The Journal of international medical research
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Randomized Controlled Trial
Selective neurogenic blockade and perioperative immune reactivity in patients undergoing lung resection.
This double-blind, prospective, randomized, controlled trial examined the effects of thoracic epidural block and intravenous clonidine and opioid treatment on the postoperative Th1/Th2 cytokine ratio after lung surgery. The primary endpoint was the interferon γ (IFN-γ; Th1 cytokine)/interleukin 4 (IL-4; Th2 cytokine) ratio. Secondary endpoints were reductions in pain and incidence of pneumonia. ⋯ Intraoperative thoracic epidural block decreased the IFN-γ/IL-4 ratio immediately after lung surgery, indicating less inflammatory stimulation during surgery.
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Randomized Controlled Trial Multicenter Study
Prolonged-release oxycodone/naloxone in postoperative pain management: from a randomized clinical trial to usual clinical practice.
These studies evaluated the feasibility of using oral prolonged-release oxycodone/naloxone (OXN PR) for the management of acute postoperative pain. ⋯ The analgesic efficacies of OXN PR and OXY PR were similar in postoperative pain settings. OXN PR reduced the degree of restriction in relation to patients carrying out physiotherapy compared with other opioids, and improved bowel and bladder function.
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Randomized Controlled Trial
Outcomes of endovascular coiling versus surgical clipping in the treatment of ruptured intracranial aneurysms.
The effects of treatment modality (endovascular coiling or surgical clipping) on incidence of cerebral vasospasm and infarction following aneurysmal subarachnoid haemorrhage (aSAH) remain controversial. This study compared outcomes between endovascular coiling versus surgical clipping to treat patients with acute (< 72 h) aSAH. ⋯ In this study, coiling yielded less symptomatic vasospasm, cerebral infarction and complete occlusion than surgical clipping, with no between-group differences in clinical outcome.
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Randomized Controlled Trial
Bilateral superficial cervical plexus block reduces postoperative nausea and vomiting and early postoperative pain after thyroidectomy.
To compare the incidence of postoperative nausea and vomiting (PONV) and postoperative pain in thyroidectomy patients undergoing general anaesthesia, with or without bilateral superficial cervical plexus block (BSCPB). ⋯ BSCPB with 0.5% ropivacaine administered before surgery can significantly reduce the incidence of PONV and early postoperative pain and also reduce perioperative opioid requirements in thyroidectomy patients undergoing general anaesthesia.
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Randomized Controlled Trial Comparative Study
Comparison of desflurane and sevoflurane anaesthesia in relation to the risk of vagally mediated reflex bradycardia during gastrectomy.
This study compared the risk of clinically significant reflex bradycardia during anaesthesia with sevoflurane or desflurane in patients undergoing gastrectomy. ⋯ Clinically significant reflex bradycardia occurred with a relatively high frequency during gastrectomy. Although desflurane is associated with sympathetic activation, it did not provide a protective effect against vagally mediated reflex bradycardia during gastrectomy compared with sevoflurane.