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https://www.readbyqxmd.com/read/28627290/continuous-adductor-canal-block-added-to-local-infiltration-analgesia-lia-after-total-knee-arthroplasty-has-no-additional-benefits-on-pain-and-ambulation-on-postoperative-day-1-and-2-compared-with-lia-alone
#1
Svava Gudmundsdottir, Jonas L Franklin
Background and purpose - The additional effects of a continuous adductor canal block (ACB) compared with a single-dose local infiltration anesthesia (LIA) after total knee arthroplasty (TKA) has not been widely researched. Both methods have good effect individually. We hypothesized that a continuous ACB added to a single-dose LIA would lower pain scores while ambulating on postoperative day 1 (POD1) and postoperative day 2 (POD2). Patients and methods - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial...
June 19, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28611004/an-in-situ-forming-phospholipid-based-phase-transition-gel-prolongs-the-duration-of-local-anesthesia-for-ropivacaine-with-minimal-toxicity
#2
Hanmei Li, Tao Liu, Yuxuan Zhu, Qiang Fu, Wanxia Wu, Jie Deng, Li Lan, Sanjun Shi
An injectable, phospholipid-based phase transition gel (PPTG) has been developed for prolonging the release of ropivacaine (RO) for local anesthesia. PPTG was prepared by mixing phospholipids, medium-chain triglyceride and ethanol. Prior to injection, the PPTG is in a sol state with low viscosity. After subcutaneous injection, the PPTG rapidly forms a gel in situ, which acts as a drug release depot as verified by in vitro release profiles and in vivo pharmacokinetics. Administering RO-PPTG to rats led to a significantly smaller initial burst release than administering RO solution or RO base suspension...
June 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28603868/pre-operative-brachial-plexus-block-compared-with-an-identical-block-performed-at-the-end-of-surgery-a-prospective-double-blind-randomised-clinical-trial
#3
A Holmberg, A R Sauter, Ø Klaastad, T Draegni, J C Raeder
We evaluated whether pre-emptive analgesia with a pre-operative ultrasound-guided infraclavicular brachial plexus block resulted in better postoperative analgesia than an identical block performed postoperatively. Fifty-two patients undergoing fixation of a fractured radius were included. All patients received general anaesthesia with remifentanil and propofol. Patients were randomly allocated into two groups: a pre-operative block or a postoperative block with 0.5 ml.kg(-1) ropivacaine 0.75%. After surgery, all patients received regular paracetamol plus opioids for breakthrough pain...
June 12, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28598907/treating-pain-on-skin-graft-donor-sites-review-and-clinical-recommendations
#4
Sarthak Sinha, Amanda J Schreiner, Jeff Biernaskie, Duncan Nickerson, Vincent A Gabriel
Split-thickness skin grafting (STSG) is the most common reconstructive procedure in managing burn injuries. Harvesting split-thickness skin creates a new partial thickness wound referred to as the donor site. Pain at the donor site is reported to be one of the most distressing symptoms during the early post-operative period. Here, we a) identify strategies for managing donor site pain, b) assess the quality of individual studies and c) formulate evidence-based recommendations based on the amount and consistency of evidence...
June 9, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28578646/clonidine-but-not-dexamethasone-prolongs-ropivacaine-induced-supraclavicular-brachial-plexus-nerve-block-duration
#5
Dawood Nasir, Irina Gasanova, Shaina Drummond, John Alexander, Jo Howard, Emily Melikman, Gary Hill, Abu Minhajuddin, Babatunde Ogunnaike, Charles Whitten
BACKGROUND: Ultrasound-guided supraclavicular brachial plexus block (USSB) provides excellent postoperative analgesia after upper extremity surgery. Dexamethasone and clonidine have been added to local anesthetics to enhance and prolong the duration of analgesia. OBJECTIVE: The objective of this randomized prospective study is to evaluate the efficacy of dexamethasone, clonidine, or combination of both as adjuvants to ropivacaine on the duration of USSB for postoperative analgesia...
