Articles: postoperative.
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Randomized Controlled Trial
Analgesic efficacy of pre-operative stellate ganglion block on postoperative pain relief: a randomised controlled trial.
This small trial found that pre-operative stellate ganglion block before upper-limb orthopaedic surgery significantly reduced both 24 h tramadol consumption and pain at rest for up to 6 hours, although the later was of borderline clinical significance.
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Randomized Controlled Trial Multicenter Study
Effects of dexamethasone on cognitive decline after cardiac surgery: a randomized clinical trial.
Cardiac surgery can be complicated by postoperative cognitive decline (POCD), which is characterized by impaired memory function and intellectual ability. The systemic inflammatory response that is induced by major surgery and cardiopulmonary bypass may play an important role in the etiology of POCD. Prophylactic corticosteroids to attenuate the inflammatory response may therefore reduce the risk of POCD. The authors investigated the effect of intraoperative high-dose dexamethasone on the incidence of POCD at 1 month and 12 months after cardiac surgery. ⋯ Intraoperative high-dose dexamethasone did not reduce the risk of POCD after cardiac surgery.
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Randomized Controlled Trial
Erythropoietin and Protection of Renal Function in Cardiac Surgery (the EPRICS Trial).
To date, there are no known methods for preventing acute kidney injury after cardiac surgery. Increasing evidence suggests that erythropoietin has renal antiapoptotic and tissue protective effects. However, recent human studies have shown conflicting results. The authors aimed to study the effect of a single high-dose erythropoietin preoperatively on renal function after coronary artery bypass grafting in patients with preoperative impaired renal function. ⋯ Intravenous administration of a single high-dose (400 IU/kg) erythropoietin did not have a renal protective effect on patients with reduced kidney function undergoing coronary artery bypass surgery.
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Randomized Controlled Trial
Bispectral index guided titration of sevoflurane in on-pump cardiac surgery reduces plasma sevoflurane concentration and vasopressor requirements: A prospective, controlled, sequential two-arm clinical study.
Electroencephalographic-based monitoring systems such as the bispectral index (BIS) may reduce anaesthetic overdose rates. ⋯ BIS-guided titration of sevoflurane reduces the SPC and decreases noradrenaline administration compared with routine care during on-pump cardiac surgery.
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Randomized Controlled Trial Comparative Study
Intermittent epidural vs continuous wound infusion of ropivacaine for acute and chronic pain control after hysterectomy or myomectomy: a randomized controlled trial.
Adequate postoperative analgesia may enhance recovery. The efficacy of continuous wound infusion vs intermittent epidural ropivacaine for postoperative analgesia was investigated. ⋯ Based on our results, there is no clinical significant difference between the epidural ropivacaine and the subcutaneous ropivacaine group or a clear superiority to one management strategy.