Medicina
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Randomized Controlled Trial
Bilateral Rectus Sheath Block with Continuous Bupivacaine Infusions After Elective Open Gastrectomy: A Randomized Controlled Trial.
Background and Objectives: Multimodal analgesia has been shown to be effective in facilitating early postoperative gastrointestinal function and rehabilitation in patients undergoing open gastrectomy. We conducted a clinical trial to investigate the effectiveness of bilateral rectus sheath block (RSB) with continuous bupivacaine infusion in comparison with placebo following elective open gastrectomy. Materials and Methods: Patients indicated for elective open gastrectomy were screened, enrolled, and randomised between October 2021 and September 2023. ⋯ Clinically, Group A patients had a significantly shorter time to first gas (p = 0.001), a shorter time to first bowel movement (p < 0.001), a shorter time to first out-of-bed activity (p < 0.001), and a shorter overall hospitalisation duration (p < 0.001) compared to Group B patients. Conclusions: Bilateral RSB with continuous bupivacaine infusion is effective in managing pain and can reduce the use of opioid analgesics in the postoperative period. Furthermore, it promotes early recovery, and a shorter hospital stay.
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Randomized Controlled Trial
Influence of Nociception Level Monitor (NOL)-Guided Analgesic Delivery on Perioperative Course in Breast Surgeries: A Randomized Controlled Trial.
Background and Objectives: Breast cancer surgeries offer challenges in perioperative pain management, especially in the presence of inherent risk of postoperative nausea and vomiting (PONV) and postmastectomy pain syndrome (PMPS). Inappropriate opioid consumption was speculated as one of the reasons. Through this study, the influence of objective pain monitoring through a nociception level monitor (NOL) on perioperative course in breast surgeries was investigated. ⋯ There was no difference in time to eligibility for discharge from the recovery room between the groups. Conclusions: NOL monitor-guided analgesic delivery reduces intraoperative opioid consumption. No difference was demonstrated on PONV, eligibility for discharge from the recovery room, or PMPS symptoms.
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Randomized Controlled Trial
Immediate and Long-Term Effects of Breathing Exercises on Reaction Time.
Background and Objectives: The aim of this study was to investigate the immediate and long-term effects of breathing exercises on simple and choice reaction time. Materials and Methods: A total of 31 participants were included in the study. The participants were randomly divided into two groups. ⋯ Results: There was no significant difference between the groups at baseline, immediately, and A4W (p < 0.05) for the VRT, ART, and CRT results with the dominant hand (DH), whereas a group-by-time interaction was found only for the visual reaction time results with the non-dominant hand (nDH) (p > 0.05). Conclusions: The results of this study, which included the evaluation of the immediate and long-term effects of breathing exercises on reaction time, showed an improvement in visual reaction time between the groups over time. In further studies, it is recommended to evaluate the changes and responses in the central nervous system with objective methods to reveal the effect of breathing exercises on reaction time more clearly.
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Randomized Controlled Trial
A Double-Blinded Randomized Controlled Trial: Can Pulsed Electromagnetic Field Therapy Be a Novel Method for Treating Chronic Rhinosinusitis?
Background and Objectives: Pulsed electromagnetic field (PEMF) therapy offers a promising approach to treating inflammatory diseases. Its notable anti-inflammatory and antimicrobial effects and enhancement of microcirculation in the nasal mucosa make it a valuable treatment option. Despite its potential, the use of PEMF for chronic rhinosinusitis (CRS) is still in its early stages, with limited exploration of its effectiveness. ⋯ Additionally, there was a notable improvement in sinus opacifications and ostiomeatal complex obstructions among participants who received PEMF therapy. Conclusions: PEMF therapy effectively reduces fatigue, headaches, and sinus opacifications in CRS patients, suggesting its potential for inclusion in CRS management guidelines to improve patient outcomes and quality of life. The results of this study indicate that PEMF represents a noninvasive and cost-effective approach for treating adults with mild-to-moderate CRS.
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Randomized Controlled Trial
Histomorphometric and Micro-CT Evaluation of Cerabone and Bio-Oss in Maxillary Sinus Lifting: A Randomized Clinical Trial.
Background and Objectives: The loss of teeth in the posterior maxillary region often leads to significant alveolar bone resorption and maxillary sinus pneumatization, complicating dental implant placement. Maxillary sinus grafting, typically using autogenous bone, is a common solution. However, autogenous bone grafts require additional surgical procedures, leading to increased morbidity. ⋯ Micro-CT analysis revealed that the bone volume fraction in the Cerabone group was significantly higher compared to the Bio-Oss group, with significant differences in trabecular thickness (p = 0.02) but not in trabecular number or separation. Conclusions: The study demonstrates that both xenografts are effective in promoting new bone formation in maxillary sinus grafting. However, Cerabone showed superior performance in terms of new bone formation and bone volume fraction, suggesting it may be a more effective option for maxillary sinus augmentation procedures.