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Post operative pain

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https://www.readbyqxmd.com/read/28735135/endoscope-assisted-abscess-drainage-secondary-to-endoscope-assisted-tlif-1-year-follow-up
#1
Karthik Madhavan, Steven Shelby Burks, Lee Onn Chieng, Anand Veeravagu, Michael Y Wang
INTRODUCTION: Endoscopic discectomy and fusions have been gaining popularity in the recent past and are noted to be safe for its application in elderly population. It involves ultra-small incision for discectomy followed by placement of percutaneous screws in awake patients. Treatment of advanced spinal pathology using endoscope-assisted techniques are challenging. Although not common with endoscopic approach, post-operative infection can be problematic as there are no established guidelines on its management...
July 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28734776/a-preoperative-score-to-predict-early-death-after-pancreatic-cancer-resection
#2
Gianpaolo Balzano, Erica Dugnani, Stefano Crippa, Marina Scavini, Valentina Pasquale, Francesca Aleotti, Daniela Liberati, Alessandra Gandolfi, Giulio Belfiori, Michele Reni, Claudio Doglioni, Giacomo Ruffo, Cristina Marmorale, Massimo Falconi, Lorenzo Piemonti
BACKGROUND: This study aimed to develop and validate a preoperative prognostic model for death within one year post-surgery in patients with resectable pancreatic ductal adenocarcinoma (PDAC). METHODS: A derivation cohort study of 296 patients who underwent surgical resection of PDAC was prospectively enrolled in an observational study. Preoperative predictors of one year mortality were used to develop a risk score which was then validated in an external cohort of 182 patients with resectable PDAC...
July 1, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28734659/comparative-effectiveness-study-between-negative-pressure-wound-therapy-and-conventional-wound-dressing-on-perforator-flap-at-the-chinese-tertiary-referral-teaching-hospital
#3
Regis Ernest Mendame Ehya, Yong Zhao, Xun Zheng, Wanrong Yi, Guy-Armel Bounda, Zonghuan Li, Weidong Xiao, Aixi Yu
BACKGROUND: Perforator flap techniques with conventional wound dressing have being extensively used in the management of soft-tissue defects. However; the flap's survival rate is not always guaranteed and the wound healing time always long. The aim of this study was to investigate the clinical effectiveness use of a freshly transplanted perforator flap in conjunction with Vacuum-assisted closure (VAC) for better clinical outcomes. METHODS: A prospective, randomized, effectiveness study comparing the clinical outcomes of VAC versus traditional wrap and bandages for the treatment of open wounds that required hospital admission and operative debridement using perforator flaps, was carried out from March 1, 2014 to March 31, 2016 at Wuhan University Zhongnan Hospital...
July 12, 2017: Journal of Tissue Viability
https://www.readbyqxmd.com/read/28733728/totally-extraperitoneal-approach-for-ventral-hernia
#4
Sante Capitano
BACKGROUND: In open surgery, extraperitoneal sublay mesh implantation is generally preferred to intraperitoneal placement, following the same principles as in "giant prosthetic reinforcement of the visceral sac" described for inguinal hernia repair [1, 2]. Miserez and Penninckx in 2002 described an endoscopic totally preperitoneal ventral hernia repair in a small cohort of 15 cases [3]. Unfortunately, this technique has not spread, probably because of the technical difficulties that require, but not for effectiveness...
July 21, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28728827/the-use-of-perioperative-ketorolac-in-the-surgical-treatment-of-pediatric-spontaneous-pneumothorax
#5
R Michael Dorman, George Ventro, Sarah B Cairo, Kaveh Vali, David H Rothstein
BACKGROUND: We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. METHODS: The Pediatric Health Information System database was queried for patients ages 10-16years discharged in the years 2004-2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28728601/transabdominal-laparoscopic-retroperitoneal-neurectomy-for-chronic-pain-after-inguinal-hernia-repair-and-appendicectomy-a-matched-pair-study
#6
Ioannis Karampinis, Johannes Weiss, Lothar Pilz, Stefan Post, Florian Herrle
BACKGROUND: Chronic debilitating pain is a rare but significant cause of postoperative morbidity after inguinal surgery. Such pain is usually of neuropathic origin and frequently caused by intraoperative nerve damage. In this retrospective matched-pair study we analysed results of a minimal-invasive approach to neurectomy on quality of life and pain relief. METHODS: From March 2010 to January 2012, 9 patients developing chronic neuropathic pain after inguinal hernia repair (8 patients) or open appendicectomy (one patient) were operated using a laparoscopic transabdominal approach in our department...
