scholarly journals Analgesia and patient comfort after enhanced recovery after surgery in uvulopalatopharyngoplasty: a randomised controlled pilot study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Huang ◽  
Minxue Wang ◽  
Huixin Chen ◽  
Nan Cheng ◽  
Yanling Wang ◽  
...  
Keyword(s):  
Pilot Study ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Patient Comfort ◽  
Controlled Study ◽  
Control Group ◽  
Care Hospital ◽  
Positive Effects ◽  
Obstructive Sleep ◽  
Randomised Controlled

Abstract Background Uvulopalatopharyngoplasty(UPPP) is the most prevalent surgical treatment of obstructive sleep apnea, but postoperative pharyngeal pain may affect patient comfort. The enhanced recovery after surgery pathway has been proved beneficial to many types of surgery but not to UPPP yet. The aim of this pilot study was to preliminarily standrize an enhanced recovery after surgery protocol for UPPP, to assess whether it has positive effects on reducing postoperative pharyngeal pain and improving patient comfort, and to test its feasibility for an international multicentre study. Methods This randomised controlled study analysed 116 patients with obstructive sleep apnoea (OSA) who were undergoing UPPP in a single tertiary care hospital. They were randomly divided according to treatment: the ERAS group (those who received ERAS treatment) and the control group (those who received traditional treatment). Ninety-five patients completed the assessment (ERAS group, 59 patients; control group, 36 patients). Pharyngeal pain and patient comfort were evaluated using a visual analogue scale (VAS) at 30 min and at 6, 12, 24 and 48 h after UPPP. Complications, hospitalisation duration, and hospital cost were recorded. Results The VAS scores for resting pain and swallowing pain were significantly lower in the ERAS group than those in the control group at 30 min and at 6, 12, 24 and 48 h after surgery. Patient comfort was improved in the ERAS group. The hospitalisation duration and cost were comparable between the groups. The incidence of complications showed an increasing trend in the ERAS group. Conclusion The ERAS protocol significantly relieved pharyngeal pain after UPPP and improved comfort in patients with OSA, which showed the prospect for an larger study. Meanwhile a potential increase of post-operative complications in the ERAS group should be noticed. Trial registration Chinese Clinical Trial Registry (23/09/2018, ChiCTR1800018537)

scholarly journals Anti-Heartburn Effects of Sugar Cane Flour: A Double-Blind, Randomized, Placebo-Controlled Study

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1813
Author(s):  
Jeffrey M. Beckett ◽  
Neeraj K. Singh ◽  
Jehan Phillips ◽  
Krishnakumar Kalpurath ◽  
Kent Taylor ◽  
...  
Keyword(s):  
Pilot Study ◽  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Intervention Group ◽  
Controlled Study ◽  
Control Group ◽  
Life Questionnaire ◽  
Positive Effects ◽  
Symptom Scores

Gastroesophageal reflux disease (GERD) affects approximately 20% of Australians. Patients suffer a burning sensation known as heartburn due to the movement of acidic stomach content into the esophagus. There is anecdotal evidence of the effectiveness of prebiotic sugarcane flour in controlling symptoms of GERD. This pilot study aimed to investigate the effectiveness of a prebiotic sugarcane flour in alleviating symptoms in medically-diagnosed GERD patients. This pilot study was a single center, double-blinded, placebo-controlled randomized trial conducted on 43 eligible participants. The intervention group (n = 22) were randomized to receive 3 g of sugarcane flour per day, and the control group (n = 21) received 3 g of cellulose placebo per day. Symptoms of gastroesophageal reflux disease were assessed before and after three weeks treatment using the validated Gastroesophageal Reflux Disease-Health Related Quality of Life questionnaire (GERD-HRQL). After three weeks there were significant differences in symptoms for heartburn, regurgitation, and total symptoms scores (p < 0.05) between the sugarcane flour and placebo. Mean GERD-HRQL scores increased in the placebo group for regurgitation (mean increase 1.7; 95% CI 0.23 to 3.2; p = 0.015) and total symptom scores (2.9; 95% CI 0.26 to 5.7; p = 0.033). In contrast, there were significant reductions in heartburn (mean decrease −2.2; 95% CI −4.2 to −0.14; p = 0.037) and total symptom scores (−3.7; 95% CI −7.2 to −0.11; p = 0.044) in the intervention group. This pilot study has shown significant positive effects of sugarcane flour in the reduction of GERD symptoms, and a larger randomized controlled trial is warranted.

