Anesthesiology
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Randomized Controlled Trial
The Analgesic Effects of Proximal, Distal, or No Sciatic Nerve Block on Posterior Knee Pain after Total Knee Arthroplasty: A Double-blind Placebo-controlled Randomized Trial.
Either proximal or distal sciatic nerve block reduces pain in the first 6 hours after total knee arthroplasty. Distal (popliteal) may be superior.
pearl -
Randomized Controlled Trial
Anesthesia and Increased Hypercarbic Drive Impair the Coordination between Breathing and Swallowing.
Coordination between breathing and swallowing helps prevent aspiration of foreign material into the respiratory tract. The authors examined the effects of anesthesia and hypercapnia on swallowing-breathing coordination. ⋯ Anesthesia impaired the coordination between swallowing and respiration. Mild hypercapnia increased the frequency of swallowing during anesthesia and the likelihood of pathological swallowing. During anesthesia, the risk for aspiration may be further increased when ventilatory drive is stimulated.
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Randomized Controlled Trial Comparative Study
Prehabilitation versus Rehabilitation: A Randomized Control Trial in Patients Undergoing Colorectal Resection for Cancer.
The preoperative period (prehabilitation) may represent a more appropriate time than the postoperative period to implement an intervention. The impact of prehabilitation on recovery of function al exercise capacity was thus studied in patients undergoing colorectal resection for cancer. ⋯ Meaningful changes in postoperative functional exercise capacity can be achieved with a prehabilitation program.
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Randomized Controlled Trial
Lack of Nephrotoxicity by 6% Hydroxyethyl Starch 130/0.4 during Hip Arthroplasty: A Randomized Controlled Trial.
Hydroxyethyl starch (HES) is commonly used as plasma expander during surgery but may be nephrotoxic as seen in studies in patients with sepsis. The authors hypothesized that the possible nephrotoxicity of 6% HES 130/0.4 could be revealed by measurements of urinary excretion of neutrophil gelatinase-associated lipocalin (u-NGAL) in patients with normal renal function during hip arthroplasty. ⋯ The study showed no evidence of a harmful effect of intraoperative infusion of 6% HES 130/0.4 on renal function in patients during hip arthroplasty.
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Randomized Controlled Trial Comparative Study
Effect of Reversal of Neuromuscular Blockade with Sugammadex versus Usual Care on Bleeding Risk in a Randomized Study of Surgical Patients.
Previous studies show a prolongation of activated partial thromboplastin time and prothrombin time in healthy volunteers after treatment with sugammadex. The authors investigated the effect of sugammadex on postsurgical bleeding and coagulation variables. ⋯ Sugammadex produced limited, transient (<1 h) increases in activated partial thromboplastin time and prothrombin time but was not associated with increased risk of bleeding versus usual care.