International journal of clinical and experimental medicine
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To investigate the effects of different strategies of flurbiprofen axetil (FA) administration on postoperative pain and sufentanil (SF) consumption after open colorectal cancer (CRC) surgery. Forty patients undergoing elective CRC resection were divided into two groups (n = 20 each). Patients in the F50+50 group received 50 mg of intravenous FA 30 min before skin incision and six hours after the first dose; patients in the F100 group received 100 mg of intravenous FA 30 min before skin incision. ⋯ At postoperative 6 and 24 h, CFA was significantly higher, CSF was significantly lower, and the number of patients that pressed the PCIA trigger and the consumption of SF were significantly lower in the F50+50 group compared with the F100 group. At postoperative 4 h, VAS and BCS were significantly lower in the F50+50 group compared with the F100 group (P < 0.05). An administration strategy that maintains a relatively high plasma FA concentration at 6-24 h post-operatively may reduce postoperative inflammatory pain and SF-requirement in patients undergoing CRC resection.
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Fentanyl-induced cough (FIC) should be effectively prevented in patients requiring stable induction of general anesthesia. We reviewed available randomized-controlled trials (RCTs) that focused on the pre-emptive fentanyl to prevent FIC, and preformed this meta-analysis to clarify the efficacy and to recommend a specific application. The PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Chinese BioMedical Literature Database were searched for relevant RCTs without restriction on the year or language of the publications. ⋯ A total of seven studies were identified for inclusion. Meta-analysis showed that a priming fentanyl dose of 0.5 μg/kg decreased the FIC incidence (RR = 0.29, 95% CI: 0.17-0.49) and severity (WMD = -0.46, 95% CI -0.70 - -0.23) of FIC; however, a priming fentanyl dose of 1.0 μg/kg (RR = 0.26, 95% CI 0.04-1.70; WMD = -0.60, 95% CI -1.33-0.14) or 1.5 μg/kg (RR = 0.94; 95% CI: 0.77-1.15; WMD = -0.08, 95% CI -0.33-0.17) had no effect on FIC. Our meta-analysis demonstrated that pre-emptive low dose of fentanyl could effectively prevent FIC, and the dose of 0.5 μg/kg was recommended.
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There are many studies about the biliary stents, however there is a little information about the long-term stayed forgotten biliary stents except a few case reports. We have reported the results of a number of cases with biliary stents that were forgotten or omitted by the patient and the endoscopist. During February 2010 to May 2013, five patients were referred to the general surgery clinic of Haydarpasa Numune Training and Research Hospital, Istanbul Turkey. ⋯ Patients with long stayed forgotten biliary stents are inevitably treated with surgical intervention. We recommend for all endoscopic retrograde cholangiopancreatography units provide a stent registry system that the stents placed for various therapeutic procedures are not forgotten both by the patient as well as the physician. There should be a deadline for biliary stents in the registry system for each patient.
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Pneumonia is a common disease with both high morbidity and mortality, the diagnosis of pneumonia remains a clinical challenge. Many studies have been conducted to identify the usefulness of lung ultrasound for the diagnosis of pneumonia, but with inconsistent and inconclusive results. The present study aimed to establish the overall diagnostic accuracy of lung ultrasound in diagnosing pneumonia. ⋯ Lung ultrasound is a capable of diagnosing pneumonia with high accuracy and is a promising attractive alternative to chest radiography and thoracic CT scan.
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Penehyclidine hydrochloride (PH), a new anticholinerigic drug associated with few cardiovascular side effects, was used widely as premedication in China. There is no information on the pharmacodynamic interaction between PH and anesthetics for loss of consciousness (LOC). This study was designed to determine the effects of premedicated PH on the propofol dose requirement for LOC and Bispectral Index (BIS) during target-controlled infusion (TCI) of propofol. ⋯ The predicted propofol Ce and consumption based on body weight of each patient were lower in Group PH than Group NS (p < 0.05). BIS values were not significantly changed before propofol infusion, and decreased gradually as propofol Ce increased and were not significantly different when LOC was reached between two groups (p > 0.05). We conclude that premedicated PH reduces the propofol Ce and dose requirement for LOC, but has no effect on BIS.