July 20, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28728480/safety-and-efficacy-of-stenting-nonthrombotic-iliac-vein-lesions-in-octogenarians-and-nonagenarians-in-an-office-setting
#7
Pavel Kibrik, Justin Eisenberg, Ahmad Alsheekh, Syed Ali Rizvi, Afsha Aurshina, Natalie Marks, Anil Hingorani, Enrico Ascher
Objectives Treatment options for venous insufficiency are rapidly evolving in the office setting and include venography, intravascular ultrasound, and venous stenting. Non-thrombotic iliac vein lesions assessment and treatment in an office setting is currently an area of interest. The purpose of this study is to demonstrate the safety and efficacy of evaluating non-thrombotic iliac vein lesion with this office-based procedure in octogenarians and nonagenarians. Methods From January 2012 through December 2013, 300 non-thrombotic iliac vein lesion limbs in 192 patients with venous insufficiency ≥80 years old were evaluated for non-thrombotic iliac vein lesion...
January 1, 2017: Vascular
https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#8
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727706/opioids-for-ocular-pain-a-narrative-review
#9
Vinicius Bp Pereira, Renato Garcia, Andre Am Torricelli, Samir J Bechara
BACKGROUND: Refractive surgery is a common procedure, but may be associated with severe post-operative pain. OBJECTIVES: To describe studies addressing the use of opioids for control of pain after ocular surgery, with an emphasis on refractive surgery. STUDY DESIGN: This is a narrative review of relevant articles on the physiology of corneal pain and the use of opioids for its treatment after surgery. SETTING: Single tertiary center...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28727703/intrathecal-morphine-improves-hemodynamic-parameters-and-analgesia-in-patients-undergoing-aortic-valve-replacement-surgery-a-prospective-double-blind-randomized-trial
#10
Hamed Elgendy, Hatem A R Helmy
BACKGROUND: Intrathecal morphine (ITM) has been used in hopes of providing good postoperative analgesia in cardiac surgery. Little is known about its use in isolated aortic valve replacement surgery. OBJECTIVES: To evaluate the effects of 7 µ/kg ITM administration in aortic valve replacement in regards to hemodynamics, pain score, and postoperative complications when compared to general anesthesia alone. STUDY DESIGN: A randomized, double-blind trial...
July 2017: Pain Physician
https://www.readbyqxmd.com/read/28726270/equimolar-mixture-of-nitroux-oxyde-and-oxygen-during-post-operative-physiotherapy-in-patients-with-cerebral-palsy-a-randomized-double-blind-placebo-controlled-study
#11
A Delafontaine, A Presedo, D Mohamed, D Lopes, C Wood, C Alberti
BACKGROUND: The administration of an equimolar mixture of nitrous oxide and oxygen (N2O) is recommended during painful procedures. However, the evaluation of its use during physiotherapy after surgery has not been reported, although pain may hamper physiotherapy efficiency. This study investigated whether the use of N2O improves the efficacy of post-operative physiotherapy after multilevel surgery in patients with cerebral palsy. METHOD: It was a randomized 1:1, double-blind, placebo-controlled study...
July 20, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28725612/vasectomy-reversal-for-post-vasectomy-pain-syndrome
#12
REVIEW
L I Smith-Harrison, Ryan P Smith
Post-vasectomy pain syndrome (PVPS) is a rare, but devastating outcome following vasectomy. Given the widespread utilization of vasectomy for permanent contraception, with more than 500,000 procedures performed annually in the United States, it can be a significant challenge for both patients and providers. Vasectomy reversal is a surgical option for men who fail conservative or medical management. Despite improvements in technique, vasectomy carries some inherent risks making pre-procedure counseling regarding the risks of PVPS paramount...
May 2017: Translational Andrology and Urology
https://www.readbyqxmd.com/read/28723879/suppression-of-sympathetic-nerve-sprouting-by-local-administration-of-an-%C3%AE-antagonist-around-the-dorsal-root-ganglion-in-a-lumbar-radiculopathy-model
#13
Izaya Ogon, Tsuneo Takebayashi, Tsuyoshi Miyakawa, Takehito Iwase, Katsumasa Tanimoto, Yoshinori Terashima, Syunsuke Jimbo, Takeshi Kobayashi, Noritsugu Tohse, Toshihiko Yamashita
STUDY DESIGN: Animal experimental study with intervention OBJECTIVE.: The purpose of this study was to elucidate whether local administration of an α-antagonist around the dorsal root ganglion (DRG) suppressed sympathetic nerve sprouting, from the acute to the chronic pain development phase, in a lumbar radiculopathy model using immunohistochemical methods. SUMMARY OF BACKGROUND DATA: The abnormal sympathetic-somatosensory interaction may underlie some forms of neuropathic pain...
July 18, 2017: Spine
https://www.readbyqxmd.com/read/28723779/can-operations-achieve-good-outcomes-in-elderly-patients-with-sanders-ii-iii-calcaneal-fractures
#14
Jun Su, Xuecheng Cao
The aim of this study was to compare the clinical effect of operative treatment and nonoperative treatment for elderly patients with Sanders II-III calcaneal fractures.The study consisted of 60 patients with Sanders II-III calcaneal fractures who were treated in our institution from January 2007 to April 2012. The clinical effect between the operative treatment group of 32 patients and the nonoperative treatment group of 28 patients was studied. Böhler angle, Gissane angle, subtalar joint motion, calcaneal width, and calcaneal height were measured before and after treatment, and these indexes were also measured on the uninjured foot...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28722516/pre-operative-obesity-does-not-predict-poorer-symptom-control-and-quality-of-life-after-lumbar-disc-surgery
#15
Paul M Brennan, James J M Loan, Neil Watson, Pragnesh M Bhatt, Peter Alwyn Bodkin
PURPOSE: We aimed to determine whether there was a difference in post-operative symptomatic control and quality of life (QoL) between patients who were obese (BMI >30) and non-obese (BMI <30) pre-operatively. This information may inform the decision making of Physicians and patients whether to proceed to surgery for management of symptomatic lumbar disc prolapse. METHODS: We conducted a prospective questionnaire-based study of QoL and symptom control in 120 patients with postal follow-up at 3 and 12 months after lumbar disc surgery...
