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https://www.readbyqxmd.com/read/28332374/comparison-of-dexmedetomidine-and-fentanyl-as-an-adjuvant-to-ropivacaine-for-postoperative-epidural-analgesia-in-pediatric-orthopedic-surgery
#1
Sang Jun Park, Seokyung Shin, Shin Hyung Kim, Hyun Woo Kim, Seung Hyun Kim, Hae Yoon Do, Yong Seon Choi
PURPOSE: Opioids are commonly used as an epidural adjuvant to local anesthetics, but are associated with potentially serious side effects, such as respiratory depression. The aim of this study was to compare the efficacy and safety of dexmedetomidine with that of fentanyl as an adjuvant to epidural ropivacaine in pediatric orthopedic surgery. MATERIALS AND METHODS: This study enrolled 60 children (3-12 years old) scheduled for orthopedic surgery of the lower extremities and lumbar epidural patient-controlled analgesia (PCA)...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28331906/associations-between-sarcopenia-and-degenerative-lumbar-scoliosis-in-older-women
#2
Yawara Eguchi, Munetaka Suzuki, Hajime Yamanaka, Hiroshi Tamai, Tatsuya Kobayashi, Sumihisa Orita, Kazuyo Yamauchi, Miyako Suzuki, Kazuhide Inage, Kazuki Fujimoto, Hirohito Kanamoto, Koki Abe, Yasuchika Aoki, Tomoaki Toyone, Tomoyuki Ozawa, Kazuhisa Takahashi, Seiji Ohtori
BACKGROUND: Age-related sarcopenia can cause various forms of physical disabilities. We investigated how sarcopenia affects degenerative lumbar scoliosis (DLS) and lumbar spinal canal stenosis (LSCS). METHODS: Subjects comprised 40 elderly women (mean age 74 years) with spinal disease whose chief complaints were low back pain and lower limb pain. They included 15 cases of DLS (mean 74.8 years) and 25 cases of LSCS (mean age 72.9 years). We performed whole-body dual-energy X-ray absorptiometry (DXA) to analyze body composition, including appendicular and trunk skeletal muscle mass index (SMI; lean mass (kg)/height (m)(2)) and bone mineral density (BMD)...
2017: Scoliosis and Spinal Disorders
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#3
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28328862/postoperative-analgesia-comparing-levobupivacaine-and-ropivacaine-for-brachial-plexus-block-a-randomized-prospective-trial
#4
Kunitaro Watanabe, Joho Tokumine, Alan Kawarai Lefor, Kumi Moriyama, Hideaki Sakamoto, Tetsuo Inoue, Tomoko Yorozu
BACKGROUND: On a pharmacologic basis, levobupivacaine is expected to last longer than ropivacaine. However, most reports of these anesthetics for brachial plexus block do not suggest a difference in analgesic effect. The aim of this study is to compare the postoperative analgesic effects of levobupivacaine and ropivacaine when used for treating ultrasound-guided brachial plexus block. METHODS: A total of 62 patients undergoing orthopedic surgery procedures were prospectively enrolled and randomized to receive levobupivacaine (group L, N = 31) or ropivacaine (group R, N = 31)...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28327419/concomitant-unilateral-post-traumatic-leg-and-foot-compartment-syndrome-in-a-5-years-old-child-case-report
#5
Aissam Elmhiregh, Adel El Feghih, Khaled Faraj
BACKGROUND: Compartment syndrome is one of the most serious orthopedic emergencies [4]. It is usually anticipated and looked at in every single orthopedic case. Early recognition and management of those cases are quite important in order to avoid the devastating consequences of such condition. CASE SUMMARY: This is a case report of a 5 years old child with concomitant unilateral leg and foot compartment syndrome after a roll over trauma. The patient was presented with significant leg and foot swelling, severe pain and absent distal pulses...
February 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28324216/new-classification-for-the-treatment-of-pyogenic-spondylodiscitis-validation-study-on-a-population-of-250-patients-with-a-follow-up-of-2%C3%A2-years
#6
Enrico Pola, G Autore, V M Formica, V Pambianco, D Colangelo, R Cauda, M Fantoni
PURPOSE: Pyogenic spondylodiscitis (PS) is still burdened by a high rate of orthopedic and neurological complications. Despite the rising incidence, the choice of a proper orthopedic treatment is often delayed by the lack of clinical data. The aim of this study was to propose a clinical-radiological classification of pyogenic spondylodiscitis to define a standard treatment algorithm. METHODS: Based on data from 250 patients treated from 2008 to 2015, a clinical-radiological classification of pyogenic spondylodiscitis was developed...
March 21, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28301858/anti-nerve-growth-factor-therapy-increases-spontaneous-day-night-activity-in-mice-with-orthopedic-surgery-induced-pain
#7
Lisa A Majuta, Jean-Marc G Guedon, Stefanie A T Mitchell, Michael H Ossipov, Patrick W Mantyh
Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common and successful surgical interventions to relieve osteoarthritis pain. Control of postoperative pain is critical for patients to fully participate in the required physical therapy which is the most influential factor in effective postoperative knee rehabilitation. Currently, opiates are a mainstay for managing postoperative orthopedic surgery pain including TKA or THA pain. Recently, issues including efficacy, dependence, overdose, and death from opiates have made clinicians and researchers more critical of use of opioids for treating nonmalignant skeletal pain...
