Articles: postoperative.
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Randomized Controlled Trial
The effect of pre-treatment with transcutaneous electrical acupoint stimulation on the quality of recovery after ambulatory breast surgery: a prospective, randomised controlled trial.
Electroacupuncture has been demonstrated to be effective at alleviating pain and postoperative side-effects. Our aim was to investigate whether transcutaneous electric acupoint stimulation, a low-skill alternative to needle-based electroacupuncture, could improve the quality of recovery after ambulatory surgery. Seventy-two women scheduled for cosmetic breast surgery were randomly allocated to transcutaneous electric acupoint stimulation or sham groups. ⋯ We found significant mean (SD) differences between the transcutaneous electric acupoint stimulation and sham groups in the mean (SD) length of recovery room stay (35.6 (12.9) min vs 48.3 (16.3) min, p = 0.01), time to removal of the laryngeal mask airway (10.2 (2.5) min vs 17.8 (4.4) min, p = 0.01), and time to reorientation of the patient (14.6 (3.2) min vs 26.5 (5.0) min, p = 0.01). Further, postoperative pain scores and the incidence of side-effects were all lower in the transcutaneous electric acupoint stimulation group. In conclusion, transcutaneous electric acupoint stimulation can significantly improve the quality of recovery and decrease the incidence of anaesthesia-related side-effects for patients undergoing ambulatory surgery.
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Randomized Controlled Trial
Limb Remote Ischemic Preconditioning Attenuates Lung Injury after Pulmonary Resection under Propofol-Remifentanil Anesthesia: A Randomized Controlled Study.
Remote ischaemic preconditioning was induced using a BP cuff on one arm with three 5-min-ON / 5-min-OFF cycles before surgical start. Patients receiving RIPC before elective thoracotomy and pulmonary resection experienced less acute lung injury (indicated by PaO2/FiO2) and a 30% shorter hospital stay compared to those who did not receive RIPC.
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Journal of anesthesia · Aug 2014
Co-existing liver disease increases the risk of postoperative thrombocytopenia in patients undergoing hepatic resection: implications for the risk of epidural hematoma associated with the removal of an epidural catheter.
A common surgical diagnosis for hepatic resection in Japan is hepatocellular carcinoma secondary to chronic viral hepatitis. It is known that chronic liver disease causes a decrease in blood platelet count. We retrospectively reviewed the perioperative changes in blood platelet count associated with hepatic resection at a Japanese institution and evaluated the incidence and risk factors for postoperative thrombocytopenia, which may increase the potential risk of epidural hematoma. ⋯ Hepatic resection can cause postoperative thrombocytopenia that may increase the potential risk of epidural hematoma associated with catheter removal, and the presence of co-existing liver disease heightens concerns for postoperative crucial thrombocytopenia.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Comparative StudyEffect of Local Anesthetic Dilution on the Onset Time and Duration of Double-Injection Sciatic Nerve Block: A Prospective, Randomized, Blinded Evaluation.
Neither speed of onset or duration of Labat sciatic block is influenced by volume or LA concentration when the total dose of mepivacaine is constant.
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Anesthesia and analgesia · Aug 2014
ReviewEvidence for the use of preoperative risk assessment scores in elective cranial neurosurgery: a systematic review of the literature.
Preoperative risk scores are designed to guide patient management by providing a means of predicting operative outcome. Several risk scores are used in neurosurgery, but studies on their clinical relevance are scarce. Therefore, it is not clear whether these risk scores are beneficial or helpful in predicting outcome after elective cranial neurosurgery. In this review, we summarize the current scientific evidence for using preoperative risk scores in elective cranial neurosurgery. ⋯ Large prospective studies are needed to validate the use of the reviewed risk scores in elective cranial neurosurgery. It appears, however, that the patient's preoperative physical and functional status can be used to predict the short- and long-term outcome in elective cranial neurosurgery.