BMC anesthesiology
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Randomized Controlled Trial Comparative Study
Clonidine and dexmedetomidine for controlled hypotension during functional endoscopic sinus surgery: a comparative study.
Functional endoscopic sinus surgery (FESS) is minimally invasive, ambulatory endoscopic surgical procedure usually performed in most paranasal sinus diseases. Controlled hypotension during anaesthesia (hypotensive anesthesia) improves surgical field visibility and reduces risk of injuring surrounding structures. Clonidine (C) and dexmedetomidine (D) are both used to reduce blood pressure and heart rate while maintaining tissue perfusion. This study was conducted to evaluate the efficacy of clonidine compared to dexmedetomidine for controlled hypotension during FESS. ⋯ Clonidine and dexmedetomidine provided good to excellent quality of surgical field visibility to surgeons during FESS. Dexmedetomidine produce more hypotension and bradycardia compared to clonidine which may be preferable for controlled hypotension in the setting of ambulatory surgery. However, considering the small sample of this study which could not detect small but clinically differences between both drugs, there is a need for a much larger and multicenter study to confirm these findings.
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Randomized Controlled Trial
The effect of pericapsular nerve group (PENG) block on postoperative analgesia in elderly patients who underwent proximal femoral nail anti-rotation surgery: a prospective, randomized-controlled trial.
As a fascial plane block technique, further exploration is needed to determine the safety and efficacy of a peri-capsular nerve group (PENG) block in elderly patients with intertrochanteric femur fractures. We aimed to evaluate whether opioid consumption during a PENG block is better than a conventional opioid-based program for postoperative pain management after proximal femoral nail anti-rotation (PFNA). ⋯ Incorporating the PENG block into a multimodal analgesia regimen can decrease opioid consumption among elderly patients undergoing PFNA under general anesthesia.
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Randomized Controlled Trial Comparative Study
Comparison between ultrasound guided erector spinae plane block and paravertebral block on acute and chronic post mastectomy pain after modified radical mastectomy: randomized controlled trial.
Inadequate acute postoperative pain management is linked to the effect on the stress response and development of chronic pain. A unique regional anaesthetic method that is becoming more important for postoperative pain management is erector spinea plane block (ESP). Since its initial description, physicians have questioned weather this novel easy method can take the place of paravertebral block (PVB). Our goal was to evaluate, in contrast to control group, the effects of ESP & PVB on acute and chronic post-mastectomy pain. ⋯ ESP and TPV blocks provided superior early postoperative analgesia and reduced stress response compared to the control group in female patients undergoing modified radical mastectomy. PVB is better than ESB in acute postoperative pain management (the total morphine consumption VAS score and time of first analgesic request). Both techniques showed better long-term outcomes compared to the control group regarding LANSS score in the 6-month follow-up.
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Randomized Controlled Trial
Erythropoietin for the prevention of postoperative neurocognitive disorder in older adult patients undergoing total joint arthroplasty: a randomized controlled study.
Post-operative delirium (PD) is a common post-operative complication with significant clinical and financial impacts on patients. Erythropoietin (EPO), a multi-functional glycoprotein hormone, exhibits erythropoietic and non-erythropoietic anti-inflammatory properties. This study aimed to determine the role of perioperative EPO administration in the development of postoperative delirium in older adult patients undergoing total joint arthroplasty. ⋯ Perioperative EPO reduced the incidence of post-operative delirium, although not statistically significant, with no differences in post-operative cognitive function and inflammatory responses.
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Randomized Controlled Trial Comparative Study
Microbiological comparison of the disinfecting efficacy of small and large cotton swabs in nasotracheal intubation: a randomized trial.
Nasotracheal intubation (NTI) is necessary during surgeries requiring clear access to the surgical field and in patients with respiratory issues. This study investigates the pre-NTI nasal disinfection efficacy of different cotton swab sizes, hypothesizing that smaller swabs could minimize bleeding while maintaining disinfection efficacy. ⋯ Cotton swab thickness did not impact disinfection efficacy, but large swabs increased the risk of nasal bleeding. We recommend FCS for nasal disinfection prior to NTI in ASA 1-2 patients, as they reduce bleeding risk without compromising disinfection.