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Perioperative pain

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https://www.readbyqxmd.com/read/28079737/dexmedetomidine-reduces-perioperative-opioid-consumption-and-postoperative-pain-intensity-in-neurosurgery-a-meta-analysis
#1
Yi Liu, Feng Liang, Xiaochen Liu, Xinxin Shao, Nan Jiang, Xiaoliang Gan
BACKGROUND: Dexmedetomidine (DEX) has been administered to patients during neurosurgery. Some studies have found that DEX could reduce perioperative opioid consumption and postoperative pain intensity. However, no firm conclusions have been reached. The purpose of this meta-analysis was to assess the efficacy of DEX for managing pain in neurosurgical patients. MATERIALS AND METHODS: A comprehensive literature review was conducted to identify randomized controlled trials (RCTs) focusing on the effects of DEX on perioperative opioid consumption and postoperative pain intensity in patients undergoing neurosurgery...
January 10, 2017: Journal of Neurosurgical Anesthesiology
https://www.readbyqxmd.com/read/28079663/general-anesthesia-and-fabry-disease-a-case-report
#2
Stefan Krüger, Albina Nowak, Torben Christoph Müller
Fabry disease is an inherited X-linked disorder characterized by the absence (in men) or deficiency (in women) in α-galactosidase A activity that causes a progressive accumulation of glycosphingolipids within lysosomes of cells of all the major organ systems. The subsequent organ damage that manifests in childhood and early adulthood presents a widely variable clinical picture of pain, hypertension, and cardiac, renal, nervous system, and lung dysfunction. We present 2 female patients with Fabry disease who required general anesthesia twice for gynecological and trauma surgery, respectively, and discuss their perioperative management based on new information in the medical literature...
January 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28077537/chronic-postsurgical-pain-in-children-prevalence-and-risk-factors-a-prospective-observational-study
#3
H Batoz, F Semjen, M Bordes-Demolis, A Bénard, K Nouette-Gaulain
BACKGROUND: Chronic postsurgical pain (CPSP) is well known in adults, with prevalence rates ranging from 10 to 50%. Little is known about the epidemiology of CPSP in children. The aim of this prospective observational study was to evaluate the prevalence of CPSP after surgery in children. METHODS: After informed consent, children aged six to18 yr were included. Characteristics and risk factors for CPSP were recorded. Exclusion criteria included ambulatory surgery, refusal, inability to understand and change of address...
October 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/28074801/delirium-after-cardiac-surgery-a-pilot-study-from-a-single-tertiary-referral-center
#4
Ashok K Kumar, Aveek Jayant, V K Arya, Rohan Magoon, Ridhima Sharma
BACKGROUND: Advances in cardiac surgery has shifted paradigm of management to perioperative psychological illnesses. Delirium is a state of altered consciousness with easy distraction of thoughts. The pathophysiology of this complication is not clear, but identification of risk factors is important for positive postoperative outcomes. The goal of the present study was to prospectively identify the incidence, motoric subtypes, and risk factors associated with development of delirium in cardiac surgical patients admitted to postoperative cardiac intensive care, using a validated delirium monitoring instrument...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28067743/comparative-perioperative-pain-and-recovery-in-women-undergoing-vaginal-reconstruction-versus-robotic-sacrocolpopexy
#5
Lauren B Westermann, Catrina C Crisp, Donna Mazloomdoost, Steven D Kleeman, Rachel N Pauls
BACKGROUND: In this study of patients undergoing vaginal hysterectomy with either robotic or vaginal prolapse repair, there was no difference in quality of life in the weeks following surgery; however, less narcotics were used, less pain was documented by nurses and Surgical Pain Scale (SPS), and better performance on voiding trials was noted in those undergoing robotic sacrocolpopexy. OBJECTIVES: Minimally invasive surgery for pelvic organ prolapse is the preferred surgical route for optimal recovery...
