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Perioperative and chronic pain

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https://www.readbyqxmd.com/read/27893306/mesh-fixation-with-fibrin-sealant-in-totally-extraperitoneal-hernia-repair
#1
Hank Hirsch, Kei Nagatomo, Jonathan Gefen
INTRODUCTION: Repair of inguinal hernia is a common procedure, but there is a lack of consensus as to the optimal repair technique along with the use of mesh and methods of mesh fixation. The objective of this study was to evaluate the efficacy and safety of fibrin sealant for mesh fixation in laparoscopic totally extraperitoneal (TEP) inguinal hernia repair. MATERIALS AND METHODS: A study was conducted of the first 200 patients undergoing TEP hernia repair with mesh fixation using fibrin sealant between March 2012 and January 2014...
November 28, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/27884218/the-current-state-of-perioperative-pain-management-challenges-and-potential-opportunities-for-nurses
#2
Melanie H Simpson, Patricia Bruckenthal
Achievement of adequate postoperative pain management is a critical challenge in health care, with an estimated three out of four adult surgical patients reporting moderate to extreme pain after surgery. Overreliance on opioids in acute care settings has persisted, despite well-known adverse side effects frequently associated with this class of drugs. Furthermore, patients with a history of chronic opioid use present additional challenges in terms of postsurgical pain management. Advances in the development of newer analgesic agents and anesthetic techniques may be useful in surgical patients with a history of chronic opioid use and in the overall surgical patient population...
December 2016: AORN Journal
https://www.readbyqxmd.com/read/27871525/a-retrospective-study-of-open-thoracotomies-versus-thoracoscopic-surgeries-for-persistent-postthoracotomy-pain
#3
Harsha Shanthanna, Dina Aboutouk, Eugenia Poon, Ji Cheng, Christian Finley, James Paul, Lehana Thabane
OBJECTIVE: Persistent thoracotomy pain syndrome (PTPS) is a recognized complication and is considered to be less after video-assisted thoracoscopic surgery (VATS) compared with open thoracic surgery (OTS). The primary objective was to compare the incidence of PTPS at 6 months. Secondary objectives were to compare the incidence of neuropathic pain between VATS and OTS and to report perioperative factors associated with the development of PTPS. METHODS: This historical cohort study involved patient contact by a questionnaire regarding the presence of PTPS and its type...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27810456/considerations-in-spinal-fusion-surgery-for-chronic-lumbar-pain-psychosocial-factors-rating-scales-and-perioperative-patient-education-a-review-of-the-literature
#4
REVIEW
Daniel Gaudin, Brianna M Krafcik, Tarek R Mansour, Ahmed Alnemari
OBJECTIVE: This literature review was conducted to better understand the factors associated with optimal post-operative results following lumbar spinal fusion for chronic back pain, and the current tools used for evaluation. BACKGROUND: Despite widespread use of lumbar spinal fusion as a treatment for back pain, outcomes remain variable. Optimizing patient selection can help to reduce adverse outcomes. METHODS: The PubMed database was searched for clinical trials related to psychosocial determinants of outcome following lumbar spinal fusion surgery, evaluation of commonly used patient subjective outcome measures, and perioperative cognitive, behavioral, and educational therapies...
October 31, 2016: World Neurosurgery
https://www.readbyqxmd.com/read/27793238/pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#5
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27767680/postoperative-urinary-retention-in-patients-undergoing-elective-spinal-surgery
#6
David Altschul, Andrew Kobets, Jonathan Nakhla, Ajit Jada, Rani Nasser, Merritt D Kinon, Reza Yassari, John Houten
OBJECTIVE Postoperative urinary retention (POUR) is a common problem leading to morbidity and an increased hospital stay. There are limited data regarding its baseline incidence in patients undergoing spinal surgery and the risk factors with which it may be associated. The purpose of this study was to evaluate the incidence of POUR in elective spine surgery patients and determine the factors associated with its occurrence. METHODS The authors retrospectively reviewed the records of patients who had undergone elective spine surgery and had been prospectively monitored for POUR during an 18-month period...
October 21, 2016: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27736284/continuous-perioperative-sublingual-buprenorphine
#7
Marcelina Jasmine Silva, Andrea Rubinstein
Buprenorphine, a semisynthetic thebaine derivative, is a unique opioid, as it has activity at multiple receptors, including mu (partial agonist), kappa (antagonist), OLR-1 (agonist), and delta (antagonist). Because buprenorphine's pharmacology is relatively complex, misconceptions about its actions are common. Most other opioids act solely or predominately as full mu receptor agonists. Common practice at many institutions calls for the cessation of regular buprenorphine use 48-72 hours prior to surgery. This practice is based on three foundational theories that have come from scant data about the properties of buprenorphine: (1) that buprenorphine is only a partial mu agonist and therefore is not a potent analgesic; (2) because buprenorphine has a ceiling effect on respiratory depression, it also has a ceiling effect on analgesia; and (3) that buprenorphine acts as a "blockade" to the analgesic effects of other opiates when coadministered due to its strong binding affinity...
