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Post operative pain management in orthopedics

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https://www.readbyqxmd.com/read/30104925/do-orthopedic-trauma-surgeons-adhere-to-aaos-guidelines-when-treating-distal-radius-fractures
#1
Ugochi C Okoroafor, Lisa K Cannada
Background: The American Academy of Orthopedic Surgeons (AAOS) has provided Clinical Practice Guidelines (CPG) and Appropriate Use Criteria (AUC) regarding management of distal radius fractures. The purpose of this study was to evaluate current practices in management of distal radius fractures among orthopedic trauma surgeons and to examine adherence to the AAOS criteria. Methods: An online survey was posted and distributed via the Orthopaedic Trauma Association (OTA) website...
2018: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/30042629/timing-of-initiating-manual-therapy-and-therapeutic-exercises-in-the-management-of-patients-after-hindfoot-fractures-a-randomized-controlled-trial
#2
Stephanie R Albin, Shane L Koppenhaver, Drew H Van Boerum, Thomas G McPoil, James Morgan, Julie M Fritz
Study design: Randomized clinical trial. Background: Patients with fractures to the talus and calcaneus report decreased functional outcomes and develop long-term functional limitations. Although physical therapy is typically not initiated until six weeks after fixation, there's little research on the optimal time to initiate a formal physical therapy program. Objectives: To assess whether initiating physical therapy including range of motion (ROM) and manual therapy two weeks post-operatively (EARLY) vs...
July 2018: Journal of Manual & Manipulative Therapy
https://www.readbyqxmd.com/read/29945400/-precise-application-of-traditional-chinese-medicine-in-minimally-invasive-techniques
#3
Fu-Hui Dong
The miminally-invasive techniques of traditional Chinese medicine(TCM) uses different types of acupuncture needles to treat diseased locations with special techniques. These techniques include different methods of insertion and closed incision (press cutting, sliding cutting, scrape cutting, etc.). This needling technique is based on the traditional Chinese medicine theories of Pi Bu (cutaneous), Jing Jin (sinew), Jing Luo (meridian), Wu Ti (five body structure components) and Zang Fu (organ system). Commonly used needles include: needle Dao , needle with edge, Pi needle, Shui needle, Ren needle, Gou needle, Chang Yuan needle, Bo needle and so on...
June 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29935334/treatment-of-large-deep-osteochondritis-lesions-of-the-knee-by-autologous-matrix-induced-chondrogenesis-amic-preliminary-results-in-13-patients
#4
Pierre Bertho, Adrien Pauvert, Thomas Pouderoux, Henri Robert
BACKGROUND: Osteo-chondral defects due to advanced osteochondritis of the knee eventually cause osteoarthritis. Autologous matrix-induced chondrogenesis (AMIC) may hold potential for overcoming the treatment challenges raised by defects larger than 2 cm2 . The primary objective of this study was to assess medium-term functional outcomes of AMIC. The secondary objective was to confirm the absence of adverse events. HYPOTHESIS: AMIC significantly improves knee function in patients with osteochondritis responsible for osteo-chondral defects grade III or IV in the International Cartilage Repair Society (ICRS) classification...
June 20, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/29864988/pain-assessment-and-post-operative-pain-management-in-orthopedic-patients
#5
W Schmelling, J N Poulsen, L Christrup, P Gazerani
Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain...
December 29, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29777950/acceptance-and-commitment-therapy-for-prevention-of-chronic-postsurgical-pain-and-opioid-use-in-at-risk-veterans-a-pilot-randomized-controlled-study
#6
Lilian Dindo, M Bridget Zimmerman, Katherine Hadlandsmyth, Barbara StMarie, Jennie Embree, James Marchman, Toni Tripp-Reimer, Barbara Rakel
High levels of pain, significant anxiety, or depressive symptoms before surgery put patients at elevated risk for chronic pain and prolonged opioid use following surgery. The purpose of this preliminary study was to assess the efficacy of a 1-day Acceptance and Commitment Therapy (ACT) workshop in "at-risk" veterans for the prevention of chronic pain and opioid use following orthopedic surgery. In a randomized controlled trial, 88 at-risk veterans undergoing orthopedic surgery were assigned to treatment as usual (TAU; n = 44) or TAU plus a 1-day ACT workshop (n = 44)...
May 17, 2018: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29369191/comparison-of-surgical-and-conservative-treatment-of-rockwood-type-iii-acromioclavicular-dislocation-a-meta-analysis
#7
REVIEW
Guolong Tang, Yu Zhang, Yuan Liu, Xiaodong Qin, Jun Hu, Xiang Li
BACKGROUND: There is no consensus on the effects of surgical versus conservative treatment on Rockwood type-III dislocation of the acromioclavicular joint in general orthopedic practice. The objective of this meta-analysis was to compare the clinical outcomes of patients managed surgically and conservatively following type-III acromioclavicular (AC) dislocation. METHODS: The Cochrane Library, EMBASE, MEDLINE via Ovid SP, and PubMed databases were searched for randomized controlled trials and observational studies...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28928544/role-of-anesthesiologist-in-the-management-of-a-child-with-cerebral-palsy
#8
REVIEW
Safiya Imtiaz Shaikh, Ganapati Hegade
Cerebral palsy (CP) refers to a spectrum of nonprogressive neurological disorders with disturbances in posture and movement, resulting from perinatal intrauterine insult to developing infant brain. Many conditions associated with CP require surgery. Such cases pose important gastrointestinal, respiratory, and other perioperative considerations. Anesthetic management in these cases is delicate. Intraoperative complications including hypovolemia, hypothermia, muscle spasms, seizures, and delayed recovery might complicate the anesthetic management...
