Articles: postoperative-complications.
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In summary, it is clear that duration of surgery is positively correlated with postoperative morbidity in both major and relatively minor procedures. It should be kept in mind that the reason for this in many cases may be that the preoperative condition of the patient or the nature of the surgical procedure can affect both operative time and postoperative outcome. ⋯ It can be said, too, that the anesthetist will be more likely to see arrhythmias the longer the surgeon operates. The association of myocardial infarction, renal failure, thromboembolic disease, and delirium with prolonged operation time is also a possibility.
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Randomized Controlled Trial Clinical Trial
The conduct of cholecystectomy: incision, drainage, bacteriology and postoperative complications.
The benefits of some ancillary techniques of cholecystectomy are exaggerated by retrospective study of selected patients. Therefore, the authors performed a prospective, randomized study of 100 consecutive patients who underwent simple elective cholecystectomy for chronic cholecystitis and cholelithiasis. No patient was excluded because of incomplete hemostasis or fear of bile leakage. ⋯ Peritoneal drainage was found to be unnecessary. Short-term drainage may increase the frequency of postoperative fever, but did not increase pulmonary complications or wound infections. In these patients, intra-abdominal sepsis is rare; wound infections were uncommon and the gallbladder bile was usually sterile and not the cause of postoperative infection.
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Randomized Controlled Trial Clinical Trial
Intercostal nerve block with thoracoabdominal and flank incisions.
A double-blind study was done in 90 patients undergoing a rib-resecting thoracoabdominal incision for testicular cancer or a flank incision for renal surgery to determine the effect of intraoperative intercostal nerve block with bupivacaine hydrochloride on postoperative pain and complications, day of ambulation, and day of oral fluid intake. In the patients treated with bupivacaine, we found a significant reduction in the amount of postoperative analgesia required, but no difference in the day of ambulation or fluid intake. Ten of 45 patients given a placebo nerve block experienced postoperative atelectasis, whereas only 4 of 45 patients in the treated group experienced this complication. We believe that intercostal nerve block is a valuable postoperative adjuvant in patients undergoing flank surgery to reduce the postoperative analgesic requirements and incidence of atelectasis.