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Perioperative pain management

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https://www.readbyqxmd.com/read/28318866/innovations-in-joint-preservation-procedures-for-the-dysplastic-hip-the-periacetabular-osteotomy
#1
Cecilia Pascual-Garrido, Michael D Harris, John C Clohisy
The Bernese periacetabular osteotomy is an effective treatment for symptomatic developmental dysplasia in the prearthritic young adult hip. Refinements in the periacetabular osteotomy technique and perioperative management have markedly improved the clinical outcomes and recovery in these patients. We will review the clinical presentation of acetabular dysplasia, indications for surgery, perioperative management, and contemporary refinements in technique including refined acetabular reduction, adjunctive hip arthroscopy, femoral head-neck osteochondroplasty, femoral procedures, and rapid recovery protocols...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28299313/perioperative-factors-contributing-the-post-craniotomy-pain-a-synthesis-of-concepts
#2
REVIEW
Tumul Chowdhury, Rakesh Garg, Veena Sheshadri, Lakshmi Venkatraghavan, Sergio Daniel Bergese, Ronald B Cappellani, Bernhard Schaller
The perioperative management of post-craniotomy pain is controversial. Although the concept of pain control in non-neurosurgical fields has grown substantially, the understanding of neurosurgical pain and its causative factors in such a population is inconclusive. In fact, the organ that is the center of pain and its related mechanisms receives little attention to alleviate distress during neurosurgical procedures. In contrast to the old belief that pain following intracranial surgery is minimal, recent data suggest the exact opposite...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28298774/a-survey-on-awareness-about-the-role-of-anesthesia-and-anesthesiologists-among-the-patients-undergoing-surgeries-in-a-tertiary-care-teaching-women-and-children-hospital
#3
Vinay Marulasiddappa, H N Nethra
BACKGROUND: Although anesthesiology has grown tremendously and although anesthesiologists play a crucial role in the perioperative management of patients and also outside operating theater (OT) such as critical care, pain clinic, and labor analgesia, they do not get due recognition. We conducted a study to assess the awareness about the role of anesthesia and anesthesiologists among patients scheduled to undergo surgery in a Government Tertiary Care Teaching Women and Children Hospital...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28283811/techniques-to-optimize-multimodal-analgesia-in-ambulatory-surgery
#4
REVIEW
Amit Prabhakar, John N Cefalu, Josef S Rowe, Alan D Kaye, Richard D Urman
PURPOSE OF REVIEW: Ambulatory surgery has grown in popularity in recent decades due to the advancement in both surgical and anesthetic techniques resulting in quicker recovery times, fewer complications, higher patient satisfaction, and reduced costs of care. We review common approaches to multimodal analgesia. RECENT FINDINGS: A multimodal approach can help reduce perioperative opioid requirements and improve patient recovery. Analgesic options may include NSAIDs, acetaminophen, gabapentinoids, corticosteroids, alpha-2 agonists, local anesthetics, and the use of regional anesthesia...
May 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28283810/anesthetic-and-analgesic-management-for-outpatient-knee-arthroplasty
#5
REVIEW
Chris Cullom, Jonathan T Weed
PURPOSE OF REVIEW: Total knee arthroplasty traditionally has been associated with significant postoperative pain that can limit recovery and prolong hospital length of stay. Recently, however, due to financial pressures and an emphasis on improving patient satisfaction, many institutions are implementing outpatient and short-stay programs for patients undergoing this procedure. An effective perioperative anesthetic plan is an essential quality of a successful outpatient joint replacement program...
May 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28281740/comparison-of-laparoendoscopic-single-site-less-and-multiport-laparoscopic-radical-nephrectomy-for-clinical-t1b-and-t2a-renal-masses
#6
Abd-El R Hassan, Omer A Raheem, Sean Berquist, Alp T Beksac, Aaron Bloch, Charles Field, Hak J Lee, Reza Mehrazin, Marc Holden, Michelle McDONALD, Zachary Hamilton, Michael Liss, Ithaar H Derweesh
BACKGROUND: To compare outcomes of Laparoendoscopic single-site surgery (LESS) and multiport laparoscopic (MPL) Radical Nephrectomy (RN) for clinical T1b/T2a renal masses, as concerns continue regarding suitability and benefit of LESS for larger renal masses. METHODS: Retrospective single-surgeon comparison of LESS- and MPL-RN between 7/2005 and 11/2014. 63 patients underwent LESS-RN (44 cT1b/19 cT2a); 133 underwent MPL (83 cT1b/50 cT2a). All patients were managed with a standardized care pathway...
March 10, 2017: Minerva Urologica e Nefrologica, the Italian Journal of Urology and Nephrology
https://www.readbyqxmd.com/read/28277256/-anesthetic-considerations-for-awake-craniotomy-case-report
#7
Cassiano Hamacek de Freitas, Celso Homero Santos Oliveira, Daniel Câmara de Rezende, Joyce Romano, Henrique Rodrigues Lemos Silva, Ivana Mares Trivellato
BACKGROUND AND OBJECTIVES: The conscious patient cooperation during neurological procedures has become necessary for the delimitation of areas to be managed by a neurosurgeon, with better results in the treatment of tumor lesions, vascular or epileptic foci, and sequelae minimization. The need for perioperative awareness (responsiveness to commands) challenges anesthesiologists to further ensure patient safety during the procedure. Several techniques have been described for this purpose...
