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Persistent post surgical pain

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https://www.readbyqxmd.com/read/28508511/clinical-nociceptive-and-psychological-profiling-to-predict-acute-pain-after-total-knee-arthroplasty
#1
I E Luna, H Kehlet, M A Petersen, E K Aasvang
BACKGROUND: Pre-operative identification of high-pain responders for acute pain after total knee arthroplasty (TKA) could lead to targeted analgesic trials and individualized analgesic strategies to improve recovery and potentially reduce the risk of persistent post-surgical pain. The aim of this study was to use simple clinical tests and questionnaires to identify predictive nociceptive and psychological factors for acute post-TKA pain. METHODS: Sixty consecutive TKA patients were included in a prospective descriptive study of pain during a 5-m walk-test 24 h post-operatively as the primary outcome...
May 16, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#2
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
https://www.readbyqxmd.com/read/28483506/laparoscopic-repair-of-a-symptomatic-post-cesarean%C3%A2-section-isthmocele-a-video-case-report
#3
Giorgio Aimi, Laura Buggio, Nicola Berlanda, Paolo Vercellini
OBJECTIVE: To describe our technique for laparoscopic management of post-cesarean section isthmocele. DESIGN: Surgical video article. Local Institutional Review Board approval for the video reproduction has been obtained. SETTING: University hospital. PATIENT(S): A 36-year-old patient with a history of two previous cesarean deliveries. She complained of persistent postmenstrual spotting and chronic pelvic pain. At transvaginal ultrasound examination, a cesarean scar defect of 20...
May 5, 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/28465722/does-partial-coating-with-titanium-improve-the-radiographic-fusion-rate-of-empty-peek-cages-in-cervical-spine-surgery-a-comparative-analysis-of-clinical-data
#4
Andreas Kotsias, Sven Mularski, Björn Kühn, Michael Hanna, Olaf Suess
BACKGROUND: Anterior cervical diskectomy and fusion (ACDF) is a well-established surgical treatment. Several types of intervertebral spacers can be used, but there is increasing evidence that PEEK cages yield insufficient fusion and thus less clinical improvement. The study aim was to assess the outcomes of single-level ACDF with an empty PEEK cage partially coated with titanium. METHODS: This prospective multicenter single-arm clinical study collected follow-up data at 6, 12, and 18 months...
2017: Patient Safety in Surgery
https://www.readbyqxmd.com/read/28437494/patellofemoral-pain-an-enigma-explained-by-homeostasis-and-common-sense
#5
William R Post, Scott F Dye
We present a rational, scientific, low-risk approach to patellofemoral pain (anterior knee pain) based on an understanding of tissue homeostasis. Loss of tissue homeostasis from overload and/or injury produces pain. Bone overload and synovial inflammation are common sources of such pain. Chondromalacia and malalignment are findings that almost always do not need to be "corrected" to relieve pain. Patience and persistence in nonoperative care results in consistent success. Surgery should be rare and done only after extensive nonoperative management and in the setting of clearly defined pathology...
March 2017: American Journal of Orthopedics
https://www.readbyqxmd.com/read/28437260/early-postoperative-neuropathic-pain-assessed-by-the-dn4-score-predicts-an-increased-risk-of-persistent-postsurgical-neuropathic-pain
#6
Helene Beloeil, Barthelemy Sion, Chloe Rousseau, Pierre Albaladejo, Mathieu Raux, Frederic Aubrun, Valeria Martinez
BACKGROUND: Acute neuropathic pain can occur in the postoperative period but any link with persistent post-surgical neuropathic pain remains unclear. OBJECTIVES: The objectives of this study were to prospectively describe the incidence of acute post-surgical neuropathic pain in a large population using the DN4 (clinician administered) questionnaire and to confirm the hypothetical link between acute and persistent neuropathic pain at 2 months after surgery in a large population using the DN2 (self administered) questionnaire...
April 21, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28431198/serum-amylase-and-lipase-and-urinary-trypsinogen-and-amylase-for-diagnosis-of-acute-pancreatitis
#7
REVIEW
Gianluca Rompianesi, Angus Hann, Oluyemi Komolafe, Stephen P Pereira, Brian R Davidson, Kurinchi Selvan Gurusamy
BACKGROUND: The treatment of people with acute abdominal pain differs if they have acute pancreatitis. It is important to know the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis, so that an informed decision can be made as to whether the person with abdominal pain has acute pancreatitis. There is currently no Cochrane review of the diagnostic test accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase for the diagnosis of acute pancreatitis...
April 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28394854/a-role-for-nk-1-neurons-in-the-rostral-ventromedial-medulla-in-the-development-of-chronic-post-thoracotomy-pain
#8
Sergey G Khasabov, Jeffrey Chi-Fei Wang, Donald A Simone, Gary R Strichartz
Thoracotomy results in chronic post-operative pain (CPTP) in half of the cases. Earlier findings in rat models of persistent post-surgical pain suggest that spinal pathways are critical for pain onset but not its maintenance. Descending systems from the brain stem modulate nociceptive transmission in the spinal cord and contribute to persistent pain, but their role in chronic postoperative pain has not been studied. Here we ablated pronociceptive neurokinin-1 receptor (NK-1R)-expressing neurons in the rat rostral ventromedial medulla (RVM) to identify their role in CPTP...