January 6, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28067693/intraoperative-ketamine-reduces-immediate-postoperative-opioid-consumption-after-spinal-fusion-surgery-in-chronic-pain-patients-with-opioid-dependency-a-randomized-blinded-trial
#6
Rikke Vibeke Nielsen, Jonna Storm Fomsgaard, Hanna Siegel, Robertas Martusevicius, Lone Nikolajsen, Jørgen Berg Dahl, Ole Mathiesen
Perioperative handling of surgical patients with opioid dependency represents an important clinical problem. Animal studies suggest that ketamine attenuates central sensitization and hyperalgesia and thereby reduces postoperative opioid tolerance. We hypothesized that intraoperative ketamine would reduce immediate postoperative opioid consumption compared to placebo in chronic pain patients with opioid dependency undergoing lumbar spinal fusion surgery. Primary outcome was morphine consumption 0-24 h postoperatively...
January 6, 2017: Pain
https://www.readbyqxmd.com/read/28063958/prevention-of-chronic-post-thoracotomy-pain-in-rats-by-intrathecal-resolvin-d1-and-d2-effectiveness-of-perioperative-and-delayed-drug-delivery
#7
Jeffery Chi-Fei Wang, Gary R Strichartz
: Thoracotomy results in a high frequency of chronic post-operative pain. Resolvins are endogenous molecules, synthesized and released by activated immune cells, effective against inflammatory and neuropathic pain. Different resolvins have differential actions on selective neuronal and glial receptors and enzymes. This paper examines the ability of intrathecal Resolvin D1 (RvD1) and Resolvin D2 (RvD2) to reduce chronic post-thoracotomy pain in rats. Thoracotomy, involving intercostal incision and rib retraction, resulted in a decrease in the mechanical force threshold to induce nocifensive behavior, an enlargement of the pain-sensitive area, and an increase in the fraction of rats showing nocifensive behavior, all for at least 5 weeks...
January 4, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28062325/a-system-based-nursing-approach-to-improve-outcomes-in-the-postoperative-esophagectomy-patient
#8
REVIEW
Susan Collazo, Nicole L Graf
OBJECTIVE: To review essential nursing implications in the care of postoperative esophagectomy patients. DATA SOURCES: Peer-reviewed literature, institutional experience, journal articles. CONCLUSION: Utilizing a system-based approach to assess the post-esophagectomy patient will assist the nurse in ensuring safe and comprehensive care. IMPLICATIONS FOR NURSING PRACTICE: Nursing care measures to reduce perioperative esophagectomy morbidity includes aggressive fluid management, pain management, use of epidural analgesia, and early ambulation...
January 3, 2017: Seminars in Oncology Nursing
https://www.readbyqxmd.com/read/28059913/liposomal-bupivacaine-use-in-transversus-abdominis-plane-blocks-reduces-pain-and-postoperative-intravenous-opioid-requirement-after-colorectal-surgery
#9
Audrey L Stokes, Sanjib D Adhikary, Ashley Quintili, Frances J Puleo, Christine S Choi, Christopher S Hollenbeak, Evangelos Messaris
BACKGROUND: Enhanced recovery protocols frequently use multimodal postoperative analgesia to improve postoperative outcomes in patients undergoing colorectal surgery. OBJECTIVE: The purpose of this study was to evaluate liposomal bupivacaine use in transversus abdominis plane blocks on postoperative pain scores and opioid use after colorectal surgery. DESIGN: This was a retrospective cohort study comparing outcomes between patients receiving nonliposomal anesthetic (n = 104) and liposomal bupivacaine (n = 303) blocks...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28056254/-interpretation-of-american-academy-of-orthopaedic-surgeons-clinical-practice-guideline-on-the-treatment-of-pediatric-diaphyseal-femur-fractures
#10
W Chen, J Li, Y Z Zhang
The original guideline on the Treatment of Pediatric Diaphyseal Femur Fractures (PDFF) was developed by the American Academy of Orthopaedic Surgeons (AAOS) in 2009, and the guideline was updated by AAOS in 2015. In this reissue, all recommendations in the original guideline identified as"inconclusive" were removed with seven recommendations reserved and without new recommendations added. The recommendations in the current guideline were listed as follows: (1) Children younger than 36 months with PDFF should be evaluated for child abuse...
