Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Jan 1994
Randomized Controlled Trial Comparative Study Clinical TrialProlonged suction drainage prevents serous wound discharge after cardiac surgery.
A series of 180 patients was randomised to two groups after median sternotomy performed for cardiac surgery in order to evaluate the effect of suction drainage on serous wound discharge. In group A all wounds were drained using two conventional mediastinal drains, while in group B one suction drain and one conventional mediastinal drain were employed. Five patients developed serous wound discharge in group B compared with 14 in group A (chi 2, P < 0.02). There were no significant differences between the rates of major wound infection (group A, n = 1; group B, n = 1) or the incidence of postoperative pericardial effusion assessed by echocardiography (group A, n = 10; group B, n = 5).
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Ann R Coll Surg Engl · Nov 1993
Randomized Controlled Trial Clinical TrialIntraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy.
Laparoscopic cholecystectomy is now widely practised. There are various methods of pain relief used but none has been assessed or compared following this procedure. We have assessed the analgesic effect of intraperitoneal bupivacaine in laparoscopic cholecystectomy. ⋯ Postoperative pain was assessed with a visual analogue pain scale and the site of pain was recorded. Patients in the bupivacaine group had less pain in the early postoperative period and a lower incidence of pain in the right hypochondrium. Intraperitoneal bupivacaine is a simple and effective treatment for postoperative pain after laparoscopic cholecystectomy.
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Ann R Coll Surg Engl · Mar 1992
Randomized Controlled Trial Comparative Study Clinical TrialA comparison of bupivacaine instillation and inguinal field block for control of pain after herniorrhaphy.
In a single-blind, randomised trial, 50 consecutive adult patients for inguinal herniorrhaphy under general anaesthesia received either an inguinal field block or bupivacaine instilled into the wound to provide postoperative analgesia. Bupivacaine instillation was found to be simple, safe and effective. The method is particularly appropriate for day-case surgery.
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Ann R Coll Surg Engl · Nov 1991
Randomized Controlled Trial Clinical TrialAntibiotic prophylaxis in penetrating injuries of the chest.
Most prospective studies recommend antibiotic prophylaxis whilst a thoracostomy tube is in place or even longer. We conducted a randomised study of 188 patients with penetrating chest injuries requiring a chest drain. Of these patients, 95 received a single dose of ampicillin before insertion of the chest tube, the remaining 93 patients received additional antibiotic prophylaxis for as long as the drain was in place. ⋯ It is concluded that single-dose prophylaxis in penetrating chest trauma is as effective as prolonged prophylaxis. The importance of chest physiotherapy immediately after the drain insertion and of early removal of the drain is stressed. The role of various possible risk factors in the development of sepsis is discussed.
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Ann R Coll Surg Engl · Nov 1990
Randomized Controlled Trial Clinical TrialIntra-articular and subcutaneous prilocaine with adrenaline for pain relief in day case arthroscopy of the knee joint.
A randomised, double-blind study was conducted to assess the influence of intra-articular and subcutaneous prilocaine with adrenaline on postoperative pain in day case arthroscopy of the knee. The time to first dose of oral analgesia postoperatively was significantly prolonged in those patients receiving prilocaine but no significant difference in analgesic effect was demonstrated at 4, 8, and 12 h after operation between the two groups.