Articles: function.
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Randomized Controlled Trial Multicenter Study
Intravenous Lidocaine for Gut Function Recovery in Colonic Surgery: A Randomized Clinical Trial.
Despite the recovery advantages of minimally invasive surgical techniques, delayed return of gut function after colectomy is a common barrier to timely discharge from hospital. ⋯ Among patients undergoing elective minimally invasive colon resection, perioperative administration of 2% intravenous lidocaine did not improve return of gut function at 72 hours.
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Randomized Controlled Trial Multicenter Study
Vutrisiran in Patients with Transthyretin Amyloidosis with Cardiomyopathy.
Transthyretin amyloidosis with cardiomyopathy (ATTR-CM) is a progressive, fatal disease. Vutrisiran, a subcutaneously administered RNA interference therapeutic agent, inhibits the production of hepatic transthyretin. ⋯ Among patients with ATTR-CM, treatment with vutrisiran led to a lower risk of death from any cause and cardiovascular events than placebo and preserved functional capacity and quality of life. (Funded by Alnylam Pharmaceuticals; HELIOS-B ClinicalTrials.gov number, NCT04153149.).
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Anesthesia and analgesia · Jan 2025
Multi-Institutional Study of Multimodal Analgesia Practice, Pain Trajectories, and Recovery Trends After Spine Fusion for Idiopathic Scoliosis.
Posterior spinal fusion (PSF) surgery for correction of idiopathic scoliosis is associated with chronic postsurgical pain (CPSP). In this multicenter study, we describe perioperative multimodal analgesic (MMA) management and characterize postoperative pain, disability, and quality of life over 12 months after PSF in adolescents and young adults. ⋯ MMA strategies showed site-specific variability and decreasing yearly trends of in-hospital opioid use without changes in acute or chronic pain after PSF. There was a high incidence of persistent pain associated with disability and poor quality of life warrants postoperative surveillance to enable functional recovery.
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Numerous, sometimes conflicting, changes in brain functional connectivity have been associated with the transition from wakefulness to unresponsiveness at induction of general anesthesia. However, relatively few studies have looked at the detailed time evolution of the transition, for different electroencephalogram (EEG) frequency bands, and in the clinical scenario of surgical patients undergoing general anesthesia. ⋯ Propofol-induced loss of consciousness in surgical patients is associated with a global breakdown in low-frequency directed functional connectivity, coupled with a high-frequency increase between closely located brain regions. At loss of consciousness, Granger causality shows more pronounced changes than coherence.