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Perioperative pain management

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https://www.readbyqxmd.com/read/29774939/-feasibility-and-preliminary-technical-experience-of-single-incision-plus-one-port-laparoscopic-total-gastrectomy-combined-with-%C3%AF-shaped-esophagojejunal-anastomosis-in-surgical-treatment-of-gastric-cancer
#1
Guangsheng Du, Enlai Jiang, Yuan Qiu, Wensheng Wang, Shuai Wang, Yunbo Li, Ke Peng, Xiang Li, Hua Yang, Weidong Xiao
OBJECTIVE: To explore the feasibility, safety, and preliminary technical experience of single incision plus one port laparoscopic total gastrectomy combined with π-shaped esophagojejunal anastomosis (SILT-π) in the surgical treatment of gastric cancer. METHODS: Clinical data of 5 gastric cancer patients undergoing SILT-π operation at the Department of General Surgery, The Second Affiliated Hospital of the Army Medical University from August to October 2017 were retrospectively analyzed...
May 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/29774817/bladder-reconstruction-with-bowel-robot-assisted-laparoscopic-ileocystoplasty-with-mitrofanoff-appendicovesicostomy-in-pediatric-patients
#2
Nimrod S Barashi, Maria Veronica Rodriguez, Vignesh T Packiam, Mohan S Gundeti
Neurogenic bladder occur as a consequence of several conditions, most commonly posterior urethral valves syndrome, spina bifida, tethered cord, sacral agenesis, and Arnold-Chiari malformation. It is characterized by diminished bladder capacity and/or reduced compliance, associated with high-pressure voiding that can lead to deterioration of renal function if left untreated. When medical management fails, bladder reconstruction with bowel (aumentation ileocystoplasty) becomes the treatment of choice for these patients...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29773240/perioperative-risk-factors-that-predict-complications-of-radial-forearm-free-flaps-in-oral-and-maxillofacial-reconstruction
#3
C Wang, G Fu, F Liu, L Liu, M Cao
The aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22-86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011-December 2016. We recorded predictive variables, subdivided into: personal and clinical (sex, age, weight, coexisting conditions, history of smoking, radiotherapy, and primary lesions); haemodynamic (perioperative concentrations of haemoglobin and albumin, blood loss, blood transfusion, urinary output (ml), and rate (ml/kg/hour), and infusion rates for crystalloids and colloids (ml/kg/hour, and volumes given intraoperatively and postoperatively for 24hours); and anaesthetic and surgical (American Society of Anesthesiologists(ASA) grade, visual analogue pain score (VAS), and duration of tourniquet and operation)...
May 14, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29761863/surgical-treatment-of-esophageal-cancer-in-the-era-of-multimodality-management
#4
REVIEW
Alicia S Borggreve, B Feike Kingma, Serg A Domrachev, Mikhail A Koshkin, Jelle P Ruurda, Richard van Hillegersberg, Flavio R Takeda, Lucas Goense
Over the last decades, the treatment of resectable esophageal cancer has evolved into a multidisciplinary process in which all players are essential for treatment to be successful. Medical oncologists and radiation oncologists have been increasingly involved since the implementation of neoadjuvant therapy, which has been shown to improve survival. Although esophagectomy is still considered the cornerstone of curative treatment for locally advanced esophageal cancer, it remains associated with considerable postoperative morbidity, despite promising results of minimally invasive techniques...
May 15, 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#5
REVIEW
John-Paul J Pozek, Martin De Ruyter, Talal W Khan
The careful coordination of care throughout the perioperative continuum offered by the perioperative surgical home (PSH) is important in the treatment of postoperative pain. Physician anesthesiologists have expertise in acute pain management, pharmacology, and regional and neuraxial anesthetic techniques, making them ideal leaders for managing perioperative analgesia within the PSH. Severe postoperative pain is one of many patient- and surgery-specific factors in the development of chronic postsurgical pain...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29759288/perioperative-surgical-home-for-the-patient-with-chronic-pain
#6
REVIEW
Talal W Khan, Smith Manion
The management of acute pain for the phenotypically different patient who suffers from chronic pain is challenging. The care of these patients is expensive and siloed. The physician-led, multidisciplinary, patient-centric, care coordination framework of the perioperative surgical home is an optimal vehicle for the management of these patients. The engagement of physician anesthesiologists in the optimization, in-hospital management, and postdischarge care of the patient with chronic pain will lead to improved outcomes, reduced health care expenditures, and improve the health of this challenging population...
June 2018: Anesthesiology Clinics
https://www.readbyqxmd.com/read/29756086/postoperative-opioids-endocrine-changes-and-immunosuppression
#7
Simon Haroutounian
Opioids are among most effective drugs for managing acute postoperative pain. This article discusses the potential effects of perioperative opioids on endocrine and immune function.