July 2017: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/28327419/concomitant-unilateral-post-traumatic-leg-and-foot-compartment-syndrome-in-a-5-years-old-child-case-report
#9
Aissam Elmhiregh, Adel El Feghih, Khaled Faraj
BACKGROUND: Compartment syndrome is one of the most serious orthopedic emergencies [4]. It is usually anticipated and looked at in every single orthopedic case. Early recognition and management of those cases are quite important in order to avoid the devastating consequences of such condition. CASE SUMMARY: This is a case report of a 5 years old child with concomitant unilateral leg and foot compartment syndrome after a roll over trauma. The patient was presented with significant leg and foot swelling, severe pain and absent distal pulses...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28298221/post-operative-opioid-pain-management-patterns-for-patients-who-receive-hip-surgery
#10
Chad E Cook, Daniel I Rhon, Brian D Lewis, Steven Z George
BACKGROUND: Identifying optimal, post-operative opioid management strategies is a priority of health providers and government agencies. At present, there are no studies we are aware of that have formally investigated opioid prescribing patterns for post-operative non-arthroplasty orthopedic conditions such as femoroacetabular impingement, nor has any study investigated the influence of opioid prescription patterns on health care costs and utilization. We aimed to investigate a subgrouping scheme associated with post-operative opioid prescription strategies and measure the subgroups' direct and indirect health care utilization and costs in individuals undergoing non-arthroplasty orthopedic hip surgery...
March 16, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28118835/pilot-evaluation-of-a-novel-unilateral-onychectomy-model-and-efficacy-of-an-extended-release-buprenorphine-product
#11
RANDOMIZED CONTROLLED TRIAL
Masataka Enomoto, Patricia D Kigin, David Bledsoe, Robyn Slone, Jonathan Hash, Charles E Smith, B Duncan X Lascelles
BACKGROUND: Non-steroidal anti-inflammatory drugs (NSAIDs), transdermal fentanyl patches, and transmucosal buprenorphine are probably the most commonly used options for providing post-operative analgesia in the early at-home period. However, these require daily administration or are associated with abuse concerns. One of the significant unmet needs in veterinary surgery and pain management is for longer acting opioids for cats to effectively bridge the gap between the in-hospital and at-home recovery periods...
January 24, 2017: BMC Veterinary Research
https://www.readbyqxmd.com/read/27796190/postoperative-physical-therapy-management-of-tendon-transfer-for-digital-wrist-extension-due-to-multifocal-motor-neuropathy
#12
Steve Volpe
Study Design Case report. Background Multifocal motor neuropathy is a progressive motor nerve disorder characterized by muscle weakness in the extremities. Muscle imbalance and weakness can become so severe that the involved extremity can be rendered nonfunctional. The purpose of this case report is to describe the physical therapy postoperative management of a patient who underwent a multiple tendon transfer to correct the loss of digital/wrist extension of the right upper extremity. Case Description A 38-year-old woman with a medical diagnosis of multifocal motor neuropathy, which caused muscle imbalance and weakness in the right hand, underwent a multiple tendon transfer to correct the loss of digit and wrist extension...
December 2016: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/27686251/evaluation-of-injectable-robenacoxib-for-the-treatment-of-post-operative-pain-in-cats-results-of-a-randomized-masked-placebo-controlled-clinical-trial
#13
Stephen King, Elizabeth S Roberts, Jonathan N King
BACKGROUND: Few pharmaceuticals are registered in cats for the management of post-operative pain and inflammation. The objective of this study was to assess the field efficacy and safety of an injectable formulation of the nonsteroidal anti-inflammatory drug robenacoxib in cats undergoing surgery. The study was a multi-center, prospective, randomized, masked, parallel-group, placebo-controlled clinical trial. A total of 349 cats were enrolled and underwent surgery comprising forelimb onychectomy, as an example of orthopedic surgery, plus either ovariohysterectomy or castration...
September 29, 2016: BMC Veterinary Research
https://www.readbyqxmd.com/read/27423648/comparative-analysis-of-length-of-stay-and-inpatient-costs-for-orthopedic-surgery-patients-treated-with-iv-acetaminophen-and-iv-opioids-vs-iv-opioids-alone-for-post-operative-pain
#14
COMPARATIVE STUDY
Ryan N Hansen, An Pham, Scott A Strassels, Stela Balaban, George J Wan
INTRODUCTION: Recovery from orthopedic surgery is oriented towards restoring functional health outcomes while reducing hospital length of stay (LOS) and medical expenditures. Optimal pain management is a key to reaching these objectives. We sought to compare orthopedic surgery patients who received combination intravenous (IV) acetaminophen and IV opioid analgesia to those who received IV opioids alone and compared the two groups on LOS and hospitalization costs. METHODS: We performed a retrospective analysis of the Premier Database (Premier, Inc...
