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Tourniquet pain

Erhan Şükür, Yusuf Öztürkmen, Yunus Emre Akman, Ahmet Senel, İbrahim Azboy
INTRODUCTION: There is no consensus on the position of the knee joint while performing wound closure after total knee arthroplasty (TKA). Further, there are no studies focusing on the association between early functional outcomes and different wound closure strategies. Therefore, we investigated the effects of tourniquet and knee position during wound closure on early recovery of range of motion (ROM) after primary TKA. To our knowledge, this is the first study to evaluate the influence of both tourniquet and knee position during wound closure in primary TKA...
October 20, 2016: Archives of Orthopaedic and Trauma Surgery
C Lutz, L Baverel, P Colombet, J Cournapeau, F Dalmay, N Lefevre, R Letartre, J-F Potel, X Roussignol, T Cucurulo, E Servien
BACKGROUND: Anterior cruciate ligament (ACL) repair is increasingly performed on an out-patient basis. In France, however, concern about post-operative pain remains a strong barrier to out-patient ACL repair. The primary objective of this study was to compare post-operative pain after ACL repair as out-patient versus in-patient surgery. The secondary objectives were to assess the time-course of post-operative pain and to identify factors associated with pain intensity. MATERIAL AND METHODS: A multicentre, prospective, comparative, non-randomised study was conducted in France for the French Society for Arthroscopy (SFA) symposium...
September 27, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Ying Li, Rong-Hua Bao, Zhi-Qiang Jiang, Huo-Yan Wu
OBJECTIVE: The purpose of this study focused on a number of factors that have been implicated in calcaneal complications and find the incidence of wound complications. METHODS: This was a retrospective study. A total of 162 patients (176 feet) who underwent calcaneal fractures between 2007 and 2012 were included. The patient's personal details, age, time from injury to surgery, cause of injury, type of fracture, operative details, operating and tourniquet times were collected from hospital computers and paper records...
July 2016: Pakistan Journal of Medical Sciences Quarterly
Ali Akbar Jafarian, Farnad Imani, Reza Salehi, Farid Najd Mazaher, Fatemeh Moini
BACKGROUND: Intravenous Regional Anesthesia (IVRA) is a well-known technique for producing analgesia during surgical procedures in the extremities. However, the rapid onset of pain following the deflation of a double-cuff tourniquet during IVRA is a serious disadvantage, leading patient suffering. OBJECTIVES: The aim of this study was to evaluate the clinical effectiveness of a pneumatic arm tourniquet applied 2 cm above the double-cuff tourniquet in controlling the pain that occurs after its deflation...
June 2016: Anesthesiology and Pain Medicine
J A Gutiérrez-García, M Sierra-Pérez, R A García-Velazco, C A Salas-Mora, V M Cisneros-González
Comparison of immediate postoperative results of patients undergoing cemented total knee arthroplasty with and without ischemia. Observational, cross-sectional, retrospective, analytical, single-center study that included 180 patients who underwent total knee arthroplasty from 2011 to 2014: 120 without ischemia, 60 with ischemia. Mean age was 70 years with SD ± 7. Criteria to assess the immediate postoperative results include intraoperative bleeding, hemoglobin differential and pain. Exclusion criteria comprised patients being treated at a pain clinic, those on anticoagulants, with a history of bleeding disorders, psychiatric conditions, kidney failure or those intolerant to NSAIDs...
January 2016: Acta Ortopédica Mexicana
Henryk Liszka, Artur Gądek
BACKGROUND: Complex anesthesia is increasingly used in order to reduce postoperative pain and accelerate rehabilitation. The aim of this study was to evaluate the efficacy and safety of preemptive local anesthesia combined with general or spinal anesthesia in ankle arthroscopy. METHODS: From January 2014 to February 2016, 80 ankle anterior arthroscopies were performed. Patients were randomly assigned to one of 4 groups, depending on the type of anesthesia: A, general and local preemptive; B, spinal and local preemptive; C, general and placebo; D, spinal and placebo...
