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Tourniquet pain

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https://www.readbyqxmd.com/read/29773240/perioperative-risk-factors-that-predict-complications-of-radial-forearm-free-flaps-in-oral-and-maxillofacial-reconstruction
#1
C Wang, G Fu, F Liu, L Liu, M Cao
The aim of the study was to find out what perioperative risk factors predicted complications in patients having reconstructions with radial forearm free flaps (RFFF). We organised a retrospective study of 169 patients (mean (range) age 54 (22-86) years, 100 of whom were female) who had oral and maxillofacial tumours resected, and reconstructed with RFFF, from January 2011-December 2016. We recorded predictive variables, subdivided into: personal and clinical (sex, age, weight, coexisting conditions, history of smoking, radiotherapy, and primary lesions); haemodynamic (perioperative concentrations of haemoglobin and albumin, blood loss, blood transfusion, urinary output (ml), and rate (ml/kg/hour), and infusion rates for crystalloids and colloids (ml/kg/hour, and volumes given intraoperatively and postoperatively for 24hours); and anaesthetic and surgical (American Society of Anesthesiologists(ASA) grade, visual analogue pain score (VAS), and duration of tourniquet and operation)...
May 14, 2018: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/29679123/-wide-awake-hand-surgery-based-on-application-examples
#2
P Kaiser, M Keller, J Dörler, G Schmidle
OBJECTIVE: Anesthesiologic method with low bleeding level, risk level, and complication rate for surgical procedures on the hand without a tourniquet on an unsedated patient with the possibility for functional testing during surgery. INDICATIONS: Surgical procedures of the hand can be carried out using the wide awake technique depending on the patient's suitability and preference considering individual risk factors. CONTRAINDICATIONS: Absolute contraindications are allergies to the local anesthetic or its components...
April 20, 2018: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/29672324/lidocaine-patch-to-treat-postoperative-tourniquet-pain-after-total-knee-replacement-a-case-report
#3
Brittney M Clark, Gabriel L Pagani-Estevez, Rebecca L Johnson
Intraoperative tourniquet-related pain is well recognized by anesthesiologists, but postoperative tourniquet-related pain has received little attention. We present a patient who underwent a total knee arthroplasty under general anesthesia and an adductor canal nerve block. She complained of intractable thigh pain postoperatively. Lidocaine 5% patches completely resolved her postoperative tourniquet-related pain.
April 17, 2018: A&A practice
https://www.readbyqxmd.com/read/29643169/safety-and-feasibility-evaluation-of-tourniquets-for-total-knee-replacement-safe-tkr-study-protocol
#4
Peter Dh Wall, Imran Ahmed, Andrew Metcalfe, Andrew J Price, Kate Seers, Charles E Hutchinson, Helen Parsons, Jane Warwick, Bushra Rahman, Jaclyn Brown, Martin Underwood
INTRODUCTION: This study is designed to determine whether a full randomised controlled trial (RCT) examining the clinical effectiveness and safety of total knee replacement surgery with or without a tourniquet is warranted and feasible. METHOD AND ANALYSIS: Single centre, patient-blinded and assessor-blinded RCT. A computer-generated randomisation service will allocate 50 participants into one of two trial treatments, surgery with or without a tourniquet. The primary objective is to estimate recruitment, crossovers and follow-up of patients...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29628683/short-term-outcomes-of-long-duration-versus-short-duration-tourniquet-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#5
Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay, Manish Kumar Tiwari
Introduction: A tourniquet is used during the total knee replacement surgery to improve the visibility, to reduce the blood loss and for better cementation. Indirectly it decreases the duration of surgery and enhances the recovery of the patient. Their use however is controversial due to some side effects associated with the use of tourniquet. They may increase the risk of deep vein thrombosis and pulmonary embolism by causing venous stasis, endothelial damage and increased platelet adhesion secondary to distal limb ischemia...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29541841/much-ado-about-nothing-the-effect-of-tourniquet-time-on-an-accelerated-rehabilitation-programme-following-total-knee-replacement-tkr
#6
William Wynell-Mayow, Muhammad Zahid Saeed
BACKGROUND: The WHO includes osteoarthritis as a disease of priority, owing to its significant impact on quality of life, and globally increasing prevalence. Hospital budgets are under pressure to ration knee replacements and shorten inpatient stays. Prolonged tourniquet application has been hypothesised to extend recovery through pain and reduced mobility. PATIENTS AND METHODS: A total of 123 elective total knee replacements meeting inclusion criteria took place from July 2015 to October 2017 at the Royal Free Hospital...
