Articles: surgery.
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Intravenous fluid is recommended in international guidelines to improve patient post-operative symptoms, particularly nausea and vomiting. The optimum fluid regimen has not been established. This prospective, randomized, blinded study was designed to determine if administration of equivolumes of a colloid (hydroxyethyl starch 130/0.4) reduced post operative nausea and vomiting in healthy volunteers undergoing ambulatory gynecologic laparoscopy surgery compared to a crystalloid solution (Hartmann's Solution). ⋯ Intra-operative administration of colloid increased the incidence of early postoperative nausea and has no advantage over crystalloid for symptom control after gynaecological laparoscopic surgery.
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New laryngoscopes have become available for use in small children. The aim of the study was to compare the Storz® videolaryngoscope (SVL) to the Airtraq® Optical laryngoscope (AOL) for tracheal intubation in children younger than two years of age who had a normal airway assessment. Our hypothesis was that the SVL would have a better success rate than the AOL. ⋯ No difference in the success rate of endotracheal intubation could be established in this ten patient sample of children younger than two years with a normal airway assessment scheduled for elective cleft lip/palate surgery. However, the Airtraq® Optical videolaryngoscope showed a number of time related advantages over the Storz® videolaryngoscope. Because of the small sample size a larger trial is needed to confirm these findings. Both devices were considered safe in all intubations.
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Journal of physiotherapy · Jan 2012
CommentTargeted physiotherapy treatment for low back pain based on clinical risk can improve clinical and economic outcomes when compared with current best practice.
Does a stratified primary care approach for patients with low back pain result in clinical and economic benefits when compared with current best practice? ⋯ A stratified management approach including a prognostic screening and treatment targeting, showed improved clinical and economic benefits when compared with current best practice.
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Comput. Aided Surg. · Jan 2012
The accuracy of 3D image navigation with a cutaneously fixed dynamic reference frame in minimally invasive transforaminal lumbar interbody fusion.
In contrast to preoperative image-based 3D navigation systems, which require surgeon-dependent registration, an intraoperative cone-beam computed tomography (cb-CT) image-based 3D navigation system allows automatic registration during the acquisition of 3D images intraoperatively. Thus, the need for spinal exposure for point matching is obviated, making a cb-CT image-based navigation system ideal for use in minimally invasive spinal procedures. Conventionally, the dynamic reference frame (DRF) is mounted to an adjacent spinous process or iliac bone through a separate incision. However, the close proximity of the DRF to the surgical area may result in its interfering with the surgical procedure or causing streak artifacts on the navigation images. Cutaneous placement of the DRF overlying the sacral hiatus is one possible solution to these problems, but such a placement does not provide a solid bony fixation point and is distant from the surgical area, both of which factors may hinder the accuracy of the navigation. The purpose of this study was to evaluate the accuracy of a novel idea for DRF placement in a series of mini-open transforaminal lumbar interbody fusion (TLIF) procedures performed with intraoperative cb-CT image-based 3D navigation. ⋯ A cutaneously mounted DRF overlying the sacral hiatus provides accuracy in intraoperative 3D image guided navigation for mini-open TLIF that is comparable to that obtained in other reported series using a fixed bony attachment point for the DRF.
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Comput. Aided Surg. · Jan 2012
Comparative StudyComparison of robot-assisted and conventional total knee arthroplasty: a controlled cadaver study using multiparameter quantitative three-dimensional CT assessment of alignment.
A functional total knee replacement has to be well aligned, which implies that it should lie along the mechanical axis and in the correct axial and rotational planes. Incorrect alignment will lead to abnormal wear, early mechanical loosening, and patellofemoral problems. There has been increased interest of late in total knee arthroplasty with robotic assistance. This study was conducted to determine whether robot-assisted total knee arthroplasty is superior to the conventional surgical method with regard to the precision of implant positioning. ⋯ Robot-assisted total knee arthroplasty showed excellent precision in the sagittal and coronal planes of the 3D CT scan. In particular, the robot-assisted technique showed better accuracy in femoral rotational alignment compared to the conventional surgery, despite the fact that the surgeons who performed the operations were more experienced and familiar with the conventional method than with robot-assisted surgery. It can thus be concluded that robot-assisted total knee arthroplasty is superior to conventional total knee arthroplasty.