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https://www.readbyqxmd.com/read/28718036/paravertebral-blocks-reduce-narcotic-use-without-affecting-perfusion-in-patients-undergoing-autologous-breast-reconstruction
#1
Elizabeth B Odom, Nili Mehta, Rajiv P Parikh, Ryan Guffey, Terence M Myckatyn
BACKGROUND: Autologous breast reconstruction offers excellent long term outcomes after mastectomy. However, maintaining adequate postoperative analgesia remains challenging. Use of paravertebral blocks (PVBs) reduces postoperative narcotic use and length of stay, and enhanced recovery protocols with mixed analgesia methods are gaining popularity, but few studies have explored the intraoperative effects of these interventions. METHODS: Patients who underwent abdominally based autologous breast reconstruction between 2010 and 2016 were compiled into a retrospective database...
July 17, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28713853/factors-associated-with-acute-postoperative-pain-following-breast-reconstruction
#2
Anita R Kulkarni, Andrea L Pusic, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Edwin G Wilkins, Randy S Roth
INTRODUCTION: Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS: Women (N = 2207; one-week 82...
March 2017: JPRAS Open
https://www.readbyqxmd.com/read/28713565/chronic-postoperative-pain-recent-findings-in-understanding-and-management
#3
REVIEW
Darin Correll
Chronic postoperative pain is a poorly recognized potential outcome from surgery. It affects millions of patients every year, with pain lasting for months to years, resulting in patient suffering and ensuing economic consequences. The operations with the highest incidence of chronic postoperative pain are amputations, thoracotomies, cardiac surgery, and breast surgery. Other risk factors include preoperative pain, psychological factors, demographics, and the intensity of acute postoperative pain. Attempts to prevent chronic postoperative pain have often led to debatable results...
2017: F1000Research
https://www.readbyqxmd.com/read/28712018/laparoscopic-implantation-of-electrodes-for-bilateral-neuromodulation-of-the-pudendal-nerves-and-s3-nerve-roots-for-treating-pelvic-pain-and-voiding-dysfunction
#4
Adrienne L K Li, Renato Marques, Acary Oliveira, Laise Veloso, Manoel J B C Girão, Nucelio Lemos
INTRODUCTION AND HYPOTHESIS: The objective of this video is to describe the technique for laparoscopic implantation of electrodes for bilateral neuromodulation of S3 and pudendal nerves. We report a successful case of a 48-year-old woman with spina bifida occulta referred with a 14-year history of intense acyclic pelvic pain, urinary hesitancy, and intermittent flow refractory to various conservative measures. METHODS: The procedure began with the removal of two previously placed InterStims...
July 15, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28705700/incidental-primary-intradural-carcinoid-tumor-in-a-patient-with-lumbar-radiculopathy
#5
Stavros Koustais, Philip O'Halloran, Alfrazdaq Hassan, Francesca Brett, Steven Young
BACKGROUND: Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Central nervous system involvement is rare. The reported cases include metastases to brain or spinal cord, as well as primary skeletal or extradural disease resulting in compressive myelo-radiculopathy. There are two previously reported cases of primary intradural extramedullary carcinoid tumor, presenting with compressive symptoms. We report the first case of primary incidental intradural extramedullary carcinoid tumor...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28701853/low-incidence-of-failure-after-proximal-biceps-tenodesis-with-unicortical-suture-button
#6
Jay B Cook, David M Sedory, Michael C Freidl, Douglas R Adams
PURPOSE: Recent interest in suture button fixation has developed with regard to proximal biceps tenodesis fixation. Biomechanical studies have demonstrated viability of a unicortical suture button technique in vitro. Despite this, no clinical data has been reported to validate the biomechanical data. The purpose of this study is to report on complication and failure rates in the early postoperative period after bicep tenodesis with a unicortical suture button. METHODS: A retrospective review was performed of all biceps tenodesis performed at our institution over a 36-month period using a unicortical suture button for fixation...
September 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28701028/psychological-interventions-for-acute-pain-after-open-heart-surgery
#7
REVIEW
Susanne Ziehm, Jenny Rosendahl, Jürgen Barth, Bernhard M Strauss, Anja Mehnert, Susan Koranyi
BACKGROUND: This is an update of a Cochrane review previously published in 2014. Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES: To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention control in adults undergoing open heart surgery for pain, pain medication, psychological distress, mobility, and time to extubation...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28698794/robotic-right-segmental-hepatectomy-for-the-treatment-of-a-giant-hepatic-hemangioma-a-case-report
#8
Christoforos Efthimiadis, Aristeidis Ioannidis, Marios Grigoriou, Konstantinia Kofina, Michael Lazaridis, Christoforos Kosmidis
Hemangioma is the most common benign hepatic tumor. We present the case of a patient with a giant symptomatic hemangioma, treated with segmental liver resection using the Da Vinci Robotic System. A 38-year-old woman presented to our surgical out-patient Department complaining about abdominal discomfort and recurrent episodes of acute abdominal pain. CT-scan and MRI imaging of the abdomen revealed the presence of a giant hepatic hemangioma (>5 cm) involving segments VI and VII. Robotic right segmental hepatectomy was performed...