January 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28052827/perioperative-glucocorticoid-administration-improves-elbow-motion-in-terrible-triad-injuries
#11
Mihir J Desai, Andrew P Matson, David S Ruch, Fraser J Leversedge, J Mack Aldridge, Marc J Richard
PURPOSE: Among patients who undergo surgical treatment of terrible triad elbow injuries (TTEI), we hypothesized that those who received perioperative glucocorticoid (GC) therapy would have improved postoperative pain and range of motion (ROM) and a similar complication rate compared with patients who did not receive GC therapy. METHODS: We retrospectively identified 26 patients who underwent surgical treatment of TTEI from 2009 to 2015. Thirteen patients received a single intraoperative dose of 10 mg intravenous dexamethasone followed with a 6-day oral methylprednisolone taper course (GC group), and 13 did not (control group)...
January 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28051905/a-prospective-nonrandomized-study-of-comparison-of-perioperative-and-quality-of-life-outcomes-of-endoscopic-versus-open-inguinal-hernia-repair-data-from-a-developing-country
#12
Awanish Kumar, Arvind Agrahari, Harvinder Singh Pahwa, Akshay Anand, Saumya Singh, Jitendra Kumar Kushwaha, Abhinav Arun Sonkar
OBJECTIVES: To determine the perioperative outcomes and quality of life (QOL) following endoscopic inguinal hernia repair (EIH) versus open inguinal hernia repair (OIH) using the hernia-specific Carolinas Comfort Scale(®) (CCS) questionnaire. MATERIALS AND METHODS: A prospective nonrandomized study from September 2014 to August 2015 included all patients who underwent elective primary endoscopic (totally extraperitoneal repair/transabdominal preperitoneal) or OIH...
January 4, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28045238/secure-low-cost-technique-for-laparoscopic-hepatic-resection-using-the-crush-clamp-method-with-a-bipolar-sealer
#13
Takatsugu Yamamoto, Takahiro Uenishi, Kazuhisa Kaneda, Masato Okawa, Shogo Tanaka, Shoji Kubo
INTRODUCTION: Laparoscopic hepatectomy is difficult because surgeons must perform the transection using many (four and more) energy devices and without direct manual maneuvers. Here we introduce hepatic transection by the classical method with a few (two or three) energy devices. MATERIALS AND SURGICAL TECHNIQUE: We performed laparoscopic hepatectomy for 40 patients with hepatic tumor and liver dysfunction. For parenchymal transection, we used bipolar radiofrequency coagulation forceps connected to a voltage-controlled electrosurgical generator and ultrasonic dissector...
February 2017: Asian Journal of Endoscopic Surgery
https://www.readbyqxmd.com/read/28043841/non-opioid-pain-management-in-benign-minimally-invasive-hysterectomy-a-systematic-review
#14
REVIEW
Emily Blanton, Georgine Lamvu, Insiyyah Patanwala, Kenneth I Barron, Kathryn Witzeman, Frank F Tu, Sawsan As-Sanie
BACKGROUND: Less postoperative pain is typically associated with a minimally invasive hysterectomy compared to a laparotomy approach but poor pain control can still be an issues. Multiple guidelines exist for managing postoperative pain yet most are not specialty-specific and are based on procedures bearing little relevance to a minimally invasive hysterectomy. OBJECTIVE: To determine if there is enough quality evidence within the benign gynecology literature to make non-opioid pain control recommendations for women undergoing a benign minimally invasive hysterectomy...
December 30, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28040079/prevalence-and-risk-factors-for-re-interventions-following-reamed-intramedullary-tibia-nailing
#15
Petros Z Stavrou, Vincenzo Ciriello, Stylianos Theocharakis, Suribabu Gudipati, Theodoros H Tosounidis, Nikolaos K Kanakaris, Peter V Giannoudis
INTRODUCTION: This study aimed to identify the prevalence and the risk factors for re-interventions following reamed intramedullary nailing (IMN) of tibial shaft fractures. PATIENTS AND METHODS: We retrospectively analysed a prospectively populated data of adult patients that underwent reamed intramedullary nailing for stabilization of tibial shaft fractures over a period of three years. Exclusion criteria were immature patients, pathological and periarticular fractures...
