Articles: surgery.
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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 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
Impact on Quality of Life of Full-Time and Night-Time Braces in Adolescent Idiopathic Scoliosis: A Randomized Clinical Trial.
Randomized clinical trial. ⋯ According to our results, both braces are equally effective in avoiding the progression of the deformity and need for surgery. However, FT brace has a higher impact on self-image and pain compared with NT brace.
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Mayo Clinic proceedings · Feb 2025
Randomized Controlled TrialA Randomized, Controlled Trial of In-Hospital Use of Virtual Reality to Reduce Preoperative Anxiety Prior to Cardiac Surgery.
To study the effectiveness of virtual reality (VR) in reducing anxiety levels in patients undergoing first-time sternotomy for cardiac surgery. ⋯ Overall, the findings suggest that treatment of older adults with an immersive VR experience before cardiac surgery can significantly reduce overall anxiety. Further investigation determining how such interventions can be optimally implemented in surgical practices and whether such interventions reduce the need for anxiolytic medications and improve the overall patient experience is needed.
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Randomized Controlled Trial
Effects of intravenous tranexamic acid on bleeding during burn surgery: A double-blinded randomized clinical trial.
Blood loss during burn surgery significantly contributes to morbidity and mortality. Tranexamic acid (TXA), an antifibrinolytic agent, is hypothesized to reduce intraoperative bleeding. This double-blinded, randomized clinical trial aimed to assess the efficacy of systemic TXA in severe burn patients (total body surface area [TBSA] > 20 %) undergoing surgery. ⋯ Results demonstrated significant reductions in blood loss (P = 0.043), total IV fluid volume (P = 0.021), OR time (P = 0.002), LOS (P = 0.0001), and transfusions (P = 0.024) in the TXA group. Notably, women and patients without inhalation injuries exhibited better responses to TXA treatment, and graft survival was lower in the TXA group. The study concludes that IV TXA administration during burn surgery can reduce bleeding, minimize IV fluid and blood transfusion needs, and shorten surgery duration, enhancing overall surgical outcomes.