March 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29535279/intra-operative-periarticular-multimodal-injection-in-total-knee-arthroplasty-a-local-hospital-experience-in-hong-kong
#7
J Ch Fan
INTRODUCTION: Data from a local report revealed the superior outcome of regional anaesthesia and analgesia compared with general anaesthesia and intravenous patient-controlled analgesia in total knee arthroplasty. This retrospective study aimed to assess the efficacy of intra-operative periarticular multimodal injection in improving postoperative pain and reducing morphine consumption with patient-controlled analgesia after total knee arthroplasty in patients with knee osteoarthritis...
March 14, 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29529607/ankle-nerve-block-adjuvant-to-general-anesthesia-reduces-post-surgical-pain-and-improves-functional-outcomes-in-hallux-valgus-surgery
#8
Mustafa Kir, Gulay Kir
OBJECTIVE: Postoperative pain is a frequently problem after orthopedic procedures like hallux valgus surgery. The aim of this study was to evaluate whether ankle block improves early and mid-term functional outcomes and postoperative pain management after hallux valgus surgery in patients receiving general anesthesia. SUBJECTS AND METHODS: This randomized controlled trial investigated 60 patients who underwent hallux valgus surgery under general anesthesia. Patients were prospectively randomized into two groups; general anesthesia only (Group A) and ankle block added to general anesthesia (Group B)...
March 12, 2018: Medical Principles and Practice: International Journal of the Kuwait University, Health Science Centre
https://www.readbyqxmd.com/read/29522115/prediction-of-pain-and-opioid-utilization-in-the-perioperative-period-in-patients-undergoing-primary-knee-arthroplasty-psychophysical-and-psychosocial-factors
#9
Christopher R Abrecht, Marise Cornelius, Albert Wu, Robert N Jamison, David Janfaza, Richard D Urman, Claudia Campbell, Michael Smith, Jennifer Haythornthwaite, Robert R Edwards, Kristin L Schreiber
Objective: To identify factors associated with pain severity and opioid consumption in the early perioperative period. Design: Prospective observational cohort study. Setting: Tertiary academic medical center. Subjects: Patients with osteoarthritis older than age 45 years undergoing primary total knee replacement at Brigham and Women's Hospital. A total of 126 patients enrolled. Methods: Preoperatively, pain questionnaires and quantitative sensory testing were performed on patients to develop a psychosocial and psychophysical profile...
March 7, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29510953/comparing-the-effect-of-tourniquet-vs-tourniquet-less-in-simultaneous-bilateral-total-knee-arthroplasties
#10
Mohamed Shaher Hasanain, Dragos Apostu, Attaallh Alrefaee, Samih Tarabichi
BACKGROUND: Total knee arthroplasty (TKA) is a commonly performed procedure worldwide for the treatment of knee joint disease. Tourniquet is frequently used during the entire procedure to reduce blood loss and increase surgical comfort. On the other hand, tourniquet-related complications exist, and there are still controversies whether benefits outweigh the risks. METHODS: Patients undergoing simultaneous TKAs had one knee assigned to group A (use of tourniquet during the entire procedure) and the other knee assigned to group B (use of tourniquet only during cementation)...