July 19, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28722339/structured-pain-management-reduces-patient-discomfort-after-catheter-ablation-and-rhythm-device-surgery
#16
M Dörschner, A Bollmann, B Dinov, S Richter, M Döring, A Arya, A Müssigbrodt, S Kircher, N Dagres, P Sommer, G Hindricks, K Bode
BACKGROUND: The goal was to test the effectiveness of a structured pain management programme after invasive electrophysiological interventions in cardiology including ablation of atrial fibrillation (AF) or ventricular tachycardia (VT) and implantation, or explantation, of pacemakers or implantable cardioverter defibrillators. METHODS: This was a prospective study with a pre-/post-design where a post-intervention group (116 consecutive patients) was compared to a pre-intervention group (102 consecutive patients) after implementation of a structured pain-management programme using the numeric rating scale (NRS 0-10) and classified as moderate-to-severe if NRS > 3...
July 18, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28721190/a-case-of-fatal-internal-jugular-vein-perforation-during-nasogastric-tube-insertion
#17
Katherine A Smith, Jeffrey P Fleming, Robert D Bennett, Andrew A Taitano
Nasogastric tube (NGT) insertion is a routine procedure in the management of surgical patients. We report the second case of internal jugular vein perforation during NGT insertion. A 79-year-old man presented with diffuse abdominal pain secondary to a perforated viscus. Abdominal CT revealed pneumoperitoneum, necessitating emergent exploratory laparotomy. On post-operative Day 7, the patient developed mild abdominal distension and subjective nausea for which NGT placement was ordered for decompression. Tube placement was confirmed by insufflation of air without aspiration of gastric contents...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28720091/clinical-and-imaging-outcome-of-osteochondral-lesions-of-the-talus-treated-using-autologous-matrix-induced-chondrogenesis-technique-with-a-biomimetic-scaffold
#18
Domenico Albano, Nicolò Martinelli, Alberto Bianchi, Carmelo Messina, Francesco Malerba, Luca Maria Sconfienza
BACKGROUND: The purpose of our study was to assess the clinical and imaging outcome of autologous matrix-induced chondrogenesis (AMIC) technique consisting of microfractures followed by the filling of osteochondral lesions of the talus (OLTs) with a cell-free biphasic collagen-hydroxyapatite osteochondral scaffold (MaioRegen). METHODS: Sixteen patients (eight males, age: 42.6 ± 18.4, range 14-74) with OLT repaired using AMIC technique, with implantation of MaioRegen, were clinically evaluated through the American Orthopedic Foot and Ankle Society Score (AOFAS) and a 10-point Visual Analogue Scale (VAS) pain score after a mean follow-up of 30 ± 16...
July 18, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28718606/-interventional-treatment-of-venous-insufficiency
#19
Barbara Ney, Rolf P Engelberger, Amin Dabiri, Jean-François Lüthi, Andreas Erdmann, Caroline Krieger, Sébastien Déglise, Thierry Merminod, Philippe Kern, Lucia Mazzolai
Interventional treatment of venous insufficiency has been revolutionized by endovascular techniques. Some of these techniques, and particularly thermal ablation (endovenous laser, radiofrequency) are now recommended as first-line therapy in the latest international guidelines. This is because of less post-operative pain, a shorter leave from employment and similar or lower recurrence rate. Endovenous techniques allow safer and more efficient treatment of certain particular conditions : small saphenous vein, ulcers, and recurrent varicose veins...
March 15, 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28717869/transoral-endoscopic-thyroidectomy-vestibular-approach-toetva-indications-techniques-and-results
#20
Angkoon Anuwong, Thanyawat Sasanakietkul, Pornpeera Jitpratoom, Khwannara Ketwong, Hoon Yub Kim, Gianlorenzo Dionigi, Jeremy D Richmon
INTRODUCTION: The Transoral Neck Surgery (TONS) Study Group was established at the 1st International Thyroid NOTES Conference in February 2016 with the intention of standardizing and refining thyroid NOTES techniques, including both transoral endoscopic and robotic thyroidectomy approaches. Herein, the authors report the modification of indications, preparation, and step-by-step explanations for operative techniques, as well as results and postoperative care for transoral endoscopic thyroidectomy vestibular approach (TOETVA)...
July 17, 2017: Surgical Endoscopy
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