Journal of clinical anesthesia
-
Randomized Controlled Trial Comparative Study
Ultrasound-guided erector spinae plane block versus oblique subcostal transversus abdominis plane block for postoperative analgesia of adult patients undergoing laparoscopic cholecystectomy: Randomized, controlled trial.
Laparoscopic cholecystectomy (LC) is a frequently applied minimally invasive surgery. Intraoperative access is provided with small keyhole entries on the abdominal wall. However, LC causes moderate to severe postoperative pain. The subcostal approach of TAP block was described by Hebbard et al. for postoperative analgesia especially for upper abdominal surgeries. Ultrasound-guided erector spinae plane (US-ESP) block is a novel technique targeting ventral rami, dorsal rami and rami communicantes of the spinal nerves. ⋯ Ultrasound-guided ESP block reduced postoperative tramadol consumption and pain scores more effectively than OSTAP block after laparoscopic cholecystectomy surgery.
-
Randomized Controlled Trial Multicenter Study
Cost-benefit analysis of the use of tranexamic acid in total replacement hip surgery.
To establish the best dose regimen for tranexamic acid (TXA) in total hip replacement surgery. ⋯ The administration of TXA is cost-effective, especially in the case of the two-dose regimen studied.
-
Observational Study
Postoperative cognitive dysfunction is rare after fast-track hip- and knee arthroplasty - But potentially related to opioid use.
Postoperative cognitive dysfunction (POCD) remains a frequent postoperative complication in non-fast-track surgeries, with negative implications for return to daily activities and work. In fast-track total hip and -knee arthroplasty (THA/TKA) an 8-9% incidence of POCD after 3 months has been reported, but without details on specific perioperative risk factors. Thus, we re-investigated the incidence and role of suggested factors for POCD in a well-controlled patient cohort, to guide future preventive interventions. ⋯ POCD is rare in fast-track THA/TKA patients and may be related to postoperative opioid consumption, supporting the ongoing focus on opioid-sparing analgesia.