2016: BMC Veterinary Research
Han Bum Joe, Jong Yeop Kim, Hyun Jeong Kwak, Sang Eon Oh, Sook Young Lee, Sung Yong Park
BACKGROUND: Remifentanil can improve insertion of a laryngeal mask airway (LMA) during induction with propofol. Recently, it has been suggested that there is a sex difference in opioid requirements for this procedure. The purposes of this study were to determine the effective effect-site concentration (Ce) of remifentanil for the facilitation of LMA insertion in male and female patients during propofol anesthesia without neuromuscular blockade and to evaluate whether there are sex differences in the Ce of remifentanil required for successful LMA insertion...
September 2016: Medicine (Baltimore)
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