Cough Suppression during Flexible Bronchoscopy Using Transcutaneous Electric Acupoint Stimulation: A Randomized Controlled Study

Background and Objective. Transcutaneous electric acupoint stimulation (TEAS) is recommended for its sedative and analgesic effects. We sought to evaluate the effect of TEAS on cough suppression during flexible bronchoscopy (FB) and explore the underlying mechanism. Methods. In this single-center, randomized, single-blind, parallel-controlled study, we randomized 100 patients scheduled for FB into two equal groups treated with or without TEAS (TEAS group and control group). Patients in the TEAS group received 30 min of stimulation at the Hegu (LI4), Neiguan (PC6), and Lieque (LU7) points before FB. The control group underwent the same procedure, but without stimulation. The primary outcome was the intraoperative cough score determined by the bronchoscopist. The secondary outcomes were patient-reported discomfort scores and other procedural parameters. Results. Compared with the controls, patients who received TEAS preconditioning had lower cough scores (P=0.0027) and requirement of lidocaine and fentanyl (P<0.05) and significantly higher postprocedural plasma β-endorphin levels (P=0.0367). There were no intergroup differences in discomfort scores, midazolam dosage, rate of premature termination, oxygen requirement, sedation level, airway assistance, oxygen saturation, lowest oxygen saturation level, heart rate, plasma substance-P levels, and rate of complications after 24 h. The total procedure duration, time for passage of the bronchoscope through the vocal cords, and systolic and diastolic blood pressure levels were less in the TEAS group than in the control group (P=0.033, 0.039 and <0.05, respectively). Conclusion. The combination of midazolam and TEAS was superior to midazolam alone for cough suppression during FB, probably due to increased plasma β-endorphin levels. This trial is registered with ChiCTR1800016612 at chictr.org.cn/index.aspx.

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Effect of Cigarette Smoking on Patient-Reported Outcomes in Hip Arthroscopic Surgery: A Matched-Pair Controlled Study With a Minimum 2-Year Follow-up

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118822837 ◽

2019 ◽

Vol 7 (1) ◽

pp. 232596711882283 ◽

Cited By ~ 2

Author(s):

Ajay C. Lall ◽

Jon E. Hammarstedt ◽

Asheesh G. Gupta ◽

Joseph R. Laseter ◽

Mitchell R. Mohr ◽

...

Keyword(s):

Patient Reported Outcomes ◽

Smoking Status ◽

Arthroscopic Surgery ◽

Matched Pair ◽

Harris Hip Score ◽

Controlled Study ◽

Control Group ◽

Patient Reported ◽

Smoking Group

Background: The rate of hip arthroscopic surgery has recently increased; however, there is limited literature examining patient-reported outcomes (PROs) in cigarette smokers. Purpose/Hypothesis: The purpose of this study was to evaluate whether smoking status for patients undergoing hip arthroscopic surgery affects clinical findings and PRO scores. We hypothesized that patients who smoke and undergo primary hip arthroscopic surgery will have similar clinical examination findings and preoperative and postoperative PRO scores compared with nonsmoking patients. Study Design: Cohort study; Level of evidence, 3. Methods: Data were collected on all patients who underwent primary hip arthroscopic surgery from February 2008 to July 2015. A retrospective analysis of the data was then conducted to identify patients who reported cigarette use at the time of the index procedure. Patients were matched 1:2 (smoking:nonsmoking) based on sex, age within 5 years, labral treatment (repair vs reconstruction vs debridement), workers’ compensation status, and body mass index within 5 kg/m2. All patients were assessed preoperatively and postoperatively using 4 PRO measures: the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), and International Hip Outcome Tool–12 (iHOT-12). Pain was estimated using a visual analog scale. Satisfaction was measured on a scale from 0 to 10. Significance was set at P < .05. Results: A total of 75 hips were included in the smoking group, and 150 hips were included in the control group. Preoperatively, the smoking group had significantly lower PRO scores compared with the control group for the mHHS, NAHS, and HOS-SSS. Both groups demonstrated significant improvement from preoperative levels. A minimum 2-year follow-up was achieved, with a mean of 42.5 months for the smoking group and 47.6 months for the control group ( P = .07). At the latest follow-up, the smoking group reported inferior results for all outcome measures compared with controls. The improvement in PRO scores and rates of treatment failure, revision arthroscopic surgery, and complications was not statistically different between the groups. Conclusion: Patients who smoke had lower PRO scores preoperatively and at the latest follow-up compared with nonsmokers. Both groups demonstrated significant improvement in all PRO scores. These results show that while hip arthroscopic surgery may still yield clinical benefit in smokers, these patients may ultimately achieve an inferior functional status. To optimize results, physicians should advise patients to cease smoking before undergoing hip arthroscopic surgery.

