World journal of surgery
-
World journal of surgery · Oct 2010
Randomized Controlled Trial Comparative StudyPreincisional versus postincisional administration of parecoxib in colorectal surgery: effect on postoperative pain control and cytokine response. A randomized clinical trial.
Preincisional pain management aims at reducing pain and inflammatory response. We investigated whether preincisional parecoxib administration reduces pain, opioid requirements, and cytokine production after surgery for colonic cancer. ⋯ Preincisional parecoxib administration compared to postincisional administration reduced postoperative morphine consumption, but without affecting morphine-related adverse effects and attenuated IL-6 production 24 h after surgery for colorectal cancer.
-
World journal of surgery · Oct 2010
Randomized Controlled TrialBilateral superficial cervical plexus block combined with general anesthesia administered in thyroid operations.
We investigated the analgesic efficacy of bilateral superficial cervical plexus block in patients undergoing thyroidectomy and to determine whether it reduces the adverse effects of general anesthesia. ⋯ Bilateral superficial cervical plexus block reduces general anesthetics required during thyroidectomy. It also significantly lowers the severity of postoperative pain during the first 24 h and shortens the hospital stay.
-
Cutaneous malignancies are considered rare among Africans. Trauma, its sequelae, and other chronic non-healing wounds are known to predispose to malignant degeneration. Not much is known of the demographics of Marjolin's ulcers in sub-Saharan Africa. ⋯ Marjolin's ulcers in sub-Saharan African have a shorter latent period, and they occur in younger patients. Provision of early stable wound cover is essential for prevention of malignant degeneration of scars, while early appropriate intervention is crucial in the treatment of chronic ulcers.
-
World journal of surgery · Oct 2010
Clinical TrialOut with the old, in with the new: a novel approach to treating pain associated with rib fractures.
Rib fractures continue to be a challenging problem from both a pulmonary and analgesia standpoint. As a result, numerous modalities have been used to treat this condition, but none has proven universally available and efficacious. The objective of this pilot study was to assess the efficacy of a novel technique for placing an elastomeric infusion pump (EIP) catheter (On-Q; Lake Forest, CA, USA) in the extrathoracic paraspinous space to create a continuous intercostal nerve block. ⋯ These pilot data indicate that the placement of EIP catheters in the extrathoracic paraspinous space may be a safe, viable, and efficacious procedure for ameliorating pain secondary to rib fractures.
-
World journal of surgery · Oct 2010
Clinical TrialRoutine ultrasound and limited computed tomography for the diagnosis of acute appendicitis.
Acute appendicitis continues to be a challenging diagnosis. Preoperative radiological imaging using ultrasound (US) or computed tomography (CT) has gained popularity as it may offer a more accurate diagnosis than classic clinical evaluation. The optimal implementation of these diagnostic modalities has yet to be established. The aim of the present study was to investigate a diagnostic pathway that uses routine US, limited CT, and clinical re-evaluation for patients with acute appendicitis. ⋯ A diagnostic pathway using routine US, limited CT, and clinical re-evaluation for patients with acute abdominal pain can provide excellent results for the diagnosis and treatment of appendicitis.