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排序方式: 共有1698条查询结果,搜索用时 296 毫秒
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Lesley A. Mathews Griner Rajarshi Guha Paul Shinn Ryan M. Young Jonathan M. Keller Dongbo Liu Ian S. Goldlust Adam Yasgar Crystal McKnight Matthew B. Boxer Damien Y. Duveau Jian-Kang Jiang Sam Michael Tim Mierzwa Wenwei Huang Martin J. Walsh Bryan T. Mott Paresma Patel William Leister David J. Maloney Christopher A. Leclair Ganesha Rai Ajit Jadhav Brian D. Peyser Christopher P. Austin Scott E. Martin Anton Simeonov Marc Ferrer Louis M. Staudt Craig J. Thomas 《Proceedings of the National Academy of Sciences of the United States of America》2014,111(6):2349-2354
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Surgical repair of Ebstein's anomaly. 总被引:6,自引:0,他引:6
Ebstein's anomaly is a complex malformation that has been treated by various surgical techniques, with variable results. We have developed a repair-by plication of the free wall of the atrialized portion of the right ventricle, posterior tricuspid annuloplasty, and right atrial reduction--that has been used since 1972 in 16 patients. The repair is based on the construction of a monocusp valve by the use of the anterior leaflet of the tricuspid valve, which is usually enlarged in this anomaly. There were 14 operative survivors and no instances of complete heart block. Two patients with refractory dysrhythmias due to the Wolff-Parkinson-White syndrome underwent successful intraoperative epicardial and endocardial mapping and surgical division of accessory pathways. This repair has resulted in improvement in the operative mortality and in gratifying early and late results in most patients. 相似文献
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Caroline Maloney Michelle Kallis Ibrahim Abd El-Shafy Aaron M. Lipskar John Hagen Michelle Kars 《Journal of pediatric surgery》2018,53(3):431-436
Introduction
Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge.Methods
We retrospectively reviewed 275 children, ages 4 to 17 years old, who underwent TULA for uncomplicated appendicitis in a single institution from August 2014 to July 2015. We compared those that received preincision bilateral RSB (n = 136) with those who received LAI (n = 139). The primary outcome was narcotic administration. Secondary outcomes included initial and mean scores, time from anesthesia induction to release, operative time, time to rescue dose of analgesic in the PACU and time to PACU discharge.Results
Total narcotic administration was significantly reduced in patients that underwent preincision RSB compared to those that received conventional LAI, with a mean of 0.112 mg/kg of morphine versus 0.290 mg/kg morphine (p < 0.0001). Patients undergoing RSB reported lower initial (0.38 vs. 2.38; p < 0.0001) and mean pain scores (1.26 vs. 1.77; p < 0.015). Time to rescue analgesia was prolonged in patients undergoing RSB compared to LAI (58.93 min vs. 41.56 min; p = 0.047).Conclusion
Preincision RSB for TULA in uncomplicated appendicitis in children is associated with decreased opioid consumption and lower pain scores compared with LAI. As the addition of this procedure only added 6.67 min to time under anesthesia, we feel that it is a viable option for postoperative pain control in pediatric single-incision laparoscopic surgery.Retrospective comparative study
LEVEL III EVIDENCE. 相似文献7.
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Han S Martin GS Maloney JP Shanholtz C Barnes KC Murray S Sevransky JE 《Critical care (London, England)》2011,15(6):R262-8