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postoperative chronic pain

Rodney A Gabriel, Brian M Ilfeld
Maximizing analgesia is critical following joint arthroplasty because postoperative pain is a major barrier to adequate physical therapy. Continuous peripheral nerve blocks have been the mainstay for acute pain management in this population; however, this and similar techniques are limited by their duration of action. Cryoneurolysis and peripheral nerve stimulation are two methodologies used for decades to treat chronic pain. With the advent of portable ultrasound devices and percutaneous administration equipment, both procedures may now be suitable for treatment of acute pain...
September 2018: Anesthesiology Clinics
Jeff Gonzales, Scott T Lovald, Edmund C Lau, Kevin L Ong
Postoperative analgesia after primary total knee arthroplasty (TKA) and revision knee arthroplasty (RKA) can be reliant on the use of opioids and may lead to opioid-related adverse events (ORAEs). This study evaluated the risk of ORAEs following TKA and RKA using the 5% Medicare claims (2010-2013) database. There were 41,702 TKA and 3817 RKA patients who met the inclusion criteria. At 90 days, respiratory complications were the most common complication (TKA: 6.12%; RKA: 8.01%), followed by postoperative nausea and vomiting (TKA: 2...
2018: Journal of Surgical Orthopaedic Advances
Tian Li, Yan Liu, Weihong Zhang
BACKGROUND: Breast prosthesis implants have been safely and efficiently used in the plastic surgery department. With the increasing demand for aesthetics, these silicon implants were not only used in breast augmentation surgery but also in breast reconstruction after mastectomy. Nevertheless, breast prosthesis implantation brings a lot of complications, such as: postoperative chronic pain, capsule contracture, prosthesis displacement and prosthesis rupture and infection in severe cases...
August 6, 2018: Aesthetic Plastic Surgery
Cheryl A Allen, Julius R Ivester
Ketamine, an anesthetic agent, is gaining attention as an analgesic for the management of acute and chronic pain conditions. Perianesthesia nurses may expect to see ketamine's use increase as more anecdotal and evidence-based experience is gained with its use for pain management. Unlike opioids, ketamine supports respirations while supporting hemodynamic function; moreover, the agent has potential for decreasing opioid-induced hyperalgesia. Ongoing clinical evidence continues to support ketamine's use for analgesia, thus it may be argued that the current Food and Drug Administration classification for ketamine as an anesthetic agent is outdated, and patients would be better served by a reclassification of this medication to include its use for analgesic purposes...
August 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
Trent M Gause, John J Nunnery, Abhinav B Chhabra, Brian C Werner
BACKGROUND: The goals of the study were to: (1) evaluate trends in preoperative and prolonged postoperative narcotic use in carpal tunnel release (CTR); (2) characterize risks for prolonged narcotic use; and (3) evaluate narcotic use as an independent risk factor for complications following CTR. METHODS: A query of a large insurance database from 2007-2016 was conducted. Patients undergoing open or endoscopic CTR were included. Revision surgeries or patients undergoing median nerve repair at the forearm, upper extremity fasciotomies, or with distal radius fractures were excluded...
August 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Renato Ribeiro de Jesus, Adebaldo Maia Leite, Simone Soares Leite, Márcio Carneiro Vieira, Nivaldo Ribeiro Villela
Inappropriate therapy of postoperative pain in laparoscopic cholecystectomy may lead to late mobilization, patient dissatisfaction, delayed hospital discharge, and chronic pain development. Our objective was to identify the best therapeutic strategy available to the anesthesiologist for the acute postoperative pain of patients submitted to elective laparoscopic cholecystectomy. This is a systematic review that included 36 complete articles indexed in the Medline, Scopus, Web of Science and LILACS databases, with a five-year time cut (2012 to 2016), resulting from controlled and randomized studies that were submitted to qualitative analysis...
July 30, 2018: Revista do Colégio Brasileiro de Cirurgiões
Rebekah Gibbons, Katherine E Mackie, Todd Beveridge, Dana Hince, Peter Ammon
BACKGROUND: Plantar fasciitis is a common condition prevalent in both athletic and nonathletic populations. Approximately 10% of patients do not respond to conservative treatment and suffer chronic recalcitrant plantar fasciitis. Outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and return to activity, and significant improvements in symptoms. Previous study limitations include small patient cohorts, short-term duration of follow-up or lack of validated outcome measures...
