scholarly journals Effect of fast-track surgery in gynecological laparoscopy: a randomized controlled trial

2020 ◽  
Vol 7 (3) ◽  
pp. 235-238
Author(s):  
Xue-Ping Zhu ◽  
Sha-Sha Zhao ◽  
Jie-Dan Qin

AbstractObjectiveTo evaluate the value of fast-track surgery (FTS) in gynecological laparoscopy during the perioperative period.MethodsThe clinical data of 234 patients who underwent gynecological laparoscopy from January to December in 2018 were collected. Of note, 117 patients received a routine nursing method (control group), and 117 patients received the FTS nursing method (observation group).ResultsCompared with the control group, FTS group had a quicker postoperative bowel function recovery, earlier to get out of bed, and a lower anxiety level (P < 0.05); The incidence of postoperative nausea and vomiting of two groups had no statistical difference.ConclusionsThe application of FTS in gynecological laparoscopy is safe, effective, and worth promoting.

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Jae Yen Song ◽  
Hoon Choi ◽  
Minsuk Chae ◽  
Jemin Ko ◽  
Young Eun Moon

Abstract Background Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods The participants (n = 78) will be allocated to one of the two groups; the study group will receive bolus and infusion of dexmedetomidine and lidocaine, and the control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in the two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, and opioid-related side effects will be assessed. Additionally, an ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during the study period. Discussion This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA. Trial registration ClinicalTrials.gov NCT04409964. Registered on 28 May 2020


2019 ◽  
Vol 47 ◽  
pp. 102222 ◽  
Author(s):  
Jenwit Phutsisen ◽  
Chumnan Kietpeerakool ◽  
Nampet Jampathong ◽  
Bundit Chumworathayi ◽  
Amornrat Temtanakitpaisan ◽  
...  

2017 ◽  
Vol 102 (3-4) ◽  
pp. 151-156 ◽  
Author(s):  
Jiayan Wu ◽  
Hongcun Sha ◽  
Xiaoting Ren ◽  
Xiaoming Hong

The objective of this study is to evaluate the safety and efficacy of fast track surgery (FTS) management in gastric cancer (GC) with laparoscopy D2 gastrectomy. FTS is the integration of different medical intervention activities during the perioperative period to accelerate the recovery of patients undergoing surgery. It has been used for colorectal cancer. The present study focuses on evaluating FTS in GC with laparoscopy D2 gastrectomy. Seventy-five patients diagnosed with GC between June 2014 and December 2016 were enrolled in this study and were divided into FTS and conventional care groups. All patients received elective standard D2 gastrectomy. The clinical parameters and serum indicators were compared. FTS was associated with shorter postoperative hospital stay (17.17 ± 9.27 versus 14.06 ± 5.05 days; P = 0.046), shorter time to bowel function return (4.56 ± 1.16 versus 3.12 ± 0.88 days; P &lt; 0.01), less stress response on postoperative day 1 (108.13 ± 40.55 versus 79.01 ± 37.10; P &lt; 0.01), and accelerated decrease in serum albumin (30.76 ± 4.10 versus 32.56 ± 3.20 g/L; P = 0.04) and lymphocyte count (0.78 ± 0.34 versus 0.78 ± 0.34 g/L; P = 0.016). The postoperative complications, including ileus, anastomotic leakage, and infection, were similar (all P &gt; 0.05). FTS combined with laparoscopy D2 gastrectomy can promote faster postoperative recovery, improve early postoperative nutritional status, and more effectively reduce postoperative stress reaction and is safe and effective for GC patients.


2019 ◽  
Vol 29 (4) ◽  
pp. 555-560 ◽  
Author(s):  
Shuangjiang Li ◽  
Wenbiao Zhang ◽  
Shan Cheng ◽  
Yongjiang Li

Summary A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was whether pregabalin could effectively and safely reduce postoperative pain in patients undergoing pulmonary resections. Altogether 23 papers were found using the reported search, of which 6 randomized controlled trials represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Five of 6 randomized controlled trials demonstrated that the application of oral pregabalin during the perioperative period could effectively reduce postoperative pain after pulmonary resections without compromising patients’ safety. One randomized controlled trial reported no difference in the postoperative pain levels between the pregabalin group and the control group. The rates of adverse effects were generally found to be decreased in patients who received pregabalin compared to the patients who received routine analgesia, although 2 studies reported significantly higher incidences of mild drowsiness and dizziness among the pregabalin-treated patients. Currently available evidence supports that the perioperative administration of pregabalin can effectively and safely relieve postoperative pain for patients undergoing pulmonary resections.


2020 ◽  
Author(s):  
Jae Yen Song ◽  
Hoon Choi ◽  
Minsuk Chae ◽  
Jemin Ko ◽  
Youg Eun Moon

Abstract Background: Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods: The patients (n=78) will be allocated to one of the two groups; Study group will receive bolus and infusion of dexmedetomidine and lidocaine and Control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, opioid-related side effects will be assessed. Additionally, ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during study period. Discussion: This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA.


2021 ◽  
Author(s):  
Jae Yen Song ◽  
Hoon Choi ◽  
Minsuk Chae ◽  
Jemin Ko ◽  
Youg Eun Moon

Abstract Background: Because of the indiscriminate use of opioids during the perioperative period, opioid-free anesthesia (OFA) has been increasingly required. Nevertheless, the studies on the detailed techniques and effects of OFA are not sufficient. The Quality of Recovery-40 (QoR-40) questionnaire is a validated assessment tool for measuring recovery from general anesthesia. However, no study has used the QoR-40 to determine if OFA leads to better recovery than standard general anesthesia. Therefore, we aim to perform this study to determine the effects of OFA using dexmedetomidine and lidocaine on the quality of recovery as well as the various postoperative outcomes. Methods: The participants (n=78) will be allocated to one of the two groups; Study group will receive bolus and infusion of dexmedetomidine and lidocaine and Control group will receive remifentanil infusion during general anesthesia for gynecological laparoscopy. The other processes including anesthetic and postoperative care will be performed similarly in two groups. Intraoperative hemodynamic, anesthetic, and nociceptive variables will be recorded. Postoperative outcomes such as QoR-40, pain severity, opioid-related side effects will be assessed. Additionally, ancillary cytokine study (inflammatory cytokine, stress hormone, and reactive oxygen species) will be performed during study period. Discussion: This will be the first study to determine the effect of OFA, using the combination of dexmedetomidine and lidocaine, on the quality of recovery after gynecological laparoscopy compared with standard general anesthesia using remifentanil. The findings from this study will provide scientific and clinical evidence on the efficacy of OFA.Trial registration: ClinicalTrials.gov: NCT04409964. Registered on 28 May 2020.


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