Surgical endoscopy
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Randomized Controlled Trial
The effects of preoperative rofecoxib, metoclopramide, dexamethasone, and ondansetron on postoperative pain and nausea in patients undergoing elective laparoscopic cholecystectomy.
No trial to date has evaluated the combined effect of preoperative Rofecoxib, Metoclopramide, Dexamethasone, and Ondansetron on postoperative pain and nausea in patients undergoing laparoscopic cholecystectomy (LC). ⋯ The use of this preoperative regimen resulted in decreased LOS, maximum pain, and nausea ratings. Patients in the intervention group required less postoperative anti-emetics.
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Randomized Controlled Trial
Effects of different anesthetic techniques on antidiuretic hormone secretion during laparoscopic cholecystectomy.
With the advent of minimally invasive surgery, laparoscopic cholecystectomy has become the standard treatment for symptomatic gallbladder disease. This study aimed to evaluate the effects of using high- versus low-pressure pneumoperitoneum with different anesthetic techniques on hemodynamics and antidiuretic hormone (ADH) secretion. ⋯ Pneumoperitoneum can affect several homeostatic systems, leading to hemodynamic and hormonal stress responses. The use of general anesthesia plus epidural analgesia with low insufflation pressure, general anesthesia with low insufflation pressure, or general anesthesia plus epidural analgesia with high insufflation pressure is safe and effective in attenuating these responses.
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Randomized Controlled Trial
Effect of intercostals neural blockade with Marcaine (bupivacaine) on postoperative pain after laparoscopic cholecystectomy.
Postoperative pain experienced by patients who undergo laparoscopic cholecystectomy may aggravate surgical complications, prevent early discharge, and cause readmission. This study aimed to evaluate the effectiveness of an intraoperative intercostals neural blockade for the control of postoperative pain after laparoscopic cholecystectomy. ⋯ Intercostals neural blockade may safely be used to reduce the postoperative pain after laparoscopic cholecystectomy.
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Randomized Controlled Trial
Single use of fentanyl in colonoscopy is safe and effective and significantly shortens recovery time.
Colonoscopy remains an uncomfortable examination and many patients prefer to be sedated. The aim of this study was to evaluate the efficacy and safety of intravenous administration of fentanyl in titrated doses compared with intravenous administration of the well-known midazolam in titrated doses. ⋯ Administration of fentanyl in low incremental doses is sufficient to achieve a satisfactory level of comfort during colonoscopy.
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Randomized Controlled Trial
Prospective randomized study on perioperative enteral immunonutrition in laparoscopic colorectal surgery.
Perioperative nutrition for patients undergoing colon surgery seems to be effective in reducing catabolism and improving immunologic parameters. A relatively low-fiber and highly absorbable diet may facilitate the intestinal cleansing and loop relaxation fundamental for laparoscopic surgery with a lower dose of iso-osmotic laxative. ⋯ Perioperative immunonutrition proved to be safe and useful in increasing the perioperative immunologic cell response. It may contribute toward improving the preparation and relaxation of the intestinal loops despite the shorter intestinal preparation.