Latest Articles
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Acta Anaesthesiol Scand · Mar 2025
Randomized Controlled Trial Multicenter StudyThe adverse effects with ibuprofen after major orthopedic surgeries: A protocol for the PERISAFE randomized clinical trial.
Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for pain treatment after elective hip and knee arthroplasties. However, evidence regarding the incidence of adverse effects with short-term NSAID treatment following surgery is limited. We, therefore, aim to assess the adverse effects with an eight-day postoperative treatment with ibuprofen after elective hip and knee arthroplasties. ⋯ The trial is approved by the Danish Medicine Agency and the Research Ethics Committee (EU CT no. 2022-502, 502-32-00). We plan to submit for publication in a major international peer-reviewed journal and present results at scientific meetings.
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Randomized Controlled Trial
Effects of Sub-Anesthetic Oro-Mucosal Dexmedetomidine on Sleep in Humans: A Randomized, Controlled Pharmacokinetics-Pharmacodynamics Study.
The locus coeruleus noradrenergic system may provide a potential new target for pharmacologic insomnia treatment, particularly in patients suffering from elevated distress. The selective α 2 -noradrenergic agonist dexmedetomidine attenuates locus coeruleus activity in subanesthetic doses, yet no adequate nonparental delivery systems of dexmedetomidine are currently available. To examine the feasibility of oromucosal dexmedetomidine administration, the authors developed two distinct-one sublingual and one buccal-oromucosal, fast-disintegrating dexmedetomidine formulas tailored for self-administration. Here, the authors established the formulas' pharmacokinetic and pharmacodynamic profiles. ⋯ The favorable pharmacokinetic and pharmacodynamic profile of oromucosal dexmedetomidine delivery warrants further dose-finding and clinical studies to establish the exact roles of α 2 receptor agonism in pharmacologic sleep enhancement and as a possible novel mechanism to alleviate stress-related insomnia.
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Randomized Controlled Trial Comparative Study
The Effect of Thrombin-gelatin Matrix Compared With Absorbable Gelatin Sponge on Intraoperative Hemostasis in Unilateral Open-door Laminoplasty: A Randomized Controlled Trial.
Prospective, randomized, parallel-controlled trial. ⋯ The hemostatic efficacy of TGM-AGS is better than that of an AGS alone in IBL. TGM-AGS is also superior to an AGS alone in the evaluation of hemostatic efficiency and postoperative bleeding.
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Randomized Controlled Trial
A Randomized, Controlled Trial Evaluating Perioperative Risk-Stratification and Risk-Based, Protocol-Driven Management After Elective Major Cancer Surgery.
To evaluate the efficacy of risk-based, protocol-driven management versus usual management after elective major cancer surgery to reduce 30-day rates of postoperative death or serious complications (DSCs). ⋯ Risk-based, protocol-driven management did not reduce the 30-day rate of DSC after elective major cancer surgery compared with usual management, nor did it improve postoperative health care utilization, HRQOL, or cancer outcomes. Trials are needed to identify cost-effective, tailored perioperative strategies to optimize outcomes after major cancer surgery.
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Randomized Controlled Trial
Ultrasound-Guided Percutaneous Cryoneurolysis for the Treatment of Pain following Traumatic Rib Fracture: A Randomized, Active-Controlled, Participant- and Observer-Masked Study.
Traumatic rib fractures are associated with pain lasting weeks to months and a decreased ability to inspire deeply or cough to clear secretions. Ultrasound-guided percutaneous cryoneurolysis involves reversibly ablating peripheral nerve(s) using exceptionally low temperature with a transdermal probe, resulting in a prolonged nerve block with a duration measured in months. The authors hypothesized that cryoneurolysis would improve analgesia and inspired volume after rib fracture. ⋯ Ultrasound-guided percutaneous cryoneurolysis improves maximum inspired lung volume while concurrently decreasing pain and opioid consumption after traumatic rib fracture. These results should be considered preliminary, requiring confirmation with a trial including a larger sample size.