February 15, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29454711/outcomes-of-post-burn-flexion-contracture-release-under-tourniquet-versus-tumescent-technique-in-children
#11
Muhammad Mustehsan Bashir, Muhammad Sohail, Ahmad Wahab, Umar Iqbal, Rehan Qayyum, Saadia Nosheen Jan
OBJECTIVE: To compare the clinical outcomes of release of flexion contractures after burn of the hand in children using tourniquet or tumescent technique in terms of operative time, postoperative pain score, and percentage of graft take. METHODS: Patients aged 3 to 12 years who required release of post-burn flexion contractures involving volar aspect of palm and fingers were enrolled from outpatient clinic. Patients were randomized in 1:1 ratio to the use of either tumescent technique or tourniquet during contracture release...
May 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29430498/a-comparison-between-single-and-double-tourniquet-technique-in-distal-upper-limb-orthopedic-surgeries-with-intravenous-regional-anesthesia
#12
Mohammad Haghighi, Mohsen Mardani-Kivi, Ahmadreza Mirbolook, Samaneh Ghazanfar Tehran, Nasim Ashouri Saheli, Keyvan Hashemi-Motlagh, Khashayar Sahbe-Ekhtiari
Background: Several studies have put an effort to minimize the tourniquet pain and complications after conventional double tourniquet intravenous regional anesthesia (IVRA). We expressed in our hypothesis that an upper arm single wide tourniquet (ST) may serve a better clinical efficacy rather than the conventional upper arm double tourniquet (DT) in distal upper extremity surgeries. Methods: In this randomized controlled trial, 80 patients undergoing upper limb orthopedic surgeries were randomized into two groups...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29430495/a-comparison-of-the-postoperative-complications-between-two-drainage-methods-after-total-knee-arthroplasty
#13
Fardin Mirzatolooei, Ali Tabrizi, Maryamsadat Mokaram Gargari
Background: The role of wound drainage after total knee arthroplasty is still considered controversial as although closed drainage systems have been believed to be effective in decreasing the post-operative complications, they could also facilitate the bleeding and increase the rate of transfusion and infection. We have conducted the current study to compare the outcomes superficial subcutaneous, one deep, and two deep drain techniques after total knee arthroplasty. Methods: Between 2014 and 2015 sixty consecutive patients were prospectively selected and underwent primary total knee arthroplasty...
January 2018: Archives of Bone and Joint Surgery
https://www.readbyqxmd.com/read/29430406/effect-of-remote-ischemic-preconditioning-on-troponin-i-in-cabg
#14
Fatemeh Javaherforoosh Zadeh, Mohsen Moadeli, Mansoor Soltanzadeh, Farahzad Janatmakan
Background: Elective open heart surgery is associated with troponin release in some cases due to myocyte necrosis. Objectives: The aim of this study was to measure cardiac troponin I (cTnI) preoperatively in elective CABG after remote ischemic preconditioning. Methods: Twenty-eight patients were selected for elective CABG. They were randomized to receive remote ischemic preconditioning (induced by three 5-min cycles of inflation with a pneumatic tourniquet and 5-min deflation between inflation episodes as reperfusion)...
August 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29409425/a-median-nerve-anterior-transposition-procedure-for-multi-recurrent-hemodialysis-related-carpal-tunnel-syndrome
#15
Ichiro Okutsu, Ikki Hamanaka, Aya Yoshida
BACKGROUND: Some long-term hemodialysis patients suffer from multi-recurrent carpal tunnel syndrome because amyloid originating from β2 -microglobulin continues to be deposited mainly in the flexor tendons, tendon sheaths and flexor retinaculum during maintenance hemodialysis. These amyloid deposits inside carpal canal (tunnel) tissues increase carpal canal pressure and this leads to compression of the median nerve. When multi-recurrent carpal tunnel syndrome occurs, previous operative scarring of soft tissue may prohibit further enlargement of the carpal canal even if any carpal canal decompression procedure is used...