October 13, 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27716330/survival-rate-and-perioperative-data-of-patients-who-have-undergone-hemipelvectomy-a-retrospective-case-series
#8
Alfredo Guilherme Haack Couto, Bruno Araújo, Roberto André Torres de Vasconcelos, Marcos José Renni, Clóvis Orlando Da Fonseca, Ismar Lima Cavalcanti
BACKGROUND: Hemipelvectomy is a major orthopedic surgical procedure indicated in specific situations. Although many studies discuss surgical techniques for hemipelvectomy, few studies have presented survival data, especially in underdeveloped countries. Additionally, there is limited information on anesthesia for orthopedic oncologic surgeries. The primary aim of this study was to determine the survival rate after hemipelvectomy, and the secondary aims were to evaluate anesthesia and perioperative care associated with hemipelvectomy and determine the influence of the surgical technique (external hemipelvectomy [amputation] or internal hemipelvectomy [limb sparing surgery]) on anesthesia and perioperative care in Brazil...
October 7, 2016: World Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27687381/perioperative-factors-associated-with-hospital-consumer-assessment-of-healthcare-providers-and-systems-responses-of-total-hip-arthroplasty-patients
#9
Dermot P Maher, Pauline Woo, Waylan Wong, Xiao Zhang, Roya Yumul, Charles Louy
OBJECTIVE: To determine perioperative treatments and events associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) responses among patients who undergo total hip arthroplasties (THAs) and total knee arthroplasties (TKAs). DESIGN: Retrospective analysis. SETTING: Single tertiary care, academic, urban, level 1 trauma center. PARTICIPANTS: Final cohort represents 301 consecutive surgical inpatients meeting criteria for evaluation by HCAHPS survey...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27651509/the-influence-of-type-of-anesthesia-perioperative-pain-and-preoperative-health-status-on-chronic-pain-six-months-after-thoracotomy-a-prospective-cohort-study
#10
Sandra Kampe, Bianca Geismann, Gerhard Weinreich, Georgios Stamatis, Uwe Ebmeyer, Hans J Gerbershagen
BACKGROUND:  Chronic post-thoracotomy pain (CPP) has a high incidence. However, less is known about risk factors and the influence of different analgesia therapies. METHODS:  In this prospective cohort study, patients either received standardized epidural analgesia or began an oral analgesic protocol with controlled-release oxycodone immediately postoperatively. Patients answered a baseline questionnaire on the day before surgery and a follow-up questionnaire six months postoperatively...
September 20, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27639506/-pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#11
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
September 14, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27566812/pain-management-in-patients-with-vascular-disease
#12
M Seretny, L A Colvin
Vascular disease covers a wide range of conditions, including arterial, venous, and lymphatic disorders, with many of these being more common in the elderly. As the population ages, the incidence of vascular disease will increase, with a consequent increase in the requirement to manage both acute and chronic pain in this patient population. Pain management can be complex, as there are often multiple co-morbidities to be considered. An understanding of the underlying pain mechanisms is helpful in the logical direction of treatment, particularly in chronic pain states, such as phantom limb pain or complex regional pain syndrome...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27555127/does-the-perioperative-analgesic-anesthetic-regimen-influence-the-prevalence-of-long-term-chronic-pain-after-mastectomy
#13
Arnaud Steyaert, Patrice Forget, Virginie Dubois, Patricia Lavand'homme, Marc De Kock
STUDY OBJECTIVE: To investigate if the anesthetic/analgesic regimen is associated with the risk of reporting long-term chronic postmastectomy pain (CPMP). DESIGN: Cross-sectional survey SETTING: Academic hospital PATIENTS: A total of 267 women having undergone mastectomy with axillary lymph node dissection between 2003 and 2008 INTERVENTIONS: All patients were contacted between October and December 2012, with a questionnaire asking for persistent pain after surgery and its characteristics...
September 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27551418/patient-compliance-with-postoperative-analgesia-after-day-case-surgery-a-multisite-observational-study-of-patients-in-north-east-london
#14
Nisreen Fahmy, Julian Siah, Joanna Umo-Etuk
BACKGROUND: Pain is the commonest reason for delayed discharge and readmission post day surgery with up to 45% of patients reported to suffer moderate-to-severe post-surgical pain 24 hours after discharge. The importance of post-surgical pain management extends beyond the acute phase when one considers that all chronic post-surgical pain was once acute. Although much focus is given to perioperative analgesia, a patient's pain management once discharged can be overlooked, whilst at this time the patient's pain management is within their own hands...
