Quadratus Lumborum Block As A Single Anesthetic Method For Laparoscopic Totally Extraperitoneal (Tep) Inguinal Hernia Repair: A Randomized Clinical Trial

Fávaro, Murillo de Lima; Gabor, Silvio; Souza, Diogo Barros Florenzano; Araújo, Anderson Alcoforado; Milani, Ana Luiza Castro; Ribeiro, Marcelo Augusto Fontenelle

doi:10.1038/s41598-020-65604-x

Cited by 6 publications

(1 citation statement)

References 41 publications

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“…Alternative anesthetic techniques such as local or neuraxial anesthesia (NA) are now increasingly used to mitigate the adverse effects of GA and improve the patient's postoperative recovery. There is substantial literature evidence showing the feasibility of NA (spinal or epidural) in laparoscopic cholecystectomy and inguinal hernia repair [4–8]. A few studies suggest that laparoscopic appendectomy is not only safe to perform under NA but might even be associated with favorable postoperative outcomes including superior postoperative pain control and a lower risk of complications [9–11].…”

Section: Introductionmentioning

confidence: 99%

General Versus Neuraxial Anesthesia for Appendectomy: A Multicenter International Study

et al. 2021

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Background In resource-limited countries, open appendectomy is still performed under general anesthesia (GA) or neuraxial anesthesia (NA). We sought to compare the postoperative outcomes of appendectomy under NA versus GA. Methods We conducted a post hoc analysis of the International Patterns of Opioid Prescribing (iPOP) multicenter study. All patients C 16 years-old who underwent an open appendectomy between October 2016 and March 2017 in one of the 14 participating hospitals were included. Patients were stratified into two groups: NA-defined as spinal or epidural-and GA. All-cause morbidity, hospital length of stay (LOS), and pain severity were assessed using univariate analysis followed by multivariable logistic regression adjusting for the following preoperative characteristics: age, gender, body mass index (BMI), smoking, history of opioid use, emergency status, and country. Results A total of 655 patients were included, 353 of which were in the NA group and 302 in the GA group. The countries operating under NA were Colombia (39%), Thailand (31%), China (23%), and Brazil (7%). Overall, NA patients were younger (mean age (SD): 34.5 (14.4) vs. 40.7 (17.9), p-value \ 0.001) and had a lower BMI (mean (SD): 23.5 (3.8) vs. 24.3 (5.2), p-value = 0.040) than GA patients. On multivariable analysis, NA was independently associated with less postoperative complications (OR, 95% CI: 0.30 [0.10-0.94]) and shorter hospital LOS (LOS [ 3 days, OR, 95% CI: 0.47 [0.32-0.68]) compared to GA. There was no difference in postoperative pain severity between the two techniques. Conclusions Open appendectomy performed under NA is associated with improved outcomes compared to that performed under GA. Further randomized controlled studies should examine the safety and value of NA in lower abdominal surgery.

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Section: Introductionmentioning

confidence: 99%

General Versus Neuraxial Anesthesia for Appendectomy: A Multicenter International Study

et al. 2021

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Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

et al. 2022

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Background Access to timely and quality surgical care is limited in low- and middle-income countries (LMICs). Telemedicine, defined as the remote provision of health care using information, communication and telecommunication platforms have the potential to address some of the barriers to surgical care. However, synthesis of evidence on telemedicine use in surgical care in LMICs is lacking. Aim To describe the current state of evidence on the use and distribution of telemedicine for surgical care in LMICs. Methods This was a scoping review of published and relevant grey literature on telemedicine use for surgical care in LMICs, following the PRISMA extension for scoping reviews guideline. PubMed-Medline, Web of Science, Scopus and African Journals Online databases were searched using a comprehensive search strategy from 1 January 2010 to 28 February 2021. Results A total of 178 articles from 53 (38.7%) LMICs across 11 surgical specialties were included. The number of published articles increased from 2 in 2010 to 44 in 2020. The highest number of studies was from the World Health Organization Western Pacific region ( n = 73; 41.0%) and of these, most were from China ( n = 69; 94.5%). The most common telemedicine platforms used were telephone call ( n = 71, 39.9%), video chat ( n = 42, 23.6%) and WhatsApp/WeChat ( n = 31, 17.4%). Telemedicine was mostly used for post-operative follow-up ( n = 71, 39.9%), patient education ( n = 32, 18.0%), provider training ( n = 28, 15.7%) and provider-provider consultation ( n = 16, 9.0%). Less than a third ( n = 51, 29.1%) of the studies used a randomised controlled trial design, and only 23 (12.9%) reported effects on clinical outcomes. Conclusion Telemedicine use for surgical care is emerging in LMICs, especially for post-operative visits. Basic platforms such as telephone calls and 2-way texting were successfully used for post-operative follow-up and education. In addition, file sharing and video chatting options were added when a physical assessment was required. Telephone calls and 2-way texting platforms should be leveraged to reduce loss to follow-up of surgical patients in LMICs and their use for pre-operative visits should be further explored. Despite these telemedicine potentials, there remains an uneven adoption across several LMICs. Also, up to two-thirds of the studies were of low-to-moderate quality with only a few focusing on clinical effectiveness. There is a need to further adopt, develop, and validate telemedicine use for surgical care in LMICs, particularly its impact on clinical outcomes. Supplementary Information The online version co...

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Evaluation of analgesic effects and safety of quadratus lumborum block in patients undergoing laparoscopic surgery: a meta-analysis of randomized controlled trials

Zhang

et al. 2022

Minerva Anestesiol

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Quadratus Lumborum Block As A Single Anesthetic Method For Laparoscopic Totally Extraperitoneal (Tep) Inguinal Hernia Repair: A Randomized Clinical Trial

Cited by 6 publications

References 41 publications

General Versus Neuraxial Anesthesia for Appendectomy: A Multicenter International Study

General Versus Neuraxial Anesthesia for Appendectomy: A Multicenter International Study

Telemedicine in Surgical Care in Low‐ and Middle‐Income Countries: A Scoping Review

Evaluation of analgesic effects and safety of quadratus lumborum block in patients undergoing laparoscopic surgery: a meta-analysis of randomized controlled trials

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