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Randomized controlled trial in general surgery

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https://www.readbyqxmd.com/read/29771731/effect-of-intravenous-dexmedetomidine-during-general-anesthesia-on-acute-postoperative-pain-in-adults-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Xiuqin Wang, Naifu Liu, Jinlong Chen, Zan Xu, Fumei Wang, Chuan Ding
BACKGROUND: Dexmedetomidine has been shown to have an analgesic effect. However, no consensus was reached in previous studies. METHODS: Electronic databases such as PubMed, Embase, and Cochrane Central were searched for relevant randomized controlled trials (RCTs). The relative risk (RR) and weighted mean difference (WMD) were used to analyze the outcomes. Random-effects model was used for meta-analysis. RESULTS: Compared to the normal saline group, patients using dexmedetomidine showed a significantly decreased pain intensity within 6 hours (WMD=-0...
May 16, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29770294/three-dimensional-modelling-and-three-dimensional-printing-in-pediatric-and-congenital-cardiac-surgery
#2
REVIEW
Laszlo Kiraly
Three-dimensional (3D) modelling and printing methods greatly support advances in individualized medicine and surgery. In pediatric and congenital cardiac surgery, personalized imaging and 3D modelling presents with a range of advantages, e.g., better understanding of complex anatomy, interactivity and hands-on approach, possibility for preoperative surgical planning and virtual surgery, ability to assess expected results, and improved communication within the multidisciplinary team and with patients. 3D virtual and printed models often add important new anatomical findings and prompt alternative operative scenarios...
April 2018: Translational Pediatrics
https://www.readbyqxmd.com/read/29769507/a-randomized-controlled-trial-to-compare-the-efficacy-of-intravenous-dexmedetomidine-and-clonidine-as-adjuvants-to-low-dose-opioid-in-attenuation-of-hemodynamic-response-to-laryngoscopy-and-tracheal-intubation
#3
N Gupta, A Kumar, A Jain, N Hayaran, P Mishra
Increase in sympathetic activity as a result of cardiovascular stress response to laryngoscopy can be detrimental to the patient. The primary objective is to compare intravenous dexmedetomidine and clonidine as adjuvants to low dose opioid (fentanyl) for attenuation of hemodynamic response to laryngoscopy and tracheal intubation. The secondary objectives are to compare the perioperative dose requirement of fentanyl and thiopentone, to compare the duration of postoperative analgesia, and to look for side effects in all three groups...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29761891/processed-electroencephalogram-and-evoked-potential-techniques-for-amelioration-of-postoperative-delirium-and-cognitive-dysfunction-following-non-cardiac-and-non-neurosurgical-procedures-in-adults
#4
REVIEW
Yodying Punjasawadwong, Waraporn Chau-In, Malinee Laopaiboon, Sirivimol Punjasawadwong, Pathomporn Pin-On
BACKGROUND: Postoperative delirium (POD) and postoperative cognitive dysfunction (POCD) may complicate a patient's postoperative recovery in several ways. Monitoring of processed electroencephalogram (EEG) or evoked potential (EP) indices may prevent or minimize POD and POCD, probably through optimization of anaesthetic doses. OBJECTIVES: To assess whether the use of processed EEG or auditory evoked potential (AEP) indices (bispectral index (BIS), narcotrend index, cerebral state index, state entropy and response entropy, patient state index, index of consciousness, A-line autoregressive index, and auditory evoked potentials (AEP index)) as guides to anaesthetic delivery can reduce the risk of POD and POCD in non-cardiac surgical or non-neurosurgical adult patients undergoing general anaesthesia compared with standard practice where only clinical signs are used...
May 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29761274/lower-intra-abdominal-pressure-has-no-cardiopulmonary-benefits-during-laparoscopic-colorectal-surgery-a-double-blind-randomized-controlled-trial
#5
Youn Joung Cho, Hyesun Paik, Seung-Yong Jeong, Ji Won Park, Woo Young Jo, Yunseok Jeon, Kook Hyun Lee, Jeong-Hwa Seo
BACKGROUND: Higher intra-abdominal pressure may impair cardiopulmonary functions during laparoscopic surgery. While 12-15 mmHg is generally recommended as a standard pressure, the benefits of lower intra-abdominal pressure are unclear. We thus studied whether the low intra-abdominal pressure compared with the standard pressure improves cardiopulmonary dynamics during laparoscopic surgery. METHODS: Patients were randomized according to the intra-abdominal pressure and neuromuscular blocking levels during laparoscopic colorectal surgery: low pressure (8 mmHg) with deep-block (post-tetanic count 1-2), standard pressure (12 mmHg) with deep-block, and standard pressure with moderate-block (train-of-four count 1-2) groups...
