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Orthopedic anesthesia

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https://www.readbyqxmd.com/read/29315129/relative-contributions-of-adductor-canal-block-and-intrathecal-morphine-to-analgesia-and-functional-recovery-after-total-knee-arthroplasty-a-randomized-controlled-trial
#1
Abhijit Biswas, Anahi Perlas, Meela Ghosh, KiJinn Chin, Ahtsham Niazi, Barjind Pandher, Vincent Chan
BACKGROUND AND OBJECTIVES: Effective postoperative analgesia may enhance early rehabilitation after orthopedic surgery. This randomized double-blind trial investigates the relative contributions of adductor canal block and low-dose intrathecal morphine (ITM) to postoperative analgesia and functional recovery after total knee arthroplasty. METHODS: Two-hundred one patients undergoing elective unilateral total knee arthroplasty under spinal anesthesia were randomized to 3 groups...
January 9, 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29313504/anesthetic-activities-provided-by-the-french-forward-surgical-team-in-abidjan-ivory-coast-four-year-retrospective-analysis
#2
B Prunet, S Schmitt, J Le Gouellec, J Schmitt, J Cotte, C Nguyen, P Esnault, E Meaudre
The aims of this study were to review and quantify the types of anesthetic procedures performed by anesthesiologists assigned to the forward surgical team (FST) deployed in Abidjan, Ivory Coast. The study includes all patients undergoing surgery by the FST from July 2012 through July 2016. The activity was retrospectively analyzed and divided according to demographics, surgical specialties, emergency versus elective surgery, types of anesthetic and post-operative analgesic procedures, and transfusion aspects...
November 1, 2017: Médecine et Santé Tropicales
https://www.readbyqxmd.com/read/29284871/comparative-study-of-clonidine-with-ropivacaine-versus-ropivacaine-alone-in-epidural-anesthesia-for-lower-limb-orthopedic-surgery
#3
Mahendra Singh, Amitesh Pathak, Aamir Laique Khan, Amit Srivastava, Devendra Negi
Background: Epidural anesthesia has been well established as a safe and effective technique not only for perioperative anesthesia but also for postoperative analgesia. Various adjuvants have been added to local anesthetic agent in an effort to prolong this duration. Aims: The aim of this study was to compare and evaluate the anesthesia and analgesic property of ropivacaine to its combination with clonidine for lower limb orthopedic surgery under epidural. Materials and Methods: In a prospective, randomized, double-blind study, eighty adult patients undergoing lower limb surgeries received either 0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29284861/a-comparison-of-intrathecal-dexmedetomidine-and-neostigmine-as-adjuvant-to-ropivacaine-for-lower-limb-surgeries-a-double-blind-randomized-controlled-study
#4
Ashutosh Kumar Singh, Abhyuday Kumar, Ashok Kumar, Braj Kishore Prasad, Pradeep Kumar Tiwary, Ranjeet Kumar
Objective: The primary objective of this study was to compare the analgesic effects of intrathecal ropivacaine with or without neostigmine or dexmedetomidine in lower limb surgeries. Secondary objectives were to study the characteristics of block, duration of analgesia, postoperative analgesic requirement, and associated side effects. Materials and Methods: Seventy-five patients posted for elective orthopedic lower limb surgeries under spinal anesthesia were randomly divided into three equal groups to receive intrathecal ropivacaine 0...
October 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29279832/the-comparison-of-preventive-analgesic-effects-of-ketamine-paracetamol-and-magnesium-sulfate-on-postoperative-pain-control-in-patients-undergoing-lower-limb-surgery-a-randomized-clinical-trial
#5
Seyed Morteza Heydari, Seyed Jalal Hashemi, Shahpour Pourali
Background: In considering the importance of postoperative pain management and its consequences on its related secondary outcomes including nausea, vomiting, and operation-related complications, we aimed to compare the effectiveness of the three analgesic agents including ketamine, paracetamol, and magnesium sulfate for postoperative pain relief and associated consequences in this trial. Materials and Methods: In this double-blinded randomized control clinical trial, patients scheduled for elective lower extremity orthopedic surgery under general anesthesia were enrolled and randomized into four groups for receiving intravenous ketamine (0...
