International journal of surgery
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The effect of vasopressors on the healing of gastrointestinal anastomoses is still controversial. The purpose of our study was to research the relationship between dose of dopamine, which is used generally as a vasopressor in shock status, and anastomotic leak in colonic surgery. ⋯ Although vasopressors appeared to increase the risk of anastomotic leakage as a result of splanchnic vasoconstriction, deterioration of microcirculation, and local hypoxia, we found that BPA were increased with high doses of vasopressor. We speculated that the use of vasopressors without shock might increase blood supply to the anastomotic line by increasing cardiac output.
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Randomized Controlled Trial Comparative Study
Prophylactic antibiotics in open mesh repair of inguinal hernia - a randomized controlled trial.
The role of prophylactic antibiotics in mesh repair of inguinal hernia is unclear. A Cochrane meta-analysis in 2005 concluded that "antibiotic prophylaxis for elective inguinal hernia repair cannot be firmly recommended or discarded" and "further studies are needed, particularly on the use for mesh repair." So, we designed a study to define the role of prophylactic antibiotics in mesh repair of inguinal hernia. We conducted a prospective, randomized, double-blind, trial comparing wound infection rates in 450 patients (225 received intravenous Cefazolin, 225 received a placebo) undergoing primary inguinal hernia repair electively using polypropylene mesh. 334 patients who completed a followup period of one month were analyzed. ⋯ Most of the infections occurred between the 7th and 12th post-operative day after discharge from the hospital. Antibiotic prophylaxis was associated with decreased incidence of wound infection when compared to control group, but the difference was not statistically significant. Based on our results we do not recommend the routine use of antibiotic prophylaxis in elective mesh repair of inguinal hernias.
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Randomized Controlled Trial
Pain after surgery: can protective analgesia reduce pain? A randomised clinical trial.
To improve the patients postoperative pain experience using protective analgesia for patients undergoing third molar surgery under day case general anaesthesia. ⋯ There was no difference in the protective analgesia group compared with conventional analgesia group in improving postoperative pain experience. A different protective analgesia regime may be necessary, which employs a more aggressive and multimodal strategy for postoperative pain management.
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Obesity is fast becoming one of the world's leading health problems and together with its many associated medical sequelae significantly increases morbidity and mortality. In this review, we briefly explore the history of bariatric surgery, the benefits of surgery and the various procedures carried out.