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Persistent post surgical pain

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https://www.readbyqxmd.com/read/29137580/prevalence-and-predictors-of-persistent-post-surgical-opioid-use-a-prospective-observational-cohort-study
#1
N Stark, S Kerr, J Stevens
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29123662/chronic-postsurgical-pain-is-there-a-possible-genetic-link
#2
Sabu Kumar James
Persistent or chronic postsurgical pain (CPSP) has been defined as 'pain persisting beyond 2 months'. The cut-off limit of 2 months has been controversial, and some researchers argue for a 3-month period for the definition of CPSP. Multiple mechanisms, including both patient and surgical, have been shown to influence this transition. Patient factors include age, gender, anxiety, depression, somatisation, catastrophising, pre-existing pain anywhere and pain at the site of surgery. The various surgical factors include site and nature of surgery, infection, inflammation and repeat surgery...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29115943/membrane-protein-nav1-7-contributes-to-the-persistent-post-surgical-pain-regulated-by-p-p65-in-dorsal-root-ganglion-drg-of-smir-rats-model
#3
Zhisong Li, Yaru Li, Jing Cao, Xuemin Han, Weihua Cai, Weidong Zang, Jitian Xu, Wei Zhang
BACKGROUND: Persistent post-surgical pain is a difficult clinical problem. In this study, we intend to explore the mechanism underlying the persistent post-surgical pain in SMIR (skin/muscle incision and retraction) rats. METHODS: First of all, the expression of membrane protein Nav1.7 and p-p65 (Phosphorylation of p65) were detected in ipsilateral L4-6 DRGs of SMIR rats by western-blot and immunostaining. Then with ProTx-II (Nav1.7 blocker) or PDTC (p65 inhibitor) were intrathecally injected while the change of Nav1...
November 7, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/29078686/uniportal-video-assisted-thoracoscopic-surgery-in-hemothorax
#4
REVIEW
Stefano Sanna, Luca Bertolaccini, Jury Brandolini, Desideria Argnani, Marta Mengozzi, Alessandro Pardolesi, Piergiorgio Solli
The management of hemothorax (spontaneous or, more often, due to thoracic trauma lesions), follows basic tenets well-respected by cardiothoracic surgeons. In most, a non-operative approach is adequate and safe, with a defined group of patients requiring only tube thoracostomy. Only a minority of patients need a surgical intervention due to retained hemothorax, persistent bleeding or incoming complications, as pleural empyema or entrapped lung. In the early 1990s, the rapid technological developments determined an increase of diagnostic and therapeutical indications for multiport video-assisted thoracoscopic surgery (VATS) as the gold standard therapy for retained and persistent hemothorax, allowing an earlier diagnosis, total clots removal and better tubes placement with less morbidity, reduced post-operative pain and shorter hospital stay...
2017: J Vis Surg
https://www.readbyqxmd.com/read/29075936/local-anesthetic-delivery-via-surgical-drain-provides-improved-pain-control-versus-direct-skin-infiltration-following-axillary-node-dissection-for-breast-cancer
#5
Muska Khpal, James R C Miller, Zika Petrovic, Delilah Hassanally
BACKGROUND: Axillary node dissection has a central role in the surgical management of breast cancer; however, it is associated with a significant risk of lymphoedema and chronic pain. Peri-operative administration of local anesthesia reduces acute and persistent post-surgical pain, but there is currently no consensus on the optimal method of local anesthetic delivery. METHODS: Patients undergoing axillary dissection for breast cancer were randomly assigned to receive a one-off dose of levobupivacaine 0...
October 26, 2017: Breast Cancer: the Journal of the Japanese Breast Cancer Society
https://www.readbyqxmd.com/read/29066932/efficiency-of-spinal-anesthesia-versus-general-anesthesia-for-lumbar-spinal-surgery-a-retrospective-analysis-of-544-patients
#6
John T Pierce, Guy Kositratna, Mark A Attiah, Michael J Kallan, Rebecca Koenigsberg, Peter Syre, David Wyler, Paul J Marcotte, W Andrew Kofke, William C Welch
BACKGROUND: Previous studies have shown varying results in selected outcomes when directly comparing spinal anesthesia to general in lumbar surgery. Some studies have shown reduced surgical time, postoperative pain, time in the postanesthesia care unit (PACU), incidence of urinary retention, postoperative nausea, and more favorable cost-effectiveness with spinal anesthesia. Despite these results, the current literature has also shown contradictory results in between-group comparisons...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/29021888/a-good-short-term-outcome-in-delayed-decompression-of-cauda-equina-syndrome-in-klebsiella-pneumoniae-spinal-epidural-abscess-a-case-report
#7
J Hanifah, J Joehaimey, M I Yusof
Spinal epidural abscess is a severe, generally pyogenic, infection of the epidural space of spinal cord or cauda equina. The swelling caused by the abscess leads to compression or vascular disruption of neurological structures that requires urgent surgical decompression to avoid significant permanent disability. We share a rare case of Klebsiella pneumoniae spinal epidural abscess secondary to haematogenous spread of previous lung infection that presented late at our centre with cauda equina syndrome that showed good short-term outcome in delayed decompression...
