Prilozi / Makedonska akademija na naukite i umetnostite, Oddelenie za biološki i medicinski nauki = Contributions / Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences
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Randomized Controlled Trial Comparative Study
Continuous femoral nerve block versus fascia iliaca compartment block as postoperative analgesia in patients with hip fracture.
Systemic postoperative analgesia is inefficient in most patients with hip fracture, which is the reason for pain, especially during leg movement. Peripheral and plexus nerve blocks are an efficient option for postoperative pain relief. The aim of this study was to compare the effect and duration of continuous FNB versus a single FIC block as a postoperative analgesia in patients with hip fracture. ⋯ Pain relief in the postoperative period was superior in the FNB group versus the FIC group at rest and in movement in patients with hip fracture.
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Randomized Controlled Trial
Improvement of cerebral oxygenation during laparoscopy using intermittent sequential compression of legs.
The creation of CO₂ pneumoperitoneum during laparoscopy causes a series of adverse effects. Impairment of brain oxygen saturation during laparoscopy is a result of increased intra-abdominal pressure, absorbed CO₂ and increased intracranial pressure. The aim of this study is to investigate the possible effects of pneumatic inter-mittent sequential compression (ISC) of legs on oxygenation of the brain during laparoscopy. 100 patients, ASA groups 1 and 2, subjected to elective laparoscopic cholecystectomy, were included in this study. ⋯ The ISC in group II was terminated after obtaining the last blood sample. Results showed that the average values of oxygen saturation of the mixed venous blood from the internal jugular vein--SjvO₂ levels were higher in group II where ISC was applied (82.3%→86.4%→85.3%→80.2%→82.8%→80.4%), compared to group I, without ISC (85.5%→77.8%→80.6%→83.8%→84.8%), statistically significant in the second and third measurement for p<0.05 for the second and the third measurement, i.e. after the creation of pneumoperitoneum, when the decreease in the brain oxygenation is most dramatic in the group without ISC. In conclusion, application of intermittent sequential compression of the legs is a simple and safe technique for preserving the brain oxygenation during laparoscopy by restoring the blood return from the legs.
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To compare and evaluate the success rates of various surgical techniques of pterygium excision, including pterygium excision with complete suture of conjunctivae (PESC), pterygium excision with conjunctival auto-graft transplantation with graft from the inferior temporal bulbar conjunctiva (ITBC) and pterygium excision with conjunctival auto-graft transplantation with graft from the superior temporal bulbar conjunctiva (STBC). ⋯ A comparison of the groups demonstrated that the recurrence rate was highest in the group without transplantation, using only complete suture of the conjunctiva. The excision of the pterygium with conjunctival auto-graft transplantation from the inferior or superior temporal bulbar conjunctiva are highly efficient in terms of low recurrence rates. The modified surgical technique using the graft from the inferior temporal bulbar conjunctivae is preferred because the superior bulbar conjunctiva is intact for eventual future surgical intervention.
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Randomized Controlled Trial
The advantages of the application of amnion membrane in the treatment of burns.
A crucial and important factor for successful treatment of burns is the early covering of the burned area with skin substitutes. The covering of the burn requires material that restores the epidermal function and integrates itself into the process of healing. Biological dressings are the golden standard for the temporary covering of burns. ⋯ The histological analysis of the bioptical material not only determines the degree of the burns specifically, but facilitates the choice of method for further treatment, observes the speed of the re-epithelialization and plays an important part in the correct diagnosis and the early start of the specific therapy, important in preventing sepsis. The application of amnion membrane as a biological dressing speeds the re-epithelialization and prevents invasive bacterial infection. Pathohistological examination of the burns is recommended to be established as a standard method in clinical practice.
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Randomized Controlled Trial
Spinal anaesthesia for cesarean section with reduced dose of intrathecal bupivacaine plus fentanyl.
The hypotension following spinal anesthesia remains common place in cesarean delivery. The combination of reduced dose of local anesthetics with intrathecal opioids makes it possible to achieve adequate spinal anesthesia with minimum hypotension. We investigate whether this synergistic phenomenon could be used to provide less frequent hypotension while incurring adequate spinal anesthesia for cesarean section. ⋯ Bupivacaine 9 mg plus fentanyl 20 microgr provided spinal anesthesia for cesarean delivery with less hypotension and vasopressor requirements while ensuring excellent perioperative surgical anesthesia.