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Orthopedic anesthesia

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https://www.readbyqxmd.com/read/29120004/nerve-traction-injury-after-subacute-revision-external-fixation-of-a-tibial-plateau-fracture
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
https://www.readbyqxmd.com/read/28955163/anesthetic-management-with-sevoflurane-combined-with-alfaxalone-medetomidine-constant-rate-infusion-in-a-thoroughbred-racehorse-undergoing-a-long-time-orthopedic-surgery
#10
Ai Wakuno, Tatsuya Maeda, Kazumichi Kodaira, Takuya Kikuchi, Minoru Ohta
A three-year old Thoroughbred racehorse was anesthetized with sevoflurane and oxygen inhalation anesthesia combined with constant rate infusion (CRI) of alfaxalone-medetomidine for internal fixation of a third metacarpal bone fracture. After premedication with intravenous (IV) injections of medetomidine (6.0 µg/kg IV), butorphanol (25 µg/kg IV), and midazolam (20 µg/kg IV), anesthesia was induced with 5% guaifenesin (500 ml/head IV) followed immediately by alfaxalone (1.0 mg/kg IV). Anesthesia was maintained with sevoflurane and CRIs of alfaxalone (1...
2017: Journal of Equine Science
https://www.readbyqxmd.com/read/28928579/to-evaluate-the-efficacy-of-fentanyl-and-dexmedetomidine-as-adjuvant-to-ropivacaine-in-brachial-plexus-block-a-double-blind-prospective-randomized-study
#11
Nyla Farooq, Raj Bahadur Singh, Arindam Sarkar, Mohd Asim Rasheed, Sanjay Choubey
CONTEXT: Anesthesia and analgesia for surgeries to the upper extremity are commonly provided using brachial plexus anesthesia. There are limited or almost no studies comparing the use of ropivacaine with fentanyl to ropivacaine with dexmedetomidine. AIMS: To compare the efficacy of fentanyl and dexmedetomidine as adjuvants to ropivacaine for brachial plexus block among patients undergoing upper limb orthopedic surgeries. SETTINGS AND DESIGN: This was a prospective, randomized, double-blinded study...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28928571/dexmedetomidine-as-adjuvant-to-lower-doses-of-intrathecal-bupivacaine-for-lower-limb-orthopedic-surgeries
#12
Taznim Mohamed, Indu Susheela, Beena P Balakrishnan, Suvarna Kaniyil
BACKGROUND: Dexmedetomidine, an α2 adrenergic agonist, has been found to be a useful adjuvant to local anesthetics. It has been found to produce satisfactory block with lower doses of spinal bupivacaine. AIM: The aim of this study is to compare the difference in spinal block characteristics and hemodynamic effects of 7, 8, and 9 mg hyperbaric bupivacaine combined with 5 μg dexmedetomidine and to find out the optimum dose that would provide satisfactory block and hemodynamic stability for lower limb orthopedic surgeries...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28922228/anesthesia-capacity-in-ghana-a-teaching-hospital-s-resources-and-the-national-workforce-and-education
#13
Mark A Brouillette, Alfred J Aidoo, Maria A Hondras, Nana A Boateng, Akwasi Antwi-Kusi, William Addison, Alec R Hermanson
BACKGROUND: Quality anesthetic care is lacking in low- and middle-income countries (LMICs). Global health leaders call for perioperative capacity reports in limited-resource settings to guide improved health care initiatives. We describe a teaching hospital's resources and the national workforce and education in this LMIC capacity report. METHODS: A prospective observational study was conducted at Komfo Anokye Teaching Hospital (KATH) in Kumasi, Ghana, during 4 weeks in August 2016...
September 14, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28920036/hematoma-block-versus-general-anesthesia-in-distal-radius-fractures-in-patients-over-60-years-in-trauma-emergency
#14
Ali Tabrizi, Fardin Mirza Tolouei, Ebrahim Hassani, Hassan Taleb, Asghar Elmi
BACKGROUND: Distal radius fractures are among common fractures in the elderly. Regarding the age, background diseases, and possible risks, analgesia method is of great importance in this group. OBJECTIVES: The aim of this study was to compare two analgesia methods including hematoma block and general anesthesia in people over 60 years in the orthopedic emergency department. METHODS: 68 elderly patients referring to the emergency department of a medical teaching center were selected based on the inclusion criteria for a non-randomized clinical trial...
