RESUMEN
This systematic review and meta-analysis aimed to assess the effects of pre and intraoperative lidocaine infusion on short-term recovery quality after laparoscopic bariatric surgeries. In the search across MEDLINE, Embase, and Cochrane databases, we considered randomized controlled trials comparing intravenous lidocaine vs placebo (saline) for patients with obesity undergoing laparoscopic bariatric surgery. Seven studies (640 patients) were included. The lidocaine group had a significantly higher recovery quality score, a lower morphine consumption, and a notably reduced rate of nausea and vomiting compared with the placebo group. Additionally, Lidocaine infusion was associated with a shorter hospital stay, while no significant difference was observed in the time to bowel function recovery between both groups. In conclusion, lidocaine infusion before and during laparoscopic bariatric surgery contributes to an enhanced quality of recovery.
Asunto(s)
Anestésicos Locales , Cirugía Bariátrica , Laparoscopía , Tiempo de Internación , Lidocaína , Ensayos Clínicos Controlados Aleatorios como Asunto , Humanos , Anestésicos Locales/administración & dosificación , Anestésicos Locales/uso terapéutico , Infusiones Intravenosas , Tiempo de Internación/estadística & datos numéricos , Lidocaína/administración & dosificación , Lidocaína/uso terapéutico , Obesidad Mórbida/cirugía , Dolor Postoperatorio/tratamiento farmacológico , Náusea y Vómito Posoperatorios/prevención & control , Recuperación de la Función/efectos de los fármacos , Resultado del TratamientoRESUMEN
Fasciolosis is a disease of extreme importance, occurring throughout Brazil, with great economic losses to the animal industry. This study aims to determine the effectiveness of treatment against Fasciola hepatica on a sheep and goat farm during an outbreak of fasciolosis, in which a high proportion of deaths occurred. The farm harbored 33 sheep and 60 goats of mixed breeds with varying weights and ages. Parasite control was based on suppressive, monthly treatments with moxidectin. Over the course of the study, assessments with Famacha method, body condition score, faecal exam (EPG), coproculture and the egg sedimentation technique were made on seven occasions. At the time of the first visit 81% of the goats and 100% of the sheep were positive for F. hepatica. Salvage treatment with triclabendazole failed to relieve the heavy infection due to resistance, with an efficacy of only 66.3% being obtained against the F. hepatica population consensual in sheep and 57.3% in goats. There was no record of triclabendazole having been administered previously on the farm. A low level of correlation was found between the Famacha values and the incidence of anemia due to clinical fasciolosis (C<0.5). There is an urgent need to investigate the correct use of available drugs against F. hepatica and the implementation of alternative control strategies in endemic areas in order to ensure optimum sustainability of the efficacy of available fasciolicides.