Context: Regional anesthesia may attenuate adverse physiological stress responses associated with cardiothoracic surgery. In this study, hemodynamic stress response at the different time of surgical stimuli was compared between patients receiving general anesthesia (GA) along with caudal epidural analgesia with GA with intravenous analgesia in pediatric population undergoing open-heart surgery.
Aims: This study aims to compare the hemodynamic response at the different time of surgical stimuli and postoperative pain score, in pediatric patients undergoing open-heart procedures.
Settings And Design: We designed a prospective randomized controlled trial to study hemodynamic effects between Group I and Group II. Fifty patients were randomly allocated equally into Group I (GA + caudal epidural) and Group II (GA + intravenous analgesia) by sealed envelope technique.
Subjects And Methods: After obtaining approval from Institutional Ethical Committee, this prospective study was conducted in 50 American Society of Anesthesiologist Classes II and III pediatric patients aged between 1 and 12 years posted for cardiac surgery in our institution.
Statistical Analysis: ANOVA, two-way ANOVA, and Student's test.
Results: The heart rate, systolic blood pressure, diastolic blood pressure and mean blood pressure variations were compared between Groups I and II at different time intervals. The variations were found to be significantly higher at the time of skin incision and 2 min after skin incision in Group II as compared to Group I. Pain score was compared between the groups and was found to be significantly lower with Group I (2.5 ± 1.2) as compared to Group II (4.6 ± 1.7), P = (0.004).
Conclusions: Caudal analgesia with GA (Group I) was found to have better hemodynamic control and significantly better postoperative pain relief in the first 24 h after awakening.
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http://dx.doi.org/10.4103/aca.ACA_215_17 | DOI Listing |
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January 2025
Department of Traditional Chinese Medicine, Dongguan Binhaiwan Central Hospital, Dongguan City, Guangdong Province, 523905, China.
Objective: To explore the efficacy and safety of the direct inferior endplate approach in percutaneous endoscopic interlaminar discectomy (PEID) for the treatment of L5-S1 disc herniation.
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Skeletal Radiol
January 2025
Department of Orthopedics and Traumatology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland.
Objective: Total hip arthroplasty through the Hardinge approach damages the hip abductor muscles. MRI can be used to assess adverse postoperative events. In this prospective randomized controlled trial, we evaluated MRI findings and whether platelet-rich plasma affected postoperative healing of the gluteal muscles (gluteus medius and minimus).
View Article and Find Full Text PDFNurs Health Sci
March 2025
Department of Surgical Nursing, Faculty of Nursing, Atatürk University, Erzurum, Turkey.
The purpose of the present research is to determine the effects of pranayama and deep breathing exercises applied to patients after laparoscopic cholecystectomy on shoulder pain and sleep quality. The research was conducted at the General Surgery Clinics of the University of Health Sciences, Van Training and Research Hospital between March 2023 and June 2024. The study was carried out using a pretest-posttest control group randomized controlled experimental trial design.
View Article and Find Full Text PDFJ Knee Surg
January 2025
Orthopaedic Surgery, LifeBridge Health Rubin Institute for Advanced Orthopedics, Baltimore, United States.
Introduction: The widespread adoption of smartphones and wearable technology has introduced innovative approaches in healthcare, particularly in postoperative rehabilitation. These technologies hold significant promise for improving recovery following lower extremity arthroplasty, especially total knee arthroplasty (TKA). Despite growing interest, the evidence on their effectiveness and long-term impact remains variable.
View Article and Find Full Text PDFJ Knee Surg
January 2025
Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky.
Stiffness after total knee arthroplasty (TKA) can lead to decreased function and patient dissatisfaction. Manipulation under anesthesia (MUA) is often performed to improve range of motion (ROM); however, there is no consensus on indications or timing. The purpose of this study was to compare clinical results and patient-reported outcome measures (PROMs) between patients who underwent MUA versus those with an uncomplicated postoperative course following primary TKA.
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