April 5, 2017: Pain
https://www.readbyqxmd.com/read/28393507/-nephrectomies-in-poor-or-non-functioning-kidneys-is-it-the-right-thing-to-do
#9
B Estors, A E Hernández, E Calleja, M D Rodrigo, J Lumbreras, C Marhuenda
AIM OF THE STUDY: To review our management and outcomes of nephrectomies performed in patients with non-functioning kidneys. METHODS: Retrospective analysis of the patients who underwent nephrectomy surgery in our hospital between 2010 and 2014. Data was collected from the patient charts paying special attention to the clinical resolution of the symptoms that motivated surgery. MAIN RESULTS: A total of 18 nephrectomies were performed. Median age was of 6,5 years (range: 11 months to 15 years)...
July 10, 2016: Cirugía Pediátrica: Organo Oficial de la Sociedad Española de Cirugía Pediátrica
https://www.readbyqxmd.com/read/28384895/combined-conventional-and-endoscopic-microdebrider-assisted-adenoidectomy-a-tertiary-centre-experience
#10
Amal T Das, S B Prakash, V Priyadarshini
INTRODUCTION: Adenoidectomy is one of the most commonly performed surgical procedures in children. Conventional adenoidectomy is associated with incomplete adenoid tissue removal with persistence of symptoms. The advent of rigid nasal endoscopes, cold light source, fiber optics and powered instruments used in functional endoscopic sinus surgery helped in the development of endoscopic microdebrider-assisted adenoidectomy. AIM: To establish the safety and efficacy of combined conventional and endoscopic microdebrider-assisted adenoidectomy procedure...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28323223/robotic-assisted-conservative-excision-of-retrocervical-rectal-deep-infiltrating-endometriosis-a-case-series
#11
Alfredo Ercoli, Emma Bassi, Stefania Ferrari, Daniela Surico, Anna Fagotti, Francesco Fanfani, Fiorenzo De Cicco, Nicola Surico, Giovanni Scambia
Deep infiltrating endometriosis (DIE) is a complex disease that impairs the quality of life and the fertility of women. Colorectal DIE accounts for 70% to 93% of all the intestinal endometriotic sites and frequently needs a surgical approach. However, the indications for the surgical management of this condition are still controversial. From March 2010 to June 2014, we scheduled 33 consecutive patients presenting with retrocervical-rectal DIE of any diameter not involving the mucosa nor producing rectal stenosis > 50% for laparoscopic robotic assisted nerve-sparing rectal nodulectomy (LRN)...
March 18, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28273606/an-impressive-choledochal-cyst-and-its-surgical-resection
#12
Nhu Thao Nguyen Galván, Kayla Kumm, Dor Yoeli, Ellen Witte, Michael Kueht, Ronald Timothy Cotton, Abbas Rana, Christine A O'Mahony, John A Goss
INTRODUCTION: Choledochal cysts are rare congenital dilations of the biliary tree that can present with non-specific symptoms such as abdominal pain, jaundice, cholelithiasis and pancreatitis. Although most commonly identified in children, they can be found in the adult population. However, because of the non-specific symptoms, this diagnosis may be difficult to make in the adult. A physician therefore must keep this diagnosis within their differential, as it may arise in an unexpected patient population who may present with a convoluted work up...
February 21, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28237074/systematic-review-predicting-adverse-psychological-outcomes-after-hand-trauma
#13
Emma Ladds, Nathalie Redgrave, Matthew Hotton, Michael Lamyman
STUDY DESIGN: Systematic review. INTRODUCTION AND PURPOSE OF THE STUDY: After traumatic hand injury, extensive physical and psychological adaptation is required following surgical reconstruction. Recovery from injury can understandably be emotionally challenging, which may result in impaired quality of life and delayed physical recovery. However, the evidence base for identifying high-risk patients is limited. METHODS: A PROSPERO-registered literature search of MEDLINE (1946-present), EMBASE (1980-present), PsychInfo, and CINAHL electronic databases identified 5156 results for studies reporting psychological outcomes after acute hand trauma...
February 22, 2017: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
https://www.readbyqxmd.com/read/28222811/recurring-septic-shock-in-a-patient-with-blunt-abdominal-and-pelvic-trauma-how-mandatory-is-source-control-surgery-a-case-report
#14
Antonella Frattari, Giustino Parruti, Rocco Erasmo, Luigi Guerra, Ennio Polilli, Rosamaria Zocaro, Giuliano Iervese, Paolo Fazii, Tullio Spina
BACKGROUND: In critically ill patients with colonization/infection of multidrug-resistant organisms, source control surgery is one of the major determinants of clinical success. In more complex cases, the use of different tools for sepsis management may allow survival until complete source control. CASE PRESENTATION: A 42-year-old white man presented with traumatic hemorrhagic shock. Unstable pelvic fractures led to emergency stabilization surgery. Fever ensued with diarrhea, followed by septic shock...