August 1, 2018: Foot & Ankle International
Lingfei Cui, Ping Fan, Chaoxue Qiu, Yong Hong
Post Mastectomy Pain Syndrome (PMPS) is a common postoperative condition for breast cancer, but has been ignored. The aim of this study was to investigate the prevalence of PMPS and the risk factors in women submitted to surgical treatment for breast cancer. The study included 532 postoperative breast cancer patients in a hospital for five consecutive years period, of whom 473 were considered eligible and included in the study. A total of 420 people completed a questionnaire survey, which revealed that 152 (36...
July 31, 2018: Scientific Reports
Lloyd Edward Kwanten, Ben O'Brien, Sibtain Anwar
Opioids have played in a key role in cardiac anesthesia and analgesia since the early years of cardiac surgery. Today, opioids continue to be the primary mode for analgesia in cardiac surgery, yet there is considerable variability in the choice, dose and route of used. A history of the use of opioids in cardiothoracic anesthesia is presented, followed by an examination of the differences among current opioids in use and of outcome variables important in cardiac anesthesia, such as postoperative analgesia, extubation times, fast-track cardiac anesthesia, chronic neuropathic pain, and cardioprotection...
June 5, 2018: Journal of Cardiothoracic and Vascular Anesthesia
Sharona Ben-Haim, Zaman Mirzadeh, William S Rosenberg
OBJECTIVE Deep brain stimulation (DBS) is a well-established, evidence-based therapy with FDA approval for Parkinson's disease and essential tremor. Despite the early successful use of DBS to target the sensory thalamus for intractable facial pain, subsequent studies pursuing various chronic pain syndromes reported variable efficacy, keeping DBS for pain as an investigational and "off-label" use. The authors report promising results for a contemporary series of patients with intractable facial pain who were treated with DBS...
August 2018: Neurosurgical Focus
Manuel Jiménez Ortiz, Alfonso Espinosa Ruiz, Cristóbal Martínez Delgado, Pablo Barrena Sánchez, José A Salido Valle
BACKGROUND: The association of depression and chronic pain in knee osteoarthritis is a complex and difficult phenomenon to understand. In fact, establishing the order of appearance of these entities might result in an arduous task. OBJECTIVE: In addition to analyzing the relationship between preoperative anxiety and depression according to the results of total knee arthroplasty (TKA), we will assess the evolution of anxiety and depression symptoms. MATERIAL AND METHODS: A study of 260 patients with a mean age of 70...
July 26, 2018: Reumatología Clinica
Chao Liu, Yue Zhou
OBJECTIVE: To compare the clinical outcomes of patients withlumbar disc herniation with bi-radicular symptomsundergoing percutaneous endoscopic lumbar discectomy and minimally invasive transforaminal lumbar interbody fusion at a single clinic. METHODS: From January 2008 to January 2016, 89consecutive patients with lumbar disc herniation with bi-radicular symptoms were treated with percutaneous endoscopic lumbar discectomy(PELD) or minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF)...
July 25, 2018: World Neurosurgery
Weigang Dai, Yujie Yuan, Jidong Zuo, Jinfu Tan, Weidong Feng, Kaitao Yuan, Qiongyun Zhao, Min Tan
OBJECTIVE: To observe the safety and efficacy of biological patch (Biodesign Surgisis mesh, SIS) in hybrid technique for incisional herniorrhaphy. METHODS: Clinical and follow-up data of 14 incisional hernia patients who underwent incisional herniorrhaphy with hybrid technique, using porcine small intestinal submucosa acellular matrix patch, at the First Affiliated Hospital of Sun Yat-sen University from January 1, 2012 to June 31, 2016 were analyzed retrospectively...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Xitao Wang, Gengwen Huang, Dingcheng Shen, Jiayan Lin, Caihong Ning, Xintong Cao, Liandong Ji, Yebin Lu, Wei Wei
OBJECTIVE: To explore the appropriate operative strategy in recurrent groin hernia repair. METHODS: Clinical and follow-up data of 82 patients with recurrent groin hernia undergoing operation at Department of Pancreatobiliary Surgery, Xiangya Hospital of Central South University from April 2010 to April 2017 were analyzed retrospectively. The operative approaches included laparoscopic transabdominal preperitoneal (TAPP) hernia repair, Lichtenstein repair and hybrid repair...