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A Standardized Transcutaneous Electric Acupoint Stimulation for Relieving Tobacco Urges in Dependent Smokers

Evidence-based Complementary and Alternative Medicine ◽

10.1093/ecam/nen074 ◽

2011 ◽

Vol 2011 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

Caroline Lambert ◽

Ivan Berlin ◽

Tat-Leang Lee ◽

Siew Wan Hee ◽

Audrey S. L. Tan ◽

...

Keyword(s):

Clinical Trials ◽

Smoking Cessation ◽

Control Group ◽

Double Blind ◽

Standardized Protocol ◽

Urge To Smoke ◽

The Difference ◽

To Receive ◽

Transcutaneous Electric Acupoint Stimulation ◽

Acupoint Stimulation

The efficacy of acupuncture in smoking cessation, and its effect on the urge to smoke are unclear. We evaluated the effect of a standardized protocol of transcutaneous electric acupoint stimulations (TEAS) on alleviating the urge to smoke. Ninety-eight smokers were recruited in two double-blind studies. Participants abstained from smoking for 26 h, and were randomized to receive TEAS alternating between 2 and 100 Hz at four acupoints (LI4 and PC8, PC6 and TE5) at four different intensities (10, 5, Intermittent 5 or 0 mA). The urge to smoke was assessed by the Questionnaire of Smoking Urges (QSU-Brief). In Experiment 1, the 10 mA group (n= 20) was compared with the 5 mA group (n= 20); the increase in smoking urges did not differ significantly. Considering the possibility that 5 mA may be an active intervention, in Experiment 2, a true placebo (0 mA), and a proxy of placebo [Intermittent 5 mA (i5 mA)] were compared with 10 mA TEAS. In this experiment, 10 mA (n= 20) TEAS showed a tendency to alleviate smoking urges compared with 0 mA (n= 16), and i5 mA (n= 19) TEAS. Only when the data of smokers with Fagerstöm Test for Nicotine Dependence score ≥5 were analyzed that the difference between the 10 mA group and the control group (0 and i5 mA) became significant. Based on these preliminary findings, we conclude that TEAS applied on the skin may antagonize the increase in urge to smoke in abstinent-dependent smokers. It seems warranted to assess the efficacy of TEAS in smoking cessation clinical trials involving a larger population of dependent smokers.

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Evaluation of a digitally enhanced cardiac auscultation learning method: a controlled study

BMC Medical Education ◽

10.1186/s12909-021-02807-4 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Fred-Cyrille Goethe Doualla ◽

Georges Bediang ◽

Chris Nganou-Gnindjio

Keyword(s):

Medical Students ◽

Teaching Method ◽

Intervention Group ◽

Controlled Study ◽

Control Group ◽

Learning Method ◽

Cardiac Auscultation ◽

Link Type ◽

Digitally Enhanced ◽

Clinical Internship

Abstract Background Cardiac auscultation remains an efficient and accessible diagnostic tool, especially in resource-limited countries where modern diagnostic devices like cardiac ultrasound are expensive and difficult to access. However, cardiac auscultation skills of medical students and physicians are declining, mainly because of an ineffective teaching method for this technique. The objective of this study is to evaluate the effect of a digitally enhanced cardiac auscultation learning method on participants’ theoretical knowledge and auscultation skills. Methods This will be a controlled study with two parallel arms (1:1). Participants (fourth-year medical students) will be divided into two groups: an intervention group (receiving additional lectures, clinical internship and audio listening sessions) and a control group (receiving additional lectures and clinical internship). At the beginning of the study, all participants will undergo a pre-test that consist of two parts: a knowledge assessment based on multiple-choice questions and a skills assessment based on recognition of cardiac sounds from audio files. Thereafter, three specific additional lectures on cardiac auscultation will be delivered and all participants will take part in their official clinical internship. During these clinical internships (eight weeks), participants of the intervention group will be invited to two listening sessions based on five digital recordings of heart sounds. At the end of the clinical internship, all participants will be invited to a post-test to evaluate their knowledge, skills and satisfaction according to their learning method. The main outcome will be the participants’ knowledge progression. The other outcomes will be the participants’ skills progression, participants’ total progression and satisfaction. Data will be collected and analyzed in per protocol. Discussion This study could contribute to the development of a learning method that takes into account the advantages of the conventional method and the contribution of digital technology. Positive results could lead to improved cardiac auscultation skills among health professionals, especially in developing countries. Trial registration The trial is registered on the Pan-African Clinical Trials Registry (http://www.pactr.org) under unique identification number: PACTR202001504666847, registered the 29 November 2019.