June 4, 2017: Current Clinical Pharmacology
https://www.readbyqxmd.com/read/28576901/anankle-trial-study-protocol-a-randomised-trial-comparing-pain-profiles-after-peripheral-nerve-block-or-spinal-anaesthesia-for-ankle-fracture-surgery
#6
Rune Sort, Stig Brorson, Ismail Gögenur, Ann Merete Møller
INTRODUCTION: Ankle fracture surgery is a common procedure, but the influence of anaesthesia choice on postoperative pain and quality of recovery is poorly understood. Some authors suggest a benefit of peripheral nerve block (PNB) in elective procedures, but the different pain profile following acute fracture surgery and the rebound pain on cessation of the PNB both remain unexplored. We present an ongoing randomised study aiming to compare primary PNB anaesthesia with spinal anaesthesia for ankle fracture surgery regarding postoperative pain profiles and quality of recovery...
June 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28562733/randomized-clinical-study-on-the-analgesic-effect-of-local-infiltration-versus-spinal-block-for-hemorrhoidectomy
#7
Luis Antônio Borges, Plínio da Cunha Leal, Ed Carlos Rey Moura, Rioko Kimiko Sakata
BACKGROUND AND OBJECTIVES: Postoperative analgesia and early recovery are important for hospital discharge. The primary objective of this study was to compare the analgesic effectiveness of perianal infiltration and subarachnoid anesthesia for hemorrhoidectomy. The secondary objective was to compare time to discharge, adverse effects and complications. DESIGN AND SETTING: Randomized, prospective and comparative study at Dr. Mário Gatti Hospital. METHODS: Forty patients aged 18-60, in American Society of Anesthesiologists physical status category 1 or 2, were included...
May 29, 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28562567/successful-treatment-of-refractory-cancer-pain-with-morphine-and-ropivacaine-a-case-report
#8
Hongyan Li, Liqiang Yang, Zhaoxuan Guo, Yuanzhang Tang, Nan Chen, Yinying Lu, Jiaxiang Ni
RATIONALE: Pain is one of the most common and distressing symptoms experienced by cancer patients. Cancer pain is a complex phenomenon with physical, psychological, social, and cognitive domains. Although opioids remain a cornerstone of cancer pain management, they are not effective in all patients. This case highlights the successful treatment of an opioid-refractory severe cancer pain crisis with ropivacaine infusion and subsequent rapid tapering of opioid dose. PATIENT CONCERNS: This report illustrates the use of ropivacaine for cancer pain...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28562541/preoperative-flap-site-injection-with-ropivacaine-and-epinephrine-in-baba-robotic-and-endoscopic-thyroidectomy-safely-reduces-postoperative-pain-a-consort-compliant-double-blinded-randomized-controlled-study-pain-brekor-trial
#9
Joon-Hyop Lee, Yong Joon Suh, Ra-Yeong Song, Jin Wook Yi, Hyeong Won Yu, Hyungju Kwon, June Young Choi, Kyu Eun Lee
BACKGROUND: Clinical trials on bilateral axillo-breast approach (BABA) thyroidectomy show that levobupivacaine and ropivacaine significantly reduce postoperative pain, but they focused on BABA robotic thyroidectomy only and did not identify specific sites of significant pain relief. Our objective was to assess the pain reduction at various sites and safety of ropivacaine-epinephrine flap injection in BABA thyroidectomy. METHODS: This prospective double-blinded randomized controlled trial was conducted in compliance with the revised CONSORT statement (ClinicalTrials...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28560554/continuous-local-analgesia-is-effective-in-postoperative-pain-treatment-after-medium-and-large-incisional-hernia-repair
#10
M C Gherghinescu, C Copotoiu, A E Lazar, D Popa, S S Mogoanta, C Molnar
INTRODUCTION: Incisional hernias are a frequent complication of laparotomy. Open surgery is still an option for the treatment of incisional hernias with medium and large wall defects. Major opioids are routinely used in the treatment of postoperative pain, with several side effects. Continuous local analgesia can be effective in postoperative pain management after various surgical interventions. However, very few reports exist on its application in incisional hernias. PURPOSE: We assessed the effectiveness of ropivacaine in reducing the need for systemic analgesics in postoperative pain management related to these interventions...
