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https://www.readbyqxmd.com/read/29784431/-continuous-quadratus-lumborum-type-ii-block-in-partial-nephrectomy
#1
Rita Graça, Pilar Miguelez, José Miguel Cardoso, Miguel Sá, Joana Brandão, Célia Pinheiro, Duarte Machado
BACKGROUND AND OBJECTIVES: Quadratus lumborum block was first described in 2007 and currently there are descriptions of its achievement through four different injection points. This blockage provides abdominal wall and visceral analgesia, and one of its mechanisms is the dispersion of the local anesthetic into the paravertebral space. We describe the performance of a continuous quadratus lumborum type II block for postoperative analgesia in a partial nephrectomy. CASE REPORT: A 64-year-old woman, scheduled for partial left laparoscopic nephrectomy...
May 18, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29782641/the-analgesic-efficacy-and-pharmacokinetics-of-epidural-oxycodone-after-gynaecologic-laparotomy-a-randomised-double-blind-double-dummy-comparison-with-intravenous-administration
#2
Panu Piirainen, Hannu Kokki, Heidi Hautajärvi, Veli-Pekka Ranta, Merja Kokki
AIM: To compare the analgesic efficacy of epidural and i.v. oxycodone at the same dose. METHODS: In this randomised, double-blind, double-dummy clinical trial 30 women, aged 24-67 years, undergoing elective gynaecologic laparotomy were administrated either i.v. saline and epidural oxycodone 0.1 mg·kg-1 (EPI-group; n=15) or i.v. oxycodone 0.1 mg·kg-1 and epidural saline (IV-group; n=15). For multimodal analgesia patients received i.v. paracetamol and dexketoprofen, and a triple-mixture epidural infusion after the first four postoperative hours...
May 21, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29782451/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#3
Cecilia Otten, Karen S Dunn
BACKGROUND: Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty. PURPOSE: The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29781876/postpartum-pain-management
#4
(no author information available yet)
Pain and fatigue are the most common problems reported by women in the early postpartum period. Pain can interfere with a woman's ability to care for herself and her infant. Untreated pain is associated with a risk of greater opioid use, postpartum depression, and development of persistent pain. Nonpharmacologic and pharmacologic therapies are important components of postpartum pain management. Because 81% of women in the United States initiate breastfeeding during the postpartum period, it is important to consider the drug effects of all prescribed medications on the mother-infant dyad...
May 17, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29773484/the-effect-of-a-single-intraoperative-dose-of-intravenous-dexamethasone-8-mg-on-post-cesarean-delivery-analgesia-a-randomized-controlled-trial
#5
U Ituk, K Thenuwara
BACKGROUND: A single perioperative dose of dexamethasone has been shown to improve postoperative analgesia and reduce opioid consumption. However, this analgesic and opioid sparing effect has not been well assessed as part of a multimodal analgesic regimen in women post-cesarean delivery. METHODS: Healthy women having cesarean delivery under spinal anesthesia were randomly assigned to receive intravenous dexamethasone 8 mg or placebo after delivery and clamping of the umbilical cord...
March 26, 2018: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/29759061/role-of-ultrasound-guided-transversus-abdominis-plane-block-as-a-component-of-multimodal-analgesic-regimen-for-lower-segment-caesarean-section-a-randomized-double-blind-clinical-study
#6
Ashok Jadon, Priyanka Jain, Swastika Chakraborty, Mayur Motaka, Sudhansu Sekhar Parida, Neelam Sinha, Amit Agrawal, Asit Kumar Pati
BACKGROUND: While opioids are the mainstay for post-operative analgesia after lower segment caesarean section, they are associated with various untoward effects. Ultrasound guided transversus abdominis plane (TAP) block has been postulated to provide effective analgesia for caesarean section. We evaluated the analgesic efficacy of this block for post caesarean analgesia in a randomised controlled trial. METHODS: One hundred thirty-nine mothers undergoing caesarean delivery were randomised to receive TAP block with either 20 ml 0...