May 2016: British Journal of Pain
https://www.readbyqxmd.com/read/27545699/evidence-based-surgical-treatments-for-chronic-pancreatitis
#15
Jörg Kleeff, Christian Stöß, Julia Mayerle, Lynne Stecher, Matthias Maak, Peter Simon, Ulrich Nitsche, Helmut Friess
BACKGROUND: If conservative treatment of chronic pancreatitis is unsuccessful, surgery is an option. The choice of the most suitable surgical method can be difficult, as the indications, advantages, and disadvantages of the available methods have not yet been fully documented with scientific evidence. METHODS: In April 2015, we carried out a temporally unlimited systematic search for publications on surgery for chronic pancreatitis. The target parameters were morbidity, mortality, pain, endocrine and exocrine insuffi - ciency, weight gain, quality of life, length of hospital stay, and duration of urgery...
July 25, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/27531573/tramadol-hydrochloride-acetaminophen-combination-versus-non-steroidal-anti-inflammatory-drug-for-the-treatment-of%C3%A2-perioperative-pain-after-total-knee-arthroplasty-a-prospective-randomized-open-label-clinical-trial
#16
Takeshi Mochizuki, Koichiro Yano, Katsunori Ikari, Ryo Hiroshima, Hiromitsu Takaoka, Kosei Kawakami, Naoko Koenuma, Mina Ishibashi, Toshikatsu Shirahata, Shigeki Momohara
BACKGROUND: While many of the commonly used treatments for perioperative pain after total knee arthroplasty (TKA) have been recognized as effective, there is still insufficient evidence for oral medication. In orthopedics, non-steroidal anti-inflammatory drugs (NSAIDs) have been commonly used for perioperative pain; however, serious adverse events have been reported. Conversely, tramadol hydrochloride/acetaminophen combination (TRAM/APAP) therapy has been shown to reduce pain, particularly for chronic pain in Japan...
September 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/27523659/peripheral-nerve-crushing-to-relieve-chronic-pain-in-diabetic-and-ischaemic-foot-ulcers
#17
K Nagasaki, H Obara, K Tanaka, K Koyano, A Asamia, Y Kitagawa
OBJECTIVE: We retrospectively assessed the effectiveness of peripheral nerve crushing (Smithwick operation) in relieving intractable chronic pain associated with foot ulcers caused by diabetes mellitus (DM) or atherosclerosis. METHOD: From April 2009 to April 2012, patients underwent peripheral nerve crushing in the leg affected by foot ulceration. The cause of ulceration was either DM alone, atherosclerosis alone, or both DM and atherosclerosis. Because sensation in the foot is associated with five nerves: the tibial, deep peroneal, superficial peroneal, sural, and saphenous, one or more of these nerves were crushed over a length of 1...
August 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27521193/chronic-pain-in-neurosurgery
#18
REVIEW
Samuel Grodofsky
This review includes a summary of contemporary theories of pain processing and advocates a multimodal analgesia approach for providing perioperative care. A summary of various medication classes and anesthetic techniques is provided that highlights evidence emerging from neurosurgical literature. This summary covers opioid management, acetaminophen, nonsteroidal antiinflammatories, ketamine, lidocaine, dexmedetomidine, corticosteroids, gabapentin, and regional anesthesia for neurosurgery. At present, there is not enough investigation into these areas to describe best practices for treating or preventing chronic pain in neurosurgery; but providers can identify a wider range of options available to personalize perioperative care strategies...
September 2016: Anesthesiology Clinics
https://www.readbyqxmd.com/read/27514825/-surgical-treatment-of-de-novo-scoliosis
#19
M Putzier, M Pumberger, H Halm, R K Zahn, J Franke
BACKGROUND: De-novo scoliosis is most commonly associated with chronic back pain and in 70 % of cases with neurological symptoms of the lower extremities. In recent literature, the occurrence and severity of segmental lateral listhesis has been discussed as being an important prognostic factor of sagittal and frontal deformity progression. In general, operative interventions in patients with de-novo scoliosis are associated with a high rate of complications. Therefore, conservative treatment modalities are recommended at early stages of the disease...
September 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27450713/the-natural-history-of-chronic-pancreatitis-after-operative-intervention-the-need-for-revisional-operation
#20
Vikrom K Dhar, Nick C Levinsky, Brent T Xia, Daniel E Abbott, Gregory C Wilson, Jeffrey J Sussman, Milton T Smith, Sampath Poreddy, Kyuran Choe, Dennis J Hanseman, Michael J Edwards, Syed A Ahmad
BACKGROUND: For patients with chronic pancreatitis, duodenum-sparing head resections and pancreaticoduodenectomy are effective operations to relieve abdominal pain. For patients who develop recurrent symptoms after their index operation, the long-term management remains controversial. METHODS: Between 2002 and 2014, patients undergoing operative intervention for chronic pancreatitis were identified retrospectively. Patients requiring reoperation after their index operation were reviewed...
October 2016: Surgery
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