July 2017: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29017511/mechanical-wrist-traction-as-a-non-invasive-treatment-for-carpal-tunnel-syndrome-a-randomized-controlled-trial
#8
Margreet Meems, Viola Spek, Willem J Kop, Berend-Jan Meems, Leo H Visser, Victor J M Pop
BACKGROUND: Carpal tunnel syndrome (CTS) is a common, compressive nerve-entrapment disorder with symptoms of numbness, paresthesia, and pain. Carpal tunnel release surgery is the only known long-term effective treatment. However, surgery is invasive and up to 30% of patients report recurrence or persistence of symptoms or suffer from post-surgical complications. A promising non-surgical treatment for CTS is mechanical wrist traction. The purpose of this study was to evaluate clinical outcomes following mechanical traction in patients with CTS compared to care as usual...
October 10, 2017: Trials
https://www.readbyqxmd.com/read/28934803/two-interesting-cases-of-meralgia-paraesthetica
#9
Christopher David Jones, Luke Guiot, Mark Portelli, Timothy Bullen, Paul Skaife
Meralgia paraesthetica (MP) is a condition originally described by Bernhardt in 1878 and was eventually named by Roth in 1895. It is caused by compression of the lateral femoral cutaneous nerve (LFCN) resulting in varying types of discomfort. Severity of the symptoms can range from mildly uncomfortable to painfully disabling. In this article we discuss 2 patients with a LFCN injury occurring as a result of laparoscopic ventral rectopexy (LVR). The first patient is a 46-year-old female who reported pain and dysesthesia in the left groin and the anterolateral thigh, 2 days post LCR...
September 2017: Pain Physician
https://www.readbyqxmd.com/read/28915961/short-stem-total-hip-arthroplasty-potential-explanations-for-persistent-post-surgical-thigh-pain
#10
Isabel A C Baert, Enrique Lluch, Francis Van Glabbeek, Rudy Nuyts, Salim Rufai, Joanna Tuynman, Filip Struyf, Mira Meeus
Short stem uncemented femoral implants were developed with the aim of preserving proximal bone stock for future revisions, improving biomechanical reconstruction, aiding insertion through smaller incisions and potentially decreasing or limiting the incidence of thigh pain. Despite all the advantages of short stem designs, it remains unclear whether they are able to limit post-surgical thigh pain. In patients with short stem hip arthroplasty and persistent thigh pain, it is of the utmost importance to understand the potential etiologies of this chronic pain for selecting the appropriate treatment strategy...
September 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28898685/avoidance-of-the-vaginal-incision-site-for-mesh-placement-in-vaginal-wall-prolapse-surgery-a-prospective-study
#11
Alfred Robichaud, Mathieu Bélanger, Martine Poirier, Frank Cloutier, Jeffrey Gaudet, Caroline Jose
OBJECTIVE: To evaluate efficacy of a minimal surface area, vaginally-installed polypropylene tape (VPT), avoiding insertion on the incision line to treat an anterior, posterior or anteroposterior vaginal wall prolapse. STUDY DESIGN: Patients with an anterior, posterior or anteroposterior vaginal wall prolapse waiting for surgical treatment were included in the study. Primary outcome was the incidence of prolapse recurrence reported with combined outcome measures and was reported with Kaplan-Meier cumulative incidence...
October 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28890413/persistent-postherniorrhaphy-pain-following-inguinal-hernia-repair-a-cross-sectional-study-of-prevalence-pain-characteristics-and-effects-on-quality-of-life
#12
Tolga Ergönenç, Serbülent Gökhan Beyaz, Hande Özocak, Onur Palabıyık, Fatih Altıntoprak
INTRODUCTION: Chronic inguinal pain due to the inguinal hernia repair is still a serious consideration, and its incidence is evident in approximately 3%-6% of the patients. The purpose of this study was performed to assess the prevalence of chronic pain after inguinal hernia repair and the effects on the quality of life in our patient. METHODS: The records of the patients who were 18 years of age or older and had had an inguinal hernia repair under spinal anesthesia after receiving a diagnosis of inguinal hernia at this hospital from 2009 to 2015 were accessed through the hospital's data system...
October 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28877144/reductions-in-perceived-injustice-are-associated-with-reductions-in-disability-and-depressive-symptoms-after-total-knee-arthroplasty
#13
Esther Yakobov, Whitney Scott, William Stanish, Michael Tanzer, Michael Dunbar, Glen Richardson, Michael Sullivan
INTRODUCTION: Perceptions of injustice have been associated with problematic recovery outcomes in individuals suffering from a wide range of debilitating pain conditions. It has been suggested that, in patients with chronic pain, perceptions of injustice might arise in response to experiences characterized by illness-related pain severity, depressive symptoms, and disability. If symptoms severity and disability are important contributors to perceived injustice, it follows that interventions that yield reductions in symptom severity and disability should also contribute to reductions in perceptions of injustice...
