Introduction
Optimal pain control after major surgery contributes to a patient’s recovery and satisfaction. The use of liposomal bupivacaine in subcostal transversus abdominis plane (TAP) blocks for postoperative pain control after robot assisted abdominal surgery has yet to be studied.
Methods
We conducted a prospective randomized controlled observer-blinded study comparing bilateral subcostal TAP blocks with bupivacaine to bilateral subcostal TAP blocks with liposomal bupivacaine. These were performed prior to the patient undergoing robot assisted hysterectomy. The patients’ pain scores, opioid use, side effects, and satisfaction were followed for 72 h after injection.
Results
Total opioid use in the first 72 h after injection was significantly decreased in the group that received liposomal bupivacaine compared to bupivacaine. Patients in the liposomal bupivacaine group had significantly lower maximal pain scores at all time periods studied as well as decreased incidence of nausea/vomiting. There was a trend toward decreased length of stay in the liposomal bupivacaine group.
Conclusion
Subcostal TAP blocks with liposomal bupivacaine decreased the total opioid requirement for the first 72 h after robot assisted hysterectomy when compared to subcostal TAP blocks with bupivacaine.
A video tape was developed to present each of 40 high school age clients. For the first 20 clients two separate sections of the video tape were developed. In one section the clients appeared alone. In the second section an experienced counselor appeared with each client. This counselor made an appropriate counselor tacting response lead (CTRL) to each client. Using this tape, several procedures were compared to test their effectiveness in facilitating the acquisition of CTRL for Ss (trainees in counseling). These procedures included: presentation of a model, systematic reinforcement, and a combination of both. Transfer effects were also assessed. The most important finding was that modeling procedures were demonstrated to have the greatest effect on Ss' use of CTRL to clients on video tape. 'This article was accepted for publication by the previous editor, Francis P. Robinson.This article is based on the senior author's doctoral dissertation completed at the University of Illinois. In addition to the co-author, the committee included: Merle M. Ohlsen (chairman), J.
Background: Incomplete data are presented to determine the role of vitamin A supplement therapy to improve outcomes in patients with coronavirus disease 2019 (COVID-19). Aims: We compared treatment effects between a groups that received vitamin A added to the standard COVID-19 treatment and a group that received the standard drug treatment alone. Methods: In this triple-blind controlled trial, the participants comprised 182 COVID-19 outpatients in Saveh city, Markazi Province, Islamic Republic of Iran, in 2020. Patients were randomly divided into experimental (n = 91) and control (n = 91) groups. Patients in the control group received the national standard treatment for COVID-19 (hydroxychloroquine), and those in the intervention group received 25 000 IU/d oral vitamin A for 10 days in addition to the standard treatment recommended by the national protocol. We evaluated the clinical symptoms, paraclinical criteria and hospitalization status before and 10 days after both interventions. Results: The treatment groups did not differ significantly in terms of clinical and paraclinical symptoms before the intervention, but clinical symptoms such as fever, body ache, weakness and fatigue, paraclinical symptoms, white blood cell count and C-reactive protein showed a significantly greater decrease in the experimental group 10 days post-intervention compared with the standard treatment alone (P < 0.05). Conclusion: Vitamin A supplement demonstrated efficacy in improving some clinical and paraclinical symptoms in patients with COVID-19. Future studies should evaluate vitamin A supplementation with a larger sample size and compare different dosages, especially in hospitalized patients.
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