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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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.
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Randomized Controlled Trial
General Anesthesia Maintained with Sevoflurane versus Propofol in Pediatric Surgery Shorter Than 1 Hour: A Randomized Single-Blind Study.
BACKGROUND Sevoflurane was compared with propofol for general anesthesia maintenance in pediatric operations lasting less than 1 hour in terms of anesthetic effect and postoperative recovery. MATERIAL AND METHODS Children scheduled for inguinal hernia repair or hydrocele testis repair were randomly assigned to receive general anesthesia maintained with either sevoflurane (n=43) or propofol (n=43). The ilioinguinal nerve was blocked with 1% lidocaine (7 mg/kg) after intravenous administration of ketamine (2 mg/kg). ⋯ Propofol was associated with a significantly higher incidence of intraoperative body movement (33.3%) than was sevoflurane (13.5%; P=0.045). However, the 2 groups showed no important differences in other adverse events such as hypoxia, emergence agitation, and additional use of propofol. CONCLUSIONS In pediatric surgery lasting less than 1 hour, anesthesia maintained with sevoflurane was associated with significantly less use of ketamine, shorter postoperative recovery time, and less intraoperative body movement than was propofol.
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Randomized Controlled Trial
Comparison of Effects of Abdominal Draw-In Lumbar Stabilization Exercises with and without Respiratory Resistance on Women with Low Back Pain: A Randomized Controlled Trial.
BACKGROUND This study examined the effects of abdominal draw-in lumbar stabilization exercises (ADIM) with respiratory resistance on women ages 40-49 years with low back pain. MATERIAL AND METHODS Forty-four women ages 40-49 years were screened for participation and were randomly assigned to either a respiratory with resistance exercise group (n=22) or a control group (n=22). Abdominal draw-in lumbar stabilization exercises were administered to both groups, but only the respiratory with resistance exercise group received the respiratory resistance training. ⋯ CONCLUSIONS A lumbar stabilization exercise program consisting of ADIM and respiratory resistance resulted in decreased pain, reduced dysfunctions, and increased muscle thickness in contraction, contraction rate, and pulmonary function. Strong contraction of the diaphragm and deep abdominal muscles through breathing resistance increased the pressure in the abdominal cavity. Therefore, this may be an effective clinical exercise method for patients with lumbar instability.
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Randomized Controlled Trial Comparative Study
Impact of Sevoflurane Versus Propofol Anesthesia on Post-Operative Cognitive Dysfunction in Elderly Cancer Patients: A Double-Blinded Randomized Controlled Trial.
BACKGROUND Research on the clinical outcomes of surgical patients anaesthetized with sevoflurane and the association of sevoflurane with post-operative cognitive dysfunction (POCD) is scarce. We evaluated whether sevoflurane-based anesthesia increased the incidence of POCD and worsened prognosis compared to propofol-based anesthesia in elderly cancer patients. MATERIAL AND METHODS This single-center, prospective, double-blind randomized controlled trial included 234 patients aged 65 to 86 years undergoing tumor resection who received sevoflurane-based (Group S) or propofol-based (Group P) anesthesia during surgery. ⋯ During the first 2 days post-operation, the QoR-40 global score was significantly lower in Group S compared to Group P [POD 1: P=0.004; POD 2: P=0.001]. There were no significant differences in in-hospital post-operative complications, post-operative length of hospital stay, all-cause mortality at 30 days, and 3 months post-operation, or post-operative quality of life at 3 months between patients in Group S and Group P. CONCLUSIONS Sevoflurane-based anesthesia did not increase the incidence of POCD compared to propofol-based anesthesia at 7 days or 3 months post-operation or impact short-term post-operative prognosis.