Comparative evaluation of intraoperative use of normal saline, Ringer's lactate, and combination of normal saline and Ringer's lactate in neurosurgical patients – A preliminary randomized clinical trial

2019 ◽  
Vol 67 (2) ◽  
pp. 452
Author(s):  
Hemant Bhagat ◽  
Vasudha Singhal ◽  
HariH Dash ◽  
Shalvi Mahajan ◽  
Nitasha Mishra ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Normal Saline ◽  
Comparative Evaluation ◽  
Neurosurgical Patients ◽  
Ringer’S Lactate

scholarly journals Intraoperative protective ventilation in patients undergoing major neurosurgical interventions: a randomized clinical trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Federico Longhini ◽  
Laura Pasin ◽  
Claudia Montagnini ◽  
Petra Konrad ◽  
Andrea Bruni ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Clinical Outcome ◽  
Adverse Events ◽  
Respiratory Rate ◽  
Randomized Clinical Trial ◽  
Protective Ventilation ◽  
Adult Patients ◽  
Control Group ◽  
Neurosurgical Procedures ◽  
Neurosurgical Patients

Abstract Background Post-operative pulmonary complications (PPC) can develop in up to 13% of patients undergoing neurosurgical procedures and may adversely affect clinical outcome. The use of intraoperative lung protective ventilation (LPV) strategies, usually including the use of a low Vt, low PEEP and low plateau pressure, seem to reduce the risk of PPC and are strongly recommended in almost all surgical procedures. Nonetheless, feasibility of LPV strategies in neurosurgical patients are still debated because the use of low Vt during LPV might result in hypercapnia with detrimental effects on cerebrovascular physiology. Aim of our study was to determine whether LPV strategies would be feasible compared with a control group in adult patients undergoing cranial or spinal surgery. Methods This single-centre, pilot randomized clinical trial was conducted at the University Hospital “Maggiore della Carità” (Novara, Italy). Adult patients undergoing major cerebral or spinal neurosurgical interventions with risk index for pulmonary post-operative complications > 2 and not expected to need post-operative intensive care unit (ICU) admission were considered eligible. Patients were randomly assigned to either LPV (Vt = 6 ml/kg of ideal body weight (IBW), respiratory rate initially set at 16 breaths/min, PEEP at 5 cmH2O and application of a recruitment manoeuvre (RM) immediately after intubation and at every disconnection from the ventilator) or control treatment (Vt = 10 ml/kg of IBW, respiratory rate initially set at 6–8 breaths/min, no PEEP and no RM). Primary outcomes of the study were intraoperative adverse events, the level of cerebral tension at dura opening and the intraoperative control of PaCO2. Secondary outcomes were the rate of pulmonary and extrapulmonary complications, the number of unplanned ICU admissions, ICU and hospital lengths of stay and mortality. Results A total of 60 patients, 30 for each group, were randomized. During brain surgery, the number of episodes of intraoperative hypercapnia and grade of cerebral tension were similar between patients randomized to receive control or LPV strategies. No difference in the rate of intraoperative adverse events was found between groups. The rate of postoperative pulmonary and extrapulmonary complications and major clinical outcomes were similar between groups. Conclusions LPV strategies in patients undergoing major neurosurgical intervention are feasible. Larger clinical trials are needed to assess their role in postoperative clinical outcome improvements. Trial registration registered on the Australian New Zealand Clinical Trial Registry (www.anzctr.org.au), registration number ACTRN12615000707561.

scholarly journals The Analgesic Effects of Bupivacaine and Magnesium Sulfate Combination, Bupivacaine, and Adrenaline Combination and Bupivacaine Alone on Post-cesarean Section Pain: A Randomized Clinical Trial

2018 ◽  
Vol 9 (4) ◽  
pp. 284-290
Author(s):  
Zinatossadat Bouzari ◽  
Seyedeh Rabeeh Rouhani ◽  
Ebrahim Alijanpour ◽  
Shahla Yazdani ◽  
Bahman Hasannasab ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Magnesium Sulfate ◽  
Randomized Clinical Trial ◽  
Normal Saline ◽  
Repeated Measures ◽  
The Other ◽  
Hemodynamic Parameters ◽  
Analgesic Effects ◽  
Single Blind

Objectives: The present study was performed to compare the analgesic effects of bupivacaine and magnesium sulfate combination on post-cesarean (C) section pain. Materials and Methods: The present single-blind randomized clinical trial was conducted on 160 C-section candidates. The participants were randomly divided into four groups. When the fascia healed, the first group received 20 mL of 0.25% bupivacaine and the second group received 20 mL of 0.25% bupivacaine combined with subcutaneous adrenaline. In addition, both groups received 50 mL of intravenous normal saline. Further, the third group received subcutaneous bupivacaine and 50 mg/kg of magnesium sulfate and the fourth group received subcutaneous and intravenous normal saline as a placebo. The pain intensity was assessed 2, 6, 12, 18, and 24 hours after spinal anesthesia using the visual analogue scale (VAS) for pain. The dose of pethidine (as a standard analgesic) and hemodynamic parameters (i.e., heart rate [HR] and blood pressure [BP]) was recorded as well. The obtained data were then analyzed utilizing ANOVA, Tukey’s HSD, and repeated measures ANOVA tests. Results: The intensity of pain and the dose of pethidine decreased significantly in the combination of bupivacaine with magnesium compared to the other groups at all times (P < 0.001). However, diastolic BP significantly increased in the bupivacaine + adrenaline group in comparison with the other groups (P = 0.02). Conclusions: Overall, bupivacaine combination with magnesium sulfate is suitable for controlling post-cesarean section pain.

scholarly journals EVALUATION OF KITE AND PONSETI METHODS IN THE TREATMENT OF IDIOPATHIC CONGENITAL CLUBFOOT

2018 ◽  
Vol 26 (6) ◽  
pp. 366-369
Author(s):  
Lucas Cortizo Garcia ◽  
Lucas Rocha de Jesus ◽  
Mateus de Oliveira Trindade ◽  
Fernando Cal Garcia Filho ◽  
Magda Leão Pinheiro ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Conservative Treatment ◽  
Randomized Clinical Trial ◽  
Musculoskeletal System ◽  
Comparative Evaluation ◽  
Ponseti Method ◽  
Congenital Clubfoot ◽  
Level Of Evidence ◽  
Congenital Deformities

ABSTRACT Objective: Clubfoot is one of the most common congenital deformities affecting the musculoskeletal system. The main conservative treatment for clubfoot includes the Ponseti's and Kite's methods. This study aimed to perform a comparative evaluation of the effectiveness of the Ponseti and Kite approaches for the conservative treatment of clubfoot. Methods: One hundred children with clubfoot abnormality, visiting the Martagão Gesteira Hospital, were divided in two groups. The first group received conservative treatment using the Kite method and the second group received conservative treatment using the Ponseti method. At the end of the treatment, both groups were evaluated based on the Pirani classification to verify whether there had been an adequate correction of the deformity. The variables studied included correction of deformity, age, sex, and laterality. Results: The effectiveness of the Kite and Ponseti methods of conservative treatment showed significant statistical differences. Conclusion: The present study shows that the efficacy of conservative treatment using the Ponseti method was 18% higher than that of the Kite method. Level of evidence II, randomized clinical trial.

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