Articles: post-operative.
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Randomized Controlled Trial Multicenter Study
Chewing gum to treat postoperative nausea and vomiting in female patients: a multicenter randomized trial.
Postoperative nausea and vomiting is common after general anesthesia, with consequences for patient outcomes, satisfaction with care, and healthcare costs. The aim was to compare a new treatment, chewing gum, with a widely used intravenous agent, ondansetron, to treat postoperative nausea and vomiting in female patients in the postanesthesia care unit. ⋯ Chewing gum cannot be recommended as an alternative to ondansetron for treatment of postoperative nausea and vomiting in female patients administered antiemetic prophylaxis.
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Randomized Controlled Trial Comparative Study
Comparison between ultrasound-guided intertransverse process and erector spinae plane blocks for breast cancer surgery: A randomised controlled trial.
Clinical comparisons between intertransverse process block (ITPB) and erector spinae plane block (ESPB) are lacking. ⋯ Although ITPB demonstrated more consistent anterior dermatomal spread and improved immediate postoperative analgesia compared to ESPB, no additional benefits were identified for breast cancer surgery. Future studies may investigate the potential of ITPB for surgical anaesthesia.
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Randomized Controlled Trial
Positive end-expiratory pressure and emergence preoxygenation after bariatric surgery: A randomised controlled trial on postoperative oxygenation.
Positive end-expiratory pressure (PEEP) is important to increase lung volume and counteract airway closure during anaesthesia, especially in obese patients. However, maintaining PEEP during emergence preoxygenation might increase postoperative atelectasis by allowing susceptible lung areas to be filled with highly absorbable oxygen that gets entrapped when small airways collapse due to the sudden loss of PEEP at extubation. ⋯ www.clinicaltrials.gov , NCT04150276.
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Randomized Controlled Trial Comparative Study
Protamine Dosing for Heparin Reversal Following Cardiopulmonary Bypass: A Double-Blinded Prospective Randomized Control Trial Comparing Two Strategies.
Drug shortages are a frequent challenge in current clinical practice. Certain drugs (e.g., protamine) lack alternatives, and inadequate supplies can limit access to services. Conventional protamine dosing uses heparin ratio-based calculations for heparin reversal after cardiopulmonary bypass and may result in excess protamine utilization and potential harm due to its intrinsic anticoagulation. This study hypothesized that a fixed 250-mg protamine dose would be comparable, as measured by the activated clotting time, to a 1:1 (1 mg for every 100 U) protamine-to-heparin ratio-based strategy for heparin reversal and that protamine would be conserved. ⋯ A 1:1 heparin ratio-based protamine dosing strategy compared to a fixed 250-mg dose resulted in the administration of a larger total dose of protamine but no difference in either the initial activated clotting time or the amount postoperative chest-tube bleeding.
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Anesthesia and analgesia · Jan 2025
Randomized Controlled TrialThe Effect of Intravenous Lidocaine, Ketamine, and Lidocaine-Ketamine Combination in Colorectal Cancer Surgery: A Randomized Controlled Trial.
Colorectal resections are associated with a pronounced inflammatory response, severe postoperative pain, and postoperative ileus. The aim of this study was to evaluate the main effects of lidocaine and ketamine, and their interaction in colorectal cancer (CRC) patients after open surgery. The interaction could be additive if the effect of 2 drugs given in combination equals the sum of their individual effects, or multiplicative if their combined effect exceeds the sum of their individual effects. We hypothesized that the combination of lidocaine and ketamine might reduce the inflammatory response additively or synergistically. ⋯ Our study results do not support the use of an intraoperative combination of lidocaine and ketamine in patients undergoing open surgery for CRC.