February 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28901120/perioperative-stroke-incidence-etiologic-factors-and-prevention
#15
Sher-Lu Pai, R Doris Wang, Stephen Aniskevich
INTRODUCTION: Stroke is a devastating complication that is difficult to diagnose in the perioperative setting because of the effects of anesthetic and analgesic agents. Lingering anesthesia effects hinder clinicians in identifying stroke symptoms, frequently resulting in a delay in diagnosis and treatment and in unfavorable outcomes. EVIDENCE ACQUISITION: The authors performed a systematic search in PubMed and the Cochrane Central Register. The search aimed to identify studies published between January 1990 and December 2015 related to the common etiologic factors, incidence, risk factors, risk modifiers, and early management of perioperative stroke...
September 13, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28870306/pediatric-perioperative-pain-management
#16
REVIEW
Kaela H Frizzell, Priscilla K Cavanaugh, Martin J Herman
Effective perioperative pain control in pediatric patients undergoing orthopedic surgery remains a challenge. Developing a successful pain control regimen begins preoperatively with assessment of the patient and discussion with the patient and family regarding expectations. Perioperative pain control regimens are customized based on the type of surgery, patient characteristics, and anticipated severity and duration of the postoperative pain. Recent study focuses on multimodal strategies and regional anesthesia options, allowing for decreased opioid use...
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28841617/benefit-of-local-anesthesia-in-reducing-pain-during-collagenase-injection-for-dupuytren-s-contracture
#17
Jesper Nordenskjöld, Markus Waldén, Anders Kjellin, Herbert Franzén, Isam Atroshi
Collagenase injection for Dupuytren's contracture is commonly administered without anesthesia. The authors studied the benefit of injecting local anesthesia before collagenase in reducing treatment-related pain. This prospective cohort study included 187 patients (mean age, 69 years; 80 percent men) at two orthopedic departments in Sweden. At one center, 161 consecutive patients scheduled for collagenase injection were assigned to two groups by alternating outpatient clinics; 78 received collagenase without local anesthesia using a modified method (injecting 0...
September 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28820799/regional-anesthesia-and-analgesia-after-surgery-in-icu
#18
Mathieu Capdevila, Séverin Ramin, Xavier Capdevila
PURPOSE OF REVIEW: The aim is to demonstrate that ICU physicians should play a pivotal role in developing regional anesthesia techniques that are underused in critically ill patients despite the proven facts in perioperative and long-term pain, organ dysfunction, and postsurgery patient health-related quality of life improvement. RECENT FINDINGS: Regional anesthesia and/or analgesia strategies in ICU reduce the surgical and trauma-stress response in surgical patients as well as complications incidence...
October 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28814096/ankle-block-vs-single-shot-popliteal-fossa-block-as-primary-anesthesia-for-forefoot-operative-procedures-prospective-randomized-comparison
#19
Oliver N Schipper, Kenneth J Hunt, Robert B Anderson, W Hodges Davis, Carroll P Jones, Bruce E Cohen
BACKGROUND: Postoperative pain is often difficult to control with oral medications, requiring large doses of opioid analgesia. Regional anesthesia may be used for primary anesthesia, reducing the need for general anesthetic and postoperative pain medication requirements in the immediate postoperative period. The purpose of this study was to compare the analgesic effects of an ankle block (AB) to a single-shot popliteal fossa block (PFB) for patients undergoing orthopedic forefoot procedures...
November 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28747204/just-fun-or-a-prejudice-physician-stereotypes-in-common-jokes-and-their-attribution-to-medical-specialties-by-undergraduate-medical-students
#20
Sigrid Harendza, Martin Pyra
BACKGROUND: Many jokes exist about stereotypical attributes of physicians in various specialties, which could lead to prejudices against physicians from a specific specialty. It is unknown whether and when medical students are aware of stereotypes about different specialties. The goal of this study was to analyze the degree of stereotypes that exist about medical specialties amongst undergraduate medical students at different stages of their education. METHODS: One hundred fifty-two jokes with different content about attributes of physicians from different specialties were found by an internet search...
July 26, 2017: BMC Medical Education
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