May 14, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29756694/effects-of-inhalation-and-intravenous-anaesthesia-on-intraoperative-cardiopulmonary-function-and-postoperative-complications-in-patients-undergoing-thoracic-surgery-a-systematic-review-and-meta-analysis
#6
Qian-Yun Pang, Ran An, Hong-Liang Liu
INTRODUCTION: There is a high incidence of postoperative cardiopulmonary complications after thoracic surgery with one lung ventilation (OLV), the effect of general anaesthetics on intraoperative cardiopulmonary function and postoperative complications is still unclear. EVIDENCE ACQUISITION: We searched the Embase, Pubmed, Cochrane Library, Springer, Wiley, CNKI, VIP and Wanfang databases for randomized controlled trials (RCTs) in which inhalation anaesthesia and intravenous anaesthesia were compared; intraoperative cardiopulmonary function and postoperative complications were assessed in patients undergoing thoracic surgery with intraoperative one-lung ventilation (OLV)...
May 11, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29746373/incidence-of-akathisia-after-postoperative-nausea-and-vomiting-prophylaxis-with-droperidol-and-ondansetron-in-outpatient-surgery-a-multicentre-controlled-randomised-trial
#7
Antoine Charton, Nicolas Greib, Aude Ruimy, Valentina Faitot, Yves Noudem, Girish P Joshi, Nicolas Meyer, Pierre Diemunsch
BACKGROUND: Akathisia, a distressing movement disorder induced by butyrophenones, has been described with low doses of droperidol used for postoperative nausea and vomiting (PONV) prophylaxis, but the incidence remains unclear. OBJECTIVES: To determine the incidence of akathisia after PONV prophylaxis with two doses of droperidol in comparison with ondansetron, in patients undergoing ambulatory surgery. We hypothesised that the incidence of akathisia is higher with droperidol than that with ondansetron...
May 8, 2018: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29742708/the-effectiveness-and-safety-of-nonsurgical-integrative-interventions-for-symptomatic-lumbar-spinal-spondylolisthesis-a-randomized-controlled-multinational-multicenter-trial-protocol
#8
Kiok Kim, Yousuk Youn, Sang Ho Lee, Jung Chul Choi, Jae Eun Jung, Jaehong Kim, Wenchun Qu, Jason Eldrige, Tae-Hun Kim
BACKGROUND: Surgery is generally accepted as the main therapeutic option for symptomatic lumbar spondylolisthesis. However, new nonsurgical therapeutic options need to be explored for this population. OBJECTIVES: The objective of this study is to assess the effectiveness and safety of a 5-week Mokhuri treatment program compared with conventional nonsurgical treatments for symptomatic lumbar spondylolisthesis. METHODS: This is a study protocol for a multinational, multicenter clinical randomized controlled trial comparing the effectiveness and safety of 5 weeks of nonsurgical integrative treatments (a Mokhuri treatment program consisting of Chuna, acupuncture, and patient education) with nonsurgical conventional treatments (drugs for pain relief, epidural steroid injections, and physical therapy)...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29730798/effects-of-an-infratrochlear-nerve-block-on-reducing-the-oculocardiac-reflex-during-strabismus-surgery-a-randomized-controlled-trial
#9
Seung-Hyun Kim, Hyun Jin Shin
PURPOSE: To determine whether an infratrochlear nerve block (ITB) can reduce the oculocardiac reflex (OCR) during strabismus surgery on the medial rectus muscle (MR). METHODS: This prospective, randomized single-masked study included 60 patients with intermittent exotropia scheduled for unilateral MR resection/lateral rectus recession under general anesthesia. Patients were randomly allocated to receive a regional nerve block of the infratrochlear nerve (ITB group) prior to surgery or standard treatment without a nerve block (control group)...