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Limited lumbopelvic mobility does not influence short-term outcomes after primary hip arthroscopy: a propensity-matched controlled study

Journal of Hip Preservation Surgery ◽

10.1093/jhps/hnab056 ◽

2021 ◽

Author(s):

Andrew E Jimenez ◽

James D Fox ◽

Kara Miecznikowski ◽

David R Maldonado ◽

Benjamin R Saks ◽

...

Keyword(s):

Hip Arthroscopy ◽

Matched Control ◽

Harris Hip Score ◽

Controlled Study ◽

Control Group ◽

Sacral Slope ◽

Short Term ◽

Matched Control Group ◽

Femoroacetabular Impingement Syndrome ◽

Patient Reported

ABSTRACT There is a paucity of literature investigating the effect of lumbopelvic mobility on patient-reported outcome scores (PROs) after primary hip arthroscopy. The purpose of this study was (i) to report minimum 1-year PROs in patients with limited lumbopelvic mobility (LM) who underwent primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) and (ii) to compare clinical results with a propensity-matched control group of patients with normal lumbopelvic mobility (NM). Data were reviewed for surgeries performed between November 2019 and March 2020. Patients were considered eligible if they received a primary hip arthroscopy for FAIS in the setting of LM (seated to standing change in sacral slope ≤ 10°). LM patients were propensity-matched to a control group of patients with normal lumbopelvic motion (seated to standing change in sacral slope > 10°) for comparison. A total of 17 LM and 34 propensity-matched NM patients were included in the study. LM patients showed significant improvement in all outcome measures and achieved the minimum clinically important difference (MCID) and patient acceptable symptomatic state (PASS) at high rates for modified Harris Hip Score (MCID: 94% and PASS: 82%) and International Hip Outcome Tool-12 (iHOT-12; MCID: 94% and iHOT-12: 76%). When LM patients were compared to a propensity-matched control group of NM patients, they demonstrated similar postoperative PROs and rates of achieving MCID/PASS. LM patients who undergo primary hip arthroscopy may expect favorable short-term PROs at minimum 1-year follow-up. These results were comparable to a control group of NM patients.

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Intact Ligamentum Teres Predicts Superior Prognosis in Borderline Dysplastic Patients: A Matched Pair Controlled Study with Minimum Five-Year Outcomes Following Hip Arthroscopy

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00425 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0042

Author(s):

Benjamin Domb ◽

Sarah Chen ◽

Rafael Walker-Santiago ◽

Jacob Shapira ◽

Philip Rosinsky ◽

...

Keyword(s):

