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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/28298775/a-comparative-study-of-intravenous-dexmedetomidine-and-intravenous-clonidine-for-postspinal-shivering-in-patients-undergoing-lower-limb-orthopedic-surgeries
#2
Manohar Panneer, Prakash Murugaiyan, Sufala Viswas Rao
BACKGROUND: Dexmedetomidine and clonidine have been used for the prevention and treatment of shivering following spinal blockade. A prospective randomized, double-blinded study was conducted to compare the efficacy and safety of dexmedetomidine and clonidine in controlling postspinal shivering. METHODS: A total of sixty participants of equal sex, aged between 18 and 60 years of American Society of Anesthesiologists (ASA) I/II Class, who underwent orthopedic lower limb surgeries under spinal anesthesia with ≥Grade III shivering were randomly divided into two groups, Group D (n = 30) received injection dexmedetomidine 0...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28298772/effect-of-dexmedetomidine-as-an-adjuvant-to-0-75-ropivacaine-in-interscalene-brachial-plexus-block-using-nerve-stimulator-a-prospective-randomized-double-blind-study
#3
H D Rashmi, H K Komala
BACKGROUND: Ropivacaine, a newer local anesthetic (LA), has been increasingly used nowadays in different concentrations for peripheral nerve blocks. It has lesser cardiac toxicity and higher safety margin when compared to bupivacaine. Dexmedetomidine, a novel α2 agonist, is widely used as adjuvant to LA in peripheral nerve blocks to decrease the time of onset and increase the duration of the block. In this study, we evaluated the effect of dexmedetomidine as an adjuvant with 0.75% ropivacaine for interscalene brachial plexus block using nerve stimulator...
January 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28282305/ce-original-research-identifying-hospitalized-patients-at-risk-for-harm-a-comparison-of-nurse-perceptions-vs-electronic-risk-assessment-tool-scores
#4
Andrea Stafos, Susan Stark, Kathryn Barbay, Kristen Frost, David Jackel, Lindsey Peters, Elizabeth Riggs, Susan Schedler, Shalan Stroud
: Objective: In many hospitals, nurse-led "safety huddles" are used to relay patient safety information, although whether this effectively identifies patients at risk for harm has not been determined. New electronic risk assessment tools are designed to identify patients at risk for harm during hospitalization, based on specific markers in the electronic health record. This study sought to compare the results of both methods. The findings may help to enhance decision making at the level of care delivery. METHODS: A nonexperimental correlational study was conducted over a three-week period in 2015 in a large metropolitan acute care community hospital...
April 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28271090/intrapelvic-protrusion-of-a-broken-guide-wire-fragment-during-fixation-of-a-femoral-neck-fracture
#5
Ahmadreza Afshar
During fixation of a femoral neck fracture in a 23-year-old male patient with cannulated screws, a broken guide wire fragment inadvertently advanced through the hip joint and protruded into the pelvis. A second surgical approach was needed to remove the broken fragment from the pelvis. Awareness of such a potentially devastating complication will make surgeons more cautious during implementation of orthopedic instruments and increases patient's safety during surgery.
January 2017: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/28261434/survey-of-preferences-in-patients-scheduled-for-carpal-tunnel-release-using-conjoint-analysis
#6
Wan Lim Kim, Jin Sam Kim, Jun Bum Lee, Sun Hwa Kim, Dong-Uk Min, Ho Youn Park
BACKGROUND: This study aimed to investigate the preferences of patients scheduled for carpal tunnel release using conjoint analysis and also introduce an example of how to apply a conjoint analysis to the medical field. The use of conjoint analysis in this study is new to the field of orthopedic surgery. METHODS: A total of 97 patients scheduled for carpal tunnel release completed the survey. The following four attributes were predefined: board certification status, distance from the patient's residency, medical costs, and waiting time for surgery...