March 2018: Pain Reports (Baltimore, Md.)
https://www.readbyqxmd.com/read/29755709/perioperative-management-of-sickle-cell-disease
#8
REVIEW
Kwame Ofori Adjepong, Folashade Otegbeye, Yaw Amoateng Adjepong
Over 30 million people worldwide have sickle cell disease (SCD). Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlusive (painful) crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Pre-operative assessment must include a careful review of the patient's known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and opioid use...
2018: Mediterranean Journal of Hematology and Infectious Diseases
https://www.readbyqxmd.com/read/29754384/magnesium-sulfate-reduced-opioid-consumption-in-obese-patients-undergoing-sleeve-gastrectomy-a-prospective-randomized-clinical-trial
#9
Nurcan Kizilcik, Ozge Koner
OBJECTIVE: The purpose of the study was to investigate the effect of magnesium sulfate on pain management for pain after sleeve gastrectomy operation. DESIGN: A prospective, randomized, placebo-controlled clinical study. SETTING: University hospital. PARTICIPANTS: Eighty patients undergoing sleeve gastrectomy. MEASUREMENTS AND MAIN RESULTS: Visual analog scale for the evaluation of pain, sedation score, mean arterial pressure, heart rate, and total analgesic consumption was recorded...
May 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29748103/gabapentin-as-an-adjunct-to-standard-postoperative-pain-management-protocol-in-lower-extremity-surgery
#10
REVIEW
P Andrew Crisologo, Erik K Monson, Said A Atway
Postoperative pain is a problem that plagues physicians and has since the dawn of the surgical arts. Many interventions are available and used as the standard such as preoperative local anesthetic blocks, opiates, both oral and intravenous, and nonsteroidal antiinflammatory drugs. Although the temptation often exists to increase the postoperative opiate dose, opiate abuse is an increasing problem. This abuse has fueled the search for nonopiate pain adjuncts. Gabapentinoids have been shown to both decrease postoperative pain and, secondarily, decrease opiate dependence...
May 7, 2018: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/29742787/-organisation-of-perioperative-pain-management
#11
Winfried Meißner, Joachim Erlenwein, Ulrike Stamer
Organisational issues of acute pain management are as important as details of pharmacologic treatments or regional analgesia. Lothar Lachgas is a young intern in the department of anaesthesiology of a German hospital. This overview illuminates organisation of perioperative pain management based on his virtual experiences and questions: pain assessment and documentation, patient information and education, tasks of an Acute Pain Service.
April 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29739536/opioids-respiratory-depression-and-sleep-disordered-breathing
#12
REVIEW
Mahesh Nagappa, Toby N Weingarten, Gaspard Montandon, Juraj Sprung, Frances Chung
The increasing use of opioids in the perioperative period has increased opioid-associated morbidity and mortality. There is a well-established connection between opioids, sleep-disordered breathing (SDB), and respiratory depression. The treatment of postoperative pain with opioids in patients with SDB may result in respiratory depression. In an unmonitored setting, it may lead to life-threatening respiratory events. More studies are required to evaluate the effective management and prevention of respiratory depression in patients with SDB...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#13
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29720267/efficacy-of-postoperative-pain-management-in-head-and-neck-cancer-patients
#14
Ashley Hinther, Steven C Nakoneshny, Shamir P Chandarana, T Wayne Matthews, Joseph C Dort
BACKGROUND: Our study quantifies the effectiveness of perioperative pain control in a cohort of patients undergoing major head and neck surgery with free flap reconstruction. Our long-term goal is to improve pain control and thereby increase mobility, decrease postoperative complications and decrease hospital stay. METHODS: A retrospective analysis was performed at a tertiary, academic head and neck surgical oncology program in Calgary, Alberta, Canada from January 1, 2015 - December 31, 2015...
May 2, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29719126/randomized-controlled-trial-comparing-the-supraglottic-airway-to-use-of-an-endotracheal-tube-in-sinonasal-surgery
#15
Austin S Adams, Todd J Wannemuehler, Benjamin Hull, Jeffanie Wu, Rakesh K Chandra, Kate VonWahlde, Matthew S Shotwell, Stephen Harvey, Michael Higgins, Kelly McQueen, Justin H Turner
BACKGROUND: The supraglottic airway (SGA) represents an alternative to endotracheal intubation (endotracheal tube [ETT]) in many types of ambulatory surgery. Adoption of the SGA has progressed slowly in sinonasal surgery due to concerns about airway protection. The purpose of this study was to compare quality of life measures and indices of airway protection between patients undergoing sinonasal surgery who were ventilated via an SGA or ETT. METHODS: Patients undergoing outpatient sinonasal surgery were enrolled into a randomized, single-blind study in which patients would be ventilated with either an SGA or ETT...