April 2017: Pain
https://www.readbyqxmd.com/read/28298758/comparison-of-analgesic-efficacy-of-dexmedetomidine-and-midazolam-as-adjuncts-to-lignocaine-for-intravenous-regional-anesthesia
#8
Bharti Gupta, Ravinder Kumar Verma, Sudershan Kumar, Geeta Chaudhary
BACKGROUND: Intravenous regional anesthesia (IVRA) is safe, technically simple, and cost-effective technique compared to general anesthesia with success rates of 94-98% for upper and lower limb surgeries. The main disadvantage of this procedure is its limited duration for surgery, lack of postoperative analgesia, and tourniquet pain. To overcome this disadvantage, various adjuvants to lignocaine have been studied from time to time. AIM: To compare the analgesic efficacy of dexmedetomidine and midazolam as adjuncts to lignocaine for IVRA for forearm and hand surgeries...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298756/comparison-of-postoperative-pain-after-epidural-anesthesia-using-0-5-0-75-ropivacaine-and-0-5-bupivacaine-in-patients-undergoing-lower-limb-surgery-a-double-blind-study
#9
Tripat Kaur Bindra, Rajvinder Singh, Ruchi Gupta
BACKGROUND: Ropivacaine (S (-)-1-propyl-2", 6"; pipecoloxylidide hydrochloride) a newer long-acting amide local anesthetic has various clinical and pharmacokinetic advantages over bupivacaine. AIMS: The aim of this study is to compare the onset as well as the duration of sensory block, hemodynamic variables, and postoperative analgesia with 0.5%, 0.75% ropivacaine and 0.5% bupivacaine after epidural anesthesia for lower limb orthopedic surgery. PATIENTS AND METHODS: Sixty American Society of Anesthesiologists I and II patients scheduled for lower limb orthopedic surgery were enrolled into this randomized, double-blind study...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298221/post-operative-opioid-pain-management-patterns-for-patients-who-receive-hip-surgery
#10
Chad E Cook, Daniel I Rhon, Brian D Lewis, Steven Z George
BACKGROUND: Identifying optimal, post-operative opioid management strategies is a priority of health providers and government agencies. At present, there are no studies we are aware of that have formally investigated opioid prescribing patterns for post-operative non-arthroplasty orthopedic conditions such as femoroacetabular impingement, nor has any study investigated the influence of opioid prescription patterns on health care costs and utilization. We aimed to investigate a subgrouping scheme associated with post-operative opioid prescription strategies and measure the subgroups' direct and indirect health care utilization and costs in individuals undergoing non-arthroplasty orthopedic hip surgery...
March 16, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28293511/de-novo-reconstruction-of-a-hybrid-patella-by-staged-fabrication-of-a-microvascular-bone-transplant-with-an-osteointegrated-prosthetic-socket
#11
Goetz A Giessler, Christian Hendrich
Total patellectomy is sometimes unavoidable but usually results in severely impaired function, pain, and instability in the affected knee. Any patellar prosthetic solutions rely on a certain amount of remaining bone and therefore are not applicable after total patellectomy. Traditionally, reconstruction of a neopatella by avascular or allogeneic bone grafts is hampered by mechanical failure, resorption, or infection. We developed a new, 3-stage approach to reconstruct a hybrid patella composed of a revascularized scapula tip transplant fabricated with a prosthetic socket...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293156/indications-of-implant-removal-a-study-of-83-cases
#12
Muhammad Haseeb, Muhammad Farooq Butt, Tariq Altaf, Khalid Muzaffar, Anil Gupta, Aleena Jallu
INTRODUCTION: Fracture fixation has become advanced with the advent of new and custom metal implants for each type of bone/fracture. After union though, the implant ceases to be important and may be removed. Routine removal is advocated by some and opposed by others. Nevertheless, some patients require removal of the hardware because of various implant-related problems. Our study was aimed at identifying the most common causes for implant removal. OBJECTIVE: To investigate the common indications of orthopedic implant removal surgeries...
January 2017: International Journal of Health Sciences
https://www.readbyqxmd.com/read/28292507/opioid-exit-plan-a-pharmacist-s-role-in-managing-acute-postoperative-pain
#13
Cheryl Genord, Timothy Frost, Deeb Eid
OBJECTIVES: The benefits of a pharmacist's involvement in medication reconciliation and discharge counseling are well documented in the literature as improving patient outcomes. In contrast, no studies have focused on the initiation of a pharmacist-led opioid exit plan (OEP) for acute postoperative pain management. This paper summarizes a pharmacist-led OEP practice model and the potential role that pharmacists and student pharmacists can have at the point of admission, during postoperative recovery, and on discharge in acute pain management patients...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28291395/prospective-evaluation-of-intra-articular-dextrose-prolotherapy-for-treatment-of-osteoarthritis-in-dogs
#14
J Matthew Sherwood, James K Roush, Laura J Armbrust, Walter C Renberg
The objective of this study was to evaluate intra-articular dextrose prolotherapy for osteoarthritis of the elbow or stifle in dogs in a randomized, double-blind, placebo-controlled, prospective pilot study. Seventeen dogs were evaluated with 10 meeting inclusion criteria for this study. Evaluations included orthopedic exam, visual lameness scoring, Canine Brief Pain Inventory (CBPI), goniometry, kinetic gait analysis, and radiography. Initial lameness score, age, body weight, duration of lameness, and CBPI scores did not differ between groups...