February 22, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28204925/circumferential-fusion-for-degenerative-lumbar-spondylolisthesis-complicated-by-distal-junctional-grade-4-spondylolisthesis-in-the-sub-acute-post-operative-setting
#15
Alexander A Theologis, Deeptee Jain, Christopher P Ames, Murat Pekmezci
INTRODUCTION: Surgical management for lumbar stenosis is generally safe and provides significant improvements in pain, disability, and function. Successful lumbar decompression hinges on removing an appropriate amount of lamina and other compressive pathology in the lateral recess. Too little bony decompression can result in persistent pain and disability, while over resection of the pars and/or facets may jeopardize spinal stability. CASE REPORT: In this unique report, we present for the first time an acute iatrogenic grade 4 L5-S1 spondylolisthesis distal to a L3-5 laminectomy and circumferential instrumented fusion due to bilateral iatrogenic L5 pars fractures and its management and clinical outcomes after revision operation...
February 15, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28185371/do-depression-and-anxiety-profiles-over-time-predict-persistent-post-surgical-pain-a-study-in-cardiac-surgery-patients
#16
M Gabrielle Pagé, J Watt-Watson, M Choinière
BACKGROUND: Rates of depression and anxiety in cardiac surgery patients are higher than in the general population. The development of persistent post-surgical pain (PPSP) in this population is also concerning. The objectives of this study were to (1) identify anxiety and depression trajectories of cardiac surgery patients over a 2-year period; (2) examine demographic and clinical characteristics associated with trajectory memberships and (3) determine if anxiety and/or depression trajectories predict PPSP...
February 10, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28180101/evaluation-of-complications-after-surgical-treatment-of-thoracic-outlet-syndrome
#17
Mohammad Ali Hosseinian, Ali Gharibi Loron, Yalda Soleimanifard
BACKGROUND: Surgical treatment of thoracic outlet syndrome (TOS) is necessary when non-surgical treatments fail. Complications of surgical procedures vary from short-term post-surgical pain to permanent disability. The outcome of TOS surgery is affected by the visibility during the operation. In this study, we have compared the complications arising during the supraclavicular and the transaxillary approaches to determine the appropriate approach for TOS surgery. METHODS: In this study, 448 patients with symptoms of TOS were assessed...
February 2017: Korean Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28161890/homology-guided-mutational-analysis-reveals-the-functional-requirements-for-antinociceptive-specificity-of-collapsin-response-mediator-protein-2-derived-peptides
#18
Aubin Moutal, Wennan Li, Yue Wang, Weina Ju, Shizhen Luo, Song Cai, Liberty François-Moutal, Samantha Perez-Miller, Jackie Hu, Erik T Dustrude, Todd W Vanderah, Vijay Gokhale, May Khanna, Rajesh Khanna
BACKGROUND AND PURPOSE: N-type voltage-gated calcium (Cav 2.2) channels are critical determinants of increased neuronal excitability and neurotransmission accompanying persistent neuropathic pain. Although Cav 2.2 channel antagonists are recommended as first-line treatment for neuropathic pain, calcium-current blocking gabapentinoids inadequately alleviate chronic pain symptoms and often exhibit numerous side effects. Collapsin response mediator protein 2 (CRMP2) targets Cav 2.2 channels to the sensory neuron membrane and allosterically modulates their function...
February 5, 2017: British Journal of Pharmacology
https://www.readbyqxmd.com/read/28161752/reversibility-of-nerve-root-sedimentation-sign-in-lumbar-spinal-stenosis-patients-after-decompression-surgery
#19
Christian Barz, Markus Melloh, Lukas P Staub, Sarah J Lord, Harry R Merk, Thomas Barz
PURPOSE: The nerve root sedimentation sign (SedSign) is a magnetic resonance imaging (MRI) sign for the diagnosis of lumbar spinal stenosis (LSS). It is included in the assessment of LSS to help determine whether decompression surgery is indicated. Assessment of the reversibility of the SedSign after surgery may also have clinical implications for the decision about whether or not a secondary operation or revision is needed. This study investigated if lumbar decompression leads to a reversal of the SedSign in patients with LSS and a positive SedSign pre-operatively; and if a reversal is associated with more favourable clinical outcomes...
February 4, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28158960/dry-needling-combined-with-physical-therapy-in-patients-with-chronic-postsurgical-pain-following-total-knee-arthroplasty-a-case-series
#20
Rodrigo Núñez-Cortés, Carlos Cruz-Montecinos, Álvaro Vásquez-Rosel, Orlando Paredes-Molina, Antonio Cuesta-Vargas
Study Design Case series. Background This case series describes a combined program of dry needling and therapeutic exercise in a small group of patients with persistent pain following total knee arthroplasty (TKA). Case Description Fourteen patients who underwent TKA had persistent postsurgical pain and myofascial trigger points that were nonresponsive to treatment with conventional physical therapy and/or medication. The patients received a weekly dry needling treatment in combination with therapeutic exercises for 4 weeks...
March 2017: Journal of Orthopaedic and Sports Physical Therapy
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