BMC anesthesiology
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Randomized Controlled Trial
Lung ultrasound score to determine the effect of fraction inspired oxygen during alveolar recruitment on absorption atelectasis in laparoscopic surgery: a randomized controlled trial.
Although the intraoperative alveolar recruitment maneuver (RM) efficiently treats atelectasis, the effect of FIO2 on atelectasis during RM is uncertain. We hypothesized that a high FIO2 (1.0) during RM would lead to a higher degree of postoperative atelectasis without benefiting oxygenation when compared to low FIO2 (0.4). ⋯ The modified LUSS before capnoperitoneum and RM (P = 0.747) were similar in both groups. However, the postoperative modified LUSS was significantly lower in the low FIO2 group (median difference 5.0, 95% CI 3.0-7.0, P < 0.001). Postoperatively, substantial atelectasis was more common in the high-FIO2 group (relative risk 1.77, 95% CI 1.27-2.47, P < 0.001). Intra- and postoperative PaO2 to FIO2 were similar with no postoperative pulmonary complications. Atelectasis occurred more frequently when RM was performed with high than with low FIO2; oxygenation was not benefitted by a high-FIO2. CONCLUSIONS: In patients undergoing laparoscopic surgery in the Trendelenburg position, absorption atelectasis occurred more frequently with high rather than low FIO2. No oxygenation benefit was observed in the high-FIO2 group.
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Randomized Controlled Trial
Effectiveness of wound infusion of 0.2% ropivacaine by patient control analgesia pump after minithoracotomy aortic valve replacement: a randomized, double-blind, placebo-controlled trial.
Local anesthetic wound infusion has become an invaluable technique in multimodal analgesia. The effectiveness of wound infusion of 0.2% ropivacaine delivered by patient controlled analgesia (PCA) pump has not been evaluated in minimally invasive cardiac surgery. We tested the hypothesis that 0.2% ropivacaine wound infusion by PCA pump reduces the cumulative dose of opioid needed in the first 48 h after minithoracothomy aortic valve replacement (AVR). ⋯ Wound infusion of local anesthetic by PCA pump significantly reduced opioid dose needed and improves pain control postoperatively. We have also shown that it is a feasible method of analgesia and it should be considered in the multimodal pain control strategy following minimally invasive cardiac surgery.
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Randomized Controlled Trial Comparative Study
Early versus delayed postoperative oral hydration in children following general anesthesia: a prospective randomized trial.
Oral hydration has typically not been administered for between 4 and 6 h postoperative for children's safety in China. But children are more likely to suffer from apnea, crying and agitation, wound bleeding, and other complications during the post-anesthesia recovery period because of thirsty and fear. This Prospective, randomized study sought to assess the compare the early and late oral hydration (EOH and DOH, respectively) in children following general anesthesia, with the goal of assessing relative safety and tolerability and thereby improving patient comfort. ⋯ For children undergoing general anesthesia, a small amount of drinking water in the early stages of recovery will not increase the incidence of nausea, vomiting, or hypoxemia, but will decrease thirst and improve satisfaction. It is important, however, that medical staff carefully monitor the swallowing reflex and vital signs of all children.
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Randomized Controlled Trial
The clinical effect of dexmedetomidine combined with parecoxib sodium on sedation, antianxiety and prevention of intubation stress in patients undergoing functional endoscopic sinus surgery: a randomised controlled trial.
To investigate the effect of intravenous injection of dexmedetomidine combined with parecoxib sodium on sedation and anxiety and stress response of tracheal intubation in patients undergoing functional endoscopic sinus surgery. ⋯ Preoperative intravenous infusion of dexmedetomidine combined with parecoxib sodium by functional nasal endoscopy can not only calm and resist anxiety, but also better prevent stress response of endotracheal intubation, which is a safe and effective way of preoperative medication.