Articles: postoperative.
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Randomized Controlled Trial Comparative Study
A randomised controlled trial comparing the GlideScope(®) and the Macintosh laryngoscope for double-lumen endobronchial intubation.
Double-lumen endobronchial tubes are the most common method of achieving lung isolation and one-lung ventilation during thoracic anaesthesia and surgery. We compared the clinical performance of the Macintosh laryngoscope and the GlideScope(®) during endobronchial intubation with a double-lumen tube. Seventy patients with no predictors for difficult laryngoscopy were allocated randomly to the Macintosh laryngoscope or GlideScope. ⋯ On a numerical rating scale (scored from 0 to 10), the 30 anaesthetists who took part in the study rated endobronchial intubation overall as easier using the Macintosh compared with the GlideScope, 2 (1-3 [0-8]) vs 3 (2-6 [0-10]), respectively, p = 0.003. Postoperative voice changes were also less common in the Macintosh group (8 (22%) vs 17 (58%), p = 0.045). Anaesthetists found the GlideScope more difficult to use than the Macintosh laryngoscope and endobronchial intubation took longer; therefore, we cannot recommend its routine use with double-lumen tubes in patients who are predicted to have a normal airway.
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Randomized Controlled Trial
Perioperative Auto-titrated Continuous Positive Airway Pressure Treatment in Surgical Patients with Obstructive Sleep Apnea: A Randomized Controlled Trial.
In those with moderate or severe sleep apnoea, perioperative auto-titrated CPAP improves oxygen saturation and reduces postoperative AHI.
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African health sciences · Sep 2013
Randomized Controlled TrialEffect of wound infiltration with bupivacaine on pulmonary function after elective lower abdominal operations.
Subcutaneous or intrafascial wound infiltration of local anaesthetic with systemic opioids has been shown to enhance patient comfort with improved analgesia and reduced opioid requirements. ⋯ Bupivacaine wound infiltration produced statistically significant elevations in pulmonary function tests results at all assessment periods.
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The veterinary journal · Sep 2013
Randomized Controlled TrialComparison of intrarectal ozone, ozone administered in acupoints and meloxicam for postoperative analgesia in bitches undergoing ovariohysterectomy.
Since all analgesics currently available for use in dogs have been associated with some adverse effects, the search for an effective analgesic that does not cause harm is important. This study investigated the postoperative analgesic effects of ozone administered either intrarectally or into acupoints in bitches undergoing ovariohysterectomy (OH). Twenty-four healthy adult bitches were randomly assigned to one of the three treatments 10 min after sedation, as follows: 0.2mg/kg of intramuscular (IM) meloxicam (M); rectal insufflation of 10 mL of 30 μg/mL ozone (OI), or acupoint injection of 0.5 mL ozone (30 μg/mL; OA). ⋯ Two dogs treated with OA required rescue analgesia. Meloxicam, rectal insufflation of ozone and ozone injected into acupoints provided satisfactory analgesia for 24h in bitches undergoing elective OH. Ozone had no measurable adverse effects and is an alternative option to promote pain relief.
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Randomized Controlled Trial
Significant analgesic effects of one session of postoperative left prefrontal cortex repetitive transcranial magnetic stimulation: a replication study.
In a recent preliminary trial in 20 patients after gastric bypass surgery, 20 minutes of repetitive transcranial magnetic stimulation (TMS) over the left prefrontal cortex was associated with a 40% reduction in postoperative patient-controlled morphine use. As is the case with all novel scientific findings, and especially those that might have an impact on clinical practice, replicability is paramount. This study sought to test this finding for replication and to more accurately estimate the effect size of this brief intervention on postoperative morphine use and postoperative pain and mood ratings. ⋯ Although more research is needed to verify these observed effects independently, findings from the original postoperative TMS trial were replicated. TMS may have the potential to significantly improve current standards of postoperative care among gastric bypass patients, and further studies may be warranted on other surgical populations. Future investigations should use methodology that permits more definitive conclusions about causal effects of TMS on postoperative pain (for example, double-blinding, sham stimulation that is matched with real TMS with respect to scalp discomfort).