Medical science monitor : international medical journal of experimental and clinical research
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Randomized Controlled Trial
Effects of a Preoperative Carbohydrate-Rich Drink Before Ambulatory Surgery: A Randomized Controlled, Double-Blinded Study.
BACKGROUND The guidelines recommend oral carbohydrates up to 2 hr before elective surgery. The objective of this study was to explore the safety and feasibility of preoperative carbohydrate drink in patients undergoing ambulatory surgery. MATERIAL AND METHODS Patients undergoing ambulatory surgery under general anesthesia were enrolled. ⋯ Blood electrolytes (sodium, potassium, calcium) and glucose concentration levels were similar in both groups at T₂. No gastric regurgitation or pulmonary aspiration was recorded. CONCLUSIONS Administration of 200 mL of oral carbohydrate beverage 2 hr before ambulatory surgery is safe, effective, and can be used for preoperative management of fasting patients.
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Traced back to December 2019, an unexpected outbreak of a highly contagious new coronavirus pneumonia (COVID-19) has rapidly swept around China and the globe. There have now been an estimated 2 580 000 infections and more than 170 000 fatal cases around the world. The World Health Organization (WHO) estimated that approximately 14% of infections developed into severe disease, 5% were critically ill, and the mortality rate of critically ill patients is reported to be over 50%. ⋯ This difficult situation calls for the use of extracorporeal membrane oxygenation (ECMO) for assisting respiration and circulation if necessary. This article reviews the pertinent clinical literature, technical guidance, and expert recommendations on use of ECMO in critically ill cases of COVID-19. Here, we present basic knowledge and opinions about COVID-19 and ECMO, review the evidence on ECMO use in Middle East Respiratory Syndrome (MERS) and H1N1 influenza, share the technical guidance and recommendations on use of ECMO in COVID-19, summarize the current use of ECMO against COVID-19 in China, and discuss the issues in use of ECMO in COVID-19.
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Randomized Controlled Trial
Elevated Lateral Position Improves the Success of Paramedian Approach Subarachnoid Puncture in Spinal Anesthesia before Hip Fracture Surgery in Elderly Patients: A Randomized Controlled Study.
BACKGROUND The aim of this study was to determine whether an elevated lateral recumbent position, compared to regular lateral recumbent position, may reduce the number of needle passes and attempts required for success subarachnoid puncture in spinal aesthesia before surgery in elderly patients with hip fractures. MATERIAL AND METHODS This was a randomized controlled interventional study in Beijing Jishuitan Hospital. Patients older than 65 years of age with hip fracture orthopedics who were planned to receive subarachnoid block in the lateral recumbent position before surgery were enrolled. ⋯ The procedure process, including overall times needed for puncture, anesthesia, and surgery did not show differences between the 2 groups. Complications were few and similar between the 2 groups. CONCLUSIONS An elevated lateral recumbent position during the subarachnoid puncture in spinal anesthesia significantly reduced the needle pass numbers needed for success dural puncture, and reduced discomfort in elderly patients with hip fractures.