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Perioperative pain management

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https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#1
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29318091/nerve-blocks-in-the-geriatric-patient-with-hip-fracture-a-review-of-the-current-literature-and-relevant-neuroanatomy
#2
REVIEW
Nirav H Amin, Jacob A West, Travis Farmer, Hrayr G Basmajian
Introduction: Hip fracture is a common occurrence in the elderly population with high morbidity and mortality due to postoperative pain and opioid use. The goal of this article is to review the current literature on the neuroanatomy of the hip and the use of localized nerve block in controlling hip fracture pain. Methods: A thorough search of MEDLINE/PubMed, Embase, and the Cochrane Database of Systematic Reviews was conducted using the search terms "hip fracture" and "fascia iliaca block (FICB)...
December 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/29316592/the-addition-of-diclofenac-to-a-multimodal-pain-control-regimen-decreases-postoperative-pain-and-opioid-consumption
#3
Nicole E George, Cheryle Gurk-Turner, Jennifer I Etcheson, Chukwuweike U Gwam, Randal De Souza, Spencer S Smith, James Nace, Ronald E Delanois
INTRODUCTION: Total knee arthroplasty (TKA) is a commonly-performed orthopaedic procedure in the United States. However, inadequate postoperative pain management following TKA has been associated with a number of negative consequences, including chronic postoperative pain requiring long-term opioid use. Multimodal pain control is a recently-popularized means of maximizing analgesia and postoperative outcomes. We aimed to evaluate the outcomes of a multimodal pain regimen incorporating diclofenac, including: 1) length of stay (LOS); 2) pain intensity; and 3) opioid consumption in primary TKA patients...
December 22, 2017: Surgical Technology International
https://www.readbyqxmd.com/read/29316474/spinal-versus-general-anesthesia-for-lumbar-spine-surgery-in-high-risk-patients-perioperative-hemodynamic-stability-complications-and-costs
#4
Michael Finsterwald, Marco Muster, Mazda Farshad, Andrea Saporito, Muriel Brada, José A Aguirre
OBJECTIVE: More stable perioperative hemodynamic conditions, lower costs and a lower perioperative complication rate were reported in young healthy patients undergoing lumbar spine surgery in spinal anesthesia (SA) compared to general anesthesia (GA). However, the benefits of SA in high risk patients (ASA≥II suffering from cardiovascular and/or pulmonary pathologies) undergoing this surgery are unclear. Our objective was to analyze whether SA leads to an improved perioperative hemodynamic stability and to a more cost-effective management compared to GA in high risk patients undergoing this surgery...
January 6, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29310376/perioperative-analgesia-after-intrathecal-fentanyl-and-morphine-or-morphine-alone-for-cesarean-section-a-randomized-controlled-study
#5
Wojciech Weigl, Andrzej Bieryło, Monika Wielgus, Świetlana Krzemień-Wiczyńska, Marcin Kołacz, Michał J Dąbrowski
OBJECTIVES: Intrathecal morphine is used in the postoperative management of pain after caesarean section (CS), but might not be optimal for intraoperative analgesia. We hypothesized that intrathecal fentanyl could supplement intraoperative analgesia when added to a local anesthetic and morphine without affecting management of postoperative pain. METHODS: This prospective, randomized, double-blind, parallel-group study included 60 parturients scheduled for elective CS...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29303238/perioperative-management-of-a-parturient-with-complex-regional-pain-syndrome-for-elective-c-section
#6
Badie S Mansour, Gretchen Wienecke, Neeti Sadana, Pooya Pouralifazel, Alberto de Armendi
A 33 year-old female at 38 weeks gestation with a history of Complex Regional Pain Syndrome (CRPS) Type 1 of the upper extremities, diagnosed 13 years prior to this admission, was scheduled for an elective cesarean section (C-Section). She refused neuraxial anesthesia and requested general anesthesia. This abstract discusses the general anesthesia steps taken to pre-empt recurrence of CRPS symptoms.
April 2017: Journal of the Oklahoma State Medical Association
https://www.readbyqxmd.com/read/29289394/laparoscopic-guided-abdominal-wall-nerve-blocks-in-the-pediatric-population-a-novel-technique-with-comparison-to-ultrasound-guided-blocks-and-local-wound-infiltration-alone
#7
Alessandra Landmann, Mihaela Visoiu, Marcus M Malek
BACKGROUND: Abdominal wall nerve blocks have been gaining popularity for the treatment of perioperative pain in children. Our aim was to compare a technique of surgeon-performed, laparoscopic abdominal wall nerve blocks to anesthesia-placed, ultrasound-guided abdominal wall nerve blocks and the current standard of local wound infiltration. METHODS: After institutional review board approval was obtained, a retrospective chart review was performed of pediatric patients treated at a single institution during a 2-year period...
