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Randomized controlled trial in general surgery

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https://www.readbyqxmd.com/read/28533571/local-infiltration-of-tramadol-versus-bupivacaine-for-post-cesarean-section-pain-control-a-double-blind-randomized-study
#1
Mohammad Ali Sahmeddini, Simin Azemati, Ehsan Masoudi Motlagh
BACKGROUND: Postoperative pain control after cesarean section (C/S) is important because inadequate postoperative pain control can result in a prolonged hospital stay. In this study, we compared postoperative somatic wound pain control between patients receiving tramadol and bupivacaine, infiltrated at the wound site. METHODS: In this randomized clinical trial, 98 patients, eligible for elective C/S under general anesthesia, were randomly allocated to 2 groups. Before wound closure, 20 cc of 0...
May 2017: Iranian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28527646/high-dose-amino-acid-administration-achieves-an-anabolic-response-in-type-2-diabetic-patients-that-is-independent-of-glycaemic-control-a-randomized-clinical-trial
#2
Chelsia Gillis, Patricia S Roque, Jürgen Bläss, Albert Urwyler, Harald Schepperle, Guido Kunz, Thomas Peters, Thomas Schricker, Linda Wykes, Andrea Kopp Lugli
BACKGROUND & AIMS: Surgical stress provokes protein catabolism and hyperglycaemia that is enhanced in patients with type 2 diabetes (T2DM), and increases perioperative morbidity. This study hypothesized that perioperative administration of high dose intravenous (IV) amino acids (AA) will augment protein balance in T2DM patients receiving tight plasma glucose control via continuous IV insulin compared to standard plasma glucose control via subcutaneous (SC) insulin sliding scale. METHODS: Eighteen patients with well-controlled T2DM (HbA1C% < 7...
May 3, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28527613/no-344-opportunistic-salpingectomy-and-other-methods-of-risk-reduction-for-ovarian-fallopian-tube-peritoneal-cancer-in-the-general-population
#3
Shannon Salvador, Stephanie Scott, Julie Ann Francis, Anita Agrawal, Christopher Giede
OBJECTIVE: This guideline reviews the potential benefits of opportunistic salpingectomy to prevent the development of high grade serous cancers (HGSC) of the ovary/fallopian tube/peritoneum based on current evidence supporting the fallopian tube origin of disease. INTENDED USERS: Gynaecologists, obstetricians, family doctors, registered nurses, nurse practitioners, residents, and health care providers. TARGET POPULATION: Adult women (18 and older): OPTIONS: Women considering hysterectomy who wish to retain their ovaries in situ have traditionally also retained their fallopian tubes...
June 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28527546/-keeping-them-warm-a-randomized-controlled-trial-of-two-passive-perioperative-warming-methods
#4
Michael Koenen, Megan Passey, Margaret Rolfe
PURPOSE: Inadvertent perioperative hypothermia is a common problem for patients undergoing surgery. Heat redistribution from the body's core to the periphery after induction of anesthesia is the major contributor. DESIGN: A prospective randomized controlled trial was conducted to determine if reflective blankets are more effective than cotton blankets in reducing the core-peripheral temperature gradient and increasing peripheral compartment heat content during the preoperative phase among adult patients undergoing elective surgery of less than 1 hour...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28527545/comparing-effects-of-two-different-types-of-nei-guan-acupuncture-stimulation-devices-in-reducing-postoperative-nausea-and-vomiting
#5
Hanna Oh, Bo Hwan Kim
PURPOSE: To compare the effects of a relief band using transcutaneous electrical nerve stimulation with a wrist band using acupressure on the Nei-Guan acupuncture point to relieve postoperative nausea and vomiting (PONV) in patients who had undergone gynecologic surgery. DESIGN: A double-blinded randomized controlled trial. METHODS: In total, 54 patients scheduled for gynecologic surgery under general anesthesia were included in this study...
June 2017: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/28508234/surgical-treatment-of-extraesophageal-manifestations-of-gastroesophageal-reflux-disease
#6
REVIEW
Feroze Sidwa, Alessandra L Moore, Elaine Alligood, P Marco Fisichella
OBJECTIVE: To review the current literature on the role of antireflux surgery (ARS) for the treatment of extraesophageal manifestations of GERD. The extraesophageal manifestations of gastroesophageal reflux disease (GERD) include chronic cough, laryngopharyngeal reflux, and asthma. They are responsible for significant morbidity in affected patients and a high economic burden on healthcare resources. We recently published a larger review on the symptoms, diagnosis, medical, and surgical treatment of the extraesophageal manifestations of GERD...
May 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/28506475/a-novel-perfused-porcine-simulator-for-teaching-aortic-anastomosis-increases-resident-interest-in-vascular-surgery
#7
Peter B Bartline, Jennie O'Shea, James M McGreevy, Michelle T Mueller
OBJECTIVE: This report describes a novel simulator, euthanized pigs on cardiopulmonary bypass, and validates this simulator with a controlled trial in general surgery residents learning aortic anastomosis. We evaluated this novel simulator with the following hypothesis: our porcine perfused simulator is as good as or better than the standard rubber tubing, low-fidelity models used for vascular anastomotic training. METHODS: Euthanized pigs were placed on cardiopulmonary bypass, creating a perfused, ex vivo model on which to perform surgical procedures...