Hip Arthroscopy ◽

Matched Control ◽

Ligamentum Teres ◽

Matched Pair ◽

Controlled Study ◽

Control Group ◽

Matched Control Group ◽

Center Edge ◽

Significant Difference ◽

Patient Reported

Objectives: (1) To report minimum five-year patient reported outcomes (PROs) in borderline dysplastic patients with ligamentum teres (LT) tears who underwent hip arthroscopy and (2) to compare these PROs to a pair-matched control group of borderline dysplastic hips without LT tears. Methods: Data was prospectively collected for patients who underwent hip arthroscopy during September 2008 and August 2013. Patients were included if had a preoperative diagnosis of borderline dysplasia [lateral center-edge angle (LCEA) of 18°- 25°] and had preoperative and minimum five-year postoperative modified Harris Hip Scores (mHHS), Non-Arthritic Hip Scores (NAHS), and Visual Analogue Scale for pain (VAS) scores. Exclusion criteria were Tönnis grade osteoarthritis >1, previous hip conditions, any prior ipsilateral hip surgery, or workers’ compensation status. Two borderline dysplastic groups were created. An LT tear group was matched 1:1 to a control group (no LT tear) with similar age, sex, body mass index (BMI), and laterality via propensity score matching. Significance was set at P < 0.05. Results: 24 LT tear patients (24 hips) were matched 24 patients (24 hips) without an LT tear. There was no significant difference in age, sex, BMI, or laterality between groups. Mean age was 36.2 ± 17.2 and 34.9 ± 15.9 years for the control and LT tear group, respectively (P = 0.783). There were 17 (70.8%) and 16 (66.7%) females in the control and LT tear group, respectively and the mean preoperative LCEA was 23.3° and 22.2° in the control and LT tear group, respectively. No differences were observed between groups in baseline PROs, intraoperative findings, or surgical procedures, except for LT treatment. Five-year postoperative PROs were comparable in both groups, with the control group exhibiting superior Veterans RAND 12-Item Health Survey Mental Component (VR-12M) (P = 0.041) and Short Format 12 Mental Health (SF-12M) (P = 0.042). The control group exhibited less pain and higher satisfaction with surgery; however, this trend was not significant. Finally, the LT tear group was significantly less likely to achieve the patient acceptable symptomatic state (PASS) for mHHS (P = 0.022). Conclusion: Following hip arthroscopy, patients with borderline dysplasia and LT tears demonstrated favorable PROs at minimum five-year follow-up. Outcomes were similar to a pair-matched control group without LT tears, with the control group showing higher VR-12M and SF-12M scores. Furthermore, borderline dysplastic patients with LT tears were significantly less likely to achieve the PASS for mHHS.

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Iliopsoas pathology, treatment, and outcomes in patients undergoing hip arthroscopy for femoroacetabular impingement: Findings from the [redacted] study group

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967120s00429 ◽

2020 ◽

Vol 8 (7_suppl6) ◽

pp. 2325967120S0042

Author(s):

Benjamin Kivlan ◽

Shane Nho ◽

Andrew Wolff ◽

John Salvo ◽

John Christoforetti ◽

...

Keyword(s):

Hip Arthroscopy ◽

Group Versus ◽

Labral Repair ◽

Controlled Study ◽

Control Group ◽

Symptom Duration ◽

Study Group ◽

Significant Difference ◽

Patient Reported ◽

Chi Square Analysis

Paste abstract here and remove the remaining text. *For structured abstracts, begin each section under a separate, bolded subheading. Suggested subheadings are below Objectives: The iliopsoas is a major hip flexor that provides anterior hip stability. Recent studies report significant compromise to these important functions with iliopsoas tenotomy. The purpose of this study is to report the prevalence, associated findings, rendered procedures, and outcomes of hips with iliopsoas involvement undergoing hip arthroscopy for FAI and/or chondrolabral pathology. The hypothesis is that there is a decrease in the incidence of tenotomy compared with historic controls and that tenotomy compromises patient-reported outcomes. Methods: Level of evidence 3 controlled study with prospectively-collected multicenter database from 7 centers. Enrolled patients that underwent isolated hip arthroscopy that reached 2-year minimum follow-up with iHOT-12 were assigned to Iliopsoas group defined as pre-operative diagnosis of iliopsoas tendonitis, internal snapping symptoms, intra-operative anteroinferior labral pathology (below 3 O’clock location) and/or preoperative psoas injection or the control group. The prevalence of iliopsoas pathology, radiographic and intra-operative findings, and rendered procedures between groups were compared using Chi square analysis. Minimum 2-year outcomes of Iliopsoas group versus control group were compared using analysis of variance (a priori alpha set at 0.05). Subanalysis within the Iliopsoas group was performed of patients with versus without tenotomy. Results: There were 97 study group subjects and 1053 control group subjects. There was no statistical difference in demographics between the groups (p>0.05) nor was there a difference in length of preoperative symptom duration (p=0.51). There were no significant differences in the incidence of cam impingement, pincer impingement or dysplasia between cohorts, nor were there significant differences between radiographic measures. There was a similar incidence of femoroplasty, acetabuloplasty, chondroplasty, microfracture, and synovectomy (p>0.05) regardless of iliopsoas involvement. There was not a significant effect on the surgical treatment of the labrum based on psoas involvement (p>0.16). Labral repair was performed in 55% of patients with iliopsoas involvement and 62% of patients without iliopsoas involvement. Although there was not a significant difference in capsular closure between cohorts (96% vs 93%, p=0.121), the overwhelming majority of patients with psoas involvement received capsular repair (87%) or plication (9%). Pre-operative iHOT-12 scores were similar 34 (SD: 18) for the iliopsoas group and 35 (SD 18) for the control group groups (p=0.51). Post-operative iHOT-12 scores improved to 72 for both the groups. The iliopsoas group achieved MCID, SCB, and PASS scores established for the iHOT-12 of 83%, 62%, and 58% which were similar to the control group. Ten subjects (10%) in the iliopsoas group received iliopsoas tenotomy. Subjects with tenotomy had lower 2-year post-op iHOT-12 scores compared to the non-tenotomy subgroup (55 vs 72, respectively; p=0.03) . This corresponded with lower achievement of MCID scores (60% vs 86%; p=0.03) and SCB scores (30% vs 70%, p=0.01) of patients with tenotomy compared to those without tenotomy. Conclusion: Iliopsoas tenotomy is rarely performed relative to its prevalence in patients undergoing hip arthroscopy by high volume surgeons for FAI and/or chondrolabral pathology. Surgical outcomes are not worsened with iliopsoas involvement but are worsened with tenotomy.

