Articles: surgery.
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Data on the incidence of recurrent adhesive small bowel obstruction (ASBO) following index admission for ASBO in children are limited. We sought to determine if operative management was associated with a lower rate of recurrence compared to non-operative management (NOM). ⋯ Although the rate of recurrent ASBO in children is nearly 15% within one year, this rate does not differ based on the initial management strategy. Among children with recurrent ASBO, one-third underwent an urgent or emergent operation at readmission. NOM appears to be as effective in preventing recurrent ASBO as surgery.
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After cardiac surgery, complete heparin reversal with protamine is essential. Accordingly, there is a need for an accurate and precise point-of-care device to detect possible residual heparin after protamine administration. ⋯ Both the ACT-LR and ACT+ tests of Hemochron Signature Elite device and the INTEM:HEPTEM CT ratio of ROTEM Sigma device have poor ability to detect residual heparin shortly after protamine administration.
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To investigate patient-reported outcomes following lumbar discectomy in patients with lateral lumbar disc herniation (LDH) compared with patients with paramedian LDH. ⋯ Patients with lateral and paramedian LDH reported similar postsurgical outcomes. Spine surgeons should be less hesitant to operate on patients with lateral LDH. Patients with extraforaminal LDH experienced the least relief of leg pain.
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Minerva anestesiologica · Feb 2025
Real-time ultrasound-guided neuraxial puncture in elderly patients: a randomized controlled trial comparing paramedian transverse and parasagittal approaches.
Historically, spinal anesthesia has been performed using anatomical landmarks. This study aimed to compare the efficacy and procedural outcomes of real-time ultrasound-guided parasagittal oblique (RTU-PO) and real-time ultrasound-guided paramedian transverse (RTU-PT) approaches in elderly patients undergoing elective surgery under spinal anesthesia. ⋯ In elderly patients undergoing elective surgeries under spinal anesthesia, the RTU-PO and the RTU-PT techniques are comparable in almost all aspects.