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Perioperative and chronic pain

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https://www.readbyqxmd.com/read/29772595/-case-report-metamizole-induced-agranulocytosis
#1
Falk A Gonnert, Winfried Meißner
Metamizole is primarily used for severe perioperative pain, acute injury and colic, and cancer pain. For other acute/chronic forms of pain and high fever, it should only be used if unresponsive to other agents. Metamizole should not be used for middle and low pain. Oral application should be preferred. A contraindication for metamizole is leukopenia. Clinical signs for agranulocytosis are fever, tonsillitis and aphthous stomatitis.
May 2018: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29759289/comprehensive-acute-pain-management-in-the-perioperative-surgical-home
#2
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
#3
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/29757886/perioperative-lidocaine-infusions-for-the-prevention-of-chronic-post-surgical-pain-a-systematic-review-and-meta-analysis-of-efficacy-and-safety
#4
Martin Bailey, Tomas Corcoran, Stephan Schug, Andrew Toner
Chronic post-surgical pain (CPSP) occurs in 12% of surgical populations and is a high priority for perioperative research. Systemic lidocaine may modulate several of the pathophysiological processes linked to CPSP. This systematic review aims to identify and synthesize the evidence linking lidocaine infusions and CPSP.The authors conducted a systematic literature search of the major medical databases from inception until October 2017. Trials that randomized adults without baseline pain to perioperative lidocaine infusion or placebo were included if they reported on CPSP...
May 11, 2018: Pain
https://www.readbyqxmd.com/read/29748103/gabapentin-as-an-adjunct-to-standard-postoperative-pain-management-protocol-in-lower-extremity-surgery
#5
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/29739543/special-indications-for-opioid-free-anaesthesia-and-analgesia-patient-and-procedure-related-including-obesity-sleep-apnoea-chronic-obstructive-pulmonary-disease-complex-regional-pain-syndromes-opioid-addiction-and-cancer-surgery
#6
REVIEW
Adrian Sultana, David Torres, Roman Schumann
Opioid-free anaesthesia (OFA) is a technique where no intraoperative systemic, neuraxial or intracavitary opioid is administered with the anaesthetic. Opioid-free analgesia similarly avoids opioids in the perioperative period. There are many compelling reasons to avoid opioids in the surgical population. A number of case reports and, increasingly, prospective studies from all over the world support its benefits, especially in the morbidly obese population with or without sleep apnoea. A derivative technique is opioid sparing, where the same techniques are used but some opioid use is allowed...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29739537/opioid-free-anesthesia-opioid-side-effects-tolerance-and-hyperalgesia
#7
REVIEW
Patricia Lavand'homme, Arnaud Steyaert
Opioids are the most potent drugs used to control severe pain. However, neuroadaptation prevents opioids' ability to provide long-term analgesia and produces opposite effects, i.e., enhancement of existent pain and facilitation of chronic pain development. Neuroadaptation to opioids use results in the development of two interrelated phenomena: tolerance and "opioid-induced hyperalgesia" (OIH). Tolerance, a pharmacologic concept, and OIH, a clinical syndrome, have been mostly observed under experimental conditions in animals and in human volunteers...
December 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/29701506/outcomes-of-laparoscopic-subtotal-colectomy-with-cecorectal-anastomosis-for-slow-transit-constipation-a-single-center-retrospective-study
#8
Dong Yang, Liang He, Tong-Rong Su, Yan Chen, Quan Wang
PURPOSE: To study the safety and efficacy of laparoscopic subtotal colectomy (LASC) with cecorectal anastomosis for slow-transit constipation (STC). METHODS: This study was a retrospective review of all patients undergoing LASC with cecorectal anastomosis for STC between March 2010 and May 2017. The main variables included the operative time, blood loss, length of postoperative hospital stay, complications, and long-term outcomes. RESULTS: In this analysis, 56 patients were included...
April 27, 2018: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/29676223/opiate-free-tricuspid-valve-replacement-case-report
#9
Jeffrey P Cardinale, George Gilly
The utility of opioid pain medications for perioperative analgesia is well described. However, opioids have many dangerous side effects including respiratory depression, acute tolerance, hyperalgesia, and chronic opioid dependence. Multimodal approaches continue to be used in more invasive and complex surgical procedures for enhanced recovery and decreased postoperative complications from opioid administration. The current case report centers on a 30-year-old male recovering from opioid addiction presenting with severe tricuspid regurgitation scheduled to undergo a tricuspid valve replacement...