May 30, 2017: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28554928/epidural-analgesia-in-critically-ill-patients-with-acute-pancreatitis-the-multicentre-randomised-controlled-epipan-study-protocol
#11
Stéphanie Bulyez, Bruno Pereira, Elodie Caumon, Etienne Imhoff, Laurence Roszyk, Lise Bernard, Leo Bühler, Claudia Heidegger, Samir Jaber, Jean-Yves Lefrant, Russell Chabanne, Pierre-Marie Bertrand, Pierre-François Laterre, Philippe Guerci, Pierre-Eric Danin, Etienne Escudier, Achille Sossou, Dominique Morand, Vincent Sapin, Jean-Michel Constantin, Matthieu Jabaudon
BACKGROUND: Acute pancreatitis (AP) is associated with high morbidity and mortality in its most severe forms. Most patients with severe AP require intubation and invasive mechanical ventilation, frequently for more than 7 days, which is associated with the worst outcome. Recent increasing evidence from preclinical and clinical studies support the beneficial effects of epidural analgesia (EA) in AP, such as increased gut barrier function and splanchnic, pancreatic and renal perfusion, decreased liver damage and inflammatory response, and reduced mortality...
May 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/28550902/quantification-of-the-vasodilatory-effect-of-axillary-plexus-block-a-prospective-controlled-study
#12
Andrea Wenger, Jens Rothenberger, Lara-Elena Hakim-Meibodi, Thomas Notheisen, Hans-Eberhard Schaller
BACKGROUND: Axillary plexus block is a common method for regional anesthesia, especially in hand and wrist surgery. Local anesthetics (e.g., mepivacaine) are injected around the peripheral nerves in the axilla. A vasodilatory effect due to sympathicolysis has been described, but not quantified. MATERIALS AND METHODS: In a prospective controlled study between October 2012 and July 2013, we analyzed 20 patients with saddle joint arthritis undergoing trapeziectomy under axillary plexus block...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28542052/continuous-interscalene-block-for-postoperative-analgesia-and-shoulder-immobilization-after-pectoralis-major-tendon-reinsertion-a-case-report
#13
John J Finneran, Brian M Ilfeld, Jacklynn F Sztain
We present the case of a 38-year-old man undergoing surgical repair of his pectoralis major tendon. An interscalene catheter was placed between the middle and lower trunks of the brachial plexus. Postoperatively, ropivacaine 0.2% was infused through postoperative day. The patient had excellent pain control requiring minimal opioid analgesics. A catheter between the middle and lower trunks of the brachial plexus provided excellent postoperative analgesia after pectoralis major tendon reinsertion. Additionally, the block likely protected the surgical repair during emergence from anesthesia and in the early postoperative period by providing a motor block of the pectoralis major muscle...
May 23, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28535549/epidural-dexamethasone-influences-postoperative-analgesia-after-major-abdominal-surgery
#14
Jeong-Min Hong, Kyung-Hoon Kim, Hyeon Jeong Lee, Jae-Young Kwon, Hae-Kyu Kim, Hyae-Jin Kim, Ah-Reum Cho, Wang-Seok Do, Hyo Sung Kim
BACKGROUND: Epidurally administered dexamethasone might reduce postoperative pain. However, the effect of epidural administration of dexamethasone on postoperative epidural analgesia in major abdominal surgery has been doubtful. OBJECTIVES: To investigate the effects and optimal dose of epidural dexamethasone on pain after major abdominal surgery. STUDY DESIGN: A prospective randomized, double-blind study. SETTING: University hospital...
May 2017: Pain Physician
https://www.readbyqxmd.com/read/28528536/efficacy-of-ultrasound-guided-transversus-abdominis-plane-block-and-rectus-sheath-block-with-ropivacaine-and-dexmedetomidine-in-elderly-high-risk-patients-undergoing-emergency-abdominal-surgery
#15
Lili Xu, Zhiyong Hu, Jianjun Shen, Patrick M McQuillan
BACKGROUND: This study was designed to evaluate the effectiveness and safety of ultrasound-guided transversus abdominis plane (TAP) and rectus sheath (RS) blocks with ropivacaine and dexmedetomidine in elderly, high-risk patients undergoing emergency abdominal surgery. METHODS: Sixty elderly patients undergoing emergency abdominal surgery receiving both bilateral ultrasound-guided TAP and RS blocks were randomly divided into two groups: R+D (10 ml of 0.25% ropivacaine+0...