March 2017: Clinics in Orthopedic Surgery
https://www.readbyqxmd.com/read/28259490/what-do-patients-expect-from-total-knee-arthroplasty-a-delphi-consensus-study-on-patient-treatment-goals
#7
Toni Lange, Jochen Schmitt, Christian Kopkow, Elisabeth Rataj, Klaus-Peter Günther, Jörg Lützner
BACKGROUND: Although total knee arthroplasty (TKA) is among the most frequent orthopedic procedures for end-stage knee osteoarthritis (OA), systematically developed patient treatment goals for this elective intervention are missing. This constitutes a relevant barrier toward patient-centered healthcare. METHODS: A Delphi consensus study was conducted. Patients who were candidates for TKA were recruited through 11 outpatient orthopedic surgeons, 4 physiotherapists, and a patient organization in Germany...
February 7, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28255955/parecoxib-provides-analgesic-and-opioid-sparing-effects-following-major-orthopedic-surgery-a-subset-analysis-of-a-randomized-placebo-controlled-clinical-trial
#8
Efrain Diaz-Borjon, Armando Torres-Gomez, Margaret Noyes Essex, Patricia Salomon, Chunming Li, Raymond Cheung, Bruce Parsons
INTRODUCTION: Orthopedic surgeries are among the most common and most painful surgeries performed. A multimodal analgesic approach is recommended to reduce opioid consumption, provide effective pain relief, and improve outcomes following surgery. This study examined the efficacy and opioid-sparing effects of parecoxib following major orthopedic surgery. METHODS: This subset analysis of a large, multicenter, randomized, double-blind, placebo-controlled study of parecoxib examined treatment effects on postoperative pain severity, pain interference with function, opioid consumption, occurrence of opioid-related symptoms, safety, and patient satisfaction following major orthopedic surgery...
March 2, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28255511/can-direct-current-electrotherapy-be-used-for-patients-with-orthopedic-implants
#9
Evangeline Thaler, Felippe Toledo, Holger Korte
INTRODUCTION: Although electrotherapy appears to have particularly interesting applications in the field of postoperative orthopedic rehabilitation, relatively little scientifically based research has been conducted in the area of electrotherapy with regard to safety involving patients with orthopedic implants. METHOD: Three electrotherapy forms were tested, such as high-volt stimulation (HVS), transcutaneous electric nerve stimulation (TENS), and galvanic current (GAL), using a model system containing a metal implant plate to evaluate whether heating in excess of 3°C would occur...
March 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28246009/clinical-and-radiographic-features-of-hybrid-surgery-for-the-treatment-of-skip-level-cervical-degenerative-disc-disease-a-minimum-24-month-follow-up
#10
Ting-Kui Wu, Bei-Yu Wang, Ding Cheng, Xin Rong, Ji-Gang Lou, Ying Hong, Hao Liu
We describe the radiographic changes of IS and investigate the safety and feasibility of hybrid surgery (HS) coupling cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF) for the treatment of skip-level cervical degenerative disc disease (CDDD). Twenty-seven patients who received HS were retrospectively reviewed. Clinical evaluation based on the Japanese Orthopedic Association (JOA) and Neck Disability Index (NDI) and Visual Analog Scale (VAS) scores. Radiographic parameters included cervical alignment (CA), functional spine unite (FSU) angle of intermediated segment (IS), range of motion (ROM) and intervertebral disc height (IDH)...
