Surgical endoscopy
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Randomized Controlled Trial
Postoperative pain relief after laparoscopic cholecystectomy: a placebo-controlled double-blind randomized trial of preincisional infiltration and intraperitoneal instillation of levobupivacaine 0.25%.
The aim of this study was to test the use of preincisional and intraperitoneal levobupivacaine (L-B) 0.25% in laparoscopic cholecystectomies for postoperative analgesia. ⋯ The combination of preincisional local infiltration and intraperitoneal instillation of L-B 0.25% shows an advantage for postoperative analgesia after laparoscopic cholecystectomy.
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Primary hyperaldosteronism caused by an aldosterone-producing adenoma of the adrenal gland is regarded as the most common type of endocrine hypertension. The aim of this study was to analyze the changing pattern of the intraoperative blood pressure during endoscopic adrenalectomy recorded in patients with Conn's syndrome compared to patients with hormone-inactive incidentaloma and its possible influence by the surgical approach. ⋯ Our results demonstrate that relevant intraoperative increases in blood pressure occur in patients with Conn's syndrome despite prior therapy with an aldosterone antagonist, necessitating specific precautionary measures during anesthesia. Intraoperative blood pressure was significantly higher for the retroperitoneal than for the transperitoneal procedure, which leads us to advocate the latter approach for endoscopic adrenalectomy.