September 2016: Advances in Therapy
https://www.readbyqxmd.com/read/27403409/comparison-between-paracetamol-piroxicam-their-combination-and-placebo-in-postoperative-pain-management-of-upper-limb-orthopedic-surgery-a-randomized-double-blind-clinical-trial
#15
Gholamreza Khalili, Marzieh Salimianfard, Abolghasem Zarehzadeh
BACKGROUND: Therapeutic superiority of a combination of Paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) over either drug alone remains controversial. We evaluated the efficiency of a combination of Paracetamol and Piroxicam versus each drug alone and also placebo in the management of postoperative pain, in patients who had undergone elective upper limb orthopedic surgery under general anesthesia. MATERIALS AND METHODS: A total of 100 patients were randomly divided into four groups to receive either intravenous (IV) infusion of Paracetamol, 15 mg/kg...
2016: Advanced Biomedical Research
https://www.readbyqxmd.com/read/27171143/pain-and-laboratory-animals-publication-practices-for-better-data-reproducibility-and-better-animal-welfare
#16
Larry Carbone, Jamie Austin
Scientists who perform major survival surgery on laboratory animals face a dual welfare and methodological challenge: how to choose surgical anesthetics and post-operative analgesics that will best control animal suffering, knowing that both pain and the drugs that manage pain can all affect research outcomes. Scientists who publish full descriptions of animal procedures allow critical and systematic reviews of data, demonstrate their adherence to animal welfare norms, and guide other scientists on how to conduct their own studies in the field...
2016: PloS One
https://www.readbyqxmd.com/read/27152748/intravenous-ibuprofen-for-treatment-of-post-operative-pain-a-multicenter-double-blind-placebo-controlled-randomized-clinical-trial
#17
RANDOMIZED CONTROLLED TRIAL
Andrea Gago Martínez, Blanca Escontrela Rodriguez, Antonio Planas Roca, Alberto Martínez Ruiz
BACKGROUND: Non-steroidal anti-inflammatory drugs are often used as components of multimodal therapy for postoperative pain management, but their use is currently limited by its side effects. The specific objective of this study was to evaluate the efficacy and safety of a new formulation of intravenous (IV) ibuprofen for the management of postoperative pain in a European population. METHODS AND FINDINGS: A total of 206 patients from both abdominal and orthopedic surgery, were randomly assigned in 1:1 ratio to receive 800 mg IV-ibuprofen or placebo every 6 hours; all patients had morphine access through a patient controlled analgesia pump...
2016: PloS One
https://www.readbyqxmd.com/read/26859916/regional-analgesia-for-post-operative-pain-management-initial-experience-in-a-low-resource-setting
#18
A A Yunus, E O Nwasor, M E Idris, F S Ejagwulu
OBJECTIVE: The aim of this study is to demonstrate the use of some regional anaesthetic techniques in effective postoperative pain control in a low resource setting. We also wanted to find out the potential benefits and prospects of regional techniques to achieve effective postoperative analgesia. DESIGN: This study was a prospective observational study in which 25 patients presenting for various orthopaedic and general surgical procedures were recruited randomly...
March 2012: East African Medical Journal
https://www.readbyqxmd.com/read/26801194/giant-central-thoracic-disc-herniations-surgical-outcome-in-17-consecutive-patients-treated-by-mini-thoracotomy
#19
Roland Roelz, Christoph Scholz, Jan-Helge Klingler, Christian Scheiwe, Ronen Sircar, Ulrich Hubbe
PURPOSE: Safe treatment of giant central thoracic disc herniations (cTDHs) remains a surgical challenge due to frequent calcifications, intradural extension and, importantly, the rare exposure of spine surgeons to these lesions. We report our 10-year experience in the management of giant cTDH by mini-thoracotomy and offer a detailed description of the technique. METHODS: 17 patients harboring 17 giant cTDH operated on via a mini-thoracotomy at the authors' institution between 2004 and 2014 were reviewed...
May 2016: European Spine Journal
https://www.readbyqxmd.com/read/26751750/assessment-of-outcomes-of-treatment-of-fractures-of-distal-femur-with-a-locking-plate-taking-into-account-factors-influencing-the-result
#20
Grzegorz Pakuła, Krzysztof Kwiatkowski, Piotr Kuczmera, Piotr Fudalej
BACKGROUND: The aim of this paper is to evaluate the results of treatment of distal femoral fractures (DFF) fixed with locking plates and analysis of factors that influence the final outcome. MATERIAL AND METHODS: The patients were treated at the Department of Traumatology and Orthopedics, Military Medical Institute in Warsaw, and the Department of Orthopedics and Traumatology, 4th Military Research Hospital in Wroclaw. We analysed 39 patients with 42 fractures of the distal femur...
October 2015: Ortopedia, Traumatologia, Rehabilitacja
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