July 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Mellar P Davis, Gavril Pasternak, Bertrand Behm
The buprenorphine receptor binding profile is unique in that it binds to all three major opioid receptors (mu, kappa, delta), and also binds to the orphan-like receptor, the receptor for orphanin FQ/nociceptin, with lower affinity. Within the mu receptor group, buprenorphine analgesia in rodents is dependent on the recently discovered arylepoxamide receptor target in brain, which involves a truncated 6-transmembrane mu receptor gene protein, distinguishing itself from morphine and most other mu opioids. Although originally designed as an analgesic, buprenorphine has mainly been used for opioid maintenance therapy and only now is increasingly recognized as an effective analgesic with an improved therapeutic index relative to certain potent opioids...
July 26, 2018: Drugs
Masakazu Ohuchi, Masaki Fukunaga, Kunihiko Nagakari, Daisuke Azuma, Shintaro Kohama, Jun Nomoto, Kazuhiro Sakamoto
PURPOSE: The question as to whether laparoscopic surgery should be applied for inguinal hernia after radical prostatectomy remains a debate due to surgical difficulty arising from adhesions in the prevesical space. We report the surgical technique used in our department, its outcomes, and its safety and effectiveness compared with the surgical outcomes of primary transabdominal preperitoneal inguinal hernia repair (TAPP) cases. METHODS AND MATERIALS: From February 2013 to January 2017, 30 patients with inguinal hernia were treated with TAPP after radical prostatectomy...
July 25, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
Orlando J M Torres, Romerito F Neiva, Camila C S Torres, Theago M Freitas, Eduardo S M Fernandes
Complications related to cholecystectomy occur in <3% of patients. Endoclip migration after laparoscopic cholecystectomy with hepatolithiasis is an extremely rare complication. We report a case of hepatolithiasis secondary to endoclip migration after laparoscopic cholecystectomy treated successfully via right hepatectomy. A 35-year-old female presented with upper abdominal pain, fever and vomiting 9 years after laparoscopic cholecystectomy for chronic calculus cholecystitis. Laboratory investigation revealed gamma-glutamyl transpeptidase of 550 U/L and alkaline phosphatase of 350 U/L...
July 2018: Journal of Surgical Case Reports
Xiao Li, Li Tang, Yong Feng Lin, Gui Fang Xie
BACKGROUND: Postoperative wound healing is an important part of the success of the dental implant surgery. However, in case of complex surgery or unfavorable factors, wound healing is often unsatisfactory. OBJECTIVE: The aim of this study was to explore the effects of vitamin C supplementation in wound healing, following the placement of dental implants with or without bone grafts and patients with chronic periodontitis. METHODS: This randomized controlled clinical trial included 128 patients requiring dental implants to replace missing teeth...
July 24, 2018: Clinical Implant Dentistry and related Research
Erin Baumann, William Rice, Mitchell Selhorst
Background and Purpose: Chronic instability of the proximal tibiofibular joint (PTFJ) is an uncommon condition that accounts for <1% of knee injuries. The mechanism of injury is a high-velocity twisting motion on a flexed knee. Surgical management is controversial due to complications; however, surgeons are now utilizing ligament reconstruction to restore stability. There is a paucity of information in the literature regarding postoperative care and rehabilitation after PTFJ reconstruction...
June 2018: International Journal of Sports Physical Therapy
Turgay Tuna, Sibel Boz, Luc Van Obbergh, Alphonse Lubansu, Edgard Engelman
STUDY DESIGN: This was a prospective study evaluating the Pain Sensitivity Questionnaire (PSQ) in 110 patients undergoing spine surgery. OBJECTIVE: The purpose of this study was to compare the ability of the PSQ-total and PSQ-minor scores with the Pain Catastrophizing Scale (PCS) in predicting the immediate postoperative pain of patients after spinal surgery and their risk of developing a chronically painful state. SUMMARY OF BACKGROUND DATA: Studies evaluating the PSQ as a preoperative determinant for the development of chronic pain are lacking...
July 21, 2018: Clinical Spine Surgery
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