April 1, 2018: Seminars in Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29628772/incidence-and-association-factors-for-the-development-of-chronic-post-hysterectomy-pain-at-4-and-6-month-follow-up-a-prospective-cohort-study
#10
Ban Leong Sng, Yin Ying Ching, Nian-Lin R Han, Farida Binte Ithnin, Rehena Sultana, Pryseley Nkouibert Assam, Alex Tiong Heng Sia
Chronic pain has major adverse effects on health-related quality of life and contributes to significant socioeconomic burden. Hysterectomy is a very common gynecological surgery, resulting in chronic post-hysterectomy pain (CPHP), an important pain syndrome. We conducted a prospective cohort study in 216 Asian women who underwent abdominal or laparoscopic hysterectomy for benign conditions. Demographic, psychological, and perioperative data were recorded. Postoperative 4- and 6-month phone surveys were conducted to assess the presence of CPHP and functional impairment...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29608462/management-of-a-patient-with-a-history-of-nonanesthesia-related-malignant-hyperthermia-undergoing-laparoscopic-cholecystectomy-a-case-report
#11
Emily P Nelson, Margaret E Dorlon, Tamas A Szabo, Jonathan B Trollinger, Crystal Johnson-Mann, Gearin Broderick, Robert D Warters
A 36-year-old African American with a medical history of nonanesthesia-related malignant hyperthermia (MH) who was taking chronic oral dantrolene therapy presented with right upper quadrant pain for a laparoscopic cholecystectomy. A multidisciplinary perioperative plan was implemented with the goal of avoiding triggering an MH episode or rhabdomyolysis. He developed a postoperative left brachial vein thrombus of unclear etiology, possibly related to dantrolene administration or his underlying susceptibility to MH...
March 30, 2018: A&A practice
https://www.readbyqxmd.com/read/29587906/-a-comparative-study-of-acute-and-chronic-pain-between-single-port-and-triple-port-video-assisted-thoracic-surgery-for-lung-cancer
#12
Caiwei Li, Meiqing Xu, Guangwen Xu, Ran Xiong, Hanran Wu, Mingran Xie
BACKGROUND: Through the comparative analysis of the acute and chronic pain postoperative between the single port and triple port video-assisted thoracic surgery to seek the better method which can reduce the incidence of acute and chronic pain in patients with lung cancer. METHODS: Data of 232 patients who underwent single port -VATS (n=131) or triple port VATS (n=101) for non-small cell lung cancer (NSCLC) on January 1, 2016 to June 30, 2017 in our hospital were analyzed...
April 20, 2018: Zhongguo Fei Ai za Zhi, Chinese Journal of Lung Cancer
https://www.readbyqxmd.com/read/29576119/pain-after-orthopaedic-surgery-differences-in-patient-reported-outcomes-in-the-united-states-vs-internationally-an-observational-study-from-the-pain-out-dataset
#13
R Zaslansky, W Meissner, C R Chapman
BACKGROUND: A previous PAIN OUT study found that American orthopaedic-surgical patients rated 'worst pain' higher than did similar European patients. This study aims to confirm these findings in a larger, international patient sample, explore whether risk factors for greater postoperative pain exist disproportionately in the American population, and confirm the findings for one procedure. METHODS: Surveyors collected patient reported outcomes (PROs) and perioperative pain management practices using PAIN OUT methodology...
April 2018: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/29570151/incidence-and-risk-factors-for-chronic-postoperative-opioid-use-after-major-spine-surgery-a-cross-sectional-study-with-longitudinal-outcome
#14
Lauren K Dunn, Sandeep Yerra, Shenghao Fang, Mark F Hanak, Maren K Leibowitz, Siny Tsang, Marcel E Durieux, Edward C Nemergut, Bhiken I Naik
BACKGROUND: Chronic opioid use is a significant public health concern. Surgery is a risk factor for developing chronic opioid use. Patients undergoing major spine surgery frequently are prescribed opioids preoperatively and may be at risk for chronic opioid use postoperatively. The aim of this study was to investigate the incidence of and perioperative risk factors associated with chronic opioid use after major spine surgery. METHODS: The records of patients who underwent elective major spine surgery at the University of Virginia between March 2011 and February 2016 were retrospectively reviewed...
