International journal of clinical and experimental medicine
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There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. ⋯ Patients with long stayed forgotten biliary stents are inevitably treated with surgical intervention. We recommend for all endoscopic retrograde cholangiopancreatography units provide a stent registry system that the stents placed for various therapeutic procedures are not forgotten both by the patient as well as the physician. There should be a deadline for biliary stents in the registry system for each patient.
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To compare the different outcomes of dexmedetomidine (Dex) vs. propofol combined with sevoflurane in children's laparoscopic surgery by noninvasive continuous cardiac output monitoring (NICOM). ⋯ Compared with propofol, the combination of Dex in children undergoing laparoscopic surgery shows better inhibition on HR.
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Fentanyl-induced cough (FIC) should be effectively prevented in patients requiring stable induction of general anesthesia. We reviewed available randomized-controlled trials (RCTs) that focused on the pre-emptive fentanyl to prevent FIC, and preformed this meta-analysis to clarify the efficacy and to recommend a specific application. The PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Chinese BioMedical Literature Database were searched for relevant RCTs without restriction on the year or language of the publications. ⋯ A total of seven studies were identified for inclusion. Meta-analysis showed that a priming fentanyl dose of 0.5 μg/kg decreased the FIC incidence (RR = 0.29, 95% CI: 0.17-0.49) and severity (WMD = -0.46, 95% CI -0.70 - -0.23) of FIC; however, a priming fentanyl dose of 1.0 μg/kg (RR = 0.26, 95% CI 0.04-1.70; WMD = -0.60, 95% CI -1.33-0.14) or 1.5 μg/kg (RR = 0.94; 95% CI: 0.77-1.15; WMD = -0.08, 95% CI -0.33-0.17) had no effect on FIC. Our meta-analysis demonstrated that pre-emptive low dose of fentanyl could effectively prevent FIC, and the dose of 0.5 μg/kg was recommended.
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Caudal block is the regional anesthetic technique that is used most frequently in pediatric surgery and bupivacaine and levobupivacaine are widely utilized in this technique. Opioid drugs have been added to local anesthetic solutions to prolong duration of analgesia but ideal combination were not found. We compared the postoperative analgesic efficacy of equal concentrations of bupivacaine or levobupivacaine plus tramadol in pediatric patients. ⋯ There were no significant differences between groups for arterial pressures and heart rate values after caudal block and during the operation. Caudal bupivacaine plus tramadol and levobupivacaine plus tramadol have similar postoperative analgesic efficacy. But the use of bupivacaine plus tramadol may cause a greater frequency of urinary retention.
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Penehyclidine hydrochloride (PH), a new anticholinerigic drug associated with few cardiovascular side effects, was used widely as premedication in China. There is no information on the pharmacodynamic interaction between PH and anesthetics for loss of consciousness (LOC). This study was designed to determine the effects of premedicated PH on the propofol dose requirement for LOC and Bispectral Index (BIS) during target-controlled infusion (TCI) of propofol. ⋯ The predicted propofol Ce and consumption based on body weight of each patient were lower in Group PH than Group NS (p < 0.05). BIS values were not significantly changed before propofol infusion, and decreased gradually as propofol Ce increased and were not significantly different when LOC was reached between two groups (p > 0.05). We conclude that premedicated PH reduces the propofol Ce and dose requirement for LOC, but has no effect on BIS.