May 14, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29758039/effects-of-palonosetron-for-prophylaxis-of-postoperative-nausea-and-vomiting-in-high-risk-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-double-blind-placebo-controlled-study
#7
Jung-Hee Ryu, Young-Tae Jeon, Byunghun Min, Jin-Young Hwang, Hye-Min Sohn
BACKGROUND: The preemptive multimodal pain protocols used in total knee arthroplasty (TKA) often cause emesis postoperatively. We investigated whether palonosetron prophylaxis reduces postoperative nausea and vomiting (PONV) in high-risk patients after TKA. METHODS: We randomized 120 female patients undergoing TKA to receive either palonosetron (0.075 mg, intravenous) or no antiemetic prophylaxis (0.9% saline, control group). All patients were given spinal anesthesia, a continuous femoral nerve block, and fentanyl-based intravenous patient controlled analgesia...
2018: PloS One
https://www.readbyqxmd.com/read/29732387/transversus-abdominis-plane-blockade-as-part-of-a-multimodal-postoperative-analgesia-plan-in-patients-undergoing-radical-cystectomy
#8
Richard S Matulewicz, Mehul Patel, Brian J Jordan, Jacqueline Morano, Brendan Frainey, Yasin Bhanji, Mahreen Bux, Antoun Nader, Shilajit D Kundu, Joshua J Meeks
Background: Radical cystectomy (RC) is a morbid procedure with frequent complications that may benefit from implementation of an enhanced recovery after surgery (ERAS) protocol. Objective: To examine the benefits of a multimodal analgesic plan that uses continuous transversus abdominis plane (TAP) blockade as part of an ERAS protocol after RC. Methods: A retrospective comparison of consecutive patients undergoing RC over a 4-year period was conducted...
April 26, 2018: Bladder Cancer
https://www.readbyqxmd.com/read/29727003/safety-in-acute-pain-medicine-pharmacologic-considerations-and-the-impact-of-systems-based-gaps
#9
Toby N Weingarten, Andreas H Taenzer, Nabil M Elkassabany, Linda Le Wendling, Olga Nin, Michael L Kent
Objective: In the setting of an expanding prevalence of acute pain medicine services and the aggressive use of multimodal analgesia, an overview of systems-based safety gaps and safety concerns in the setting of aggressive multimodal analgesia is provided below. Setting: Expert commentary. Methods: Recent evidence focused on systems-based gaps in acute pain medicine is discussed. A focused literature review was conducted to assess safety concerns related to commonly used multimodal pharmacologic agents (opioids, nonsteroidal anti-inflammatory drugs, gabapentanoids, ketamine, acetaminophen) in the setting of inpatient acute pain management...
May 2, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#10
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29725506/comparison-of-adductor-canal-block-versus-local-infiltration-analgesia-on-postoperative-pain-and-functional-outcome-after-total-knee-arthroplasty-a-randomized-controlled-trial
#11
W Kampitak, A Tanavalee, S Ngarmukos, C Amarase, B Songthamwat, A Boonshua
Introduction: Total knee arthroplasty (TKA) is associated with intense postoperative pain for which effective analgesia is essential to facilitate early postoperative recovery. Adductor canal block (ACB) and local infiltration analgesia (LIA) have become increasingly involved in postoperative pain management after TKA. We aimed to compare their efficacy and outcomes in patients undergoing TKA. Materials and Methods: Sixty patients undergoing unilateral TKA were randomized to receive either postoperative single-injection ACB (Group A) or LIA (Group L) during the operation...
