Effect of Low-pressure Pulmonary Recruitment Maneuver on Postlaparoscopic Shoulder Pain: Randomized Controlled Trial
Publication date: Available online 28 March 2019Source: Journal of Minimally Invasive GynecologyAuthor(s): Jiyoung Lee, Chunghyun Park, Jihee Kim, Yumin Ki, Sun Hee Cha, Jong Yeop KimAbstractStudy ObjectivePostlaparoscopic shoulder pain (PLSP) is effectively reduced by a pulmonary recruitment maneuver (PRM). The goal of this study is to assess the efficacy of a PRM using maximal inspiratory pressure of 30 cm H2O, which is lower than previously studied pressure for reducing PLSP.DesignRandomized controlled trial.SettingUniversity hospital.PatientsEighty-four patients who were undergoing elective gynecologic laparoscopy.InterventionsPatients were randomly assigned to the control (n = 42) or the PRM (n = 42) group.Measurements and Main ResultsThe primary outcome was the intensity of the shoulder pain using the visual analog scale (VAS). The VAS score of shoulder pain (median [interquartile range]) was significantly lower in the PRM group than in the control group at 24 hours (0 [0–0] vs 1.5 [0–4.0], p
As a component of multimodal analgesia, the administration of systemic lidocaine is a well-known technique. We aimed to evaluate the efficacy of lidocaine infusion on postoperative pain-related outcomes in pat...
Optimal postoperative pain therapy for patients undergoing minimally invasive surgery remains controversial. The aim of this meta-analysis was to compare the efficacy and safety of the novel laparoscopic-guided transversus abdominis plane block (L-TAP) to other analgesic alternatives in adults undergoing minimally invasive surgery.
Conclusion: ITM 5 μg/kg provides better intraoperative and postoperative analgesia and reduces postoperative PCA fentanyl requirement in laparoscopic donor nephrectomy compared to TAP block or intravenous fentanyl.
ConclusionThis video demonstrates a form to extract a displaced gastric clip used to create a calibrated tubular gastroplasty using a laparoscopic approach.
Rationale: Malignant peritoneal mesothelioma is a rare tumor with a poor prognosis and has no recommended therapy after first-line pemetrexed and platinum-based chemotherapy. Moreover, effects of immune checkpoint inhibitors on peritoneal mesothelioma remains to be elucidated. We herein report the case of a 75-year-old man with peritoneal mesothelioma treated with cisplatin plus pemetrexed and subsequent nivolumab. Patient concerns: A 75-year-old man was referred to our hospital due to lower abdominal pain. Diagnosis: Positron emission tomography-computed tomography (CT) showed the accumulation of fluorodeoxyglucos...
Conclusions: NOSES was shown to be a safe and viable alternative to CLAPS in colorectal oncology in terms of short-term results. Further long-term and randomized trials are required. PMID: 32454825 [PubMed]
Authors: Abdelhamid BM, Khaled D, Mansour M, Hassan MM Abstract BACKGROUND: Pain control in the morbidly obese has presented as an anesthetic challenge. The aim of this study is to assess the analgesic efficacy of ultrasound guided bilateral erector spinae block compared to bilateral subcostal transversus abdominis plane block. METHODS: Prospective randomized, double-blinded controlled study was conducted at Kasr Alainy Hospital on 66 patients scheduled for laparoscopic sleeve gastrectomy. Patients were randomly allocated into three groups and received general anesthesia: bilateral erector spinae block at the l...
In this meta-analysis, Hamid et al discuss a subset of the currently available data on the impact of transversus abdominis plane (TAP) block on postoperative pain and opioid consumption. In the era of protocols to enhance recovery this is a worthy endeavor. The MBSAQIP D.R.O.P program (Decreasing Readmissions Through Opportunities Provided), described in 2014 by John Morton, was the first QI initiative to originate from this accreditation program . Notably, the DROP program originated from a desire to decrease readmissions, and postoperative pain was not one of the author ’s proposed causes for readmission.
ConclusionThe incidence of hemorrhage or complication does not seem to vary depending on the fibroid location. However, the sample size was limited; observed values suggest that fibroid location does not affect hemorrhage and complication rates.