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acute postoperative pain

Frédéric Cochennec, Jean Marzelle
Acute aortic syndromes include aortic dissections, intramural hematomas, penetrating ulcers, ruptured or contained ruptured aortic aneurysms. In presence of acute thoracic or dorsal pain, elevated D-Dimers and if acute coronary artery syndrome has been ruled out, additional imaging should be performed to detect acute aortic pathologies. Acute type A dissections involve the ascending aorta. Emergent open repair is the preferred treatment. Acute type B dissections involve the thoracic descending aorta. Endovascular treatment using thoracic stent grafts is indicated in complicated cases (malperfusion, rupture, uncontrolled hypertension) or in cases where risk factors of aortic degeneration are identified...
March 8, 2018: La Presse Médicale
Christopher R Abrecht, Marise Cornelius, Albert Wu, Robert N Jamison, David Janfaza, Richard D Urman, Claudia Campbell, Michael Smith, Jennifer Haythornthwaite, Robert R Edwards, Kristin L Schreiber
Objective: To identify factors associated with pain severity and opioid consumption in the early perioperative period. Design: Prospective observational cohort study. Setting: Tertiary academic medical center. Subjects: Patients with osteoarthritis older than age 45 years undergoing primary total knee replacement at Brigham and Women's Hospital. A total of 126 patients enrolled. Methods: Preoperatively, pain questionnaires and quantitative sensory testing were performed on patients to develop a psychosocial and psychophysical profile...
March 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Patricia Lavand'homme
PURPOSE OF REVIEW: Cesarean section is the most common surgical procedure performed in the world. Postoperative pain management remains a challenge, particularly in a context of enhanced recovery after surgery. Several barriers related to the specific condition of 'postpartum recovery' may prevent application of effective analgesia in this population. The present review focuses on novel approaches of cesarean section postoperative pain assessment, beyond pain-rating intensity, including objective patient-centered recovery parameters...
March 7, 2018: Current Opinion in Anaesthesiology
Andres Zorrilla-Vaca, Jinlei Li
INTRODUCTION: Femoral nerve block (FNB) appears to have higher postoperative analgesic benefits compared with the patient-controlled analgesia (PCA) in total knee arthroplasty (TKA). However, the role of sciatic nerve block (SNB) as a complement to FNB remains controversial. We performed a meta-analysis assessing the benefits of the SNB as a complement to FNB, as well as comparing the efficacy of single-injection versus continuous SNB in TKA. METHODS: Our group conducted a systematic literature search in PubMed, EMBASE and Google Scholar...
March 8, 2018: Journal of Anesthesia
Kwan-Sub Kim, Nam-Kyung Yeo, Seong-Su Kim, Woong-Sub Park, Su-Hyun Kwak, Sang-Hyeon Cho, Gyu-Wan Sung, Hae-Sook Kim, Sang-Wook Yi, Hae Jun Cho
PURPOSE: Nasal packing is an option for bleeding control after endoscopic sinus surgery and septoplasty. Although new packing materials have been developed, patients still suffer from pain and require additional analgesics treatments. In this study, a prospective, randomized, and double-blind controlled trial was designed to evaluate the effect of fentanyl-soaked packing on pain after endoscopic sinus surgery and septoplasty. METHODS: One hundred fifty-two patients who underwent nasal surgeries due to chronic rhinosinusitis or nasal septal deviation were enrolled in this study...
March 1, 2018: Annals of Otology, Rhinology, and Laryngology
Rikke Vibeke Nielsen
Increasing evidence indicate that pain is insufficiently treated following surgical procedures. It is essential that pain treatment is effective with a minimum of side effects in order to promote postoperative rehabilitation. Multimodal analgesia is most likely an important strategy in reducing postoperative pain. Combinations of different analgesics with different mechanisms of action may have an additive analgesic effect with fewer side effects compared to using a single drug. However, there is still a pronounced lack of documentation for the effect and side effects of these multimodal analgesic regimes...
March 2018: Danish Medical Journal
Morten Rune Blichfeldt-Eckhardt
The thesis comprises an overview and four papers, all published or submitted for publication in international peer-reviewed scientific journals.
Chronic pain after surgery is a common and debilitating complication after many types of surgery. The cause and pathology behind is still mainly uncovered, though several risk factors have been proposed. One of the strongest risk factors for persistent postsurgical pain is the intensity of the acute pain response though the mechanisms involved remain unsettled...