May 2, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29714650/real-time-view-of-anesthetic-solution-spread-during-an-ultrasound-guided-thoracic-paravertebral-block
#16
Domenico P Santonastaso, Annabella de Chiara, Marco Rispoli, Giovanni Musetti, Vanni Agnoletti
BACKGROUND: Thoracic paravertebral block is a technique for perioperative analgesia in patients undergoing thoracic, chest wall, or breast surgery, or for pain management with rib fractures, which can be performed with or without ultrasound guidance. The ultrasound guidance technique can be used to identify the thoracic paravertebral space, guide needle placement, monitor the spread of local anesthetic (LA) solution, and reduce complications such as pleural puncture and pneumothorax. The possibility of assessing anesthetic spread in real time using ultrasound guidance during paravertebral block offers numerous advantages, including the immediate and accurate identification of the extent of nervous block, with a consequent reduction of LA dose...
March 1, 2018: Tumori
https://www.readbyqxmd.com/read/29710075/effect-of-perioperative-gabapentin-use-on-postsurgical-pain-in-patients-undergoing-head-and-neck-mucosal-surgery-a-randomized-clinical-trial
#17
Melanie Townsend, Tina Liou, Dorina Kallogjeri, Morgan Schoer, Nicholas Scott-Wittenborn, Miranda Lindburg, Michael Bottros, Ryan S Jackson, Brian Nussenbaum, Jay F Piccirillo
Importance: Effective postoperative pain management increases patient satisfaction, reduces cost, reduces morbidity, and shortens hospitalizations. Previous studies investigating multimodal pain therapy in otolaryngology patients focused on homogenous patient groups with short postoperative follow-up times. Objective: To investigate the effect of perioperative gabapentin treatment on postsurgical pain in patients undergoing head and neck mucosal surgery. Design, Setting, and Participants: Adults undergoing head and neck mucosal surgery from July 25, 2016, through June 19, 2017, were included in this double-blinded, placebo-controlled randomized clinical trial and randomized to receive gabapentin, 300 mg twice daily, or placebo before surgery and up to 72 hours after surgery...
April 19, 2018: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29705086/transaxillary-decompression-of-thoracic-outlet-syndrome-patients-presenting-with-cervical-ribs
#18
Hugh A Gelabert, David A Rigberg, Jessica B O'Connell, Sinan Jabori, Juan Carlos Jimenez, Steven Farley
OBJECTIVE: The transaxillary approach to thoracic outlet decompression in the presence of cervical ribs offers the advantage of less manipulation of the brachial plexus and associated nerves. This may result in reduced incidence of perioperative complications, such as nerve injuries. Our objective was to report contemporary data for a series of patients with thoracic outlet syndrome (TOS) and cervical ribs managed through a transaxillary approach. METHODS: We reviewed a prospectively maintained database for all consecutive patients who underwent surgery for TOS and who had a cervical rib...
April 25, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29701424/perioperative-family-centered-care-nursing-interventions-that-support-child-and-family-s-emotional-management
#19
Dario Antunes, Paula Diogo
INTRODUCTION: Hospitalization is a negative tonality experience for both child and family, being fear and anxiety their emotional mirror. Concerning the surgical experience, the environment, invasiveness, fear of pain, of not waking up from anaesthesia and parental separation are both causes and enhancers of child and family perioperative distress. A study concerning parent's emotional experience of child's submitted to cardiac surgery, refer guilt for their son's cardiopathy, a roller coaster of emotions, impotence and being seated on pins and needles while waiting during the surgery...
July 2017: Revista Portuguesa de Cirurgia Cardio-torácica e Vascular
https://www.readbyqxmd.com/read/29698513/complications-and-risk-management-in-the-use-of-the-reaming-irrigator-aspirator-ria-system-ria-is-a-safe-and-reliable-method-in-harvesting-autologous-bone-graft
#20
Patrick Haubruck, Julian Ober, Raban Heller, Matthias Miska, Gerhard Schmidmaier, Michael C Tanner
BACKGROUND: Autologous bone grafting (ABG) remains the gold standard for augmentation of bone defects. The RIA system has become more prevalent, but evidence regarding risk management and complications remain scarce. This study presents the risk management and complications associated with RIA in the largest single-center case series to date. METHODS: All records, operative notes, lab data and radiographs of patients receiving a RIA procedure at Heidelberg´s University Hospital between 01/01/2010 and 31/12/2016 were reviewed...
2018: PloS One
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