May 12, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#8
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28502521/-extracorporeal-life-support-in-thoracic-surgery-what-are-the-indications-and-the-pertinence
#9
REVIEW
J Reeb, A Olland, S Renaud, O Collange, X Delabranche, N Santelmo, F Meziani, P-M Mertes, G Massard, P-E Falcoz
INTRODUCTION: In thoracic surgery, extracorporeal life support (ECLS) technologies are used in cases of severe and refractory respiratory failure or as intraoperative cardiorespiratory support. The objectives of this review are to describe the rationale of ECLS techniques, to review the pulmonary diseases potentially treated by ECLS, and finally to demonstrate the efficacy of ECLS, using recently published data from the literature, in order to practice evidence based medicine. STATE OF THE ART: ECLS technologies should only be undertaken in expert centers...
May 12, 2017: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/28498176/effectiveness-of-haloperidol-prophylaxis-in-critically-ill-patients-with-a-high-risk-of-delirium-a-systematic-review
#10
Eduardo Santos, Daniela Cardoso, Hugo Neves, Madalena Cunha, Manuel Rodrigues, João Apóstolo
BACKGROUND: Delirium is associated with increased intensive care unit and hospital length of stay, prolonged duration of mechanical ventilation, unplanned removal of tubes and catheters, and increased morbidity and mortality. Prophylactic treatment with low-dose haloperidol may have beneficial effects for critically ill patients with a high risk of delirium. OBJECTIVES: To identify the effectiveness of haloperidol prophylaxis in critically ill patients with a high risk for delirium...
May 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28497218/to-evaluate-the-efficacy-of-an-acellular-flowable-matrix-in-comparison-with-a-wet-dressing-for-the-treatment-of-patients-with-diabetic-foot-ulcers-a-randomized-clinical-trial
#11
F Campitiello, M Mancone, A Della Corte, R Guerniero, S Canonico
The authors aimed to evaluate the efficacy of an advanced wound matrix (Integra Flowable Wound Matrix, Integra LifeScience Corp, Plainsboro, NJ, USA) for treating wounds with irregular geometries versus a wet dressing in patients with diabetic foot ulcers. Sixty patients with diabetic foot ulcers (Grades 3 Wagner) were included in this randomized clinical trial. The study was conducted in the General Surgery Unit and Geriatric of the Second University of Naples, Italy, in the last 12 months. Forty-six cases of diabetic foot ulcers were equally and randomly divided into control and test groups...
May 11, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28495412/radiofrequency-microdebridement-versus-surgical-decompression-for-achilles-tendinosis-a-randomized-controlled-trial
#12
Rory J M Morrison, Timothy M Brock, Mike R Reed, Scott D Muller
Achilles tendinosis is primarily managed nonoperatively with activity modification and physiotherapy, although surgery can be required. This has classically involved surgical decompression of the Achilles tendon, although the use of radiofrequency microdebridement has been suggested as a novel minimally invasive alternative. We present a randomized controlled trial comparing radiofrequency microdebridement using the Topaz(®) microdebrider wand and traditional surgical decompression. All patients with Achilles tendinosis referred to a single surgeon and meeting the inclusion criteria were invited to participate in our single-blinded, randomized controlled study...
May 9, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28494914/the-effect-of-melatonin-on-early-postoperative-cognitive-decline-in-elderly-patients-undergoing-hip-arthroplasty-a-randomized-controlled-trial
#13
Yunxia Fan, Liang Yuan, Muhuo Ji, Jianjun Yang, Dapeng Gao
STUDY OBJECTIVE: The purpose of the present study was to investigate whether exogenous melatonin supplementation could ameliorate early postoperative cognitive decline (POCD) in aged patients undergoing hip arthroplasty with spinal anesthesia. DESIGN: Prospective cohort study. SETTING: Department of Anesthesiology, Jinling Hospital, Nanjing University, Nanjing, China. PATIENTS: One hundred and thirty-nine patients with ASA I-III, older than 65yr of age (mean age: 74...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494898/the-effect-of-desflurane-versus-propofol-anesthesia-on-postoperative-delirium-in-elderly-obese-patients-undergoing-total-knee-replacement-a-randomized-controlled-double-blinded-clinical-trial
#14
Pedro Tanaka, Stuart Goodman, Barbara R Sommer, William Maloney, James Huddleston, Hendrikus J Lemmens
STUDY OBJECTIVE: The goal of this study was to investigate the incidence of delirium, wake-up times and early post-operative cognitive decline in one hundred obese elderly patients undergoing total knee arthroplasty. DESIGN: Prospective randomized trial. SETTINGS: Operating room, postoperative recovery area, hospital wards. PATIENTS: 100 obese patients (ASA II and III) undergoing primary total knee replacement under general anesthesia with a femoral nerve block catheter...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494889/influence-of-the-perioperative-administration-of-magnesium-sulfate-on-the-total-dose-of-anesthetics-during-general-anesthesia-a-systematic-review-and-meta-analysis
#15
REVIEW
Laura Rodríguez-Rubio, Eduardo Nava, Julián Solís García Del Pozo, Joaquín Jordán
BACKGROUND: Magnesium sulfate displays numerous characteristics that make it a useful drug in anesthesiology (N-methyl-d-aspartate receptor antagonist, vasodilator, antiarrhythmic, inhibitor of catecholamine release and of acetylcholine in the terminal motor plate). The perioperative use of this drug as an adjuvant capable of decreasing the required dose of anesthetics, has been proposed. OBJECTIVES: To assess the influence of intravenous magnesium sulfate administration during general anesthesia on the overall dose of required anesthetics...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28494088/peripheral-nerve-blocks-for-hip-fractures
#16
REVIEW
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra Kopp
BACKGROUND: Various nerve blocks with local anaesthetic agents have been used to reduce pain after hip fracture and subsequent surgery. This review was published originally in 1999 and was updated in 2001, 2002, 2009 and 2017. OBJECTIVES: This review focuses on the use of peripheral nerves blocks as preoperative analgesia, as postoperative analgesia or as a supplement to general anaesthesia for hip fracture surgery. We undertook the update to look for new studies and to update the methods to reflect Cochrane standards...
