Medical science monitor : international medical journal of experimental and clinical research
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Randomized Controlled Trial
Dexamethasone added to local lidocaine for infiltration along the spinal-epidural needle pathway decreases incidence and severity of backache after gynecological surgery.
The aim of this study was to evaluate the effect of dexamethasone added to local lidocaine infiltration on incidence and severity of backache after combined spinal-epidural anesthesia for gynecological surgery. ⋯ Addition of dexamethasone to local lidocaine infiltration effectively decreases the incidence and severity of back pain after combined spinal-epidural anesthesia implemented for gynecological surgery.
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Comparative Study
Performance characteristics of seven bilevel mechanical ventilators in pressure-support mode with different cycling criteria: a comparative bench study.
Pressure support ventilation from a bilevel device is a standard technique for non-invasive home ventilation. A bench study was designed to compare the performance and patient-ventilator synchronization of 7 bilevel ventilators, in the presence of system leaks. ⋯ Performance and triggering workload varied significantly between bilevel ventilators, possibly due to software algorithm differences. Adjusting the cycling criteria settings can alter the shape of the inspiratory phase and peak expiratory flow, and improve patient-ventilator synchrony.
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Ketamine in subanesthetic dose added to butorphanol has been reported to give superior pain control when used for intravenous patient-controlled analgesia (PCA) after surgery. However, this admixture is not available commercially and stability data applicable to hospital practice are limited. ⋯ The results indicate that the drug mixtures of butorphanol and ketamine in 0.9% sodium chloride injection were stable for 15 days when stored in polyolefin bags at 4°C, 25°C, or 37°C.
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Obese patients are a very large high-risk group for complications after surgical procedures. In this group, optimized perioperative care and a faster recovery to full activity can contribute to a decreased rate of postoperative complications. The introduction of ERAS®-based protocol is now even more important in bariatric surgery centers. The results of our study support the idea of implementation of ERAS®-based protocol in this special group of patients. ⋯ The introduction of an ERAS® principles-inspired protocol in our center proved technically possible and safe for our patients, and allowed for reduced hospitalization times without increased rate of complications or readmissions.
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Hypoxemia is a severe perioperative complication that can substantially increase intensive care unit and hospital stay and mortality. The aim of this study was to determine the effects of non-invasive positive-pressure ventilation (NIPPV) in patients with hypoxemia after surgery for Stanford type A aortic dissection, and to compare the effects of helmet and mask NIPPV. ⋯ NIPPV effectively improved oxygenation and reduced PaCO2 in patients who developed hypoxemia soon after extubation following surgery for Stanford type A aortic dissection. Compared with mask NIPPV, helmet NIPPV more rapidly increased PaO2 and reduced PaCO2, increased patient tolerance and comfort, and reduced complications.