scholarly journals Comprehensive Geriatric Assessment for Frail Older People in Swedish Acute Care Settings (CGA-Swed): A Randomised Controlled Study

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 5 ◽  
Author(s):  
Katarina Wilhelmson ◽  
Isabelle Andersson Hammar ◽  
Anna Ehrenberg ◽  
Johan Niklasson ◽  
Jeanette Eckerblad ◽  
...  
Keyword(s):  
Older People ◽  
Geriatric Assessment ◽  
Study Design ◽  
Comprehensive Geriatric Assessment ◽  
Controlled Study ◽  
Control Group ◽  
Frail Older People ◽  
Positive Effects ◽  
Health And Social Care ◽  
Randomised Controlled

The aim of the study is to evaluate the effects of the Comprehensive Geriatric Assessment (CGA) for frail older people in Swedish acute hospital settings – the CGA-Swed study. In this study protocol, we present the study design, the intervention and the outcome measures as well as the baseline characteristics of the study participants. The study is a randomised controlled trial with an intervention group receiving the CGA and a control group receiving medical assessment without the CGA. Follow-ups were conducted after 1, 6 and 12 months, with dependence in activities of daily living (ADL) as the primary outcome measure. The study group consisted of frail older people (75 years and older) in need of acute medical hospital care. The study design, randomisation and process evaluation carried out were intended to ensure the quality of the study. Baseline data show that the randomisation was successful and that the sample included frail older people with high dependence in ADL and with a high comorbidity. The CGA contributed to early recognition of frail older people’s needs and ensured a care plan and follow-up. This study is expected to show positive effects on frail older people’s dependence in ADL, life satisfaction and satisfaction with health and social care.

scholarly journals Enhanced Recovery After Surgery (ERAS) for Hysterectomy - A Systematic Review

2021 ◽  
Author(s):  
Sarah Louise O'Sullivan ◽  
Rhoda Iranloye
Keyword(s):  
Length Of Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Major Surgery ◽  
Pain Patient ◽  
Case Control Studies ◽  
Positive Effects ◽  
Same Day Discharge ◽  
Randomised Controlled ◽  
The Impact

Abstract Purpose: Enhanced Recovery After Surgery (ERAS) is an evidence-based recovery programme that aids in the recovery time following major surgery to improve clinical outcomes while reducing demand on impatient beds. Previous studies from multiple specialities have demonstrated positive effects of ERAS, including colorectal, liver and pancreatic surgery with ERAS pathways becoming part of normal practice. The aim of this study was to systematically review the impact of ERAS in hysterectomy for benign conditions. Methods: A comprehensive literature search was undertaken using CINAHL, EMBASE and PubMed using the search terms ‘Multi-modal’ or ‘fast track’ or ‘ERAS’ or ‘enhanced recovery’ or ‘same day discharge’ and ‘hysterectomy. In accordance with the PRISMA checklist, articles were selected for inclusion based on predetermined criteria, and a narrative synthesis was used to systematically review the selected articles. Results: Eight articles describing the use of ERAS protocols in hysterectomy for benign conditions were identified. Three were cohort studies, three randomised controlled trials (RCTs) and two case-control studies. While there were no significant differences in postoperative pain, patient satisfaction, postoperative complications, or readmissions between groups, length of stay and cost were both decreased in the ERAS groups. Conclusions: The use of ERAS protocols for hysterectomy resulted in reduced length of stay without increasing rates of complications or readmissions.