February 25, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28243144/a-double-blind-randomized-comparative-study-of-the-use-of-a-combination-of-uridine-triphosphate-trisodium-cytidine-monophosphate-disodium-and-hydroxocobalamin-versus-isolated-treatment-with-hydroxocobalamin-in-patients-presenting-with-compressive-neuralgias
#11
Henrique Goldberg, Marco Antonio Mibielli, Carlos Pereira Nunes, Stephanie Wrobel Goldberg, Luiz Buchman, Spyros Ge Mezitis, Helio Rzetelna, Lisa Oliveira, Mauro Geller, Fernanda Wajnsztajn
CONTEXT: This paper reports on the results of treatment of compressive neuralgia using a combination of nucleotides (uridine triphosphate trisodium [UTP] and cytidine monophosphate disodium [CMP]) and vitamin B12. OBJECTIVES: To assess the safety and efficacy of the combination of nucleotides (UTP and CMP) and vitamin B12 in patients presenting with neuralgia arising from neural compression associated with degenerative orthopedic alterations and trauma, and to compare these effects with isolated administration of vitamin B12...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28195826/wrong-site-surgery-in-california-2007-2014
#12
Omid Moshtaghi, Yarah M Haidar, Ronald Sahyouni, Afsheen Moshtaghi, Yaser Ghavami, Harrison W Lin, Hamid R Djalilian
Objective The implementation of a universal surgical safety protocol in 2004 was intended to minimize the prevalence of wrong-site surgery (WSS). However, complete elimination of WSS in the operating room continues to be a challenge. The purpose of this study is to evaluate the prevalence and etiology of WSS in the state of California. Study Design A retrospective study of all WSS reports investigated by the California Department of Public Health between 2007 and 2014. Methods Prevalence of overall and specialty-specific WSS, causative factors, and recommendations on further improvement are discussed...
February 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28183145/minimally-invasive-microscopic-posterior-cervical-decompression-simple-safe-and-effective
#13
Pierluigi Vergara
Background and Study Aims Cervical spondylotic myelopathy (CSM) is the most common cause of spinal cord dysfunction in the elderly population. Surgery is usually successful in preventing any deterioration, as well as improving functional status and quality of life. This study assesses the safety and efficacy of minimally invasive microscopic posterior cervical decompression for the treatment of CSM. Materials and Methods A retrospective review of patients with myelopathy from cervical stenosis treated with minimally invasive posterior cervical decompression was performed...
February 9, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28143470/current-use-of-autologous-adipose-tissue-derived-stromal-vascular-fraction-cells-for-orthopedic-applications
#14
REVIEW
Jaewoo Pak, Jung Hun Lee, Kwang Seung Park, Moonhee Park, Lin-Woo Kang, Sang Hee Lee
Autologous adipose stromal vascular fractions (SVFs) containing adipose tissue-derived stem cells (ASCs) are currently being used in clinical settings for various orthopedic applications for human patients. Due to its potential capability of regenerating cartilage, bone, and tendons, autologous adipose SVFs are being tried in treating patients with osteoarthritis (OA), chondromalacia, meniscus tear, osteonecrosis of the femoral head, and tendon injuries. Here, we have reviewed available human clinical studies with regard to patient applications of autologous adipose SVF containing ASCs, specifically assessing effectiveness and safety in the field of orthopedic disorders...
January 31, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/28131017/relationship-between-bone-adaptation-and-in-vivo-mechanical-stimulus-in-biological-reconstructions-after-bone-tumor-a-biomechanical-modeling-analysis
#15
Giordano Valente, Lorenzo Pitto, Enrico Schileo, Sabina Piroddi, Alberto Leardini, Marco Manfrini, Fulvia Taddei
BACKGROUND: Biomechanical interpretations of bone adaptation in biological reconstructions following bone tumors would be crucial for orthopedic oncologists, particularly if based on quantitative observations. This would help plan for surgical treatments, rehabilitative programs and communication with the patients. We aimed to analyze the biomechanical adaptation of a femoral reconstruction after Ewing sarcoma according to an increasingly-used surgical technique, and to relate in-progress bone resorption to the mechanical stimulus induced by different motor activities...
January 21, 2017: Clinical Biomechanics
https://www.readbyqxmd.com/read/28111125/superficial-vancomycin-coating-of-bone-cement-in-orthopedic-revision-surgery-a-safe-technique-to-enhance-local-antibiotic-concentrations
#16
Florian Amerstorfer, Stefan Fischerauer, Patrick Sadoghi, Gerold Schwantzer, Klaus Dieter Kuehn, Andreas Leithner, Mathias Glehr
BACKGROUND: The use of antibiotic-loaded cement has become a well-accepted method to develop high local antibiotic concentrations in revision surgery of infected arthroplasty. A new surgical technique has been established to further increase the local antibiotic concentration and thereby minimizes the risk of reinfection. Our study aim was to investigate the safety of additional superficial vancomycin coating (SVC) by analyzing postoperative joint and serum vancomycin concentrations, as well as the creatinine levels of patients with orthopedic revision surgery...
