Canadian journal of surgery. Journal canadien de chirurgie
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Randomized Controlled Trial Clinical Trial
Efficacy and safety of controlled-release oxycodone and standard therapies for postoperative pain after knee or hip replacement.
Standard therapy (ST) for postoperative pain after knee and hip replacement at the Hamilton Health Sciences Henderson Hospital consists of epidural analgesia or patient-controlled analgesia for the first 48 hours, followed by oral or parenteral analgesics, or both, on an as-needed basis. We compared the efficacy and safety of scheduled controlled-release (CR) oxycodone hydrochloride (OxyContin; Purdue Pharma, Pickering, Ont.) and ST for postoperative pain 48 hours after primary knee and hip replacement. ⋯ CR oxycodone every 12 hours is as effective as ST in treating postoperative pain but length of hospital stay was shorter and analgesic administration in the hospital was used less frequently, providing potential hospital cost savings and reduced use of health care resources.
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Randomized Controlled Trial Meta Analysis Comparative Study Clinical Trial
Oral versus systemic antibiotic prophylaxis in elective colon surgery: a randomized study and meta-analysis send a message from the 1990s.
To compare the efficacy of combined oral and systemic antibiotics (combined) versus systemic antibiotics (systemic) alone in preventing surgical site infection in elective surgery of the colon, and to perform a meta-analysis of randomized studies comparing combined versus systemic antibiotics in elective colon surgery. ⋯ In elective surgery of the colon combined oral and systemic antibiotics are superior to systemic antibiotics in preventing surgical site infections. Orally administered antibiotics add value by reducing bacterial loading of the colon and wound fat contamination, both associated with postoperative wound infection. Meta-analysis of randomized clinical trials reported from 1975 to 1995 supports these conclusions.
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Randomized Controlled Trial Clinical Trial
Coronary artery bypass surgery with heparin-coated perfusion circuits and low-dose heparinization.
To evaluate the safety and efficacy of heparin-coated perfusion circuits with low-dose heparinization and centrifugal pumping compared with the standard method during coronary artery bypass grafting. ⋯ Heparin-coated cardiopulmonary bypass with low-dose heparinization and centrifugal pumping is a safe practice but showed no advantages over the use of regular uncoated bypass circuits for coronary bypass surgery.
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Randomized Controlled Trial Clinical Trial
The effects of a pneumatic tourniquet on blood loss in total knee arthroplasty.
In lower-extremity surgery there are significant risks associated with the use of tourniquets. This prospective study was done to assess to what extent these risks may be offset by the potential advantages of tourniquets, namely reductions in blood loss, length of hospital stay and complication rates. ⋯ The effectiveness of a pneumatic tourniquet to control blood loss in TKA is questionable.
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Randomized Controlled Trial Clinical Trial
Randomized, controlled trial of bupivacaine injection to decrease pain after laparoscopic cholecystectomy.
To determine if intraoperative instillation of bupivacaine would decrease early postoperative pain after laparoscopic cholecystectomy, if the patients would consequently require less narcotic postoperatively and if such patients would elect to be discharged on the day of operation if given the choice. ⋯ Instillation of bupivacaine into port sites should be standard practice for elective laparoscopic cholecystectomy.