Journal of clinical anesthesia
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Review Meta Analysis
Preoperative exercise therapy in surgical care: a scoping review.
Several systematic reviews have focused on the role of preoperative exercise therapy (PET) in various fields of surgical care. Aims of the present scoping review are to summarize research findings and to identify gaps in existing literature. ⋯ Overall, it seems that PET exerts beneficial effects on physical fitness and postoperative outcome measures. Gaps in current literature are the heterogeneity in selected patient populations and outcome measures as well as lack of guidelines on the specific PET regimes. Therefore, there is increasing need for multicenter randomized trials with specifically designed PET programs and a carefully selected patient population to strengthen current evidence.
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Randomized Controlled Trial Comparative Study
Comparison of caudal epidural block and ultrasonography-guided transversus abdominis plane block for pain relief in children undergoing lower abdominal surgery.
We conducted this study to compare the efficacy of caudal epidural block (CEB) vs ultrasonography-guided transversus abdominis plane (TAP) block for providing postoperative pain relief in children scheduled for lower abdominal surgery. Whereas the primary objective was to compare the duration of postoperative analgesia, the secondary objectives included comparative assessment (TAP vs CEB) of quality of pain relief in the first 24hours postoperatively and rescue analgesia requirements. ⋯ In children undergoing lower abdominal surgery, CEB provides a significantly prolonged duration of postoperative analgesia when compared with ultrasonography-guided TAP block.
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Randomized Controlled Trial Comparative Study
Comparision of clonidine and dexmedetomidine for attenuation of laryngoscopy and intubation response - A randomized controlled trial.
Clonidine and dexmedetomidine are alpha-2 agonists with beneficial effect on the hemodynamic response to laryngoscopy and intubation. The present study was designed to evaluate and compare the efficacy of intravenous clonidine 1 μg/kg, and dexmedetomidine in doses of 0.5 μg/kg and 1 μg/kg, for blunting the hemodynamic changes during laryngoscopy and intubation. ⋯ Dexmedetomidine 0.5 μg/kg, 1 μg/kg and clonidine 1 μg/kg attenuate the laryngoscopy and intubation response but Clonidine 1 μg/kg was associated with lesser side effects.
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Randomized Controlled Trial Comparative Study
Total intravenous anesthesia with propofol is associated with a lower rate of postoperative delirium in comparison with sevoflurane anesthesia in elderly patients.
Postoperative delirium (POD) is a common complication of anesthesia. The incidence of POD in elderly patients ranges from 37% to 53%, and POD increases the morbidity and mortality of elderly patients. However, the effects of anesthetics on POD are not well known. The present study aimed to compare the incidence of POD resulting from propofol and sevoflurane anesthesia. ⋯ In comparison with sevoflurane anesthesia, propofol anesthesia is associated with a lower incidence of POD in elderly patients.
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Randomized Controlled Trial Comparative Study
The effects of caudal or intravenous dexmedetomidine on postoperative analgesia produced by caudal bupivacaine in children: a randomized controlled double-blinded study.
The aim of this study was to compare the effects of caudal and intravenous (IV) dexmedetomidine (1 μg/kg) on postoperative analgesia after caudal bupivacaine in pediatric patients undergoing lower abdominal and perineal surgeries. ⋯ Compared to IV administration, caudal administration of dexmedetomidine during caudal bupivacaine anesthesia provided prolonged postoperative analgesia and a greater analgesic sparing effect without significant side effects. This suggests a greater role of neuraxial compared to that of peripheral α-2 adrenoceptors in pain processing.