Acta anaesthesiologica Scandinavica
-
Acta Anaesthesiol Scand · Jul 2020
Randomized Controlled Trial Multicenter StudyDEX-2-TKA - DEXamethasone twice for pain treatment after Total Knee Arthroplasty. Detailed statistical analysis plan for a randomized, blinded, three-group multicentre clinical trial.
Optimization of post-operative pain treatment is of upmost importance. Multimodal analgesia is the main post-operative pain treatment principle, but the evidence on optimal analgesic combinations is unclear. With the "DEXamethasone twice for pain treatment after TKA" trial, we aim to investigate the role of one or two doses of glucocorticoid for post-operative pain treatment after total knee arthroplasty. To ensure transparency and minimization of bias, we present this article with a detailed statistical analysis plan, to be published before the last participant is enrolled. ⋯ The DEX-2-TKA trial will provide high quality data regarding benefits and harms of adding one or two high-doses of dexamethasone to a multimodal analgesic regimen.
-
Acta Anaesthesiol Scand · Jul 2020
Peripheral Nerve Blocks for Analgesia after Elective Total Hip Arthroplasty.
A significant subgroup of patients suffer from moderate or severe pain after total hip arthroplasty (THA). Regional analgesia has the potential to reduce post-operative pain and thereby spare patients from opioids, but regional analgesia of the hip is complicated as the area is innervated by multiple nerves. ⋯ A femoral nerve block is known to reduce pain after THA, but is unfortunately accompanied by an increased risk of fall. We have developed a novel nerve block-the iliopsoas plane block (IPB)-that has the potential to anaesthetize the hip articular sensory branches of the femoral nerve without causing motor blockade.
-
Acta Anaesthesiol Scand · Jul 2020
Randomized Controlled Trial Multicenter Study Comparative StudyProtocol and statistical analysis plan for the REstricted fluid therapy VERsus Standard trEatment in Acute Kidney Injury - REVERSE-AKI randomized controlled pilot trial.
Fluid accumulation frequently coexists with acute kidney injury (AKI) and is associated with increased risk for AKI progression and mortality. Among septic shock patients, restricted use of resuscitation fluid has been reported to reduce the risk of worsening of AKI. Restrictive fluid therapy, however, has not been studied in the setting of established AKI. Here, we present the protocol and statistical analysis plan of the REstricted fluid therapy VERsus Standard trEatment in Acute Kidney Injury-the REVERSE-AKI trial that compares a restrictive fluid therapy regimen to standard therapy in critically ill patients with AKI. ⋯ This is the first multinational trial investigating the feasibility and safety of a restrictive fluid therapy regimen in critically ill patients with AKI.
-
Acta Anaesthesiol Scand · Jul 2020
Review Comparative StudySpontaneous versus controlled mechanical ventilation in patients with acute respiratory distress syndrome - protocol for a scoping review.
In caring for mechanically ventilated adults with acute respiratory distress syndrome (ARDS), clinicians are faced with an uncertain choice between controlled or spontaneous breathing modes. Observational data indicate considerable practice variation which may be driven by differences in sedation and mobilisation practices. The benefits and harms of either strategy are largely unknown. ⋯ We will perform a scoping review of the clinical literature on controlled vs spontaneously breathing in mechanically ventilated patients who fulfil ARDS criteria (including acute lung injury). This is to elucidate if a pragmatic clinical trial comparing controlled and spontaneous mechanical ventilation is warranted and will allow us to formulate relevant research questions.