BMC anesthesiology
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Randomized Controlled Trial Comparative Study
Clonidine and dexmedetomidine for controlled hypotension during functional endoscopic sinus surgery: a comparative study.
Functional endoscopic sinus surgery (FESS) is minimally invasive, ambulatory endoscopic surgical procedure usually performed in most paranasal sinus diseases. Controlled hypotension during anaesthesia (hypotensive anesthesia) improves surgical field visibility and reduces risk of injuring surrounding structures. Clonidine (C) and dexmedetomidine (D) are both used to reduce blood pressure and heart rate while maintaining tissue perfusion. This study was conducted to evaluate the efficacy of clonidine compared to dexmedetomidine for controlled hypotension during FESS. ⋯ Clonidine and dexmedetomidine provided good to excellent quality of surgical field visibility to surgeons during FESS. Dexmedetomidine produce more hypotension and bradycardia compared to clonidine which may be preferable for controlled hypotension in the setting of ambulatory surgery. However, considering the small sample of this study which could not detect small but clinically differences between both drugs, there is a need for a much larger and multicenter study to confirm these findings.
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Delirium is one of the most common neurological complications after cardiac surgery. The purpose of our study was to assess the relationship between perioperative blood pressure variability (BPV) and postoperative delirium (POD) in the patients undergoing cardiac surgery. ⋯ Perioperative ARV, especially postoperative high ARV exposure, was associated with POD in the patients receiving cardiac surgery. Maintaining a relatively stable blood pressure after cardiac surgery might be beneficial to avoid POD in those patients.
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Randomized Controlled Trial Comparative Study
Comparison between ultrasound guided erector spinae plane block and paravertebral block on acute and chronic post mastectomy pain after modified radical mastectomy: randomized controlled trial.
Inadequate acute postoperative pain management is linked to the effect on the stress response and development of chronic pain. A unique regional anaesthetic method that is becoming more important for postoperative pain management is erector spinea plane block (ESP). Since its initial description, physicians have questioned weather this novel easy method can take the place of paravertebral block (PVB). Our goal was to evaluate, in contrast to control group, the effects of ESP & PVB on acute and chronic post-mastectomy pain. ⋯ ESP and TPV blocks provided superior early postoperative analgesia and reduced stress response compared to the control group in female patients undergoing modified radical mastectomy. PVB is better than ESB in acute postoperative pain management (the total morphine consumption VAS score and time of first analgesic request). Both techniques showed better long-term outcomes compared to the control group regarding LANSS score in the 6-month follow-up.
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Randomized Controlled Trial
The effect of pericapsular nerve group (PENG) block on postoperative analgesia in elderly patients who underwent proximal femoral nail anti-rotation surgery: a prospective, randomized-controlled trial.
As a fascial plane block technique, further exploration is needed to determine the safety and efficacy of a peri-capsular nerve group (PENG) block in elderly patients with intertrochanteric femur fractures. We aimed to evaluate whether opioid consumption during a PENG block is better than a conventional opioid-based program for postoperative pain management after proximal femoral nail anti-rotation (PFNA). ⋯ Incorporating the PENG block into a multimodal analgesia regimen can decrease opioid consumption among elderly patients undergoing PFNA under general anesthesia.