Cir Cir
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Randomized Controlled Trial
Effect of endovenous morphine vs. ketorolac on proinflammatory cytokines during postoperative analgesia in laparoscopic cholecystectomy.
Postoperative pain is the main symptom following a surgical event and is related to an inflammatory process involving cytokine secretion. This type of pain is usually treated with opioids such as morphine, whose analgesic efficacy is well known. However, it is unknown when compared with ketorolac in measuring proinflammatory cytokine levels. The aim of this study was to determine the postoperative analgesic effect with endovenous morphine on proinflammatory cytokine levels in patients who underwent laparoscopic choleystectomy. ⋯ Proinflammatory cytokines were increased after surgery, particularly TNF-a in the group receiving morphine. The use of morphine is safe postoperatively.
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The discrepancy between organ availability and the increasing amount of patients on the waiting list has prompted the development of medical strategies to increase the usable organs, including the search for alternative sources of donation, organ optimization and extension of the criteria for donation. The recovery of lungs from non-heart-beating donors (NHBD) is a concept in which death is declared based on cardiopulmonary criteria rather than the currently used definition of "brain death." Obtaining NHBD lungs is currently practiced in many centers. In this review we discuss the current state of lung transplantation from uncontrolled NHBD.