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Arthroplasty analgesia

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https://www.readbyqxmd.com/read/28546014/-anesthetic-requirements-measured-by-bilateral-bispectral-analysis-and-femoral-blockade-in-total-knee-arthroplasty
#1
Maylin Koo, Javier Bocos, Antoni Sabaté, Vinyet López, Carmina Ribes
BACKGROUND AND OBJECTIVES: A continuous peripheral nerve blockade has proved benefits on reducing postoperative morphine consumption; the combination of a femoral blockade and general anesthesia on reducing intraoperative anesthetic requirements has not been studied. The objective of this study was to determine the relevance of timing in the performance of femoral block to intraoperative anesthetic requirements during general anesthesia for total knee arthroplasty. METHODS: A single-center, prospective cohort study on patients scheduled for total knee arthroplasty, were sequentially allocated to receive 20mL of 2% mepivacaine throughout a femoral catheter, prior to anesthesia induction (Preoperative) or when skin closure started (Postoperative)...
May 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28545172/femoral-nerve-block-versus-adductor-canal-block-for-analgesia-after-total-knee-arthroplasty
#2
REVIEW
In Jun Koh, Young Jun Choi, Man Soo Kim, Hyun Jung Koh, Min Sung Kang, Yong In
Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28499420/continuous-femoral-nerve-blockade-and-single-shot-sciatic-nerve-block-promotes-better-analgesia-and-lower-bleeding-for-total-knee-arthroplasty-compared-to-intrathecal-morphine-a-randomized-trial
#3
Nora Elizabeth Rojas Álvarez, Rosemberg Jairo Gomez Ledesma, Adilson Hamaji, Marcelo Waldir Mian Hamaji, Joaquim Edson Vieira
BACKGROUND: Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. METHODS: A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group)...
May 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28496358/analgesic-efficacy-adverse-effects-and-safety-of-oxycodone-administered-as-continuous-intravenous-infusion-in-patients-after-total-hip-arthroplasty
#4
Bogumił Olczak, Grzegorz Kowalski, Wojciech Leppert, Iwona Zaporowska-Stachowiak, Katarzyna Wieczorowska-Tobis
BACKGROUND: Total hip arthroplasty (THA) causes extensive tissue damage and severe pain. This study aimed to assess the analgesic efficacy, adverse effects (AEs), and safety of continuous intravenous (iv) oxycodone infusion with ketoprofen (injected into the iv line) in patients after THA, and to assay serum oxycodone levels. PATIENTS AND METHODS: Fourteen patients, aged 59‒82 years with American Society of Anesthesiologists (ASA) classification I or III, underwent THA with intrathecal analgesia and sedation induced by iv propofol...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28489762/comparison-of-local-infiltration-analgesia-and-sciatic-nerve-block-as-an-adjunct-to-femoral-nerve-block-for-pain-control-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#5
Zhi Zhang, Qing Yang, Wenqi Xin, Yixuan Zhang
BACKGROUND: To perform a meta-analysis to assess the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) for pain control following total knee arthroplasty (TKA). METHODS: We systemically searched the following electronic databases for potentially relevant articles: Embase (1980-2017.01), Medline (1966-2017.01), PubMed (1966-2017.01), ScienceDirect (1985-2017.01), web of science (1950-2017...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28478713/continuous-infusion-ketorolac-for-postoperative-analgesia-following-unilateral-total-knee-arthroplasty
#6
Amy J Schwinghammer, Alex N Isaacs, Rodney W Benner, Heather Freeman, Jacob A O'Sullivan, Sarah A Nisly
BACKGROUND: Previous clinical trials have demonstrated benefit with the addition of continuous infusion (CI) ketorolac to a multimodal pain regimen in surgical patients. Data following major orthopedic surgery are minimal and conflicting. OBJECTIVES: To evaluate CI ketorolac use following unilateral total knee arthroplasty (TKA) through assessment of patient-reported pain scores, opioid consumption, and safety outcomes. METHODS: This was a retrospective, open-label cohort study that included patients undergoing unilateral TKA at a single-center teaching hospital...
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28475475/preemptive-analgesia-by-using-celecoxib-combined-with-tramadol-apap-alleviates-post-operative-pain-of-patients-undergoing-total-knee-arthroplasty
#7
Zhongwei Xu, Hua Zhang, Jiao Luo, Aiguo Zhou, Jian Zhang
OBJECTIVE: This study was aimed to evaluate the efficacy of preemptive analgesia (PA) by using celecoxib combined with low-dose tramadol/acetaminophen (tramadol/APAP) in treating post-operative pain of patients undergoing unilateral total knee arthroplasty (TKA). METHODS: A total of 132 patients scheduled for TKA were included in this study. Three-day pre-operative medication was administrated in PA group with subsequent effective intra- and post-operative multimodal analgesia, while control patients received multimodal analgesia without PA...