March 14, 2017: Journal of the American Animal Hospital Association
https://www.readbyqxmd.com/read/28283444/comparison-between-simple-radiographic-and-computed-tomographic-three-dimensional-reconstruction-for-evaluation-of-the-distal-metatarsal-articular-angle
#15
Eduardo Pedrini Cruz, Felipe Victora Wagner, Carlo Henning, José Antônio Veiga Sanhudo, Fernando Pagnussato, Carlos Roberto Galia
The hallux valgus is a pathologic condition in the forefoot that often causes pain and functional limitations. Assessing all deformity components, such as the distal metatarsal articular angle (DMAA) is essential to hallux valgus treatment. Nevertheless, interobserver agreement of DMAA is poor on plain radiographs. The present study compared computed tomographic (CT) 3-dimensional (3D) reconstruction with plain radiographic measurements for measuring the DMAA. We included 43 consecutive patients (77 feet), diagnosed with hallux valgus at the orthopedic outpatient clinic at Hospital de Clínicas de Porto Alegre (Porto Alegre, Brazil) from April 2014 to June 2015 in our prospective study...
March 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28282425/administration-of-tranexamic-acid-to-patients-undergoing-surgery-for-adolescent-idiopathic-scoliosis-evokes-pain-and-increases-the-infusion-rate-of-remifentanil-during-the-surgery
#16
Nobuko Ohashi, Masayuki Ohashi, Naoto Endo, Tatsuro Kohno
BACKGROUND: We recently reported that tranexamic acid (TXA) evokes pain in rats by inhibiting γ-aminobutyric acid and glycine receptors on neurons in the spinal dorsal horn. Although TXA is commonly used to reduce perioperative blood loss during various surgeries, its potential to induce intraoperative nociception, thereby increasing the need for more analgesics during surgery, has not been investigated. Therefore, this study aimed to investigate whether TXA evokes pain and increases the need for a higher infusion rate of remifentanil in patients undergoing surgery for adolescent idiopathic scoliosis (AIS)...
2017: PloS One
https://www.readbyqxmd.com/read/28271084/analgesia-following-arthroscopy-a-comparison-of-intra-articular-bupivacaine-and-or-midazolam-and-or-fentanyl
#17
Mahmoud Nahravani, Seyed Mostafa Moosavi Tekye, Mohammad Alipour, Hadi Makhmalbaf, Monnavar Afzal Aghaee
BACKGROUND: Arthroscopic intervention is very common for conducting orthopedic surgeries. After a knee arthroscopic surgery, different drugs are used through intra-articular administration to induce analgesia. The aim of this study was to evaluate analgesic effects of Bupivacaine (marcaine), Bupivacaine plus midazolam, and Bupivacaine plus fentanyl in reducing pain after knee arthroscopic surgery. METHODS: Frothy five patients who were candidate for knee arthroscopy were divided into three groups...
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28268001/return-to-duty-following-combat-related-multi-ligamentous-knee-injury
#18
Aaron E Barrow, Andrew J Sheean, Travis C Burns
INTRODUCTION: This retrospective cohort study characterized injury patterns, treatment practices, and identified the return to duty (RTD) rate following combat-related multi-ligament knee injuries (MLKI). PATIENTS AND METHODS: We evaluated injury characteristics and treatment methods of 46 military service members who had sustained a MLKI during combat activity. The primary clinical outcome measure was ability to return to active military duty. Secondary outcomes included subjective pain score, knee motion, knee instability, and use of ambulatory assistive device...
February 22, 2017: Injury
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#19
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
March 6, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28261436/orthopedic-manifestations-of-type-i-camurati-engelmann-disease
#20
Alisher J Yuldashev, Chang Ho Shin, Yong Sung Kim, Woo Young Jang, Moon Seok Park, Jong Hee Chae, Won Joon Yoo, In Ho Choi, Ok Hwa Kim, Tae-Joon Cho
BACKGROUND: Camurati-Engelmann disease (CED) is a rare genetic skeletal disorder characterized by limb pain, muscle emaciation and weakness, and cortical thickening of the diaphysis of long bones. It is caused by mutations in the transforming growth factor beta 1 (TGFB1) (type I) or other unknown gene(s) (type II). We present 8 consecutive patients with type I CED. METHODS: We retrospectively reviewed medical records and radiographs of type I CED patients with special reference to the mode of presentation, process of diagnostic work-up, and disease course...
March 2017: Clinics in Orthopedic Surgery
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