September 12, 2016: Foot & Ankle International
Kyu Sung Chung, Jeong Ku Ha, Ho Jong Ra, Jin Goo Kim
PURPOSE: To investigate pain and tenderness, stress testing, clinical outcome scores, complications, and operation time at 24 months and magnetic resonance imaging (MRI) analysis at 12 months after the release of the distal attachment of the superficial medial collateral ligament (sMCL) during medial meniscus posterior root tear (MMPRT) fixation. METHODS: Patients who received MMPRT fixation with a follow-up of at least 2 years were included. During fixation, the release of the distal attachment of the sMCL on the proximal tibia was performed to improve visualization and provide sufficient working space...
September 7, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Ki Jinn Chin, Javier E Cubillos, Husni Alakkad
BACKGROUND: Regional anaesthesia comprising axillary block of the brachial plexus is a common anaesthetic technique for distal upper limb surgery. This is an update of a review first published in 2006 and previously updated in 2011 and 2013. OBJECTIVES: To compare the relative effects (benefits and harms) of three injection techniques (single, double and multiple) of axillary block of the brachial plexus for distal upper extremity surgery. We considered these effects primarily in terms of anaesthetic effectiveness; the complication rate (neurological and vascular); and pain and discomfort caused by performance of the block...
September 2, 2016: Cochrane Database of Systematic Reviews
R N Verma, Shahbaz Hasnain, D K Sreevastava, T V S P Murthy
BACKGROUND: Intravenous regional anaesthesia (IVRA) has been successfully used as a sole technique for forearm fractures and has high success rates. However, it is uncomfortable for the patient when the fresh fracture is manipulated for conduct of IVRA. Haematoma block (HB) has also been demonstrated as an effective anaesthetic technique for treatment of radial fractures in the ER. Unfortunately, HB does not provide muscular relaxation and may not be sufficient for operative intervention...
July 2016: Medical Journal, Armed Forces India
Anthony LaPorta, A W Kirkpatrick, J L Mckee, D J Roberts, H Tien, A Beckett, C G Ball, I Mckee, D Louw, J B Holcomb
BACKGROUND: In a care under fire situation, a first line response to haemorrhage is to apply a tourniquet and return fire. However, there is little understanding of how tourniquets and other haemorrhage control devices impact marksmanship. METHODS: We compared the impact of the iTClamp and the Combat Application Tourniquet (CAT) on marksmanship. Following randomisation (iTClamp or CAT), trained marksmen fired an AR15 at a scaled silhouette target in prone unsupported position (shooting task)...
August 16, 2016: Journal of the Royal Army Medical Corps
José R Soberón, Joseph W Crookshank, Bobby D Nossaman, Clint E Elliott, Leslie E Sisco-Wise, Scott F Duncan
PURPOSE: Limited data exist regarding the role of perineural blockade of the distal median, ulnar, and radial nerves as a primary anesthetic in patients undergoing hand surgery. We conducted a prospective and randomized pilot study to compare these techniques to brachial plexus blocks as a primary anesthetic in this patient population. METHODS: Sixty patients scheduled for hand surgery were randomized to receive either an ultrasound-guided supraclavicular, infraclavicular, or axillary nerve block (brachial plexus blocks) or ultrasound-guided median, ulnar, and radial nerve blocks performed at the level of the mid to proximal forearm (forearm blocks)...
October 2016: Journal of Hand Surgery
Yoshio Matsui, Kosuke Shintani, Yoshiaki Okajima, Masanori Matsuura, Shigeru Nakagawa
BACKGROUND: Incongruity of the patellofemoral joint after total knee arthroplasty (TKA) causes anterior knee pain. Intraoperative congruity tests are necessary to avoid unnecessary lateral retinacular release, and the usage of tourniquets may influence these results. The purpose of this study was to examine the effect of tourniquets on patellofemoral joint congruity during TKA. MATERIALS AND METHODS: Two hundreds and seventeen knees were examined after TKA. Skyline radiographs at 60° and 90° flexion were taken immediately after wound closure before and after tourniquet deflation to compare changes in patellar tilt angle...
September 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Tricia A Templet, Roger D Rholdon
Hair-thread tourniquets are a rare occurrence but result in significant injury as a hair or thread wraps around a digit, resulting in tissue swelling, pain, or possible tissue ischemia. This condition is often overlooked in the differential diagnosis for a fussy infant. Awareness of this condition will help nurses and other clinicians identify and treat the condition. Some simple prevention strategies can help parents and other caregivers mitigate risk.