December 27, 2017: Surgery
https://www.readbyqxmd.com/read/29286353/is-perioperative-pregabalin-effective-for-reducing-postoperative-pain-in-major-surgery
#8
José Canihuante, Ian Molina, Fernando Altermatt
INTRODUCTION: Pregabalin is a structural analog of γ-aminobutyric acid that may have a role in acute pain management. It has been used in the perioperative context, but there is controversy regarding its real clinical utility. METHODS: To answer this question we used Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis and generated a summary of findings table using the GRADE approach...
December 27, 2017: Medwave
https://www.readbyqxmd.com/read/29285407/designing-a-pain-management-protocol-for-craniotomy-a-narrative-review-and-consideration-of-promising-practices
#9
REVIEW
Susana Vacas, Barbara Van de Wiele
Background: Craniotomy is a relatively common surgical procedure with a high incidence of postoperative pain. Development of standardized pain management and enhanced recovery after surgery (ERAS) protocols are necessary and crucial to optimize outcomes and patient satisfaction and reduce health care costs. Methods: This work is based upon a literature search of published manuscripts (between 1996 and 2017) from Pubmed, Cochrane Central Register, and Google Scholar...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/29274600/evidence-of-intimal-tear-in-type-a-intramural-hematoma-of-the-aorta-a-case-series
#10
Gianfranco Filippone, Giovanni Caruana, Claudia Calia, Violetta Moscaritolo, Vincenzo Argano
INTRODUCTION: Aortic intramural hematoma (IMH) is described as "dissection without intimal tear" due to rupture of vasa vasorum, which results in bleeding within the tunica media in the absence of intimal disruption or blood flow communication. The aim of our study is to validate perioperative evidence of intimal entry tear in patients with IMH and to suggest that this entity may represent a part of a disease and not a separate disease. PRESENTATION OF CASES: We report two patients admitted to our institution with sudden onset thoracic pain...
December 12, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29249547/current-pain-prescribing-habits-for-common-shoulder-operations-a-survey-of-the-american-shoulder-and-elbow-surgeons-membership
#11
K Linnea Welton, Matthew J Kraeutler, Eric C McCarty, Armando F Vidal, Jonathan T Bravman
BACKGROUND: Orthopedic surgeons are among the highest prescribers of narcotic pills, and no guidelines currently exist for appropriate management of postoperative pain within this field. The purpose of this study was to gain understanding of the current pain management strategies used perioperatively and postoperatively among orthopedic shoulder surgeons. METHODS: Members of the American Shoulder and Elbow Surgeons were e-mailed an online survey regarding methods for managing pain in the perioperative and postoperative setting for total shoulder arthroplasty, labral and capsular stabilization procedures, and rotator cuff repair...
December 14, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29237666/spigelian-hernia-and-pitfalls-of-postoperative-anticoagulation
#12
Xiaotong Cheryl Tan, Sunny Nalavenkata, Michael Yunaev
Spigelian hernias are a rare lateral ventral abdominal hernia that carry a high risk of strangulation due to their smaller sizes, and require surgical intervention. In more complex cases involving an anticoagulated patient, perioperative management of anticoagulation must be monitored and reviewed to avoid potential pitfalls. We present an 81-year-old woman who presented with right groin pain, and was requiring warfarin anticoagulation due to her cardiac history. The spigelian hernia was diagnosed and reduced laparoscopically, and the defect was repaired and reinforced by mesh...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29237658/emergency-salpingectomy-for-ruptured-ectopic-pregnancy-in-patient-with-melnick-needles-syndrome-a-rare-otopalatodigital-syndrome
#13
Mark Zachary Johnson, Cormac Francis Mullins, Declan Keane, Ingrid Browne
Melnick-Needles syndrome (M-NS) is a rare genetic disorder which primarily affects skeletal developments. M-NS may also affect the cardiorespiratory and renal systems. A 35 kg patient presented complaining of abdominal pain. Following a positive pregnancy test and ultrasound examination, she was diagnosed with a ruptured ectopic pregnancy. She had a significant background history of M-NS, obstructive sleep apnoea (with narrow gauge tracheostomy in situ), obstructive lung disease and scoliosis. She received fluid resuscitation, and the case was managed using an open salpingectomy and clot evacuation under combined spinal/epidural anaesthesia...