March 2018: Danish Medical Journal
Alexandros Mallios, Benoit Boura, Alessandro Costanzo, Myriam Combes
BACKGROUND: To present a case of banding failure with vessel wall erosion and pseudo-aneurysm creation caused by the suture. CASE REPORT: A 75-year-old male patient was operated for a high-flow fistula (>2 L/min). This was overall the third time that the patient was operated for the same indication since he started dialysis 5 years ago. Standard banding technique with perioperative flow measurements was used, and three separate Prolene sutures tied over 5 and 4...
March 1, 2018: Journal of Vascular Access
Marko Tomov, Kevin Tou, Rose Winkel, Ross Puffer, Mohamad Bydon, Ahmad Nassr, Paul Huddleston, Michael Yaszemski, Bradford Currier, Brett Freedman
Study Design: Retrospective case-control study using prospectively collected data. Purpose: Evaluate the impact of liposomal bupivacaine (LB) on postoperative pain management and narcotic use following standardized single-level low lumbar transforaminal lumbar interbody fusion (TLIF). Overview of Literature: Poor pain control after surgery has been linked with decreased pain satisfaction and increased economic burden. Unfortunately, opioids have many limitations and side effects despite being the primary treatment of postoperative pain...
February 2018: Asian Spine Journal
Erin Sweet, Christine S Shusterman, Marina S Nedeljkovic, Jean C Solodiuk
Pain is a complex physical and emotional experience. Therefore, assessment of acute pain requires self-report when possible, observations of emotional and behavioral responses and changes in vital signs. Peripheral nerve and epidural catheters often provide postoperative analgesia in children. Administration of chloroprocaine (a short acting local anesthetic) via a peripheral nerve or epidural catheter allows for a comparison of pain scores, observations of emotional and behavioral responses and changes in vital signs to determine catheter function...
March 1, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Sevan Komshian, Thomas W Cheng, Alik Farber, Marc L Schermerhorn, Jeffrey A Kalish, Denis Rybin, Douglas W Jones, Jeffrey J Siracuse
OBJECTIVE: Retrograde popliteal artery (RPA) access to treat superficial femoral artery and popliteal artery disease is an option when treatment through common femoral artery (CFA) access is not possible. Our goal was to compare the safety and efficacy of RPA access with CFA access for treatment of femoral and popliteal artery lesions. METHODS: The Vascular Quality Initiative was queried for all patients undergoing RPA access from 2010 to 2016 for symptomatic peripheral arterial disease...
March 1, 2018: Journal of Vascular Surgery
Nikolas Tsilimparis, Sebastian E Debus, Max Biehl, Konstantinos Spanos, Axel Larena-Avellaneda, Sabine Wipper, Fiona Rohlffs, Tilo Kölbel
OBJECTIVE: The aim of this study was to assess the immediate postoperative and midterm outcome of complex aortic aneurysm treatment necessitating four-vessel revascularization with either a total endovascular approach (fenestrated-branched stent graft [FBSG]) or a hybrid technique of visceral debranching plus stenting. METHODS: The clinical data of consecutively treated patients presenting with a complex aortic aneurysm that necessitated four-vessel revascularization between 2010 and 2015 were retrospectively analyzed...
March 1, 2018: Journal of Vascular Surgery
Ashraf Talaat Youssef
INTRODUCTION: Many uncommon obstetric and gynecologic problems associated with pregnancy and the early postpartum period can lead to severe abdominal pain and be life-threatening. The patient will be in urgent need of a quick and accurate decision. The means of management will depend on the ability to differentiate between these problems to achieve an optimal diagnosis. MATERIALS AND METHODS: 30 pregnant females attended a private obstetric ultrasound clinic with clinical picture of acute abdomen with pregnancy...
March 3, 2018: Journal of Ultrasound
Jacques E Chelly, Peter G Lacouture, Christian Russel D Reyes
BACKGROUND: Hydroxypropyl-β-cyclodextrin-diclofenac (HPβCD-diclofenac) is an NSAID used to treat acute moderate-to-severe postoperative pain. This post hoc analysis investigated the safety of HPβCD-diclofenac in patients aged ≥ 65 years. METHODS: Data from three phase III trials of HPβCD-diclofenac in adult patients with acute moderate-to-severe postoperative pain were pooled (NCT00448110, NCT00507026, and NCT00726388). Patients who received one or more dose of HPβCD-diclofenac or placebo were included and stratified according to age: < 65, 65-74, or ≥ 75 years...