2017: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29258430/long-duration-general-anesthesia-influences-the-intelligence-of-school-age-children
#6
Qingqing Zhang, Yuanzhi Peng, Yingwei Wang
BACKGROUND: General anesthesia has been linked to impaired brain development in immature animals and young children. In this study the influence of orthopedic surgery under general anesthesia on the intelligence of school age children has been evaluated. METHODS: A total of 209 subjects aged 6-12 years were recruited and allocated into 4 groups according to the duration of general anesthesia, including a control group (n = 30), short (< 1 h, n = 49), moderate- (1-3 h, n = 51) and long-duration groups (> 3 h, n = 79), respectively...
December 19, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29242798/anterior-elbow-pain-caused-by-compression-of-the-lateral-antebrachial-cutaneous-nerve
#7
Sean M Booth, Abdulbaset Abosala, Chris Peach
Introduction: The complex anatomy and biomechanics of the elbow joint can lead to diagnostic uncertainty when a clinician is determining the cause of a patient's anterior elbow pain. We present a case of anterior elbow pain with an uncommon and often overlooked etiology. Elbow pain due to compression of the lateral antebrachial nerve (LACN) has an unknown incidence or prevalence. Case Report: A 27-year-old left-hand dominant male presented to our orthopedic elbow clinic complaining of bilateral elbow clicking and discomfort which had been present for several years...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29238687/status-of-otorhinolaryngology-as-specialty-of-choice-among-female-medical-graduates
#8
Sunil Garg, Rubeena Arora, Sunil Kumar, Gautam Bir Singh
Specialty choices among medical graduates have undergone changes over time. We aimed to analyze status of otorhinolaryngology as specialty of choice among female medical graduates and factors affecting it. A total of 123 female medical graduates were surveyed during their internship over a period of 1 year in a tertiary-care hospital. Each intern was assessed using a questionnaire at the end of otorhinolaryngology rotation. The survey included nine questions about future career choices with special focus on ENT as a choice for specialization...
December 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/29203430/optimization-of-perioperative-management-of-proximal-femoral-fracture-in-the-elderly
#9
REVIEW
P Merloz
Proximal femoral fracture in elderly subjects is a major event that is life-threatening in the medium-to-long term. Advanced age, male gender and number of comorbidities largely account for high mortality and require geriatric expertise. Protein-energy malnutrition and bone demineralization increase mortality. Mortality can, on the other hand, be reduced by acting on two variables accessible to medical intervention: daily activities and nutritional status. Functional and neurocognitive assessment allow the risk of dependency to be evaluated, and global geriatric work-up can prevent sudden breakdown of homeostasis...
December 1, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29183168/minimal-custom-pack-design-and-wide-awake-hand-surgery-reducing-waste-and-spending-in-the-orthopedic-operating-room
#10
Cassandra L Thiel, Rafaela Fiorin Carvalho, Lindsay Hess, Joelle Tighe, Vincent Laurence, Melissa M Bilec, Mark Baratz
BACKGROUND: The US health care sector has substantial financial and environmental footprints. As literature continues to study the differences between wide-awake hand surgery (WAHS) and the more traditional hand surgery with sedation & local anesthesia, we sought to explore the opportunities to enhance the sustainability of WAHS through analysis of the respective costs and waste generation of the 2 techniques. METHODS: We created a "minimal" custom pack of disposable surgical supplies expressly for small hand surgery procedures and then measured the waste from 178 small hand surgeries performed using either the "minimal pack" or the "standard pack," depending on physician pack choice...
