Articles: postoperative.
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Patients over the age of 65 represent 15% of Canada's population and one-third of patients undergoing surgery. Older surgical patients often have lasting disability following "minor" ambulatory procedures. This study sought to explore the postoperative experience of ambulatory surgery, as described by older surgical patients and their caregivers. ⋯ Patients and caregivers ardently described real challenges during convalescence. Ambulatory care facilities should prepare this specific demographic of patients and caregivers for the post-discharge experience. Paramount for participants was the need for clear communication and a commitment to ongoing support following discharge. The trial on which this analysis was based was registered with Clinical Trials.gov (NCT01382251).
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Acta Anaesthesiol Scand · Nov 2014
Intercostobrachial nerve handling and pain after axillary lymph node dissection for breast cancer.
Moderate to severe pain in the first week after axillary lymph node dissection (ALND) for breast cancer is experienced by approximately 50% of the patients. Damage to the intercostobrachial nerve (ICBN) has been proposed as a risk factor for the development of persistent pain following breast cancer surgery but with limited information on acute post-operative pain. The aim of the present study was to examine the influence of ICBN handling on pain during the first week after ALND. ⋯ The type of ICBN handling during ALND may not influence acute post-operative pain in the first week after surgery.
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Anesthesia and analgesia · Nov 2014
Randomized Controlled Trial Comparative StudySurgical Space Conditions During Low-Pressure Laparoscopic Cholecystectomy with Deep Versus Moderate Neuromuscular Blockade: A Randomized Clinical Study.
Laparoscopic cholecystectomy performed during low intraabdominal pressure (<12 mm Hg) is associated with significantly less postoperative pain than standard pressure (≥12 mm Hg). The impact on surgical space conditions and safety of operating at lower pressures has not been adequately described, but deep neuromuscular blockade may be beneficial. We investigated if deep muscle relaxation would be associated with a higher proportion of procedures with "optimal" surgical space conditions compared with moderate relaxation during low-pressure (8 mm Hg) laparoscopic cholecystectomy. ⋯ Deep neuromuscular blockade was associated with surgical space conditions that were marginally better than with moderate muscle relaxation during low-pressure laparoscopic cholecystectomy.