May 17, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28468607/does-local-infiltration-analgesia-reduce-peri-operative-inflammation-following-total-hip-arthroplasty-a-randomized-double-blind-study
#8
J Kuchálik, A Magnuson, E Tina, A Gupta
BACKGROUND: Postoperative inflammation following total hip arthroplasty (THA) can lead to delayed mobilization and return of hip function. Our primary aim was to assess whether local infiltration analgesia (LIA) during surgery can prevent postoperative inflammation. METHODS: This is a sub-analysis of data from a broader double-blind study where 56 patients received spinal anaesthesia for THA. Additionally, Group FNB (Femoral Nerve Block) received an ultrasound-guided femoral nerve block using 30 mL of ropivacaine 7...
May 3, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28464196/does-addition-of-adductor-canal-blockade-to-multimodal-periarticular-analgesia-improve-discharge-status-pain-levels-opioid-use-and-length-of-stay-after-total-knee-arthroplasty
#9
Chukwuweike U Gwam, Jaydev B Mistry, Ifie V Richards, Dhrudeep Patel, Nirav G Patel, Melbin Thomas, Hephzibah Adamu, Ronald E Delanois
Total knee arthroplasty (TKA) can be associated with substantial postoperative pain that may affect satisfaction and return to function. Various forms of pain control have been used; however, multimodal periarticular analgesia (MPA) and adductor canal block (ACB) have recently gained popularity. The purpose of this study was to compare (1) discharge status, (2) pain levels, (3) postoperative opioid consumption, and (4) length of stay (LOS) between TKA patients who received MPA only and those who received both MPA and ACB...
May 2, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28442852/perioperative-systemic-glucocorticoids-in-total-hip-and-knee-arthroplasty-a-systematic-review-of-outcomes
#10
REVIEW
Jeffrey Hartman, Vickas Khanna, Anthony Habib, Forough Farrokhyar, Muzammil Memon, Anthony Adili
BACKGROUND: Perioperative systemic glucocorticoids are frequently included in multimodal analgesia and antiemetic regimens administered to patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The objective of this systematic review was to evaluate the available randomized controlled trials (RCTs) to determine the effect of perioperative systemic glucocorticoids on postoperative nausea and vomiting (PONV), pain, narcotic consumption, antiemetic consumption, length of stay in hospital, and major complications in patients undergoing elective THA or TKA...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28440034/role-of-transcranial-direct-current-stimulation-on-reduction-of-postsurgical-opioid-consumption-and-pain-in-total-knee-arthroplasty-double-randomized-clinical-trial
#11
E M Khedr, E S A Sharkawy, A M A Attia, N M Ibrahim Osman, Z M Sayed
BACKGROUND: Postoperative pain control is an important factor in determining recovery in total knee arthroplasty (TKA).The aim of the study was to assess the efficacy of 4 sessions of transcranial direct current stimulation (tDCS) over primary motor cortex (M1) in patients undergoing unilateral TKA. MATERIALS: Fifty patients undergoing TKA were included in the study. They were divided randomly into two groups (25 patients for each, using closed envelopes): real tDCS (2 mA, 20 min, with anodal stimulation applied over M1 postoperative for 4 consecutive days) and sham tDCS...
April 25, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28435149/regional-anesthesia-did-not-delay-diagnosis-of-compartment-syndrome-a-case-report-of-anterior-compartment-syndrome-in-the-thigh-not-masked-by-an-adductor-canal-catheter
#12
Arissa Torrie, Jyoti Sharma, Mark Mason, Hillenn Cruz Eng
BACKGROUND Acute compartment syndrome (ACS) of the thigh after elective primary total knee arthroplasty is rare. If not recognized and treated promptly, devastating consequences may result. Certain regional anesthesia techniques are thought to mask the symptoms of acute compartment syndrome, but there are no cases reported of adductor canal catheters masking the symptoms of thigh compartment syndrome. We report a case where symptoms and diagnosis of acute anterior thigh compartment syndrome were not masked by a functioning adductor canal catheter...
April 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28418963/optimizing-analgesia-for-total-knee-arthroplasty-a-networked-comparison
#13
Jonathan P Wanderer, James P Rathmell
No abstract text is available yet for this article.
