Articles: postoperative.
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Randomized Controlled Trial
Effect of ultrasound-guided intercostal nerve block on postoperative pain after percutaneous nephrolithotomy : Prospective randomized controlled study.
The aim of the study was to investigate the effect of preoperative ultrasound-guided (US) intercostal nerve block (ICNB) in the 11th and 12th intercostal spaces on postoperative pain control and tramadol consumption in patients undergoing percutaneous nephrolithotomy (PCNL). ⋯ In PCNL with nephrostomy tube placement US-guided ICNB performed at the 11th and 12th intercostal spaces provided effective analgesia.
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Perioperative hypothermia is still a common occurrence, and it can be difficult to measure a patient's core temperature accurately, especially during regional anesthesia, with placement of a laryngeal mask airway device, or postoperatively. We evaluated a new disposable double-sensor thermometer and compared the resulting temperatures with those of a distal esophageal thermometer and a bladder thermometer in patients undergoing general and regional anesthesia, respectively. Furthermore, we compared the accuracy of the thermometer between regional and general anesthesia, since forehead microcirculation might differ between the two types of anesthesia. ⋯ In a perioperative patient population undergoing general or regional anesthesia, the accuracy of the noninvasive disposable double-sensor thermometer is comparable with that of the distal esophageal and bladder thermometers in routine clinical practice. Furthermore, the sensor performed comparably in patients undergoing regional and general anesthesia.
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Chylothorax is a pathologic condition defined by an accumulation of lymphatic fluid, the chyle, in the thorax. Postoperative chylothorax is a potentially lethal complication, with a reported mortality rate of 15.4%-25%. ⋯ The 2-wk regimen reduced the requirement for TDL and the overall morbidity and mortality rates compared with the 48-h regimen. Importantly, this regimen does not increase the risk of chylothorax recurrence.
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We investigated changes in concentrations of interleukin-1β, interleukin-6, tumour necrosis factor-α and bradykinin in blood during passage through a cell salvage device and a leucocyte depletion filter, with or without application of subatmospheric pressure across the filter. Blood samples from 19 healthy women undergoing scheduled caesarean section showed concentrations of cytokines and bradykinin in blood filtered under gravity flow that were equal to or significantly lower than those of pre-operative venous blood samples. They were also significantly lower than that in postoperative orthopaedic shed blood, which is commonly reinfused after orthopaedic surgery. ⋯ We suggest that use of a leucocyte depletion filter for cell-salvaged blood with gravity flow is likely to be safe with regard to concentrations of cytokines and bradykinin. However, this may not hold true for the filter used with subatmospheric pressure. If transfusion of salvaged blood using a leucocyte depletion filter seems to induce hypotension, elevation of interleukin-6 should be suspected.