March 2018: Malaysian Orthopaedic Journal
https://www.readbyqxmd.com/read/29719743/ultrasound-guided-erector-spinae-plane-block-in-a-child-undergoing-laparoscopic-cholecystectomy
#12
David Terence Thomas, Serkan Tulgar
Erector spinae plane block (ESP) is a recently described regional anesthesia technique that leads to the blockage of both visceral and somatic nerve fibers. While there are anecdotal reports of ESP used in children, none are for laparoscopic procedures. Herein we report a child undergoing laparoscopic cholecystectomy in which ESP was used as part of multimodal anesthesia. Ultrasound-guided ESP block is an easily performed peripheral nerve block that leads to long-lasting postoperative analgesia. It can be successfully used in pediatric laparoscopic procedures such as cholecystectomy and should be kept in mind as an option for multimodal analgesia in children...
February 27, 2018: Curēus
https://www.readbyqxmd.com/read/29707356/the-role-of-local-anaesthetic-techniques-in-eras-protocols-for-thoracic-surgery
#13
REVIEW
Seamus Crumley, Stefan Schraag
The use of enhanced recovery after surgery (ERAS), as in other surgical specialties, is an emerging concept in cardio-thoracic surgery but there is still a lack of effective protocols to reduce the burden of surgery on the patient, shorten the period of postoperative recovery, and reduce the likelihood of chronic pain developing. The use of local anaesthetic (LA) techniques, such as thoracic epidural analgesia (TEA) and paravertebral blocks (PVB), as an adjunct to anaesthesia are considered key components, though there is little data for direct comparison of the techniques...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29707092/improved-outcomes-associated-with-the-use-of-intravenous-acetaminophen-for-management-of-acute-post-surgical-pain-in-cesarean-sections-and-hysterectomies
#14
Richard D Urman, Elaine A Boing, An T Pham, Victor Khangulov, Randi Fain, Brian H Nathanson, Xuan Zhang, George J Wan, Belinda Lovelace, Jessica Cirillo
Background: Post-surgical pain impacts many patient outcomes. Effective pain management increasingly relies on multimodal analgesia regimens in which acetaminophen (APAP) is a key component. The aim of our study was to examine the impact of oral APAP versus intravenous (IV) APAP as a component of post-surgical pain management after Cesarean sections and hysterectomies. Methods: A retrospective analysis of the Cerner HealthFacts® database (from January, 2011 to December, 2015) was conducted to compare outcomes of Cesarean section and hysterectomy surgery patients who received oral APAP to those who received IV APAP post-surgically...
June 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29705075/effectiveness-of-continuous-versus-single-injection-femoral-nerve-block-for-total-knee-arthroplasty-a-double-blinded-randomized-trial
#15
Varun Dixit, Samreen Fathima, Stephen M Walsh, Alexandru Seviciu, Ivan Schwendt, Karl-Heinz Spittler, Dana Briggs
BACKGROUND: Effective analgesia following total knee arthroplasty (TKA) is important for maximizing patient satisfaction, early participation in physical therapy and reducing the hospital stay. This trial compared continuous catheter femoral nerve block (cFNB) to single injection femoral nerve block (sFNB) in terms of analgesia, opioid consumption, and participation in physical therapy and associated side effects. METHODS: This randomized, double blinded trial was conducted in a non-university hospital setting, without major changes to anesthesia or surgical clinical pathways...
April 26, 2018: Knee
https://www.readbyqxmd.com/read/29704223/low-thoracic-erector-spinae-plane-block-for-perioperative-analgesia-in-lumbosacral-spine-surgery-a-case-series
#16
Josh P Melvin, Rudolph J Schrot, George M Chu, Ki Jinn Chin
PURPOSE: Severe postoperative pain following spine surgery is a significant cause of morbidity, extended length of facility stay, and marked opioid usage. The erector spinae plane (ESP) block anesthetizes the dorsal rami of spinal nerves that innervate the paraspinal muscles and bony vertebra. We describe the use of low thoracic ESP blocks as part of multimodal analgesia in lumbosacral spine surgery. CLINICAL FEATURES: We performed bilateral ESP blocks at the T10 or T12 level in six cases of lumbosacral spine surgery: three lumbar decompressions, two sacral laminoplasties, and one coccygectomy...
