Articles: surgery.
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Randomized Controlled Trial
The Analgesic effect of adding ultrasound-guided pericapsular nerve group block to suprainguinal fascia iliaca compartment block for hip fracture surgery: A prospective randomized controlled trial.
Both suprainguinal ultrasound-guided fascia iliaca compartment block (FICB) and pericapsular nerve group (PENG) block have been used to treat pain after hip surgery. Motor-sparing PENG block may further expedite early postoperative rehabilitation. This study aimed to compare the analgesic efficacy and recovery outcome of suprainguinal ultrasound-guided FICB alone with FICB combined with PENG block for hip fracture surgery. ⋯ Addition of ultrasound-guided PENG block to FICB did not improve postoperative analgesic or recovery outcomes in elderly patients undergoing hip fracture surgery.
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Encapsulated papillary carcinoma (EPC) is a rare subset of breast carcinoma accounting for 0.5% to 2.0% of all patients with breast cancer and occuring mostly in postmenopausal women. It is even rarer in male breast cancer, and male EPC has only been reported in few cases. EPC has a distinctive histological pattern and a better prognosis compared with other types of breast carcinoma. Compared to the previously reported EPC cases, the lesion was unusually cystic made the diagnosis challenging. Accordingly, herein, we describe a rare case of EPC was unusually cystic in an elder male breast, associated with ductal carcinoma in situ (DCIS), along with an indepth literature discussion, and then to improve our understanding more about this uncommon tumor and further to provide more experience to treat this disease. ⋯ The operation was successful. Then the male patient recovered completely, did not require any additional treatment and continued to do well on postsurgical mammary surgical clinic visits. The patient had been followed-up regularly for 2 years after surgery; he did not experience any complications and remained disease-free.
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There is no consensus regarding how best to measure postoperative quality of recovery after anesthesia/surgery (e.g., using 24-hour survey instruments) in veterans or active military. Our goals were to (1) describe health-related quality-of-life (HRQoL) and recovery across time in veterans, (2) examine the commonality between the quality of recovery (QoR-15) and short-form (SF) surveys (including the SF-8, 24-hour version), and (3) examine the responsiveness of these surveys. ⋯ QoR-15 and SF-8 have high content commonality and performed similarly in veterans across time. SF-8 has added benefits of (1) brevity, (2) assessment of physical and mental health components, and (3) being normed to the general population. The SF-8, if used without the QoR-15 in tandem in future study of anesthesia-related outcomes, would need to be supplemented by separate questions addressing postoperative nausea/vomiting (a frequent outcome after anesthesia that is relevant to same-day and next-day mobilization after elective joint replacement surgery).
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Postoperative pulmonary complications (PPCs) increase postoperative mortality, hospital stays, and healthcare costs. Whether the use of sugammadex could reduce PPCs remains controversial. This study aimed to determine if sugammadex could more effectively reduce PPCs than acetylcholinesterase inhibitor (AChEi) in patients who had undergone spine surgery, in prone position intraoperatively. ⋯ Respiratory failure occurred in 7 (4.9%) patients in the Sugammadex group and 5 (3.5%) patients in the AChEi group (P = .77). There was no significant difference in secondary outcomes between the 2 groups. Although there have been some evidences showing that the use of sugammadex can attenuate the development of PPCs, this study did not show positive effects of sugammadex on patients who underwent spine surgery in the prone position.
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Although early surgical intervention to avoid muscle degeneration in patients with blowout fractures (BOFs) and extraocular muscle entrapment is recommended, there is still no gold standard for the surgical timing of extraocular muscle release. This study aimed to present our 10-year experience with surgical outcomes in BOF patients with extraocular muscle entrapment to provide supporting data for determining the surgical timing for better outcomes. We conducted a retrospective study of patients with BOFs with extraocular muscle entrapment who underwent surgery at a tertiary hospital between December 2009 and October 2019. ⋯ The median follow-up period was 9.0 months (IQR, 7-12). At the last follow-up, 4 patients still had EOM limitations and 3 had residual diplopia; however, this did not interfere with their daily activities. Early diagnosis through facial computed tomography and physical examinations and early intervention showed successful surgical outcomes of BOF with extraocular muscle entrapment.