The European journal of surgery = Acta chirurgica
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Randomized Controlled Trial Clinical Trial
Preoperative local infiltration with ropivacaine for postoperative pain relief after inguinal hernia repair. A randomised controlled trial.
To assess the effect of preoperative local anaesthesia with ropivacaine and find out if there was a dose-response relationship with postoperative pain after inguinal hernia repair. ⋯ Ropivacaine has a significant, dose-related pain-reducing effect in the immediate postoperative period but we could find no support for the theory that preoperative infiltration analgesia reduces long term pain.
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To study the effect of body mass index on the healing of midline laparotomy wounds closed with a continuous technique. ⋯ Overweight is a risk factor for wound infection and incisional hernia after midline abdominal surgery but these effects may be eliminated if patients are sutured with a suture length to wound length ratio of 4.0-4.9.
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To evaluate the effects of dobutamine on peripheral and hepatic tissue oxygen tensions during the treatment of haemorrhagic shock. ⋯ Dobutamine infusion did not improve tissue oxygenation when used in addition to crystalloids to treat hypovolaemic shock.
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To assess the value of preoperative or postoperative endoscopic treatment of bile duct stones and routine use of operative cholangiography (OC) for detection of unsuspected common bile duct (CBD) stones in conjunction with laparoscopic cholecystectomy. ⋯ Preoperative ERC should be done for patients with symptoms or findings indicating ductal calculi. In most patients undergoing laparoscopic cholecystectomy, OC is feasible and its routine use is strongly advocated. Bile duct stones diagnosed at OC can safely and successfully be treated endoscopically after laparoscopic cholecystectomy. Until laparoscopic bile duct exploration becomes routine and generally applicable, endoscopic management of bile duct stones both before and after cholecystectomy will be an important therapeutic option.
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To describe our experience of percutaneous drainage of intra-abdominal abscesses with large-bore catheters under computed tomographic control. ⋯ Large-bore Argyle drains are efficient and safe for the percutaneous drainage of certain types of abdominal abscesses.