June 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28698748/acute-postoperative-pain-in-trauma-patients-the-fifth-vital-sign
#9
Nikolina Farčić, Ivana Barać, Stana Pačarić, Ivana Lovrić, Vesna Ilakovac
AIM: To determine average pain intensity perceived by trauma patients at hospital admission, lowest and highest pain intensity during their hospitalisation and their satisfaction with provided pain treatment. PATIENTS AND METHODS: The research included 114 operated patients at the Clinical Department of Trauma Surgery. We used the standard Numerical Rating Scale (NRS) for a clinical measure of pain. RESULTS: The average pain intensity at hospital admission was NRS median 7 (range 4-10), the severest perceived rate of pain during hospitalisation was NRS median 5 (range 4-7)...
June 15, 2017: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/28697991/carbamazepine-effects-on-pain-management-and-serum-il-6-il-10-evaluation-in-addicted-patients-undergoing-surgery
#10
Alireza Salimi, Masoumeh Sabetkasaei, Hanna Raisi, Farzaneh Labibi, Haleh Ameli, Yalda Khazaei-Poul, Kamran Mottaghi, Farhad Safari, Ali Nazem-Bokaei, Seyed-Amir Mohajerani, Malek Zarei, Taraneh Moini-Zanjani
Postoperative pain control remains an important issue in the field of surgery. Assessing and managing patients with acute pain who are addicted to opioids are often challenging. It has been shown that, addicted patients are less tolerant to pain. There is limited evidence to guide the management of acute pain in these patients. Here we studied the effect of preemptive use of carbamazepine on pain behavior and serum IL-6, IL-10 levels in the addicted patients. 90 male patients (25-45 years, BMI 20-27), were divided into 3 group of 30 patients: 1- control, 2- addicted, 3- addicted patients receiving carbamazepine 400mg before surgery...
July 8, 2017: European Journal of Pharmacology
https://www.readbyqxmd.com/read/28694597/management-of-cervical-monoradiculopathy-due-to-prolapsed-intervertebral-disc-an-institutional-experience
#11
Amresh S Bhaganagare, S A Nagesh, B G Shrihari, Vikas Naik, M N Nagarjun, Balaji S Pai
BACKGROUND: Cervical radiculopathy is the common clinical entity, often caused by "wear and tear" changes that occur in the spine. In the younger population, cervical radiculopathy is a result of a disc herniation or an acute injury causing foraminal impingement of an exiting nerve, whereas in the older individuals, it is due to foraminal narrowing from osteophyte formation, decreased disc height, and degenerative changes of the uncovertebral joints anteriorly and of the facet joints posteriorly...
April 2017: Journal of Craniovertebral Junction and Spine
https://www.readbyqxmd.com/read/28691744/dentists-attitudes-towards-acute-pharmacological-pain-management-in-children-and-adolescents
#12
Henrik Berlin, Thomas List, Karin Ridell, Gunilla Klingberg
AIM: This study aimed to investigate Swedish dentists' attitudes regarding pain management strategies for treating children and adolescents. It assessed recommendations for pre- and postoperative analgesics, and use of local anaesthesia, and whether application of these strategies differs between general dental practitioners (GDPs) and specialists in paediatric dentistry (SPDs). DESIGN: We invited all GDPs (n = 807) in southern Sweden (Region Skåne), and all registered SPDs (n = 122) working in Sweden (929 actively practising dentists under age 65 years) to participate in a postal survey on pain management in paediatric dental care...
July 10, 2017: International Journal of Paediatric Dentistry
https://www.readbyqxmd.com/read/28691673/gastric-paraganglioma-case-report-and-review-of-the-literature
#13
REVIEW
R Bura, Antonio Manca, R Ambu, G Pisano, Alessandro Melis, A Maturo, E Erdas, A Nicolosi, P G Calò
Very few cases of gastric paragangliomas have been reported in the literature to date. We report a rare case of parietal gastric paraganglioma fortuitously detected during intraoperative exploration. A 82-years-old woman presented to our emergency room for abdominal pain. On physical examination abdomen was painful on palpation and Blumberg's sign was present. The laboratory exams showed a neutrophilia in absence of leukocytosis. Acute appendicitis was suspected and a laparoscopy was performed. At exploration, the vermiform appendix was normal while a lumpy, hard-fibrous and white-pinkish extraluminal lesion of the anterior wall of the gastric body near the greater curvature of about 2 cm in diameter was present...