November 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/29154229/iliac-fascia-compartment-block-and-analgesic-consumption-in-patients-operated-on-for-hip-fracture
#11
Mateusz Klukowski, Rafał Kowalczyk, Grzegorz Górniewski, Paweł Łęgosz, Marek Janiak, Janusz Trzebicki
BACKGROUND: Fractures of the proximal femur in elderly patients are a challenge for orthopedics, anesthe-sio-logy and geriatrics. Early mobilization reduces postoperative mortality among these patients. Effective anal-gesia is necessary to achieve this goal. MATERIAL AND METHODS: A retrospective analysis of perioperative medical records of 78. patients undergoing surgical treatment of proximal femur fractures was performed. Group 1 (n=35)consisted of patients who were treated with pharmacologic analgesia only (systemic analgesics) and Group 2 (n=43) involved patients who re-ceived a preoperative fascia iliaca compartment block (FICB) and pharmacologic analgesia...
October 31, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/29120004/nerve-traction-injury-after-subacute-revision-external-fixation-of-a-tibial-plateau-fracture
#12
Lauren E Wessel, Alexander B Christ, David Helfet, David S Wellman
Nerve traction injuries are common clinical entities that can be confused with nerve palsies secondary to alternate etiologies. Common mechanisms of nerve injury include direct laceration, crush injury, compression injury, elevated compartment pressures, or traction injury. Traction injuries commonly occur after trauma or aberrant patient positioning; however, traction injury following external fixation for lower extremity injury is rare. This case report describes a 42-year-old man who initially sustained a Schatzker VI tibial plateau fracture that required revision of external fixation for pin-site infection as soft tissues recovered from the initial trauma...
November 8, 2017: Orthopedics
https://www.readbyqxmd.com/read/29110725/tendon-split-lengthening-technique-for-flexor-hallucis-longus-tendon-rupture
#13
Jae Yong Park, Chenyu Wang, Hee Dong Kim, Hyong Nyun Kim
BACKGROUND: Flexor hallucis longus (FHL) tendon rupture is a challenging injury to lead with clawing of the great toe when the FHL tendon is repaired too tight. When the diagnosis is delayed, the tendon ends may not be opposable because of contracture or poor tendon tissue. METHODS: A technique to reconstruct FHL tendon rupture without a free tendon graft is described. A split tendon lengthening is performed at the midfoot around the knot of Henry. Ankle block anesthesia is used to allow the patient's active movement of the interphalangeal (IP) joint to determine the appropriate length of the reconstructed tendon for maintaining balance and preventing the tendon from being too tight or too loose...
November 6, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29078996/ambulatory-unicompartmental-knee-arthroplasty-short-outcome-of-50-first-cases
#14
N Ruiz, X Buisson, G Filippi, M Roulet, H Robert
INTRODUCTION: The reduction in length of stay (LOS) in orthopaedic surgery has been steady for several years. For the past 3 or 4 years in France, the trend towards outpatient surgery has been growing up, as it is a goal for hospital administration. MATERIALS AND METHODS: This is a prospective, continuous,mono-centric, single operator study on 56 UKAs. Included were all UKAs carried out between January 2014 and December 2015, meeting the following criteria: voluntary patients, supportive family environment, absence of comorbidity (oral anticoagulants, diabetes, obesity), ASA score ≤ 3...
October 24, 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29069009/oxygen-embolism-caused-by-accidental-subcutaneous-injection-of-hydrogen-peroxide-during-orthopedic-surgery-a-case-report
#15
Jinhun Chung, Minyoung Jeong
INTRODUCTION: We report a 39-year-old male patient with a fracture of the right acetabulum undergoing open reduction and internal fixation with a plate under general anesthesia. At closure, the surgeons injected 0.75% ropivacaine into the subcutaneous tissue of the incision wound for postoperative analgesia. Soon after injection, subcutaneous emphysema at the injection site and a sudden decrease in end-tidal CO2 tension with crude oscillatory ripples during the alveolar plateau phase were observed...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29065047/corticotomy-with-a-palatal-bone-borne-retractor-for-correcting-severe-bimaxillary-protrusion
#16
Min-Ki Noh, Young-Jun Kim, Kyu-Rhim Chung, Seong-Hun Kim, Gerald Nelson
BACKGROUND: This article presents an alternate surgical treatment method to correct a severe anterior protrusion in the adult patient with an extremely thin alveolus. METHODS: In the maxilla, a wide linear corticotomy was performed under local anesthesia. Cortical alveolar bone of the upper first bicuspids area was widely removed. Orthopedic force for bony block movement was applied by a palatal bone-borne type retractor supported by skeletal anchorage. Residual extraction space closure was performed by biocreative orthodontics strategy (BOS)...