May 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28492294/effect-of-remifentanil-for-general-anaesthesia-on-parturients-and-newborns-undergoing-caesarean-section-a-meta-analysis
#17
Yunhui Zhang, Hongmei Lu, Zheng Fu, Huijun Zhang, Ye Li, Wei Li, Jingui Gao
BACKGROUND: The results presented by studies investigating the effect of remifentanil on both parturients and newborns during cesarean section differed significantly. Therefore, we performed a meta-analysis to estimate the effect of remifentanil on these patients. METHODS: Potentially eligible studies published before 15 March 2016 were searched through four databases including PubMed, SCOPUS, ISI web of knowledge and EBSCO. Weighted mean difference (WMD) or odds ratios (ORs) and the corresponding 95% confidence interval (CI) were applied to estimate the strength of relationship...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28489775/effects-of-nimodipine-on-postoperative-delirium-in-elderly-under-general-anesthesia-a-prospective-randomized-controlled-clinical-trial
#18
Ya-Nan Li, Qi Zhang, Chun-Ping Yin, Yang-Yang Guo, Shu-Ping Huo, Liang Wang, Qiu-Jun Wang
Nimodipine is a clinical commonly used calcium antagonistscan lowering the apoptosis rate of hippocampal neuron to reduce the incidence of postoperative cognitive dysfunction (POCD). This study was designed to evaluate the effects of nimodipine on postoperative delirium in elderly under general anesthesia.Sixty patients shceduced spine surgery under general anesthesia were randomly assigned into 2 groups using a random number table: control group (Group C) and nimodipine group (Group N). In Group N, nimodipine 7...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489735/impact-of-a-preoperative-conversational-hypnotic-session-on-propofol-consumption-using-closed-loop-anesthetic-induction-guided-by-the-bispectral-index-a-randomized-controlled-trial
#19
Aurélien Bataille, Sébastien Besset, Barbara Szekely, Mireille Michel-Cherqui, Virginie Dumans, Ngai Liu, Thierry Chazot, Marc Fischler, Morgan Le Guen
OBJECTIVE: The automated administration of propofol in a closed loop could be used to objectively evaluate the nonpharmacological anesthetic action of hypnotherapy. The objective of this study was to evaluate the impact of a conversational hypnosis session on the consumption of propofol for anesthetic induction. DESIGN: A randomized, usual care-controlled, single-center, patient-blind trial. SETTING: Tertiary care center in France from November 2012 to December 2013...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28489641/differences-in-blood-pressure-in-infants-after-general-anesthesia-compared-to-awake-regional-anesthesia-gas-study-a-prospective-randomized-trial
#20
M E McCann, D E Withington, S J Arnup, A J Davidson, N Disma, G Frawley, N S Morton, G Bell, R W Hunt, D C Bellinger, D M Polaner, A Leo, A R Absalom, B S von Ungern-Sternberg, F Izzo, P Szmuk, V Young, S G Soriano, J C de Graaff
BACKGROUND: The General Anesthesia compared to Spinal anesthesia (GAS) study is a prospective randomized, controlled, multisite, trial designed to assess the influence of general anesthesia (GA) on neurodevelopment at 5 years of age. A secondary aim obtained from the blood pressure data of the GAS trial is to compare rates of intraoperative hypotension after anesthesia and to identify risk factors for intraoperative hypotension. METHODS: A total of 722 infants ≤60 weeks postmenstrual age undergoing inguinal herniorrhaphy were randomized to either bupivacaine regional anesthesia (RA) or sevoflurane GA...
May 4, 2017: Anesthesia and Analgesia
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