Acta Chir Belg
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Randomized Controlled Trial Multicenter Study Comparative Study
Health-related quality of life and cost-effectiveness analysis of gum chewing in patients undergoing colorectal surgery: results of a randomized controlled trial.
Postoperative ileus (POI) and anastomotic leakage (AL) following colorectal surgery severely increase healthcare costs and decrease quality of life. This study evaluates the effects of reducing POI and AL via perioperative gum chewing compared to placebo (control) on in-hospital costs, health-related quality of life (HRQoL), and assesses cost-effectiveness. ⋯ Reducing POI and AL via gum chewing reduced costs for ward stay, but did not affect overall in-hospital costs, HRQoL, or mapped utilities. More studies with adequate sample sizes using validated questionnaires at standardized time points are needed.
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Randomized Controlled Trial
The effects of adding ischemic preconditioning during desflurane inhalation anesthesia or propofol total intravenous anesthesia on pneumoperitoneum-induced oxidative stress.
The aim of the study was to explore the differences in oxidative stress during anesthesia with desflurane/N2O or propofol/remifentanil in patients undergoing laparoscopic cholecystectomy and additionally to evaluate the differential effects of desflurane and propofol on ischemic preconditioning (IP). ⋯ In laparoscopic cholecystectomy lasting less than 60 min, there were no differences in the measured oxidative stress parameters between maintenance of anesthesia by desflurane/N2O and propofol/remifentanil/N2O. The addition of 10 min IP administration during both anesthesia techniques did not result in additional changes in the analyzed oxidative stress.
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Randomized Controlled Trial
The postoperative analgesic efficacy of intraperitoneal bupivacaine compared with levobupivacaine in laparoscopic cholecystectomy.
The aim of this randomized controlled study was to compare the postoperative analgesic efficacy of intraperitoneal bupivacaine versus levobupivacaine in patients undergoing laparoscopic cholecystectomy. ⋯ Intraperitoneal instillation of bupivacaine 0.125% 80 ml (100 mg) is more effective than levobupivacaine 0.125% 80 ml (100 mg) in reducing the postoperative pain after laparoscopic cholecystectomy.
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Randomized Controlled Trial
Influence of postoperative fluid management on pulmonary function after esophagectomy.
The aim of this study was to investigate the effects of a restrictive vs. a liberal postoperative fluid therapy guided by intrathoracic blood volume index (ITBVI) on hemodynamic and pulmonary function in patients undergoing elective esophagectomy. Perioperative fluid therapy may influence postoperative physiology and morbidity after esophageal surgery. Definitions of adequate infusion amounts and evident rules for a fluid therapy are missing. ⋯ ITBVI guided restrictive infusion therapy yields a lower fluid uptake, but may not result in a difference of clinical relevant parameters. A fluid restriction after esophagectomy should always be combined with hemodynamic monitoring because additional infusions may be required.
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Randomized Controlled Trial Comparative Study
Comparison between two intraoperative intravenous loading doses of paracetamol on pain after minor hand surgery: two grams versus one gram.
Paracetamol (acetaminophen) is widely used for postoperative analgesia at a recommended dose of 1 g every six hours in adult patients. Increasing the loading dose to 2 g was suggested to improve immediate postoperative analgesia without increased toxicity in healthy adult patients. We tested the hypothesis that a loading dose of 2 g of intravenous paracetamol results in better postoperative analgesia after surgery as compared with a dose of 1 g. ⋯ An intraoperative loading dose of 2 g paracetamol improves postoperative analgesia after minor hand surgery as compared to 1 g paracetamol.