Arch Surg Chicago
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Randomized Controlled Trial Clinical Trial
Preemptive pain control in patients having laparoscopic hernia repair: a comparison of ketorolac and ibuprofen.
To determine if nonsteroidal anti-inflammatory drugs provide adequate pain control for patients having laparoscopic hernia repair and to compare the effectiveness of ketorolac tromethamine with ibuprofen in reducing postoperative laparoscopic hernia pain. ⋯ Pain relief from ibuprofen, 800 mg, administered orally an hour before laparoscopic hernia repair was not statistically different from that obtained with intravenous ketorolac, 60 mg, administered intraoperatively when comparing the hospital discharge pain score and the mean and highest pain scores 18 hours after discharge. Ibuprofen offers equivalent pain control at a lower cost and reduced potential for adverse drug events compared with intravenous ketorolac in patients having laparoscopic hernia repair. No patient required narcotic supplementation, and pain control was judged satisfactory by all the patients.
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Randomized Controlled Trial Clinical Trial
Effect of pentoxifylline in severe sepsis: results of a randomized, double-blind, placebo-controlled study.
To evaluate the effect of pentoxifylline on organ dysfunction, survival, and mediator response in patients with severe sepsis. ⋯ Continuous intravenous administration of pentoxifylline beneficially influenced cardiopulmonary dysfunction in patients with sepsis without adverse effects. Larger trials are needed to evaluate the efficacy in improving organ function in relation to the outcome for patients with severe sepsis.
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Randomized Controlled Trial Clinical Trial
Effect of route of delivery and formulation of postoperative nutritional support in patients undergoing major operations for malignant neoplasms.
To study the effect of the route of delivery and formulation of postoperative nutritional support on host defense, protein metabolism, infectious complications, and outcome. ⋯ Early postoperative enteral feeding is a valid alternative to parenteral feeding in patients undergoing major surgery. Immunonutrition enhances the host response, induces a switch from acute-phase to constitutive proteins, and improves outcome.
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparing preincisional with postincisional bupivacaine infiltration in the management of postoperative pain.
To determine if preemptive local anesthesia yields better postoperative pain control than infiltration of local anesthetic at the time of wound closure. ⋯ Based on the theory of "dorsal horn hypersensitivity," several clinical trials have shown significant improvement in pain control with preincisional infiltration of local anesthetic. Our results indicate that pain was no better controlled with preincisional infiltration than with postincisional infiltration of bupivacaine, raising the question of the benefit of preemptive anesthesia at the local level in long-term postoperative care.
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Randomized Controlled Trial Comparative Study Clinical Trial
Laparoscopic vs open appendectomy. Prospective randomized study of outcomes.
To compare open appendectomy (OA) with laparoscopic appendectomy (LA) for length of the operation, complications, postoperative pain control, length of hospitalization, postdischarge recovery time, and hospital charges. ⋯ Laparoscopic appendectomies and OAs are comparable for complications, postoperative pain control, length of hospitalization, and recovery time. Patients who underwent an OA had a shorter operative time and lower operating room and hospital charges. Laparoscopic appendectomy does not offer any proved benefits compared with the open approach for the routine patient with acute appendicitis.