American journal of surgery
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Randomized Controlled Trial Clinical Trial
Penile block for pain relief after circumcision in children. A randomized, prospective trial.
The value of adjunctive penile block for analgesia, after circumcision in children using 0.5 percent bupivacaine has been evaluated in this randomized, prospective trial. Significantly more children without nerve block were found to require analgesics, administered by injection orally, in the first 12 hour period when compared with children given the nerve block. Penile block is a procedure that is safe, simple to achieve, free from complications, and covers the postoperative period when analgesia is much needed.
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The records of 125 consecutive patients with unresectable pancreatic cancer treated between 1958 and 1979 were evaluated to determine the benefit or morbidity of gastroenterostomy performed on a routine basis. One hundred three patients had no evidence of gastric outlet obstruction from tumor extension as determined at the time of initial operation. Fifty-seven of these patients underwent biliary diversion as their only operative procedure. ⋯ Forty-six patients underwent both biliary and prophylactic gastric outlet diversion with a 15 percent mortality rate and a 46 percent incidence of morbidity. The most common complication in this group was delayed gastric emptying (14 percent). These findings, and the high incidence of delayed gastric emptying after gastroenterostomy and the relatively infrequent occurrence of gastric outlet obstruction (11 percent) after initial biliary diversion, suggest that gastroenterostomy should be performed on a selective basis only.