Laparoscopic-guided transversus abdominis plane block following laparoscopic sleeve gastrectomy is associated with an earlier return to activity: a study of 271 patients

In this study, we examined the effect of laparoscopic-guided transversus abdominis plane block (LG TAP) for further optimizing multimodal pain control.MethodsThis is a retrospective analysis of a prospectively collected database of 140 consecutive patients undergoing LSG without TAP block (pre-TAP group) compared to 131 patients undergoing LSG with LGTAP (TAP group). All operations were performed laparoscopically utilizing uniform clinical pathways. Baseline characteristics for both groups were comparable. Both groups received standardized anesthesia. Outcomes included time to postoperative ambulation, pain scores, PCA volume, length of hospital stay, utilization of oral opiate medications, and return to activity (RTA).ResultsPre-TAP versus TAP groups were comparable, mean age 42  years (p = 0.99), women 81.4% versus 87.8% (p = 0.148), mean BMI (kg/m2) 46 versus 45 (p = 0.394). Most patients ambulated within 2 h after arrival to the floor (87.9% vs. 76.3%,p = 0.013). On postoperative day (POD) 1, mean reported pain score (0–10) was 4.50 vs. 5.06 (p = 0.063) and a mean PCA morphine used for 24 h was 26.3 mL versus 26 mL,p = 0.35. Mean days of postoperative opiate medication were 2.19 versus 1.24 (p 
Source: Surgical Endoscopy - Category: Surgery Source Type: research

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Conclusions: 60% of patients with MDD and/or AAD had at least one additional NCCD, which significantly increased the economic and humanistic burden. These findings are important for payers and clinicians in making treatment decisions. These results underscore the need for development of multi-pronged interventions which aim to improve quality of life and reduce activity limitations among patients with mental health disorders and NCCDs. PMID: 32468879 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
Authors: Loh HH, Yee A, Loh HS, Kanagasundram S, Francis B, Lim LL Abstract PURPOSE: Polycystic ovarian syndrome (PCOS) is a common disorder characterized by clinical or biochemical hyperandrogenism and ovulary dysfunction. Female sexual dysfunction (FSD) adversely affects quality of life and interpersonal relationships. We aimed to compare the prevalence of FSD in women with and without PCOS. METHODS: We pooled data from 28 observational studies involving 6256 women. Apart from the total prevalence of FSD, subgroup analyses based on different PCOS diagnostic criteria and obesity status (body mass index [BMI]&t...
Source: Hormones - Category: Endocrinology Tags: Hormones (Athens) Source Type: research
ConclusionThis video demonstrates a form to extract a displaced gastric clip used to create a calibrated tubular gastroplasty using a laparoscopic approach.
Source: Obesity Surgery - Category: Surgery Source Type: research
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...
Source: Minerva Anestesiologica - Category: Anesthesiology Tags: Minerva Anestesiol Source Type: research
In this meta-analysis, Hamid et al[1] 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 [2]. 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.
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Source Type: research
CONCLUSIONS: Trials of antidepressants may be driven mainly by commercial interests, focusing on prevalent diseases and everyday problems. No one can live a full life without experiencing several of the problems for which these drugs were tested. Antidepressants, sometimes called happy pills, could be seen as the modern version of Aldous Huxley's soma pill intended to keep everyone happy in the "Brave New World". PMID: 32444565 [PubMed - as supplied by publisher]
Source: International Journal of Risk and Safety in Medicine - Category: Drugs & Pharmacology Tags: Int J Risk Saf Med Source Type: research
Conclusion: At pre-intervention, the overweight group had significantly “worse” tendon structure, with a lower prevalence of echo type II fiber and a higher prevalence of echo type III fibers compared with the control group. Following the 6-month intervention, the tendon structure of the overweight group was “positively” changed, with reduced echo type III fiber s and increased echo type II fibers.What is Known:•Physical activity and weight reduction programs are efficient for obese children.•Obese children tend to suffer orthopedic problems and pain during physical activity.What is New:&b...
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research
In conclusion, our results suggest a previously unknown mechanism whereby the canonical NF-κB cascade and a mitochondrial fission pathway interdependently regulate endothelial inflammation. Lin28 as a Target for Nerve Regeneration Researchers here show that the gene Lin28 regulates axon regrowth. In mice, raised levels of Lin28 produce greater regeneration of nerve injuries. Past research has investigated Lin28 from the standpoint of producing a more general improvement in regenerative capacity. It improves mitoch...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
DISCUSSION: This COI study provided data on health status, comorbidities, QoL, health care use, productivity losses and costs of SUI. The high prevalence of comorbidities observed in this study was comparable to obese females of a similar age group. The high economic burden of SUI requires cost-effective preventive actions and clinical treatment concepts. PMID: 32439424 [PubMed - as supplied by publisher]
Source: Zeitschrift fur Evidenz, Fortbildung und Qualitat im Gesundheitswesen - Category: Health Management Tags: Z Evid Fortbild Qual Gesundhwes Source Type: research
We read with interest the article “Effect of Intraperitoneal Bupivacaine on Postoperative Pain in Laparoscopic Bariatric Surgeries” [1]. We thank and congratulate the Iranian colleagues for this important contribution to this topic. Even if supported by scarce literature, effectiveness of peritoneal irrigation with local anesthe tics still remains controversial [2], although it seems to be one useful tool to control postoperative pain after bariatric surgery, as recently stated by a meta-analysis published within your Journal [3].
Source: Surgery for Obesity and Related Diseases - Category: Surgery Authors: Tags: Letter to the Editor Source Type: research
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