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28413514/effect-of-pre-emptive-analgesia-by-continuous-femoral-nerve-block-on-early-postoperative-cognitive-function-following-total-knee-arthroplasty-in-elderly-patients
#14
Li-Qin Deng, Lei-Na Hou, Feng-Xiang Song, Han-Yue Zhu, Hai-Ying Zhao, Gang Chen, Jing-Jing Li
To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30)...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28385937/multimodal-infiltration-of-local-anaesthetic-in-total-knee-arthroplasty-is-posterior-capsular-infiltration-worth-the-risk-a-prospective-double-blind-randomised-controlled-trial
#15
RANDOMIZED CONTROLLED TRIAL
P Pinsornsak, S Nangnual, K Boontanapibul
AIMS: Multimodal infiltration of local anaesthetic provides effective control of pain in patients undergoing total knee arthroplasty (TKA). There is little information about the added benefits of posterior capsular infiltration (PCI) using different combinations of local anaesthetic agents. Our aim was to investigate the effectiveness of the control of pain using multimodal infiltration with and without infiltration of the posterior capsule of the knee. PATIENTS AND METHODS: In a double-blind, randomised controlled trial of patients scheduled for unilateral primary TKA, 86 were assigned to be treated with multimodal infiltration with (Group I) or without (Group II) PCI...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28383293/peripheral-nerve-block-as-a-supplement-to-light-or-deep-general-anesthesia-in-elderly-patients-receiving-total-hip-arthroplasty-a-prospective-randomized-study
#16
Bin Mei, Hanning Zha, Xiaolong Lu, Xinqi Cheng, Shishou Cheng, Xuesheng Liu, Yuanhai Li, Erwei Gu
BACKGROUND: Peripheral nerve block combined with general anesthesia is a preferable anesthesia method for elderly patients receiving hip arthroplasty. The depth of sedation may influence patient recovery. Therefore, we aimed to investigate the influence of peripheral nerve blockade and different intraoperative sedation levels on the short-term recovery of elderly patients receiving total hip arthroplasty. METHODS: Patients aged 65 years and older undergoing total hip arthroplasty were randomized into three groups: a general anesthesia without lumbosacral plexus block group, and two general anesthesia plus lumbosacral plexus block groups, each with a different level of sedation (light or deep)...
April 5, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28375752/local-infiltration-for-postsurgical-analgesia-following-total-hip-arthroplasty-a-comparison-of-liposomal-bupivacaine-to-traditional-bupivacaine
#17
Carl V Asche, Jinma Ren, Minchul Kim, Kate Gordon, Marie McWhirter, Carmen S Kirkness, Brian T Maurer
OBJECTIVE: To assess postsurgical clinical and economic outcomes of patients who received local infiltration containing liposomal bupivacaine versus traditional bupivacaine for pain management following total hip arthroplasty (THA). METHODS: This retrospective study included two groups of consecutive patients undergoing THA. The experimental group received local infiltration with a combination of liposomal bupivacaine, bupivacaine HCl 0.25% with epinephrine 1:200,000, and ketorolac for postsurgical analgesia...
April 4, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28372970/reverse-shoulder-arthroplasty-for-complex-fractures-of-the-proximal-humerus-in-elderly-patients-impact-on-the-level-of-independency-early-function-and-pain-medication
#18
Fabian Wolfensperger, Patrick Grüninger, Michael Dietrich, Mathias Völlink, Emanuel Benninger, Michel Schläppi, Christoph Meier
BACKGROUND: This study investigated early functional outcome, quality of life, and the level of independency in elderly patients after primary reverse shoulder arthroplasty (RSA) for complex fractures of the proximal humerus. METHODS: This was a prospective case series that included 33 patients, aged ≥70 years, with a high level of independency who received RSA for complex fractures of the humerus (Orthopaedic Trauma Association B2/C) from January 2012 to April 2014...
March 31, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28357078/efficacy-of-intra-articular-magnesium-for-postoperative-analgesia-in-total-hip-arthroplasty
#19
Xinxian Xu, Hong Wen, Yuezheng Hu, Zhongtang Liu, Xiaoyun Pan
The aim of the present study was to compare the efficacy of intra-articular magnesium sulphate and a saline placebo for postoperative pain control following total hip arthroplasty (THA). Sixty patients underwent THA and were randomly allocated into two groups to receive intra-articular injections of either 10 ml magnesium sulphate (100 mg/ml; magnesium group, n=30) or 10 ml normal saline solution (control group, n=30). Postoperative analgesia was maintained by intravenous morphine injection. The outcome measurements were visual analogue score (VAS), morphine consumption and Harris hip score (HHS)...
February 2017: Biomedical Reports
https://www.readbyqxmd.com/read/28348503/gabapentin-does-not-appear-to-improve-postoperative-pain-and-sleep-patterns-in-patients-who-concomitantly-receive-regional-anesthesia-for-lower-extremity-orthopedic-surgery-a-randomized-control-trial
#20
Jean Daniel Eloy, Christy Anthony, Shawn Amin, Moorice Caparó, Mark C Reilly, Steven Shulman
In recent years, gabapentin has gained popularity as an adjuvant therapy for the treatment of postoperative pain. Numerous studies have shown a decrease in pain score, even with immediate postoperative activity, which is significant for early post-op ambulation and regaining functionality sooner. However, studies have been in conclusive in patients undergoing lower extremity orthopedic surgery. For this reason, we hoped to study the effect of gabapentin on postoperative pain in patients undergoing total knee arthroplasty, total hip arthroplasty, or a hip fracture repair...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
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