BMC anesthesiology
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Randomized Controlled Trial Multicenter Study
The effect of brief pre-anesthetic exercise therapy of jaw and neck joints on mouth opening, neck extension, and intubation conditions during induction of general anesthesia: a randomized controlled trial.
The effort to improve tracheal intubation process is clinically valuable. We hypothesized that a preoperative brief exercise therapy would increase mouth opening and neck extension, enhancing intubation conditions during general anesthesia. ⋯ The brief pre-anesthetic exercise improved intubation conditions and enabled faster tracheal intubation with less injury to oropharyngeal soft tissue.
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Randomized Controlled Trial
Effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures: a randomized clinical trial.
Laparoscopic surgery has become a standard of care for many gynecological surgeries due to its lower morbidity, pain and cost compared to open techniques. Unfortunately, the use of carbon dioxide (CO2) to insufflate the abdomen is the main contributor to post-operative shoulder pain. ⋯ In conclusion, Trendelenburg position is an easy non-pharmacologic intervention that is beneficial in reducing postoperative shoulder pain following gynecologic laparoscopic surgery.
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Randomized Controlled Trial
Flow-controlled ventilation (FCV) improves regional ventilation in obese patients - a randomized controlled crossover trial.
In obese patients, high closing capacity and low functional residual capacity increase the risk for expiratory alveolar collapse. Constant expiratory flow, as provided by the new flow-controlled ventilation (FCV) mode, was shown to improve lung recruitment. We hypothesized that lung aeration and respiratory mechanics improve in obese patients during FCV. ⋯ This study demonstrates that, compared to VCV, FCV improves regional ventilation distribution of the lung at comparable PEEP, tidal volume, PPlat and ventilation frequency. The increase in end-expiratory lung volume during FCV was probably caused by the increased mean tracheal pressure which can be attributed to the linearized expiratory pressure decline.
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Inadvertent intraoperative hypothermia increases the risk of adverse events, but its related risk factors have not been defined in video-assisted thoracoscopic surgery (VATS). This study aimed at analyzing the prevalence and factors related to inadvertent intraoperative hypothermia in adults undergoing elective VATS under general anesthesia. ⋯ We highlight the high prevalence of inadvertent intraoperative hypothermia during elective VATS and identify key risk factors including age, duration of surgery more than 2 h, surgery in the morning and general anesthesia combined with paravertebral block (PVB) after intubation. We also find that hypothermia did prolong the LOS in the hospital.
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Comparative Study Observational Study
Efficacy of continuous epidural infusion with epidural electric stimulation compared to that of conventional continuous epidural infusion for acute herpes zoster management: a retrospective study.
Continuous epidural infusions are commonly used in clinical settings to reduce the likelihood of transition to postherpetic neuralgia via pain control. The purpose of this study was to compare the efficacy of conventional continuous epidural infusion to that of continuous epidural infusion in which the catheter is guided by electric stimulation to areas with neurological damage for the treatment of zoster-related pain and prevention of postherpetic neuralgia. ⋯ Epidural drug administration to specific spinal segments using electric stimulation catheters may be more helpful than conventional continuous epidural infusion for improving pain and preventing postherpetic neuralgia in the acute phase of herpes zoster.