December 2016: Injury
https://www.readbyqxmd.com/read/28034981/a-preliminary-examination-of-the-comparative-efficacy-of-intravenous-vs-oral-acetaminophen-in-the-treatment-of-perioperative-pain
#16
Anthony Plunkett, Chelsey Haley, Amy McCoart, Thomas Beltran, Krista Beth Highland, Cristobal Berry-Caban, Sherry Lamberth, Michael Bartoszek
: OBJECTIVE : The management of postoperative pain is a major health care issue. While the cost of intravenous acetaminophen (IVA) is significantly greater than its oral acetaminophen (OA) counterpart, less is known regarding comparative effectiveness of these routes. The purpose of this study was to determine whether perioperative IVA is equivalent in reducing postoperative pain compared with perioperative OA for laparoscopic cholecystectomy (LapChole). DESIGN:  Double-blinded, prospective, randomized placebo-controlled trial...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28033260/transabdominal-preperitoneal-laparoscopic-approach-for-incarcerated-inguinal-hernia-repair-a-report-of-73-cases
#17
Shuo Yang, Guangyong Zhang, Cuihong Jin, Jinxin Cao, Yilin Zhu, Yingmo Shen, Minggang Wang
To investigate the efficacy, key technical points, and complication management of the transabdominal preperitoneal (TAPP) approach for incarcerated inguinal hernia repair. Seventy-three patients with incarcerated inguinal hernias underwent TAPP surgery in our department between Jan 2010 and Dec 2015. A retrospective review was performed by analyzing the perioperative data from these patients. The operation was successfully completed in all 73 patients. Operation time was 54.0 ± 18.8 minutes (range, 35-100 minutes)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28029532/role-of-periarticular-liposomal-bupivacaine-infiltration-in-patients-undergoing-total-knee-arthroplasty-a-meta-analysis-of-comparative-trials
#18
Preet Mohinder Singh, Anuradha Borle, Anjan Trikha, Lia Michos, Ashish Sinha, Basavana Goudra
BACKGROUND: Over last 2 years, many trials have evaluated newly approved liposomal bupivacaine for periarticular infiltration in total knee arthroplasty (TKA) with mixed results. Our meta-analysis attempts to consolidate the results and make evidence-based conclusions. METHODS: Trails comparing periarticular infiltration of liposomal bupivacaine to conventional analgesic regimens for total knee arthroplasty published till June 2016 were searched in medical database...
October 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28027828/prognosis-and-adjacent-segment-disease-after-lumbar-spinal-fusion-surgery-for-destructive-spondyloarthropathy-in-long-term-hemodialysis-patients
#19
Keishi Maruo, Tokuhide Moriyama, Toshiya Tachibana, Shinichi Inoue, Fumihiro Arizumi, Kazuki Kusuyama, Shinichi Yoshiya
BACKGROUND: Lumbar destructive spondyloarthropathy (DSA) is a serious complication in long-term hemodialysis patients. There have not been many reports regarding the surgical management for lumbar DSA. In addition, the adjacent segment pathology after lumbar fusion surgery for DSA is unclear. The objective of this study was to assess the clinical outcome and occurrence of adjacent segmental disease (ASD) after lumbar instrumented fusion surgery for DSA in long-term hemodialysis patients...
December 24, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28025740/long-term-follow-up-of-laparoscopic-total-extraperitoneal-tep-repair-in-inguinal-hernia-without-mesh-fixation
#20
S Golani, P Middleton
PURPOSE: From the current evidence, non-fixation of the mesh (NMF) in laparoscopic total extraperitoneal (TEP) repair appears to be a safe alternative for inguinal hernia patients in the short term. This study aims to demonstrate that NMF is as effective in the long term by following up a large number of patients with a mean follow-up of 6 years. The primary outcomes are chronic pain and recurrence rate. METHODS: A thorough review of medical records was conducted from a prospectively maintained database of 538 patients who underwent a laparoscopic TEP inguinal hernia repair by a single surgeon working in Sydney from the year 2005 to 2010...
December 26, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
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