March 1, 2018: Drugs & Aging
Marcella G Willis-Gray, Katherine E Husk, Taylor J Brueseke, Jennifer M Wu, Alexis A Dieter
OBJECTIVES: Our primary objective was to evaluate age as a predictor of postanesthesia care unit (PACU) opioid administration in women undergoing reconstructive pelvic surgery. Our secondary objective was to identify additional predictors of PACU opioid administration. METHODS: We conducted a retrospective cohort study of women undergoing outpatient urogynecologic surgery for pelvic organ prolapse and/or stress urinary incontinence between September 2015 to October 2016 at 1 academic medical center...
February 27, 2018: Female Pelvic Medicine & Reconstructive Surgery
Bryan M Saltzman, Michael J Collins, Thomas A Arns, Brian Forsythe
CASE: A snapping biceps femoris tendon, a rare etiology for symptomatic pain in the lateral aspect of the knee, has been reported infrequently. We report 2 cases of an acutely symptomatic unilateral snapping biceps femoris tendon with an intraoperatively intact anomalous insertion onto the tibia, which were treated with anatomic repositioning and "pie-crust" lengthening via a single suture anchor. CONCLUSION: Anatomic repositioning and lengthening is a novel technique that successfully resolved the painful snapping and allowed full return to competitive sports by 6 months postoperatively, with maintenance of improvement at ≥14 months postoperatively...
February 28, 2018: JBJS Case Connector
Tzung-Jiun Tsai, Hoi-Hung Chan, Kwok-Hung Lai, Chih-An Shih, Sung-Shuo Kao, Wei-Chih Sun, E-Ming Wang, Wei-Lun Tsai, Kung-Hung Lin, Hsien-Chung Yu, Wen-Chi Chen, Huay-Min Wang, Feng-Woei Tsay, Huey-Shyan Lin, Jin-Shiung Cheng, Ping-I Hsu
BACKGROUND: In patients with common bile duct stones (CBDS) and intact gallbladder, further management for the gallbladder after the CBDS clearance is still controversial. The relationship between gallbladder motility and the biliary complications were seldom discussed. Our study is to predict the subsequent biliary complications by gallbladder function test using fatty meal sonography (FMS) in patients with CBDS who had been treated by endoscopic retrograde cholangiopancreatography (ERCP)...
February 27, 2018: BMC Gastroenterology
Mengqi Zhu, Yuechao Gu, Xia Sun, Xi Liu, Wankun Chen, Changhong Miao
OBJECTIVE: To explore the feasibility, effectiveness and safety of ultrasound-guided intercostal nerve block (ICNB) for immediate relief of moderate and severe pain following esophagectomy in a post-anesthesia care unit (PACU). METHODS: Eighty-one patients who complained of moderate to severe pain on arrival to the PACU after an Ivor Lewis esophagectomy were randomly assigned to two groups: a sufentanil treatment group (Group A, n=41) and an intercostal nerve block treatment group (Group B, n=40)...
February 26, 2018: Pain Practice: the Official Journal of World Institute of Pain
Ivan Utrobičić, Frane Utrobičić, Ivona Prološčić, Toni Utrobičić, Milka Jerić, Antonia Jeličić Kadić, Livia Puljak
The management of postoperative pain after carpal tunnel syndrome surgical treatment at a tertiary hospital was analyzed and compared with the guidelines for perioperative pain management. This retrospective study included 579 patients operated on for carpal tunnel syndrome at the Split University Hospital Center in Split, Croatia. The following key data were collected from patient medical records: age, gender, type and dosage of premedication, type and dosage of anesthesia, type and dosage of postoperative analgesia per each postoperative day...
September 2017: Acta Clinica Croatica
Aarti Narayan, Arun Subramanian
We report a case of severe generalised muscle weakness in a 66-year-old man who underwent revision of left knee arthroplasty. On postoperative day 1, he developed non-focal muscle weakness and shortness of breath which progressed over a 6-hour period. Serum phosphorus level was severely low at 0.5 mg/dL, along with mild degree of hypokalaemia, hypocalcaemia and hypomagnesaemia. His symptoms completely resolved after emergent phosphorus replacement. The authors believe this case is of educational interest to physicians as generalised muscle weakness is an uncommon presentation of severe hypophosphataemia...
February 23, 2018: BMJ Case Reports
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