Articles: anesthesia.
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Journal of anesthesia · Dec 2024
Randomized Controlled TrialThe effect of lung-recruitment maneuver on postoperative shoulder pain in patients undergoing laparoscopic cholecystectomy: a randomized controlled trial.
Lung-recruitment maneuvers (LRM) have been shown to reduce postoperative pain after laparoscopic surgery. This study aimed to investigate the association of LRM with the incidence of shoulder pain after laparoscopic cholecystectomy. ⋯ LRM reduces both the incidence and intensity of shoulder pain during 24 h after laparoscopic cholecystectomy. Additionally, LRM was associated with reduced intensity of abdominal pain during mobilization over the study period.
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Randomized Controlled Trial Comparative Study
Effect of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery: a randomized clinical trial.
Muscle relaxants are used during surgery, but their impact on ECG may differ, potentially affecting cardiac safety. This study aimed to compare the effects of Atracurium versus Cisatracurium on QT interval changes in patients undergoing cataract surgery. ⋯ Atracurium causes more QT prolongation than Cisatracurium. While both affect QTc intervals, Cisatracurium has a more stable impact on cardiac repolarization, making it safer for patients at risk of QT prolongation. Cisatracurium's minimal impact on cardiovascular function, especially in patients with low ejection fraction, makes it the preferred choice for maintaining cardiac stability.
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Randomized Controlled Trial
Association between thoracic epidural anesthesia and driving pressure in adult patients undergoing elective major upper abdominal surgery: a randomized controlled trial.
Thoracic epidural anesthesia (TEA) is associated with a knowledge gap regarding its mechanisms in lung protection and reduction of postoperative pulmonary complications (PPCs). Driving pressure (ΔP), an alternative indicator of alveolar strain, is closely linked to reduced PPCs with lower ΔP values. We aim to investigate whether TEA contributes to lung protection by lowering ΔP during mechanical ventilation. ⋯ Compared to GA, TEA-GA can reduce intraoperative ΔP in patients undergoing major upper abdominal surgery, especially those undergoing laparoscopic surgery. However, compared to GA combined with ΔP-guided ventilation, TEA-GA combined with ΔP-guided ventilation does not reduce the risk of PPCs. There was no significant difference in the total use of various vasoactive drugs between the two groups.
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Randomized Controlled Trial
Effect of low-dose dexmedetomidine to prolong spinal anesthesia in elderly patients: a prospective randomized controlled study.
Spinal anesthesia for transurethral resection of the prostate (TURP) has a short duration, which poses challenges for postoperative pain management. The present study aimed to investigate the effects of intravenous (IV) dexmedetomidine at a dosage of 0.4 µg/kg in prolonging the duration of spinal anesthesia and minimizing postoperative pain in elderly patients undergoing TURP. ⋯ Intravenous dexmedetomidine at a dosage of 0.4 µg/kg significantly prolongs the duration of spinal sensory blockade. Although postoperative analgesia was not different, it provided hemodynamic stability without increasing the side effects.
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Randomized Controlled Trial Multicenter Study
Ultrasound guided pediatric caudal dose: a two-center randomized controlled trial.
The drug volume to be used in caudal in pediatric patients has remained an unmet issue since long. We determined the minimum drug volume required to reach T10 level in pediatric patients using ultrasonography and compared it with the already established volume by Armitage formula. ⋯ A volume of 0.7 ml/kg of local anaesthetic in pediatric caudal block is sufficient to achieve a target of T10 level for infraumblical surgeries.