The Journal of surgical research
-
Spinal cord injuries (SCIs) are serious and debilitating health problems that lead to severe and permanent neurological deficits resulting from the primary mechanical impact followed by secondary tissue injury. During the acute stage after an SCI, the expression of autophagy and inflammatory responses contribute to the development of secondary injury. In the present study, we examined the multifaceted effects of rapamycin on outcomes of rats after an SCI. ⋯ Rapamycin is a novel neuroprotectant with multifaceted effects on the rat spinal cord after injury. Use of such a clinically established drug could facilitate early clinical trials in selected cases of human SCIs.
-
Randomized Controlled Trial
Dexmedetomidine attenuates tourniquet-induced hyperdynamic response in patients undergoing lower limb surgeries: a randomized controlled study.
Activation of sympathetic nervous system has a crucial role in mediating the pneumatic tourniquet inflation induced hyperdynamic response. Dexmedetomidine, a selective α(2)-adrenergic receptor agonist, has potent sympatholytic effects. We conducted this prospective, randomized, placebo-controlled, double-blinded study to elucidate the effects of dexmedetomidine on attenuating the tourniquet-induced hyperdynamic response during general anesthesia. ⋯ Dexmedetomidine attenuates tourniquet-induced hyperdynamic response in general anesthesia patients undergoing lower limb surgeries.
-
Meta Analysis
The necessity of indwelling gastrointestinal decompression after gastrectomy: a meta-analysis.
This meta-analysis was designed to evaluate the necessity of indwelling gastrointestinal decompression after gastrectomy. ⋯ Routine gastrointestinal decompression after gastrectomy does not promote the recovery of gastrointestinal function or reduce the incidence of postoperative complications. In our series, decompression was correlated with a prolonged interval to oral intake, a longer duration of hospitalization, and increased patient discomfort.
-
Randomized Controlled Trial
Does dexmedetomidine affect intraoperative blood loss and clotting tests in pediatric adenotonsillectomy patients?
We hypothesize that dexmedetomidine (DEX), a selective α(2) adrenergic receptor agonist, may affect the intraoperative blood loss and clotting tests such as prothrombin time, activated partial thromboplastin time, and international normalized ratio in children undergoing adenotonsillectomy (ADT). ⋯ The premedication with DEX 0.5 μg/kg decreased postoperative agitation, pain, and analgesic requirement without significant change in the clotting tests and MAP but increased bleeding slightly during ADT.
-
Intense debate continues in the search of the optimal ratio of blood components to deliver preemptively in the critically injured patient anticipated to require a massive transfusion. A major challenge is distinguishing patients with refractory coagulopathy versus those with overwhelming injuries who will perish irrespective of blood component administration. The hypothesis of this clinical study is that a predominant number of early deaths from hemorrhage are irretrievable despite an aggressive transfusion policy. ⋯ These data indicate that 75% of patients who succumb to postinjury acute blood loss are bleeding because they are dying rather than dying because they are bleeding. Conversely, only 13 (2%) of the hospital deaths were attributed to refractory coagulopathy. These critical facts need to be considered in designing studies to determine optimal massive transfusion protocols.