October 26, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28276661/anterior-lumbar-interbody-fusion-in-left-sided-inferior-vena-cava-and-right-sided-aortic-arch
#8
Kevin Phan, Bernard A M Fang, Monish M Maharaj, Andrew F Lennox, Ralph J Mobbs
Spinal fusion via anterior lumbar interbody fusion (ALIF) can offer symptomatic relief to patients that suffer severe low back pain, radiculopathy, and claudication. However, a detailed working knowledge of the thoracic, abdominal, and lumbar anatomy, particularly of the vasculature, is vital. We report the case of a 68-year-old man who presented with radiculopathy and progressively worsening low back pain despite 9 months of unsuccessful conservative therapy and pain management. Preoperative computed tomography and magnetic resonance imaging revealed a rare anatomical variation, with an anomalous left-sided inferior vena cava and anomalous aorta...
March 9, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28275849/-beginning-of-continuous-wound-infusion-with-local-anesthetics-with-special-emphasis-on-the-contributions-from-walter-capelle-and-ewald-fulde
#9
M Goerig, A Gottschalk
Wound infusion with local anesthetics is a proven and safe analgesic procedure for modern perioperative patient care. Even the pioneers of local anesthesia practiced wound analgesia and emphasized the shortcomings of "single-shot" wound infusions. At the same time, they drew attention to the importance of long-lasting pain relief to prevent sequelae, especially after upper abdominal surgery with pneumonia, embolic events or postoperative ileus. In the early 1930s there were first sustained efforts to improve the efficiency and quality of pain therapy, especially after upper abdominal surgery by continuous wound infiltration with local anesthetics via intraoperatively introduced special cannulas...
March 8, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#10
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28262590/the-implications-of-biologic-therapy-for-elective-foot-and-ankle-surgery-in-patients-with-rheumatoid-arthritis
#11
REVIEW
Ross Diaper, Ernest Wong, Stuart A Metcalfe
INTRODUCTION: Rheumatoid arthritis (RA) is one of a number of inflammatory arthropathies resulting in foot pain and deformity. Patients with this disease may require surgical intervention as part of their management. Many of these patients are now taking biologic agents which pose several risks to patients in the perioperative phase. The surgical team therefore need to be aware of these associated complications and how to manage these cases. AIM: This paper aims to review the current literature about perioperative needs (foot and ankle surgery) associated with patients with rheumatoid arthritis receiving biologic therapy...
January 27, 2017: Foot
https://www.readbyqxmd.com/read/28260955/peroral-endoscopic-myotomy-procedural-complications-and-pain-management-for-the-perioperative-clinician
#12
Lopa Misra, Norio Fukami, Katarina Nikolic, Terrence L Trentman
Achalasia refers to the lack of smooth muscle relaxation of the distal esophagus. Although nonsurgical treatments such as pneumatic dilatation of the distal esophagus and botulinum toxin injections have been performed, these procedures have limited duration. Similarly, surgical treatment with Heller myotomy is associated with complications. At our institution, we perform the peroral endoscopic myotomy (POEM) in qualified patients. Briefly, POEM involves endoscopic creation of a mid-esophageal submucosal bleb, creation of a submucosal tunnel with the endoscope, and then a distal myotomy, resulting in relaxation of the distal esophagus...
2017: Medical Devices: Evidence and Research
https://www.readbyqxmd.com/read/28258733/-perioperative-gabapentin-and-pregabalin-in-cardiac-surgery-a-systematic-review-and-meta-analysis
#13
Souvik Maitra, Dalim K Baidya, Sulagna Bhattacharjee, Anirban Som
OBJECTIVES: Sternotomy for cardiac surgeries causes significant postoperative pain and when not properly managed may cause significant morbidity. As neuropathic pain is a significant component here, gabapentin and pregabalin may be effective in these patients and may reduce postoperative opioid consumption. The purpose of this systematic review was to find out efficacy of gabapentin and pregabalin in acute postoperative pain after cardiac surgery. METHODS: Published prospective human randomized clinical trials, which compared preoperative and/or postoperative gabapentin/pregabalin with placebo or no treatment for postoperative pain management after cardiac surgery has been included in this review...
March 1, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28255769/management-of-device-related-complications-after-sacral-neuromodulation-for-lower-urinary-tract-disorders-in-women-a-single-center-experience
#14
Tilemachos Kavvadias, Markus Huebner, Sara Yvonne Brucker, Christl Reisenauer
PURPOSE: This study is aimed at presenting and discussing the device-related complication management during a 5-year period, of the sacral nerve modulation (SNM), in a tertiary-care university unit. METHODS: This is a retrospective chart review of all women, who received SNM in our department between May 2011 and May 2016. All two-stage procedures were performed by the same experienced surgeon and according to our strict protocol of patients' selection and follow-up...
