Articles: postoperative.
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Randomized Controlled Trial Multicenter Study Comparative Study
Crystalloid versus Colloid for Intraoperative Goal-directed Fluid Therapy Using a Closed-loop System: A Randomized, Double-blinded, Controlled Trial in Major Abdominal Surgery.
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Comparative Study
Intradural spinal tumors - a review of post-operative outcomes comparing intramedullary and extramedullary tumors from a single institution's experience.
Intradural spinal tumors are rare and can be classified into extramedullary or intramedullary. They commonly present with symptoms such as intractable back pain or neurologic deficits. We retrospectively reviewed 91 cases of intradural spinal tumors that underwent surgery in our institution from 2011 to 2016 and assessed their clinical outcomes. ⋯ We achieved gross total resection in the majority of patients with both extramedullary and intramedullary tumors (65.4% vs. 70%, P = 0.91). Patients younger than 65 years (odds ratio [OR] 4.40, confidence interval [CI] 0.72-26.9, P = 0.11) and those who had complete resection of tumor (OR 2.92, CI 0.61-14.0, P = 0.18) were associated with higher odds of improved clinical outcomes, but the results were not statistically significant. The use of intraoperative neurophysiologic monitoring was not associated with improved neurologic outcomes compared with cases where it was not used (OR 0.56, CI 0.10-3.05, P = 0.50).
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Meta Analysis
Efficacy of parecoxib sodium on postoperative shivering: meta-analysis of clinical trials.
Objective To evaluate the effect of parecoxib on preventing postoperative shivering. Methods Main outcomes were the relative risk (odds ratio, OR) and 95% confidence interval (CI) relative to the incidence of shivering. Results Fourteen trials with 1,175 patients were analyzed. ⋯ Compared with placebo, there was no significant association of parecoxib sodium with restlessness [OR = 0.95, 95% CI (0.59, 1.52)] or nausea/vomiting [OR = 0.24, 95% CI (0.09, 0.66)]. In addition, pethidine rescue was used significantly more often in the control group than in the parecoxib sodium group [OR = 0.22, 95% CI (0.09, 0.53)]. Conclusions Parecoxib sodium may be an effective strategy for preventing postoperative shivering.
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Randomized Controlled Trial
Local Anesthetic Wound Infiltration after Osteosynthesis of Extracapsular Hip Fracture Does Not Reduce Pain or Opioid Requirements: A Randomized, Placebo-Controlled, Double-Blind Clinical Trial in 49 Patients.
Local infiltration analgesia (LIA) supports early mobilization after hip and knee arthroplasty. Inspired by this, we studied the effectiveness of wound infiltration with the long acting local anesthetic ropivacaine in an effort to decrease the need for postoperative opioids after osteosynthesis of extracapsular hip fracture. ⋯ Ropivacaine as single component in postoperative treatment of pain after hip fracture is not effective. In our setup, wound infiltration with ropivacaine is not statistically significantly better than placebo.
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Eur J Cardiothorac Surg · Jan 2018
Randomized Controlled TrialHigh-dose methylprednisolone in video-assisted thoracoscopic surgery lobectomy: a randomized controlled trial.
The optimal postoperative analgesic strategy after video-assisted thoracoscopic surgery lobectomy remains undetermined. We hypothesized that high-dose preoperative methylprednisolone (MP) would improve analgesia compared to placebo. ⋯ Registered at clinicaltrialsregister.eu [7 November 2012, EudraCT 2012-004451-37; https://www.clinicaltrialsregister.eu/ctr-search/trial/2012-004451-37/DK].