March 21, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29560297/harmonic-scalpel-assisted-laparoscopic-cholecystectomy-vs-conventional-laparoscopic-cholecystectomy-a-non-randomized-control-trial
#15
Kumar Rajnish, Sathasivam Sureshkumar, Manwar S Ali, Chellappa Vijayakumar, Sundaramurthi Sudharsanan, Chinnakali Palanivel
Introduction Laparoscopic cholecystectomy (LC) is the most commonly done, minimally invasive surgical procedure. Routinely used electrocautery produces more smoke, which masks the operating field, thereby prolongs the surgery and posing an increased risk of gallbladder (GB) perforation. The titanium clips used for clipping the cystic artery and cystic duct have a risk of slippage, which may lead to bleeding, and an increased risk for bile leakage. In addition, it may act as a nidus for stone formation. Advanced energy sources, such as the harmonic scalpel, though expensive, may provide the advantage of shorter operating time by reducing smoke, bloodless dissection in the GB bed, lower risk of bleeding from the cystic artery due to secure vessel sealing, and avoiding the use of a larger number of titanium clips...
January 18, 2018: Curēus
https://www.readbyqxmd.com/read/29553987/chronic-postsurgical-pain-and-cancer-the-catch-of-surviving-the-unsurvivable
#16
Stephen R Humble, Nicolas Varela, Asantha Jayaweera, Arun Bhaskar
PURPOSE OF REVIEW: Chronic postsurgical pain (CPSP) is an important and well recognized cause of much long-term suffering, which in some cases may be preventable and affects many people living with cancer. Unfortunately, general consensus is lacking as to how best reduce the risk of developing CPSP. RECENT FINDINGS: Cancer is now not always a short-lived, fatal disease and is now moving towards a chronic illness. Poorly managed perioperative pain is the greatest risk factor for CPSP...
March 16, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29540281/perioperative-pain-assessment-in-a-14-year-old-boy-with-lumbar-disc-herniation
#17
Catherine E Ferland, Diana-Luk Ye, Jean A Ouellet
This case report illustrates the value of a comprehensive perioperative pain assessment composed of quantitative sensory testing and self-reported measures that highlight the impact of pain experienced by a 14-year-old boy suffering from chronic low back pain and sciatica. Before surgery, the pain assessment revealed inefficient endogenous inhibitory pain control with presence of temporal summation of pain. The severe pain was constant and lasted for 18 months. The patient was in a high-anxiety state, and reported significant functional disability and poor sleep quality...
March 12, 2018: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/29501810/laparoscopic-neuronavigation-for-deep-lateral-pelvic-endometriosis-clinical-and-surgical-implications
#18
Vito Chiantera, Marco Petrillo, Elene Abesadze, Giulio Sozzi, Margherita Dessole, Mariano Catello Di Donna, Giovanni Scambia, Jalid Sehouli, Sylvia Mechsner
STUDY OBJECTIVE: To evaluate the clinical presentation and surgical outcome in patients with deep lateral pelvic endometriosis (dLPE). DESIGN: A retrospective multicentric study (Canadian Task Force classification II-2). SETTING: University tertiary referral centers. PATIENTS: One hundred forty-eight women with deep infiltrating endometriosis (DIE). INTERVENTIONS: Laparoscopic excision of DIE. Disease distribution was classified as follows: central pelvic endometriosis (CPE) when DIE involved 1 of the following anatomic sites: cervix, vagina, uterosacral ligaments, rectum, bladder, or pelvic peritoneum; superficial lateral pelvic endometriosis when parametria, ureters, or hypogastric plexus were involved; and dLPE in the presence of sacral plexus and/or sciatic nerve infiltration...
March 2, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29494401/neuroimaging-of-pain-human-evidence-and-clinical-relevance-of-central-nervous-system-processes-and-modulation
#19
Katherine T Martucci, Sean C Mackey
Neuroimaging research has demonstrated definitive involvement of the central nervous system in the development, maintenance, and experience of chronic pain. Structural and functional neuroimaging has helped elucidate central nervous system contributors to chronic pain in humans. Neuroimaging of pain has provided a tool for increasing our understanding of how pharmacologic and psychologic therapies improve chronic pain. To date, findings from neuroimaging pain research have benefitted clinical practice by providing clinicians with an educational framework to discuss the biopsychosocial nature of pain with patients...
June 2018: Anesthesiology
https://www.readbyqxmd.com/read/29474214/chronic-pain-after-hysterectomy
#20
Birgitte Brandsborg, Lone Nikolajsen
PURPOSE OF REVIEW: Hysterectomy is a common surgical procedure with a low risk of major complications. However, some women experience long-lasting complications, including chronic postsurgical pain, which can have a negative impact on their quality of life. This review aims to present the recent literature on chronic pain following hysterectomy for benign indications. RECENT FINDINGS: Chronic pain following hysterectomy is reported in 10-50% of women. Risk factors include preoperative pelvic pain, pain elsewhere, acute postoperative pain, surgical procedure, and psychological factors such as anxiety and depression...
June 2018: Current Opinion in Anaesthesiology
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