Articles: patients.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Multicenter StudySupplemental postoperative oxygen does not reduce surgical site infection and major healing-related complications from bariatric surgery in morbidly obese patients: a randomized, blinded trial.
12-16h of post-op supplemental O2 (80%) does not reduce wound infection or complication in the morbidly obese undergoing gastric bypass.
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Randomized Controlled Trial Comparative Study
A randomised controlled trial comparing incentive spirometry with the Acapella(®) device for physiotherapy after thoracoscopic lung resection surgery.
Lung resection surgery has been associated with numerous postoperative complications. Seventy-eight patients scheduled for elective video-assisted thoracoscopic lung resection were randomly assigned to receive standard postoperative care with incentive spirometry or standard care plus positive vibratory expiratory pressure treatment using the Acapella(®) device. ⋯ In addition, 37/39 patients (95%) stated a clear preference for the Acapella device. Postoperative treatment with the Acapella device did not improve pulmonary function after thoracoscopic lung resection surgery compared with incentive spirometry, but it may be more comfortable to use.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled Trial Comparative StudyAccuracy of the Composite Variability Index as a Measure of the Balance Between Nociception and Antinociception During Anesthesia.
The Composite Variability Index (CVI), derived from the electroencephalogram, was developed to assess the antinociception-nociception balance, whereas the Bispectral Index (BIS) was developed to assess the hypnotic state during anesthesia. We studied the relationships between these indices, level of hypnosis (BIS level), and antinociception (predicted remifentanil effect-site concentrations, CeREMI) before and after stimulation. Also, we measured their association with movement in response to a noxious stimulus. ⋯ CVI appears to correlate with somatic responses to noxious stimuli. However, unstimulated CVI depends more on hypnotic drug effect than on opioid concentration.
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Anesthesia and analgesia · Aug 2014
Randomized Controlled TrialA Simulator Study of Tube Exchange with Three Different Designs of Double-Lumen Tubes.
We sought to determine whether the design of 3 different double-lumen endobronchial tubes (DLT) (Rusch, Mallinckrodt, Fuji) has an effect on the ease of placement over an airway exchange catheter (AEC) using a video laryngoscope. ⋯ The Fuji-Phycon DLT was easier to pass over an AEC in this simulator trial and warrants consideration in patients with difficult airways who require 1-lung ventilation.
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Randomized Controlled Trial
The effect of intra-operative passive movement therapy on non-surgical site pain after breast reconstructive surgery: a preliminary study.
Pain distant to an operative site is under-reported but sometimes more severe than pain from the surgical site. Intra-operative passive movement could possibly reduce this pain. This preliminary study was designed to assess the practicalities of conducting a randomised controlled trial of this therapy in anaesthetised patients. ⋯ Forty-two patients undergoing breast reconstruction were randomly assigned to receive either intra-operative passive movement or standard care. Twenty-four hours after surgery, median (IQR [range]) morphine consumption was 33 (11-42 [0-176]) mg in the passive movement group compared with 74 (15-118 [0-238]) mg with standard care (p = 0.126), while participants reported median (IQR [range]) visual analogue scores in areas distant from the surgical site of 0 (0-4 [0-34]) mm in the passive movement group compared with 10 (2-30 [0-57]) mm in those receiving standard care (p = 0.002). A full trial of intra-operative passive movement therapy to reduce postoperative is feasible and warranted.