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Comparative study of analgesia nociception index (ANI) vs. standard pharmacokinetic pattern for guiding intraoperative fentanyl administration among mastectomy patients

BMC Anesthesiology ◽

10.1186/s12871-021-01272-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Sirirat Tribuddharat ◽

Thepakorn Sathitkarnmanee ◽

Pornlada Sukhong ◽

Maneerat Thananun ◽

Parinda Promkhote ◽

...

Keyword(s):

Mean Difference ◽

Controlled Study ◽

Postanesthesia Care Unit ◽

Control Group ◽

Loading Dose ◽

Non Invasive ◽

Link Type ◽

Sedation Scores ◽

Fentanyl Consumption ◽

Fentanyl Administration

Abstract Background The Analgesia Nociception Index (ANI) has been suggested as a non-invasive guide for analgesia. Our objective was to compare the efficacy of ANI vs. standard pharmacokinetic pattern for guiding intraoperative fentanyl administration. Methods This was a prospective, randomized, controlled study of adult female patients undergoing elective mastectomy under general anesthesia. The patients were randomized to the ANI-guided group receiving a loading dose of 75 μg of fentanyl followed by 25 μg when the ANI score was under 50. The Control group received the same loading dose followed by 25 μg every 30 min with additional doses when there were signs of inadequate analgesia (viz., tachycardia or hypertension). Results Sixty patients—30 in each group—were recruited. Although the actual mean ANI score was higher in the ANI-guided than in the Control group (mean difference 2.2; 95% CI: 0.3 to 4.0, P = 0.022), there was no difference in the primary outcome—i.e., intraoperative fentanyl consumption (mean difference − 4.2 μg; 95% CI: − 24.7 to 16.4, P = 0.686 and − 0.14 μg·kg− 1·h− 1; 95% CI: − 0.31 to 0.03, P = 0.105). No difference between groups was shown for either intraoperative blood pressure and heart rate, or for postoperative outcomes (i.e., pain scores, morphine consumption, or sedation scores) in the postanesthesia care unit. Conclusions Intraoperative fentanyl administration guided by ANI was equivalent to that guided by a modified pharmacologic pattern. In a surgical model of mastectomy, the ANI-guided intraoperative administration of fentanyl had no impact on clinical outcomes. Trial registration The study was registered with ClinicalTrials.gov (NCT03716453) on 21/10/2018.

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Transcutaneous Electrical Acupoint Stimulation Before Induction of Anesthesia Prevents Sufentanil-Induced Cough: A Prospective, Randomized, Controlled Study

10.21203/rs.3.rs-35069/v1 ◽

2020 ◽

Author(s):

Junjie Xie ◽

Yunchang Mo ◽

Junkai Wang ◽

Lili Yang ◽

Haijuan He ◽

...