May 19, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28510304/flip-flop-phenomenon-in-epidural-sufentanil-pharmacokinetics-a-population-study-in-children-and-infants
#16
Agnieszka Borsuk, Bogumiła Wołoszczuk-Gębicka, Alicja Bartkowska-Śniatkowska, Jowita Rosada-Kurasińska, Agnieszka Bienert, Paweł Wiczling
The aims of this study were to develop a population pharmacokinetic model of sufentanil coadministered with 0.2% ropivacaine as an epidural infusion in infants and describe the sufentanil absorption profile from epidural space. Data from 2 previously published studies were merged for analysis-20 infants aged 3-36 months receiving sufentanil as an epidural infusion and 41 children 0-17 years old receiving sufentanil as a long-term intravenous infusion. A population nonlinear mixed-effects model was built in NONMEM...
May 16, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28497932/individual-duration-of-axillary-brachial-plexus-block-is-unpredictable-a-prospective-double-centred-observational-study
#17
Wouter Droog, D-Yin Lin, José S Huisman, Fleur A Franssen, G Peter van Aggelen, J Henk Coert, Eilish M Galvin
BACKGROUND: The duration of effect for axillary plexus block using ropivacaine is highly variable. The available literature does not offer any plausible means of predicting time of block offset for individual patients, making it difficult to give accurate information and plan postoperative analgesics. This study was designed to identify factors influencing axillary plexus block offset time. METHODS: A total of 92 patients participated in this prospective double centred observational study...
May 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28495454/intratesticular-and-incisional-line-infiltration-with-ropivacaine-for-castration-in-medetomidine-butorphanol-midazolam-sedated-dogs
#18
Yishai Kushnir, Noa Toledano, Liat Cohen, Tali Bdolah-Abram, Yael Shilo-Benjamini
OBJECTIVE: To evaluate whether intratesticular and incisional ropivacaine infiltration produces sufficient intra- and postoperative analgesia for castrating dogs under sedation. STUDY DESIGN: Randomized, blinded, controlled clinical study. ANIMALS: Twenty-three healthy dogs weighing 5.8-35.6 kg admitted for castration. METHODS: Dogs were sedated with medetomidine (0.01 mg kg(-1)), butorphanol (0.2 mg kg(-1)) and midazolam (0...
March 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/28494892/postoperative-analgesic-efficacy-of-single-shot-and-continuous-transversus-abdominis-plane-block-after-laparoscopic-cholecystectomy-a-randomized-controlled-clinical-trial
#19
Yun-Mi Choi, Gyeong-Jo Byeon, Soon-Ji Park, Young-Min Ok, Sang-Wook Shin, Kwangho Yang
STUDY OBJECTIVE: To compare the analgesic efficacy of ultrasound-guided single-shot and continuous transversus abdominis plane (TAP) block to that of IV-PCA in patients undergoing laparoscopic cholecystectomy. DESIGN: Prospective randomized controlled trial. SETTING: Post-anesthesia care unit and General ward. PATIENTS: 108 American Society of Anesthesiologist (ASA) physical status I-II patients undergoing laparoscopic cholecystectomy...
June 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28492439/retrobulbar-block-in-pediatric-vitreoretinal-surgery-eliminates-the-need-for-intraoperative-fentanyl-and-postoperative-analgesia-a-randomized-controlled-study
#20
Lan Yao, Hong Zhao, Bailin Jiang, Yi Feng
BACKGROUND AND OBJECTIVES: Pediatric ophthalmologic surgery is traditionally accomplished by general anesthesia with opioids, but respiratory depression remains a major concern. Our study compared the efficacy of retrobulbar block with systemic fentanyl on pain, hemodynamic, and stress response in pediatric vitreoretinal surgery. METHODS: A prospective double-blind, randomized controlled study was performed comparing retrobulbar block with intravenously administered fentanyl in 28 children aged 1 to 6 years undergoing vitreoretinal surgery...
July 2017: Regional Anesthesia and Pain Medicine
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