Surg J R Coll Surg E
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Surg J R Coll Surg E · Feb 2017
Review Meta Analysis Comparative StudyLocal anaesthesia versus spinal anaesthesia in inguinal hernia repair: A systematic review and meta-analysis.
Inguinal hernias are a significant cause of morbidity. The purpose of this systematic review and meta-analysis is to determine the totality of evidence regarding the effectiveness of local anaesthesia when compared to spinal anaesthesia in individuals undergoing open inguinal hernia repair. ⋯ Our findings support the use of local anaesthetic in adult patients undergoing open repair for a primary inguinal hernia.
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Surg J R Coll Surg E · Feb 2017
Randomized Controlled TrialUsing a multimedia presentation to improve patient understanding and satisfaction with informed consent for minimally invasive vascular procedures.
As vascular procedures become more complex, patient understanding of their treatment(s) can become more difficult. We wished to evaluate the utility of multimedia presentations (MPs) to improve patient understanding of their vascular interventions. ⋯ This study suggests that patients find the use of MP during the consent process to be helpful in patient understanding and that there is improved satisfaction. Given the rapid rate of innovation in vascular interventions, increased regular use of MPs to help patients understand their procedures would be beneficial in the care of patients undergoing vascular interventions.
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Surg J R Coll Surg E · Feb 2017
Refinement of myotome values in the upper limb: Evidence from brachial plexus injuries.
We reviewed patients with partial supraclavicular brachial plexus injuries in order to refine the myotome values of the upper limb. ⋯ In upper plexus injuries paralysis of FCR indicated involvement of C7 root in addition to C5 and C6 roots. The results provide new detail of innervation of muscles acting on the hand. Flexor muscles and intrinsic muscles of the thumb and radial fingers (median nerve) have an important contribution from T1, while for those acting on the ulnar digits (ulnar nerve) the main contribution is from C8 with some input from C7. T1 also gives consistent innervation to extensor pollicis longus. A revised myotome chart for the upper limb is proposed.