scholarly journals Neurosurgical enhanced recovery after surgery (ERAS) programme for elective craniotomies: are patients satisfied with their experiences? A quantitative and qualitative analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e028706 ◽  
Author(s):  
Bolin Liu ◽  
Shujuan Liu ◽  
Yuan Wang ◽  
Binfang Zhao ◽  
Tianzhi Zhao ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Patient Experience ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Shared Responsibility ◽  
Controlled Study ◽  
Control Group ◽  
Vas Score ◽  
Neurosurgical Patients

ObjectiveTo evaluate patient satisfaction and associated predictors at discharge, as well as patient experience at 30-day follow-up, in a neurosurgical enhanced recovery after surgery (ERAS) programme.DesignA single-centre, prospective, randomised controlled study.SettingA tertiary hospital in China.ParticipantsA total of 140 neurosurgical patients aged 18–65 years old who had a single intracranial lesion and were admitted for elective craniotomy between October 2016 and July 2017 were included.InterventionsPatients were randomised into two groups: 70 patients received care according to a novel neurosurgical ERAS protocol (ERAS group) and 70 patients received conventional perioperative care (control group).Outcome measuresPatient satisfaction at discharge was evaluated using a multimodal questionnaire. A secondary analysis of patient experience regarding participation in the ERAS programme was conducted using a semistructured qualitative interview via telephone at 30-day follow-up.ResultsThe mean patient satisfaction was significantly higher in the ERAS group than in the control group at discharge (92.2±4.3 vs 86.8±7.4, p=0.0001). The most important predictors of patient satisfaction included age (OR=6.934), postoperative nausea and vomiting (PONV) Visual Analogue Scale (VAS) score (OR=0.184), absorbable skin suture (OR=0.007) and postoperative length of stay (LOS) (OR=0.765). Analysis on patient experience revealed five themes: information transfer, professional support, shared responsibility and active participation, readiness for discharge, and follow-up, all of which are closely related and represent positive and negative aspects.ConclusionsMeasures that include decreasing PONV VAS score, incorporating absorbable skin suture and shortening LOS seem to increase patient satisfaction in a neurosurgical ERAS programme. Analysis of data on patient experience highlights several aspects to achieve patient-centred and high-quality care. Further studies are warranted to standardise the assessment of patient satisfaction and experience in planning, employing and appraising the ERAS programme.Trial registration numberChiCTR-INR-16009662.

scholarly journals Multidisciplinary Cooperation Alleviates Postoperative Pain after Elective Craniotomies: A Prospective Randomized Controlled Study of Neurosurgical Enhanced Recovery After Surgery (ERAS) program

2020 ◽  
Author(s):  
Liang Qu ◽  
Yuan Wang ◽  
Bolin Liu ◽  
Haitao Zhang ◽  
Zhengmin Li ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Score ◽  
Rating Scale ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Conventional Care ◽  
Controlled Study ◽  
Control Group ◽  
Postoperative Pain Score ◽  
Eras Protocol

Abstract Objective: To prospectively evaluate the efficacy of neurosurgical enhanced recovery after surgery (ERAS) protocol on the management of postoperative pain after elective craniotomies. Methods: This randomised controlled trial was conducted in the neurosurgical center of Tangdu Hospital (Fourth Military Medical University, Xi’an, China). A total of 129 patients undergoing craniotomies between October 2016 and July 2017 were enrolled in a randomized clinical trial comparing ERAS protocol and conventional care. The primary outcome was the postoperative pain score assessed by a verbal numerical rating scale (NRS). Results: Patients in the ERAS group had a significant reduction in postoperative pain score on POD 1 compared to patients in the control group (mean NRS 3.12 vs. 4.44, OR 0.0968, 95% CI 0.3299 to 2.317, p = 0.010). More patients (n = 44, 68.8%) in the ERAS group experienced mild pain (NRS: 1 to 3) on POD1 compared with patients (n = 23, 35.4%) in the control group (p < 0.05). A significant reduction in pain score was observed on POD 2 and POD 3 in the ERAS group compared with that in the control group (POD2: mean NRS 2.85 vs. 4.32, OR 0.2628, 95% CI 0.5619 to 2.379, p=0.002. POD3: mean NRS 2.32 vs. 4.03, OR 0.1468, 95% CI 0.9537 to 2.458, p < 0.001, respectively). In addition, the median postoperative length of hospital stay was significantly decreased with the incorporation of ERAS protocol compared to the controls (ERAS: 4 days, control: 7 days, P<0.001). Conclusion: Implementation of the neurosurgical ERAS protocol for elective craniotomy patients have significant benefits in alleviating postoperative pain and enhancing recovery after surgery compared to the conventional care. Further evaluation of this protocol in larger, multi-center studies is warranted.