March 3, 2017: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/28255259/the-effect-of-unilateral-spinal-anaesthesia-and-psoas-compartment-with-sciatic-block-on-the-postoperative-pain-management-in-total-knee-artroplastic-surgery
#15
Ebru Canakci, Dogus Unal, Yunus Guzel
Purpose. This study was designed to investigate the effects of peripheral nerve block methods, applied through unilateral spinal anaesthesia on elderly patients to undergo total knee arthroplasty, on perioperative hemodynamic parameters and postoperative analgesia period. Materials and Method. 60 patients were randomly divided into two groups in the study. In group USA spinal anaesthesia was performed. In group PCS it was applied on psoas compartment block and sciatic nerve block. Results. Significantly higher intraoperative 60th and 90th minute mean arterial pressure values were ascertained in the PCS group compared to the USA group...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28251525/updates-in-pediatric-regional-anesthesia-and-its-role-in-the-treatment-of-acute-pain-in-the-ambulatory-setting
#16
REVIEW
Alecia L S Stein, Dorothea Baumgard, Isis Del Rio, Jacqueline L Tutiven
PURPOSE OF REVIEW: The purpose of this review is to summarize the latest advances in pediatric regional anesthesia with special emphasis on its role in the ambulatory surgical setting. RECENT FINDINGS: Undertreated pain in children following ambulatory surgery is not a rare occurrence and it is associated with increased morbidity and significant psychosocial harm. Use of regional anesthesia as part of the anesthetic approach in the ambulatory setting is safe when performed on children under general anesthesia and inclusion of certain adjuncts improves block outcomes...
February 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28243380/patient-reported-outcomes-from-sacroiliac-joint-fusion
#17
Vamsi K Kancherla, Shane M McGowan, Brittany N Audley, Gbolabo Sokunbi, Steven T Puccio
STUDY DESIGN: Retrospective, case series. PURPOSE: The purpose of this study is to determine morbidity, complications, and patient reported outcomes from minimally invasive sacroiliac joint (SIJ) fusion. OVERVIEW OF LITERATURE: Lumbar back pain emanating from the SIJ can be surgically treated via a percutaneous approach in the appropriately selected patient with minimal morbidity and acceptable functional outcomes. METHODS: Patients diagnosed by >2 physical examination maneuvers and subjective relief from a computed tomography-guided lidocaine-bupivacaine-steroid injection underwent SIJ fusion after failing conservative management with a combination of oral anti-inflammatory medications, physical therapy, and pelvic belt stabilization...
February 2017: Asian Spine Journal
https://www.readbyqxmd.com/read/28235576/lidocaine-multivalent-ion-complex-as-a-potential-strategy-for-prolonged-local-anesthesia
#18
You Jin Jang, Jin Ho Lee, Tae Beom Seo, Se Heang Oh
Local anesthetics are adopted in clinical practice to manage the perioperative and/or postoperative pain. However, their relatively short duration of action limit their ability to meet clinical needs. Herein, we prepared a lidocaine/multivalent ion complex (icLD) using aqueous solutions containing positively charged LD and a multivalent counter-ion as a system for producing prolonged anesthesia. The results of the in vitro and in vivo experiments indicated that the icLD facilitates prolonged LD release even without adjuvants and thus provides nerve blockade for a long duration of action (∼14hrs) without further increase in neurotoxicity than the LD itself...
February 21, 2017: European Journal of Pharmaceutics and Biopharmaceutics
https://www.readbyqxmd.com/read/28226339/current-concepts-of-phenylpiperidine-derivatives-use-in-the-treatment-of-acute-and-chronic-pain
#19
Nidal Elbaridi, Alan D Kaye, Stephanie Choi, Richard D Urman
Phenylpiperidines are a chemical class of drugs with a phenyl moiety directly attached to piperidine. These agents have an important role in many aspects of medicine including anesthesia and pain medicine. After the development of meperidine, fentanyl, which is a second generation synthetic phenylpiperidine series opioid, was synthesized and introduced into clinical anesthesia practice as fentanyl citrate in 1968. Fentanyl-mediated or modulated responses involve action at the mu-opioid receptor as an agonist at the dorsal horn inhibiting ascending pain pathways in the rostral ventral medulla, increasing pain threshold, and producing both analgesic and sedative effects...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28217067/septo-optic-dysplasia-de-morsier-s-syndrome
#20
Pedro Reis, Joana Mourão
Septo-optic dysplasia (SOD)/de Morsier's syndrome is characterized by optic nerve hypoplasia, pituitary endocrine dysfunction, and midline brain abnormalities. Hypopituitarism, hypothyroidism, hypogonadism, and adrenal insufficiency can lead to severe hypoglycemia, adrenal crisis, seizures, and sudden death. Anesthetic management of SOD was associated with high perioperative mortality. A 9-year-old male child proposed for dental treatments/extractions. Medical history of SOD with hypopituitarism, hypothyroidism, and delayed psychomotor development was observed...
January 2017: Saudi Journal of Anaesthesia
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