March 2018: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/29401335/influence-of-personality-traits-on-the-effective-performance-of-lifesaving-interventions-example-of-the-tourniquet-application-in-forward-combat-casualty-care
#16
Quentin Vuillemin, Pierre-Eric Schwartzbrod, Pierre Pasquier, Florian Sibille, Marion Trousselard, Marie-Hélène Ferrer
Introduction: Health care delivery in military conflicts implies high-stress environments. Hemorrhage is the first cause of survivable death among combat casualties, and tourniquet application is one of the most critical lifesaving interventions on the battlefield. However, previous studies have shown high failure rates in tourniquet application. Our study aimed to assess the correlation between personality traits that may interfere with effective tourniquet application in a simulated extremity hemorrhage...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29387317/analgesic-effects-of-lidocaine-ketorolac-compared-to-lidocaine-alone-for-intravenous-regional-anesthesia
#17
Shahram Seyfi, Nadia Banihashem, Ali Bijani, Karimollah Hajian-Taliki, Mohsen Daghmehchi
Background: Intravenous regional anesthesia is a simple and reliable method for upper extremity surgery. In order to increase the quality of blocks and reduce the amount of pain, many drugs are used with lidocaine. In this study, the effect of ketorolac-lidocaine in intravenous regional anesthesia was investigated. Methods: 40 patients undergoing elective upper limb with America Society of Anesthesiologists class I and II were selected and randomly divided into two groups...
2018: Caspian Journal of Internal Medicine
https://www.readbyqxmd.com/read/29374988/the-effects-of-timing-of-ankle-blocks-in-forefoot-midfoot-or-hindfoot-reconstruction-with-the-use-of-an-ankle-tourniquet
#18
James Gwosdz, Lattisha Bilbrew, Daniel Jupiter, Vinod Panchbhavi
BACKGROUND: Ankle blocks are used in the ambulatory surgery setting to control postoperative pain, which is often worst in the first 24 hours after surgery. We conducted a trial to determine whether the timing of ankle block administration in relation to ankle tourniquet inflation has an effect on perceived pain and narcotic consumption. METHODS: A prospective randomized study was conducted between August 2015 and January 2016. Patients were assigned to three groups...
January 1, 2018: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/29369184/the-effect-of-tourniquet-usage-on-cement-penetration-in-total-knee-arthroplasty-a-prospective-randomized-study-of-3-methods
#19
Okan Ozkunt, Kerim Sariyilmaz, Halil Can Gemalmaz, Fatih Dikici
BACKGROUND: It is a randomized study to compare cement penetration on x-rays after total knee arthroplasty (TKA) among 3 different ways to use tourniquets; application during the surgery, application only with implantation prosthesis and with no tourniquet use. METHODS: A total 69 knees of 59 patients were included in the study in a quasirandom manner. Each patient had physical exams and standard radiographic evaluations at 6 weeks after the TKA procedure. Outcome evaluations included visual analog scale (VAS) scores, Knee Society Scores (KSS), blood transfusion, and drainage status after surgery for all groups...
January 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29325840/early-comparative-outcomes-of-unicompartmental-and-total-knee-arthroplasty-in-severely-obese-patients
#20
Zachary C Lum, David A Crawford, Adolph V Lombardi, Jason M Hurst, Michael J Morris, Joanne B Adams, Keith R Berend
BACKGROUND: Medial unicompartmental knee arthroplasty (UKA) may have advantages over total knee arthroplasty (TKA) in the setting of obesity. There has been no direct comparison between the two cohorts. This study compares outcomes and complications of severely obese patients undergoing medial UKA versus TKA. METHODS: Six hundred and fifty medial UKA and 1300 TKA were performed in patients with BMI >35kg/m2 (mean 41kg/m2 ) between 2007 and 2012. Pre- and postoperative ROM, Knee Society scores, perioperative factors, complications and reoperations were compared...
January 2018: Knee
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