October 23, 2017: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29058757/outcomes-and-predictors-of-success-for-arthroscopic-lysis-of-adhesions-for-the-stiff-total-knee-arthroplasty
#17
Blake M Bodendorfer, Joshua A Kotler, William D Zelenty, Kareem Termanini, Rafael Sanchez, Evan H Argintar
A stiff total knee arthroplasty (TKA) can manifest as pain and decreased range of motion (ROM). When conservative management including physical therapy and manipulation under anesthesia fails, arthroscopic lysis of adhesions (LOA) is frequently pursued. The authors examined the efficacy of LOA for the stiff TKA. They retrospectively reviewed the records of 18 patients who underwent LOA for stiff TKA between April 2013 and June 2016 and who failed to meet 90° ROM at 6 weeks postoperatively. They recorded patient demographics, ROM prior to TKA, and incidence of manipulation under anesthesia between initial TKA and LOA as well as pre- and postoperative outcomes of ROM, pain, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores...
November 1, 2017: Orthopedics
https://www.readbyqxmd.com/read/29050715/the-effect-of-two-attending-surgeons-on-patients-with-large-curve-adolescent-idiopathic-scoliosis-undergoing-posterior-spinal-fusion
#18
Liam Bosch, Carla Boan, Miranda Falk, Greg R White, M Wade Shrader
STUDY DESIGN: Retrospective, chart review. OBJECTIVES: The objective of this study is to investigate the impact of using two surgeons for posterior spinal fusion (PSF) in patients with AIS with large-magnitude curves (greater than 70°). SUMMARY OF BACKGROUND DATA: Previous studies have shown that intraoperative risk factors can be reduced by having two surgeons operate simultaneously. METHODS: A retrospective chart review identified 47 patients between January 1, 2009, and December 31, 2014, who underwent a posterior spinal fusion (PSF) with AIS with large-magnitude curves (greater than 70°)...
November 2017: Spine Deformity
https://www.readbyqxmd.com/read/29046771/a-comparison-of-palonosetron-and-dexamethasone-for-postoperative-nausea-and-vomiting-in-orthopedic-patients-receiving-patient-controlled-epidural-analgesia
#19
Byung-Gun Kim, Hyunzu Kim, Hyun-Kyoung Lim, Chunwoo Yang, Sora Oh, Byung-Wook Lee
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the major concerns after anesthesia and surgery, and it may be more frequent in orthopedic patients receiving patient-controlled epidural analgesia (PCEA). The purpose of this study was to compare the effect of palonosetron and dexamethasone on the prevention of PONV in patients undergoing total joint arthroplasty and receiving PCEA. METHODS: Patients scheduled for total hip or knee arthroplasty under spinal anesthesia/PCEA were randomly allocated to receive either intravenous palonosetron (0...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28991112/the-influence-of-age-on-sensitivity-to-dexmedetomidine-sedation-during-spinal-anesthesia-in-lower-limb-orthopedic-surgery
#20
Bo Xu, Zhitao Li, Dongxu Zhou, Liuxun Li, Pingyue Li, Huayang Huang
To investigate the influence of age on sensitivity to dexmedetomidine sedation in adult patients, we selected 79 patients scheduled for lower limb orthopedic surgery under spinal anesthesia to identify the dexmedetomidine ED50 for adequate sedation among different age groups. After a spinal anesthetic was placed, a dose of dexmedetomidine determined by the Dixon up-and-down method was administered over 15 minutes. The ED50 in the elderly group was lower than in the other 2 groups (elderly: 0.88 ± 0.07; middle aged: 1...
October 5, 2017: Anesthesia and Analgesia
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