Keyword(s):

Statistical Difference ◽

Inhibitory Effect ◽

Controlled Study ◽

Common Side Effect ◽

Control Group ◽

Trial Registry ◽

Clinical Trial Registry ◽

Randomized Controlled ◽

The Mean ◽

Acupoint Stimulation

Abstract Background. Sufentanil-induced cough is a common side effect during the induction of general anesthesia.This study is to determine the inhibitory effect of transcutaneous electrical acupoint stimulation(TEAS) on sufentanil-induced cough.Methods. A total of 339 patients were recruited in this trial.After the unqualified patients were removed,300 patients were enrolled and randomly allocated into five groups(n=60):Patients did not receive TEAS in control group(C group);Patients received 2Hz TEAS at Hegu/Neiguan(LI4/PC6) in 2A group;Patients received 100Hz TEAS at LI4/PC6 in 100A group;Patients received 2Hz TEAS at Zusanli/sanyinjiao(ST36/SP6) in 2B group;Patients received 100Hz TEAS at ST36/SP6 in 100B group.Except for C group,all groups received TEAS for 30 min before the induction.Then 0.5μg/kg sufentanil was given within 2 s,the occurrence of cough was observed and recorded for 1 min.The severity of cough was graded as mild(1-2 coughs),moderate(3-5 cough),and severe(>5 coughs).The mean arterial pressure(MAP) and heart rate(HR) before (T0) and 1 min after(T1) sufentanil injection were recorded.Results. The incidence of sufentani-induced cough in C group,2A group,2Bgroup,100A group and 100B group were 37%,27%,27%,12% and 13%,respectively.Compared with C group,the incidence of 100A group and 100B group were significantly lower(P<0.05).The MAP and HR between five groups had no statistical difference.Conclusion. Groups the received 100Hz TEAS for 30 min before sufentanil injection can effectively reduce the incidence of sufentanil-induced cough during the induction of general anesthesia.Trial registration: Chinese clinical trial registry(ChiCTRINR16008759)

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Efek SuctionMelalui Catheter Mouth terhadap Saturasi Oksigen Pasien Cedera Kepala

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v1i3.64 ◽

1970 ◽

Vol 1 (3) ◽

Author(s):

Marlisa M ◽

Ponpon S Idjradinata ◽

Cecep Eli Kosasih

Keyword(s):

Head Injury ◽

Intracranial Pressure ◽

Oxygen Saturation ◽

Severe Head Injury ◽

Intervention Group ◽

Oxygen Desaturation ◽

Control Group ◽

P Value ◽

Oxygen Saturation Level ◽

Post Test

Tindakan suction endotrachealpada pasien cedera kepala berat dapat menyebabkan terjadinya oxygendesaturationarteri yang berakibat pada peningkatan intracranial pressure, pembengkakan otak dan hipoksemiasistemikbahkan dapat menyebabkan kematian. Penelitian ini bertujuan untuk mengevaluasi pengaruh suplai oksigen melalui catheter mouthsaat suction terhadap saturasi oksigen pada pasien cedera kepala yang terpasang ventilator yang dirawat di ruang perawatan intensif. Penelitian ini menggunakan desain penelitian desain kuasi eksperimen pendekatan pre dan post test dengan kelompok kontrol dan perlakuan. Jumlah sampel pada penelitian ini adalah 40 responden yang dibagi menjadi kelompok perlakuan sebanyak 20 responden yang dipasang catheter mouthdan kelompok kontrol sebanyak 20 responden tanpa menggunakan catheter mouth. Teknik sampel menggunakan accidental sampling. Penurunan saturasi oksigen nilai thitung (-16,538) < ttabel (-2,024) dan nilai p-value(0.000) < 0.05. Saturasi oksigen saat suctionpada kelompok kontrol dengan kelompok perlakuan adalah memang berbeda secara nyata. Hasil penelitian ini dapat dijadikan evidence basedbagi perawat di ruang intensif untuk meningkatkan pelayanan perawatan dalam melakukan tindakan suctionuntuk mengurangi resiko terjadinya penurunan saturasi oksigen pada pasien cedera kepala berat yang terpasang ventilator. Kata kunci : catheter mouth, suction,saturasi oksigen AbstractThe intervention of endotracheal suction to patients with the severe head injury may have effected to oxygen desaturation in arteries. The oxygen desaturation process could be impacted to increase the intracranial pressure, brain’s swelling, hypoxemia systemic, and deaths. This study aimed to evaluate the influence of the oxygen supply via oral catheterization in the suction process to the oxygen saturation level in the patient with the severe head injury who using ventilator. This research has been conducted in the intensive care unit. This study was applied the quasi experiment design using pre and post-test. Samples were chosen using accidental sampling. There were two groups of samples, the first group was the intervention group with 20 respondents using oral catheterization, and the second group was the control group with 20 respondents. The result showed that the oxygen saturation was reduced with t value (-16.538) < t table (-2.024), and p value (0.000) < 0.05. The oxygen saturation was significantly different between two groups. This study could be an evidence that nurses should enhance their services to reduce the risk of decreasing the oxygen saturation in the severe head injury patient who using ventilator.Key words:Catheter Mouth, oxygen saturation, suction

