Articles: post-operative.
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Randomized Controlled Trial
The preventive effect of 5-hydroxytryptamine-3 receptor antagonist on blood pressure reduction and postoperative nausea and vomiting during general anesthesia induction: A double-blinded, randomized controlled trial.
Administering a 5-hydroxytryptamine-3 receptor (5-HT3) at anesthesia induction may aid in achieving hemodynamic stability during general anesthesia induced using opioids. Therefore, we aimed to evaluate the effect of ramosetron, a 5-HT3 antagonist, administered on hypotension at the induction of total intravenous anesthesia (TIVA) with propofol and remifentanil. Additionally, we aimed to compare the impact of ramosetron administration at anesthesia induction versus that at the end of the surgery on postoperative nausea and vomiting (PONV). ⋯ Administering ramosetron at anesthesia induction resulted in significantly better hemodynamic stability with significantly lesser requirement of phenylephrine and ephedrine than administering at the end of the surgery did. Therefore, we recommend ramosetron administration at anesthesia induction rather than at the end of the surgery to prevent PONV and the decrease in the mean BP during TIVA with propofol and remifentanil.
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Minerva anestesiologica · Nov 2023
Randomized Controlled TrialComparison of the effects of subcostal anterior quadratus lumborum block and thoracic paravertebral block in laparoscopic nephrectomy: a randomized study.
Thoracic paravertebral block (TPVB) may provide sufficient postoperative analgesia in laparoscopic nephrectomy (LSN) by ensuring ipsilateral somatic and visceral analgesia. However, there are serious reservations due to the complexity of the technique, and various complications thereof. Subcostal anterior quadratus lumborum block (S-QLB3) may be a safe alternative in LSN procedures. Therefore, this study aimed to compare the postoperative analgesic effects of TPVB and S-QLB3. ⋯ In this study, NRS and APS-POQ-R-TR scores were similar in the S-QLB3 and TPVB groups, whereas cumulative morphine consumption was modestly lower in the TPVB group. This suggested that S-QLB3 could be an alternative to TPVB in patients undergoing LSN.
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Randomized Controlled Trial
Individualised positive end-expiratory pressure titrated intra-operatively by electrical impedance tomography optimises pulmonary mechanics and reduces postoperative atelectasis: A randomised controlled trial.
A protective intra-operative lung ventilation strategy has been widely recommended for laparoscopic surgery. However, there is no consensus regarding the optimal level of positive end-expiratory pressure (PEEP) and its effects during pneumoperitoneum. Electrical impedance tomography (EIT) has recently been introduced as a bedside tool to monitor lung ventilation in real-time. ⋯ Individualised PEEP by EIT may improve intra-operative pulmonary mechanics and oxygenation without impairing haemodynamic stability, and decrease postoperative atelectasis.
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Randomized Controlled Trial
Predicting Death or Disability after Surgery in the Older Adult.
Older patients are vulnerable to developing new or worsening disability after surgery. Despite this, patient or surgical characteristics predisposing to postoperative disability are poorly defined. The aim of the study was to develop and validate a model, subsequently transformed to point-score form, to predict 6-month death or disability in older patients after surgery. ⋯ The authors developed and validated a point score model to predict death or disability in older patients after surgery.