May 5, 2018: Graefe's Archive for Clinical and Experimental Ophthalmology
https://www.readbyqxmd.com/read/29727220/repair-of-primary-cleft-palate-and-oronasal-fistula-with-acellular-dermal-matrix-a-systematic-review-and-surgeon-survey
#10
Andrew Simpson, Osama A Samargandi, Alison Wong, M Elise Graham, Michael Bezuhly
OBJECTIVE: The current review and survey aim to assess the effectiveness of acellular dermal matrix (ADM) in the repair of cleft palate and oronasal fistula and to evaluate the current trends of ADM use in palate surgery. DESIGN: A systematic review of English articles was conducted using MEDLINE (1960 to July 1, 2016), the Cochrane Controlled Trials Register (1960 to July 1, 2016), and EMBASE (1991 to July 1, 2016). Additional studies were identified through a review of references cited in initially identified articles...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29696127/effect-of-oral-clonidine-on-shoulder-tip-pain-and-hemodynamic-response-after-laparoscopic-cholecystectomy-a-randomized-double-blind-study
#11
Hamid Mirhosseini, Mohamad Hossein Avazbakhsh, Meysam Hosseini Amiri, Ahmad Entezari, Reza Bidaki
Background: Shoulder tip pain is a common problem after laparoscopic cholecystectomy. There are a few clinical trial studies on the effect of clonidine on post laparoscopic shoulder pain (PLSP). This study aimed at evaluating the effect of oral clonidine on PLSP in semi-sitting position and post-operative hemodynamic response of patients undergoing LC surgery. Methods: This randomized controlled clinical trial was conducted on 60 patients, who were candidates for elective laparoscopic cholecystectomy surgery under general anesthesia, and were randomly allocated to clonidine and placebo groups...
December 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29696115/the-effect-of-ketamine-and-dexamethasone-in-combination-with-lidocaine-on-the-onset-and-duration-of-axillary-block-in-hand-and-forearm-soft-tissue-surgery
#12
Behrooz Zaman, Siavash Hojjati Ashrafi, Seyedalireza Seyed Siamdoust, Valiollah Hassani, Siavash Mohamad Taheri, Samad Noorizad
Background: Using peripheral nerve block compared to general anesthesia has gained more popularity due to reduced postoperative pain, less need for post-surgery analgesic drugs, reduced incidence of nausea, shortness of PACU time, and increased patient satisfaction. Objectives: The aim of this study was to compare the effect of ketamine and dexamethasone as additives to lidocaine on duration and onset of axillary block action. Methods: In this clinical trial, all patients who referred to Hazrat-e-Fatemeh hospital for forearm and hand soft tissue surgery with informed consent were randomly divided into three groups in order to examine the onset and duration of axillary block: lidocaine + ketamine, lidocaine + dexamethasone in axillary block, and lidocaine alone (control)...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29686815/the-effect-of-positive-end-expiratory-pressure-during-anesthesia-on-arterial-oxygen-saturation-after-surgery-in-patient-undergoing-cesarean-section
#13
Mahmood Ganjifard, Masoumeh Samii, Samaneh Kouzegaran, Amir Sabertanha
One of the major complications of general anesthesia in the recovery room is arterial oxygen desaturation and hypoxemia. Positive end-expiratory pressure (PEEP) can improve arterial oxygen saturation by increasing FRC. This study aims to evaluate the effects of applying PEEP on arterial oxygen saturation and hemodynamic parameters in the patient undergoing cesarean section in VALIASR hospital. In this double blind clinical trial we randomly allocated 120 patients of class1 and 2 ASA scheduled to undergoing cesarean section into 3 group (in 40)...
January 12, 2018: European Journal of Translational Myology
https://www.readbyqxmd.com/read/29682865/efficacy-of-forced-air-warming-for-preventing-perioperative-hypothermia-and-related-complications-in-patients-undergoing-laparoscopic-surgery-a-randomized-controlled-trial
#14
Shu-Fen Su, Hsiao-Chi Nieh
BACKGROUND: Perioperatively, unexpected hypothermia may cause adverse surgical outcomes. However, few studies have explored the efficacy of forced-air warming in patients undergoing laparoscopic surgery. AIM/OBJECTIVE: To determine the efficacy of forced-air warming for preventing perioperative hypothermia and complications in patients undergoing laparoscopic surgery. METHODS: A total of 127 participants undergoing laparoscopic thoracic or abdominal surgery were recruited between January and November 2015...
April 23, 2018: International Journal of Nursing Practice
https://www.readbyqxmd.com/read/29682715/-effect-of-anastomotic-reinforcing-sutures-on-the-incidence-of-anastomotic-leakage-after-laparoscopic-radical-resection-of-rectal-cancer-a-prospective-randomized-controlled-trial
#15
Yiren He, Zhiqiang Zhu, Shaojun Liu, Liu Liu, Bin Hu, Xiao Wan, Qiang Huang
OBJECTIVE: To investigate the effect of anastomotic reinforcing sutures on the incidence of anastomotic leakage after laparoscopic radical resection of rectal cancer. METHODS: In this study, 300 patients diagnosed with rectal cancer, scheduled to undergo laparoscopic anterior resection at the Department of Gastrointestinal Surgery of Anhui Provincial Hospital, between September 2014 and December 2016, were prospectively enrolled. Patients were randomly assigned to undergo laparoscopic rectal resection with (reinforcing group, n=150) or without (control group, n=150) anastomotic reinforcing sutures...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29682711/-imaging-diagnosis-and-imaging-risk-factors-of-anastomotic-leakage-after-rectal-cancer-surgery
#16
Yi Wang
Dispite continual improvements in diagnostic and management techniques, anastomotic leak (AL) remains one of the most devastating consequences of rectal cancer surgery. Recently, many investigations have attempted to identify the risk factors and established risk model to predict and prevent anastomotic leakage after low anterior resection. The distance between the lower edge of rectal cancer and the anal verge measured by magnetic resonance imaging was demonstrated as one of the independent risk factors associated with AL...