September 1, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28861623/arthroscopic-management-of-snapping-scapula-syndrome-improves-pain-and-functional-outcomes-although-a-high-rate-of-residual-symptoms-has-been-reported
#14
M Memon, J Kay, N Simunovic, O R Ayeni
PURPOSE: To investigate the use of arthroscopy in the management of patients with snapping scapula syndrome, including aetiology, surgical decision-making, outcomes, complications, effectiveness of arthroscopy, and quality of evidence of the existing literature. METHODS: Three databases (PubMed, Ovid [MEDLINE], and EMBASE) were searched independently and in duplicate to systematically screen the literature. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) checklist guided the reporting and data abstraction...
September 1, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28856511/local-infiltration-analgesia-a-2-year-follow-up-of-patients-undergoing-total-hip-arthroplasty
#15
Ján Kuchálik, Anders Magnuson, Anders Lundin, Anil Gupta
PURPOSE: Local infiltration analgesia (LIA) is commonly used for postoperative pain management following total hip arthroplasty (THA). However, the long-term effects of the component drugs are unclear. The aim of our study was to investigate functional outcome, quality of life, chronic post-surgical pain, and adverse events in patients within 2 years of undergoing THA. METHODS: The study was a secondary analysis of data from a previous larger study. Eighty patients were randomized to receive either intrathecal morphine (Group ITM) or local infiltration analgesia (Group LIA) for pain management in a double-blind study...
August 30, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28791233/non-surgical-management-of-recurrent-urinary-tract-infections-in-women
#16
REVIEW
Paul A Bergamin, Anthony J Kiosoglous
One in three women will experience a clinically significant urinary tract infection (UTI) by age twenty-four and almost half will have at least one in their lifetime. Recurrent UTIs (rUTIs) are defined as having greater than two infections in a 6-month period, or three infections over twelve months, with complete resolution for at least two weeks. These may be due to relapse from incomplete treatment (persistence) or re-infection (new source). It may be difficult to distinguish between the two, where the same organism is cultured...
July 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28731957/longitudinal-postoperative-course-of-pain-and-dysfunction-following-total-knee-arthroplasty
#17
Katherine Hadlandsmyth, M Bridget Zimmerman, Roohina Wajid, Kathleen A Sluka, Keela Herr, Charles R Clark, Nicolas O Noiseux, John J Callaghan, Barbara A Rakel
OBJECTIVES: While the majority of patients undergoing Total Knee Arthroplasty report substantial improvement in pain and function, a significant subset experience persistent post-surgical pain and dysfunction. Better understanding of the longitudinal postoperative course is needed, including the association between patient status following physical rehabilitation at 6 weeks post-TKA, to six month outcomes. This study aims to described the postoperative course of TKA and examine variables associated with change in pain and functioning between 6 weeks and 6 months post-TKA...
July 20, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28726472/the-influence-of-pain-memories-on-children-s-and-adolescents-post-surgical-pain-experience-a-longitudinal-dyadic-analysis
#18
Melanie Noel, Jennifer A Rabbitts, Jessica Fales, Jill Chorney, Tonya M Palermo
OBJECTIVE: Although children's pain memories have been shown to be a powerful predictor of subsequent pain experiences in acute procedural and experimental pain settings, little is known about the influence of children's and parents' pain memories on children's future pain experiences in other painful contexts. This study used a dyadic approach to examine the roles of children's and parents' memories of pain on their subsequent reporting of postsurgical pain several months after the child underwent a major surgical procedure...
October 2017: Health Psychology: Official Journal of the Division of Health Psychology, American Psychological Association
https://www.readbyqxmd.com/read/28725617/post-vasectomy-pain-syndrome-diagnosis-management-and-treatment-options
#19
REVIEW
Varsha Sinha, Ranjith Ramasamy
Vasectomy is the most effective form of sterilization for men. With approximately 500,000 vasectomies performed each year in the United States, 1-2% of these patients will experience chronic testicular pain for greater than three months after the procedure. Post-vasectomy pain syndrome (PVPS) is diagnosis of exclusion, and may be caused by direct damage to spermatic cord structures, compression of nerves in the spermatic cord via inflammation, back pressure from epididymal congestion, and perineural fibrosis...
May 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28713049/patient-reported-outcomes-after-surgical-stabilization-of-spinal-tumors-symptom-based-validation-of-the-spinal-instability-neoplastic-score-sins-and-surgery
#20
Ibrahim Hussain, Ori Barzilai, Anne S Reiner, Natalie DiStefano, Lily McLaughlin, Shahiba Ogilvie, Mark Bilsky, Ilya Laufer
BACKGROUND CONTEXT: Neoplastic spinal instability is movement-related pain or neurologic compromise under physiologic loads with the Spinal Instability Neoplastic Score (SINS) developed to facilitate diagnosis. There is a paucity of evidence that mechanical instability correlates with patient-reported symptoms and that surgical stabilization significantly improves these patient-reported outcomes (PROs). PURPOSE: The objective of this study was to determine if SINS correlates with patient-reported preoperative pain and disability, and if surgical stabilization significantly improves PRO...
July 13, 2017: Spine Journal: Official Journal of the North American Spine Society
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