March 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/28689784/gedos-secot-consensus-on-the-care-process-of-patients-with-knee-osteoarthritis-and-arthoplasty
#14
M A Ruiz Iban, A Tejedor, E Gil Garay, C Revenga, J C Hermosa, J Montfort, M J Peña, J M López Millán, A Montero Matamala, A Capa Grasa, M J Navarro, M Gobbo, E Loza
OBJECTIVE: To develop recommendations on the evaluation and management procedure in patients undergoing total knee replacement based on best evidence and the experience of a panel of experts. METHODS: A multidisciplinary group of 12 experts was selected that defined the scope, users and the document parts. Three systematic reviews were performed in patients undergoing knee replacement: (i)efficacy and safety of fast-tracks; (ii)efficacy and safety of cognitive interventions in patients with catastrophic pain, and (iii) efficacy and safety of acute post-surgical pain management on post-surgical outcomes...
July 6, 2017: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/28688940/thoracostomy-tube-removal-implementation-of-a-multidisciplinary-procedural-pain-management-guideline
#15
Lisa M Ring, Anne Watson
OBJECTIVE: Thoracostomy tubes are placed following cardiothoracic surgery for the repair or palliation of congenital heart defects. The aim of this project was to develop and implement a clinical practice guideline for the provision of optimal analgesia during removal of thoracostomy tubes in pediatric postoperative cardiothoracic surgery patients. METHODS: Methods used include a nonexperimental design utilizing chart audits to determine baseline documentation as well as procedure note evaluation to determine both baseline documentation and compliance with the new guideline...
July 6, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28688514/pain-control-with-continuous-infusion-preperitoneal-wound-catheters-versus-continuous-epidural-analgesia-in-colon-and-rectal-surgery-a-randomized-controlled-trial
#16
Nicolas J Mouawad, Stefan W Leichtle, Christodoulos Kaoutzanis, Kathleen Welch, Suzanne Winter, Richard Lampman, Matt McCord, Kimberly A Hoskins, Robert K Cleary
OBJECTIVE: To compare continuous infusion preperitoneal wound catheters (CPA) versus continuous epidural analgesia (CEA) after elective colorectal surgery. METHODS: An open-label equivalence trial randomizing patients to CPA or CEA. Primary outcomes were postoperative pain as determined by numeric pain scores and supplemental narcotic analgesia requirements. Secondary outcomes included incidence of complications and patient health status measured with the SF-36 Health Survey (Acute Form)...
July 1, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28684926/acute-postoperative-pain-control
#17
EDITORIAL
Volkan Hancı, Bülent S Yurtlu, Rudin Domi, Yasuyuki Shibata, Can Eyigör
No abstract text is available yet for this article.
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28683785/mesenteric-cysts-and-mesenteric-venous-thrombosis-leading-to-intestinal-necrosis-in-pregnancy-managed-with-laparotomy-a-case-report-and-review-of-the-literature
#18
Aris Giannos, Sofoklis Stavrou, Nikolaos Goumalatsos, George Fragkoulidis, Eleni Chra, Dimitrios Argiropoulos, Dimitrios Loutradis, Peter Drakakis
BACKGROUND: Mesenteric cyst is a rare clinical entity especially in pregnancy; therefore, few cases have been reported in the literature. The standard method of their treatment is surgical excision either with laparotomy or laparoscopy. In addition, mesenteric vein thrombosis is a rare and life-threatening condition in pregnancy and needs immediate treatment because it can lead to intestinal necrotic ischemia. This is the first report of the coexistence of mesenteric cysts and mesenteric vein thrombosis during gestation...
July 7, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28681626/pharmacokinetics-and-safety-of-fentanyl-sublingual-spray-and-fentanyl-citrate-intravenous-a-single-ascending-dose-study-in-opioid-na%C3%A3-ve-healthy-volunteers
#19
Richard Rauck, D Alexander Oh, Neha Parikh, Christian Koch, Neil Singla, Jin Yu, Srinivas Nalamachu, Santosh Vetticaden
OBJECTIVE: Fentanyl sublingual spray offers rapid pain relief in opioid-tolerant cancer patients, and may be useful in acute or postoperative pain. Both opioid-naïve or nontolerant patients are likely to receive opioids in these settings. Understanding the relationship between systemic exposure of fentanyl sublingual spray and effects on respiratory function in opioid-naïve or nontolerant populations is important to ensure patient safety. This study evaluated single-dose fentanyl sublingual spray in opioid-naïve participants...
July 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28679320/a-rare-case-of-non-traumatic-acute-intraabdominal-hemorrhage-ruptured-superior-mesenteric-artery-aneurysm
#20
Ersin Borazan, Latif Yılmaz, Alper Aytekin, Gökhan Gökaslan, Selim Kervancıoğlu
INTRODUCTION: Rupture of superior mesenteric artery aneurysm (SMAA) is a very rare and life-threatening condition, presenting with acute intraabdominal hemorrhage. CASE: The patient was hospitalized upon complaint of nonspecific severe abdominal pain. Diagnosis of SMAA was established by abdominal Doppler ultrasound that showed a pseudo-aneurysmal lesion with size of 76 × 47 mm at the superior mesenteric main branch. Endovascular stenting was not performed because of the wide neck in the segment of the jejunal branches from SMA and the risk of branch loss during treatment...
July 6, 2017: Acta Chirurgica Belgica
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