April 27, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29697507/population-pharmacokinetics-of-periarticular-ketorolac-in-adult-patients-undergoing-total-hip-or-total-knee-replacement-surgery
#17
Usha Gurunathan, Suzanne L Parker, Richard Maguire, Dale Ramdath, Manu Bijoor, Steven C Wallis, Jason A Roberts
BACKGROUND: Ketorolac tromethamine has been used for joint infiltration by the orthopedic surgeons as a part of postoperative multimodal analgesia. The objective of this study is to investigate the pharmacokinetic properties of S (-) and R (+) enantiomers of ketorolac in adult patients undergoing total hip (THA) and knee arthroplasty (TKA). METHODS: Adult patients with normal preoperative renal function received a periarticular infiltration of 30 mg of ketorolac tromethamine along with 100 mL of 0...
April 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29695926/pre-emptive-multimodal-analgesia-with-tramadol-and-ketamine-lidocaine-infusion-for-suppression-of-central-sensitization-in-a-dog-model-of-ovariohysterectomy
#18
Ubedullah Kaka, Nor-Alimah Rahman, Adamu Abdul Abubakar, Yong Meng Goh, Sharida Fakurazi, Mohamed Ariff Omar, Hui Cheng Chen
Objectives: The effects of pre-emptive infusion of ketamine-lidocaine with tramadol on the suppression of central sensitization were investigated in a dog ovariohysterectomy model. Patients and methods: Twelve dogs were randomly assigned to two groups: ketamine-lidocaine-tramadol (KLT) and tramadol (T) groups. Both groups received intravenous tramadol 4 mg/kg body weight as premedication. Immediately after induction, the KLT group received ketamine and lidocaine at 0...
2018: Journal of Pain Research
https://www.readbyqxmd.com/read/29687077/efficacy-and-outcomes-of-intrathecal-analgesia-as-part-of-an-enhanced-recovery-pathway-in-colon-and-rectal-surgical-patients
#19
Amit Merchea, Jenna K Lovely, Adam K Jacob, Dorin T Colibaseanu, Scott R Kelley, Kellie L Mathis, Grant M Spears, Marianne Huebner, David W Larson
Purpose: Multimodal analgesia is an essential component of an enhanced recovery pathway (ERP). An ERP that includes the use of single-injection intrathecal analgesia (IA) has been shown to decrease morbidity and cost and shorten length of stay (LOS). Limited data exist on safety, feasibility, and the optimal IA regimen. Our objective was to characterize the efficacy, safety, and feasibility of IA within an ERP in a cohort of colorectal surgical patients. Methods: We performed a retrospective review of all consecutive patients aged ≥ 18 years who underwent open or minimally invasive colorectal surgery from October 2012 to December 2013...
2018: Surgery Research and Practice
https://www.readbyqxmd.com/read/29680003/the-comparative-effectiveness-of-quadratus-lumborum-blocks-and-paravertebral-blocks-in-radical-cystectomy-patients
#20
Austin J Lee, Jonathan G Yabes, Nathan Hale, Ronald L Hrebinko, Jeffrey R Gingrich, Jodi K Maranchie, Mina M Fam, Robert M Turner I I, Benjamin J Davies, Bruce Ben-David, Bruce L Jacobs
INTRODUCTION: Multimodal analgesia is an effective way to control pain and limit opioid use after surgery. The quadratus lumborum block and paravertebral block are two regional anesthesia techniques that leverage multimodal analgesia to improve postoperative pain control. We sought to compare the efficacy of these blocks for pain management following radical cystectomy. MATERIALS AND METHODS: We performed a retrospective review of radical cystectomy patients who received bilateral continuous paravertebral blocks (n = 125) or bilateral single shot quadratus lumborum blocks (n = 50) between 2014-2016...
April 2018: Canadian Journal of Urology
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