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An Intact Ligamentum Teres Predicts a Superior Prognosis in Patients With Borderline Dysplasia: A Matched-Pair Controlled Study With Minimum 5-Year Outcomes After Hip Arthroscopic Surgery

The American Journal of Sports Medicine ◽

10.1177/0363546519898716 ◽

2020 ◽

Vol 48 (3) ◽

pp. 673-681 ◽

Cited By ~ 3

Author(s):

David R. Maldonado ◽

Sarah L. Chen ◽

Rafael Walker-Santiago ◽

Jacob Shapira ◽

Philip J. Rosinsky ◽

...

Keyword(s):

Short Form ◽

Arthroscopic Surgery ◽

Ligamentum Teres ◽

Matched Pair ◽

Harris Hip Score ◽

Controlled Study ◽

Control Group ◽

Significant Difference ◽

Patient Reported ◽

The Mean

Background: Hip arthroscopic surgery in patients with borderline dysplasia continues to be controversial. In addition, it has been suggested that ligamentum teres (LT) tears may lead to inferior short-term patient-reported outcomes (PROs) when compared with a match-controlled group. Purposes: (1) To report minimum 5-year PROs in patients with borderline dysplasia and LT tears who underwent hip arthroscopic surgery and (2) to compare these PROs to those of a matched-pair control group of patients with borderline dysplastic hips without LT tears. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected for patients who underwent hip arthroscopic surgery between September 2008 and August 2013. Patients were included if they had a preoperative diagnosis of borderline dysplasia (lateral center-edge angle [LCEA], 18°-25°) and had preoperative and minimum 5-year postoperative modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale (VAS) for pain scores. Exclusion criteria were osteoarthritis of Tönnis grade >1, previous hip conditions, any previous ipsilateral hip surgery, or workers’ compensation status. There were 2 borderline dysplastic groups created. An LT tear group was matched 1:1 to a control group (no LT tear) with similar age, sex, body mass index (BMI), and laterality via propensity score matching. Significance was set at P < .05. Results: A total of 24 patients with an LT tear (24 hips) were matched to 24 patients without an LT tear (24 hips). There was no significant difference in age, sex, BMI, or laterality between groups. The mean age was 36.2 ± 17.2 and 34.9 ± 15.9 years for the control and LT tear groups, respectively ( P = .783). There were 17 (70.8%) and 16 (66.7%) female patients in the control and LT tear groups, respectively, and the mean preoperative LCEA was 23.3° and 22.2° in the control and LT tear groups, respectively. No differences were observed between groups in baseline PROs, intraoperative findings, or surgical procedures. LT debridement was performed in 17 (70.8%) patients in the LT tear group compared with 0 (0.0%) in the control group. Also, 5-year postoperative PROs were comparable in both groups, with the control group exhibiting superior Veterans RAND 12-Item Health Survey (VR-12) mental ( P = .041) and Short Form–12 (SF-12) mental ( P = .042) scores. Finally, hips with an intact LT were significantly more likely ( P = .022) to achieve the patient acceptable symptomatic state (PASS) for the mHHS (100.0% and 75.0%, respectively). No significant differences were present between the groups for the minimal clinically important difference (MCID) of the mHHS ( P = .140), MCID of the Hip Outcome Score–Sport-Specific Subscale (HOS-SSS) ( P = .550), or PASS of the HOS-SSS ( P = .390). Conclusion: After hip arthroscopic surgery, patients with borderline dysplasia and LT tears demonstrated favorable PROs at a minimum 5-year follow-up. Outcomes were similar to a matched-pair control group without LT tears, with the group with intact LTs showing higher VR-12 mental and SF-12 mental scores. Furthermore, patients with borderline dysplasia and intact LTs were significantly more likely to achieve the PASS for the mHHS.

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