Objective: To determine if preoperative intraperitoneal bupivacaine can minimize intra- and postoperative nociception/pain in cats undergoing ovariohysterectomy.
Study Design: Prospective, randomized, investigator-blinded, placebo-controlled clinical trial.
Animals: Forty-seven, intact female cats.
Methods: Cats were anesthetized using a standard protocol and randomized to receive ultrasound-guided intraperitoneal 0.9 % saline (US-S) or 0.25 % bupivacaine (US-IPLA) before ovariohysterectomy. On recovery, US-S cats received 2 mg/kg robenacoxib subcutaneously and US-IPLA cats received equivalent volume of 0.9 % saline subcutaneously. Intraoperative outcome variables included heart rate (HR), respiratory rate (fR), systolic arterial pressure (SAP), and vaporizer setting associated with relevant surgical events characterized by manipulation of each ovarian pedicle (OP1, OP2) and the uterine body (UB). The postoperative outcome variable was need for rescue analgesia, determined using the Glasgow Composite Measure Pain Scale during 6 h after tracheal extubation. Intraoperative data were analyzed using two-way ANOVA and Šidák's multiple comparisons test. The probability of postoperative rescue analgesia was analyzed using the Gehan-Breslow-Wilcoxon test. Significance was p < 0.05.
Results: Compared to baseline, all surgical events caused significant increases in HR and SAP in both groups, fR increased in US-IPLA but not in US-S, vaporizer settings remained unchanged during OP1, OP2 and UB in group US-IPLA, and were significantly higher only during OP1 in group US-S. There were no significant between-group differences in intraoperative variables and postoperative need for rescue analgesia.
Conclusions And Clinical Relevance: Preoperative intraperitoneal bupivacaine had minimal effects on intraoperative indicators of nociception. The need for rescue analgesia was not significantly different between groups.
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http://dx.doi.org/10.1016/j.rvsc.2024.105439 | DOI Listing |
Gynecol Oncol Rep
February 2025
Dept of Surgical Oncology, Aster International Institute of Oncology, Bangalore, India.
Background: The role of enhanced recovery after surgery (ERAS) in cytoreductive surgery and/or Hyperthermic Intraperitoneal Chemotherapy HIPEC) is evolving, with promising results that improve patient outcomes. This consensus exercise was carried out to address and standardize components of the ERAS protocol pertinent to the Indian context.
Method: The modified Delphi method was employed with two rounds of voting.
Surg Oncol
December 2024
Peritoneal Surface Malignancies Unit, General and Digestive Surgery Department, Fuenlabrada University Hospital, Madrid, Spain.
Background: disease burden (PCI), completeness of cytoreduction or histological features, are known to influence survival after CRS-HIPEC for colorectal peritoneal metastases (CPM). However, there is still debate about influence of CPM onset. The aim of this study is to determine the impact of CPM onset on oncological outcomes after CRS-HIPEC.
View Article and Find Full Text PDFUltrasound Obstet Gynecol
January 2025
Division of Fetal Medicine, Department of Obstetrics and Gynecology, Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, The Netherlands.
Objective: To determine consensus, using Delphi methodology, on the critical procedural steps for intravascular intrauterine transfusion (IUT) for the treatment of fetal anemia.
Methods: We conducted a two-part Delphi survey of international experts in fetal intervention. The first round of the survey proposed 32 potentially critical steps for the IUT procedure.
Hernia
December 2024
Department of Surgery, Cleveland Clinic, Cleveland, OH, USA.
Purpose: Despite efforts to minimize opioid prescribing, outpatient ventral hernia repair (VHR) with mesh remains notoriously painful, often requiring postoperative opioid analgesia. Here, we aim to characterize patterns of opioid prescribing for the heterogenous group of patients and procedures that comprise mesh-based, outpatient VHR.
Methods: The Abdominal Core Health Quality Collaborative registry was queried for patients undergoing VHR with mesh who were discharged the same or next day between January 2019 to October 2023.
Anesth Analg
December 2024
Department of Anesthesiology, Hunan Province Key Laboratory of Brain Homeostasis, Third Xiangya Hospital, Central South University, Changsha, Hunan, P.R. China.
Background: Brain homeostasis imbalance, characterized by cognitive dysfunction and delirium, frequently occurs in the elderly after surgery. Investigating why this complication only affects part of patients undergoing the same surgery, and anesthesia remains intriguing. This study tested the role of preoperative blood-brain barrier (BBB) integrity in the occurrence of postoperative brain homeostasis imbalance using mice with conditional BBB damage.
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