scholarly journals Enhanced recovery after surgery in pediatric gastrointestinal surgery

2019 ◽  
Vol 47 (10) ◽  
pp. 4815-4826 ◽  
Author(s):  
Ruyue Gao ◽  
Heying Yang ◽  
Yanan Li ◽  
Lingbing Meng ◽  
Yaping Li ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Enhanced Recovery ◽  
Enhanced Recovery After Surgery ◽  
Hospital Costs ◽  
Gastrointestinal Surgery ◽  
Postoperative Hospital Stay ◽  
Patient Comfort ◽  
Control Group ◽  
Time Duration ◽  
Surgical Data

Objective Enhanced recovery after surgery (ERAS) protocols help optimize inpatient care and minimize discomfort. This study was performed to explore the safety, feasibility, and clinical and social value of ERAS in pediatric gastrointestinal surgery. Methods This study included all children (n = 125) who underwent appendectomy, pyloromyotomy, transabdominal Soave’s procedure, Meckel’s diverticulum resection, or reduction of intussusception in our institution from January to September 2018. We compared surgical outcomes between children who underwent surgery under conventional perioperative regimens (control group, n = 57) and those who were treated with ERAS protocols (ERAS group, n = 68). Results There were no significant intergroup differences in demographic or surgical data. However, the bowel function recovery time, postoperative intravenous nutrition time, duration of postoperative hospital stay, and hospital costs were significantly lower in the ERAS group than control group. There was no significant intergroup difference in the complication rate. Conclusions Our results indicate that implementation of ERAS protocols is safe and feasible in pediatric gastrointestinal surgery. They can improve patient comfort, shorten the duration of the postoperative hospital stay, reduce hospital costs, and accelerate postoperative rehabilitation without increasing the risk of postoperative complications. Therefore, ERAS protocols deserve wider implementation and promotion.

Effect of adjunctive sodium hyaluronate versus surfactant nasal irrigation on mucociliary clearance in allergic rhinitis: a single-blind, randomised, controlled study

2021 ◽  
pp. 1-4
Author(s):  
E Ocak ◽  
S Mulazimoglu ◽  
D Kocaoz ◽  
E Mirici ◽  
E Dagli ◽  
...  
Keyword(s):  
Allergic Rhinitis ◽  
Mucociliary Clearance ◽  
Isotonic Saline ◽  
Sodium Hyaluronate ◽  
Controlled Study ◽  
Control Group ◽  
Clearance Time ◽  
Nasal Irrigation ◽  
Persistent Allergic Rhinitis ◽  
Randomised Controlled

Abstract Objective To investigate the effects of nasal irrigation with sodium hyaluronate and surfactant solutions on mucociliary clearance time in patients with mild persistent allergic rhinitis. Methods A total of 120 patients diagnosed with mild persistent allergic rhinitis were enrolled in this prospective study. The patients were allocated randomly to the surfactant, sodium hyaluronate or isotonic saline (as a control) nasal irrigation group. The mucociliary clearance times and improvements in mucociliary clearance times were compared. Results Improvements in mean mucociliary clearance time were significantly greater in the surfactant and sodium hyaluronate groups than in the control group (p < 0.01). The mean post-treatment mucociliary clearance time of the surfactant group was significantly lower than that of the control (p < 0.001) and sodium hyaluronate groups (p = 0.03). Conclusion Surfactant and sodium hyaluronate nasal irrigation solutions may both be used as adjunctive treatments for allergic rhinitis. Surfactant nasal irrigation resulted in better mucociliary clearance times.

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