2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29680809/impact-of-dexmedetomidine-infusion-during-general-anaesthesia-on-incidence-of-postoperative-delirium-in-elderly-patients-after-major-non-cardiac-surgery-study-protocol-of-a-randomised-double-blinded-and-placebo-controlled-trial
#17
Bo-Jie Wang, Chun-Jing Li, Jian Hu, Huai-Jin Li, Chao Guo, Zhen-Han Wang, Qiao-Chu Zhang, Dong-Liang Mu, Dong-Xin Wang
INTRODUCTION: Delirium is a common complication in the elderly after surgery and is associated with worse outcomes. Multiple risk factors are related with postoperative delirium, such as exposure to general anaesthetics, pain and postoperative inflammatory response. Preclinical and clinical studies have shown that dexmedetomidine attenuated neurotoxicity induced by general anaesthetics, improved postoperative analgesia and inhibited inflammatory response after surgery. Several studies found that intraoperative use of dexmedetomidine can prevent postoperative delirium, but data were inconsistent...
April 21, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673408/long-term-scar-quality-after-hydrosurgical-versus-conventional-debridement-of-deep-dermal-burns-hycon-trial-study-protocol-for-a-randomized-controlled-trial
#18
Catherine M Legemate, Harold Goei, Esther Middelkoop, Irma M M H Oen, Tim H J Nijhuis, Kelly A A Kwa, Paul P M van Zuijlen, Gerard I J M Beerthuizen, Marianne K Nieuwenhuis, Margriet E van Baar, Cornelis H van der Vlies
BACKGROUND: Deep dermal burns require tangential excision of non-viable tissue and skin grafting to improve wound healing and burn-scar quality. Tangential excision is conventionally performed with a knife, but during the last decade hydrosurgery has become popular as a new tool for tangential excision. Hydrosurgery is generally thought to be a more precise and controlled manner of burn debridement leading to preservation of viable tissue and, therefore, better scar quality. Although scar quality is considered to be one of the most important outcomes in burn surgery today, no randomized controlled study has compared the effect of these two common treatment modalities with scar quality as a primary outcome...
April 19, 2018: Trials
https://www.readbyqxmd.com/read/29672368/pectoral-i-block-does-not-improve-postoperative-analgesia-after-breast-cancer-surgery-a-randomized-double-blind-dual-centered-controlled-trial
#19
Jérôme Cros, Patrick Sengès, Suzan Kaprelian, Julie Desroches, Caroline Gagnon, Anaïs Labrunie, Benoît Marin, Sabrina Crépin, Nathalie Nathan, Pierre Beaulieu
BACKGROUND AND OBJECTIVES: General anesthesia for breast surgery may be supplemented by using a regional anesthetic technique. We evaluated the efficacy of the first pectoral nerve block (Pecs I) in treating postoperative pain after breast cancer surgery. METHODS: A randomized, double-blind, dual-centered, placebo-controlled trial was performed. One hundred twenty-eight patients scheduled for unilateral breast cancer surgery were recruited. A multimodal analgesic regimen and surgeon-administered local anesthetic infiltration were used for all patients...
April 18, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29666130/does-dexmedetomidine-given-as-a-premedication-or-intraoperatively-reduce-post-hospitalisation-behaviour-change-in-children-a-study-protocol-for-a-randomised-controlled-trial-in-a-tertiary-paediatric-hospital
#20
Paul Lee-Archer, Craig McBride, Rebecca Paterson, Michael Reade, Britta Regli-von Ungern-Sternberg, Deborah Long
INTRODUCTION: It has been reported that post-hospitalisation behaviour change (PHBC) occurs in over 50% of children undergoing a general anaesthetic and manifests as behaviours such as sleep and eating disorders, defiance of authority, nightmares, enuresis and temper tantrums. The effect is usually short-lived (2-4 weeks); however, in 5-10% of children, these behaviours can last up to 12 months. The risk factors for developing PHBC include underlying anxiety in the child or parent, a previous bad hospital experience, emergence delirium and preschool age...
April 17, 2018: BMJ Open
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