December 13, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29236967/postoperative-analgesia-after-pulmonary-resection-with-a-focus-on-video-assisted-thoracoscopic-surgery
#14
Marzia Umari, Valentina Carpanese, Valeria Moro, Gaia Baldo, Stefano Addesa, Enrico Lena, Stefano Lena, Umberto Lucangelo
Video-assisted thoracoscopic surgery is a widespread technique that has been linked to improved postoperative respiratory function, reduced hospital length of stay and a higher level of tolerability for the patients. Acute postoperative pain is of considerable significance, and the late development of neuropathic pain syndrome is also an issue. As anaesthesiologists, we have investigated the available evidence to optimize postoperative pain management. An opioid-sparing multimodal approach is highly recommended...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29234960/a-new-postoperative-pain-management-intravenous-acetaminophen-acelio%C3%A2-leads-to-enhanced-recovery-after-esophagectomy-a-propensity-score-matched-analysis
#15
Yu Ohkura, Junichi Shindoh, Masaki Ueno, Toshiro Iizuka, Shusuke Haruta, Harushi Udagawa
PURPOSES: To investigate the efficacy of postoperative scheduled intravenous acetaminophen to reduce the opioid use and enhance the recovery after esophagectomy. METHODS: A propensity score-matched population was created using the 93 and 69 consecutive patients who underwent esophagectomy for esophageal cancer before and after the introduction of postoperative scheduled intravenous acetaminophen, and the short-term clinical outcomes were compared. RESULTS: Significant defervescence was demonstrated in the Acetaminophen group (A-group) compared with control group (C-group) during the perioperative period (p < 0...
December 12, 2017: Surgery Today
https://www.readbyqxmd.com/read/29234537/day-care-bipolar-transurethral-resection-vs-photoselective-vaporisation-under-sedoanalgesia-a-prospective-randomised-study-of-the-management-of-benign-prostatic-hyperplasia
#16
Rajeev Sood, T Manasa, Hemant Goel, Ritesh Kumar Singh, Rajpal Singh, Nikhil Khattar, Praveen Pandey
Objective: To conduct a prospective randomised study comparing the safety, effectiveness and treatment outcomes in patients undergoing bipolar transurethral resection of the prostate (bTURP) and photoselective vaporisation of the prostate (PVP) under sedoanalgesia, as sedoanalgesia is a safe and effective technique suitable for minimally invasive endourological procedures and although studies have confirmed that both TURP and PVP are feasible under sedoanalgesia there are none comparing the two...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29233628/xanthogranulomatous-pyelonephritis-in-a-paediatric-cohort-1963-2016-outcomes-from-a-large-single-center-series
#17
I Stoica, F O'Kelly, M B McDermott, F M J Quinn
BACKGROUND: Xanthogranulomatous pyelonephritis (XGP) is an uncommon chronic destructive granulomatous inflammation of the kidney. It was first described in 1916, and is thought to affect 6/1000 cases of pyelonephritis. Its manifestations are varied, and with a limited number of cases in the literature, the optimal diagnosis and management of XGP in the paediatric cohort is still unknown. MATERIAL AND METHODS: The medical records of children who were diagnosed and treated for XGP at the current unit during the period 1963-2016, inclusive, were retrospectively reviewed...
November 24, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29224990/the-shift-to-same-day-outpatient-joint-arthroplasty-a-systematic-review
#18
REVIEW
Jeffrey D Hoffmann, Nicholas A Kusnezov, John C Dunn, Nicholas J Zarkadis, Gens P Goodman, Richard A Berger
BACKGROUND: Hip and knee arthroplasties length of stay continues to shorten after advances in perioperative and intraoperative management, as well as financial incentives. Some authors have demonstrated good results with outpatient arthroplasty, but safety and general feasibility of such procedures remain unclear. Our hypothesis is that outpatient arthroplasty would demonstrate higher readmission and complication rates than inpatient arthroplasty. METHODS: We performed a systematic review of all publications on outpatient arthroplasty between January 1, 2000 and June 1, 2016...
November 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29215949/laparoscopic-retroperitoneal-lymph-node-dissection-as-a-safe-procedure-for-postchemotherapy-residual-mass-in-testicular-cancer
#19
Eliney Ferreira Faria, Hugo Silva Neves, Breno Dauster, Roberto Dias Machado, Wesley Justino Magnabosco, Roberto Lodeiro Muller, Alexandre César Santos, Marcos Tobias-Machado
BACKGROUND: To evaluate the feasibility, clinical and perioperative outcomes of laparoscopic retroperitoneal lymph node dissection (L-RPLND) in the management of patients with germ cell tumors (GCT) and residual post-chemotherapy mass. METHODS: We report our experience of 25 patients treated with L-RPLND between 2008 and 2015. All 25 patients were diagnosed with GCT by primary pathological evaluation of the specimens after orchiectomy. All patients received cisplatin-based chemotherapy...
December 7, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/29211841/perioperative-benefit-and-outcome-of-thoracic-epidural-in-esophageal-surgery-a-clinical-review
#20
P Feltracco, A Bortolato, S Barbieri, E Michieletto, E Serra, A Ruol, S Merigliano, C Ori
Surgery for esophageal cancer is a highly stressful and painful procedure, and a significant amount of analgesics may be required to eliminate perioperative pain and blunt the stress response to surgery. Proper management of postoperative pain has invariably been shown to reduce the incidence of postoperative complications and accelerate recovery. Neuraxial analgesic techniques after major thoracic and upper abdominal surgery have long been established to reduce respiratory, cardiovascular, metabolic, inflammatory, and neurohormonal complications...
December 2, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
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