December 1, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28075437/comparison-of-irrigation-times-using-gravity-and-high-pressure-lavage
#17
Stefano Muscatelli, Andrea Howe, Nathan N O'Hara, Robert V O'Toole, Sheila A Sprague, Gerard P Slobogean
The benefits of high-pressure pulsatile lavage for open fracture irrigation have been controversial based on conflicting experimental animal research. Recently published data definitively demonstrated that irrigation pressure does not affect the incidence of reoperation for the treatment of open fractures. However, proponents of pulsatile lavage argue a faster irrigation time is an important benefit of the high-pressure treatment. The purpose of this study was to determine the difference in irrigation time between gravity and high-pressure lavage...
January 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/28060333/mesenchymal-stromal-cell-culture-and-delivery-in-autologous-conditions-a-smart-approach-for-orthopedic-applications
#18
Luisa Trombi, Serena Danti, Sara Savelli, Stefania Moscato, Delfo D'Alessandro, Claudio Ricci, Stefano Giannotti, Mario Petrini
Human Mesenchymal Stromal Cells (hMSCs) are cultured in vitro with different media. Limits on their use in clinical settings, however, mainly depend on potential biohazard and inflammation risks exerted by xenogeneic nutrients for their culture. Human derivatives or recombinant materials are the first choice candidates to reduce these reactions. Therefore, culture supplements and materials of autologous origin represent the best nutrients and the safest products. Here, we describe a new protocol for the isolation and culture of bone marrow hMSCs in autologous conditions - namely, patient-derived serum as a supplement for the culture medium and fibrin as a scaffold for hMSC administration...
December 8, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/28027388/spinal-anesthesia-in-elderly-patients-undergoing-lumbar-spine-surgery
#19
Noah L Lessing, Charles C Edwards, Charles H Brown, Emily C Ledford, Clayton L Dean, Charles Lin, Charles C Edwards
Spinal anesthesia is increasingly viewed as a reasonable alternative to general anesthesia for lumbar spine surgery. However, the results of spinal anesthesia in elderly patients undergoing lumbar spine decompression and combined decompression and fusion procedures are limited in the literature. The aim of this study was to report a single institution's experience using spinal anesthesia in elderly patients undergoing lumbar spine surgery. A retrospective review was conducted using a prospectively collected database of consecutive lumbar spine surgeries performed under spinal anesthesia in patients 70 years or older at a single center between December 2013 and October 2015...
December 27, 2016: Orthopedics
https://www.readbyqxmd.com/read/28025372/a-pooled-analysis-evaluating-renal-safety-in-placebo-and-active-comparator-controlled-phase-iii-trials-of-multiple-dose-injectable-hp%C3%AE-cd-diclofenac-in-subjects-with-acute-postoperative-pain
#20
Stephen E Daniels, Tong J Tj Gan, Douglas A Hamilton, Neil Singla, Peter G Lacouture, Olufunmibi Johnson, Lauren H Min, Christian R D Reyes, Daniel B Carr
OBJECTIVE : While injectable nonsteroidal anti-inflammatory drugs (NSAIDs) are a key component of postoperative multimodal analgesia, renal safety concerns may limit use in some patients. This study examined the renal safety of injectable HPβCD-diclofenac when given for ≤ 5 days following orthopedic or abdominal/pelvic surgery. METHODS : Pooled analysis of data from two randomized, placebo- and active comparator-controlled phase III trials in 608 total patients was conducted. Renal safety was assessed by examining treatment-emergent adverse events (AEs) and postoperative blood urea nitrogen (BUN) and serum creatinine shifts...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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