August 2016: Nursing for Women's Health
P Pinsornsak, S Rojanavijitkul, S Chumchuen
BACKGROUND: Intravenous tranexamic acid (IV TXA) is one of the most effective agents in use for reducing blood loss following total knee arthroplasty (TKA) but its safety regarding venous thromboembolic events (VTEs) remains in question. The direct, local application of TXA may reduce systemic toxicity whilst maintaining good or better bleeding control compared to IV TXA. The topical application of TXA via Hemovac drains has been reported previously with good results. However, there are no data on peri-articular TXA injections during TKA...
2016: BMC Musculoskeletal Disorders
Francisco Elano Carvalho Pereira, Irene Lopes Mello, Fernando Heladio de Oliveira Medeiros Pimenta, Debora Maia Costa, Deysi Viviana Tenazoa Wong, Claudia Regina Fernandes, Roberto César Lima Junior, Josenília M Alves Gomes
This study aims to evaluate the viability of a clinical model of remote ischemic preconditioning (RIPC) and its analgesic effects. It is a prospective study with twenty (20) patients randomly divided into two groups: control group and RIPC group. The opioid analgesics consumption in the postoperative period, the presence of secondary mechanical hyperalgesia, the scores of postoperative pain by visual analog scale, and the plasma levels interleukins (IL-6) were evaluated. The tourniquet applying after spinal anesthetic block was safe, producing no pain for all patients in the tourniquet group...
2016: Pain Research and Treatment
Sung Hye Byun, Jonghoon Lee, Jong Hae Kim
BACKGROUND: Patients on antiplatelet therapy following percutaneous coronary intervention can become coagulopathic due to infection. Performing regional anesthesia for bilateral surgery in such cases is challenging. We report a case of successful combined inguinal femoral and subgluteal sciatic nerve blocks (CFSNBs) for simultaneous bilateral below-knee amputations in a coagulopathic patient on antiplatelet therapy. METHODS: A 70-year-old male patient presented with pain in both feet due to diabetic foot syndrome...
July 2016: Medicine (Baltimore)
Osman Mahir Okur, Abuzer Coskun, Afsin Emre Kayipmaz, Sedat Ozbay, Cemil Kavalci, Ummu Gulsum Kocalar
Hair-thread tourniquet syndrome is an emergency condition rarely encountered since its first description, and it may be potentially dangerous unless treated. The potential hazard of the condition stems from hair strands wrapping around and strangulating various body processes such as fingers, penis, or clitoris. In this paper we aimed to report the first case of hair-thread tourniquet syndrome affecting a haemangioma of an adult patient. A 68-year-old woman presented to emergency department for pain in the mass on her back...
July 2016: JPMA. the Journal of the Pakistan Medical Association
Qi Zhang, Jiyuan Dong, Ke Gong, Xiang Li, Shihao Zheng, Tao Wen
OBJECTIVE: To clarify the effects of tourniquet use on pain, early rehabilitation, blood loss, incidence rate of thrombosis in primary total knee arthroplasty (TKA) through a randomized controlled trial. METHODS: Between Janurary 2014 and August 2015, 168 patients with knee osteoarthritis undergoing primary TKA were randomly allocated to tourniquet group (n = 84) or non-tourniquet group (n = 82). There was no significant difference in gender, age, body mass index, affected side, osteoarthritis grading, disease duration, preoperative range of motion (ROM), visual analogue scale (VAS), Hospital for Special Surgery (HSS) score, and hemoglobin (Hb) between 2 groups (P > 0...
April 2016: Chinese Journal of Reparative and Reconstructive Surgery
J Vaigunda Ragavendran, André Laferrière, Gary J Bennett, Mark A Ware, Wiebke Gandhi, Keith Bley, Petra Schweinhardt, Terence J Coderre
This double-blind randomized controlled study was designed to evaluate the analgesic effects of topical treatments with clonidine (CLON) and pentoxifylline (PTX) tested alone or as low- and high-dose combinations in a human experimental model of pain. Of 69 healthy subjects aged 18 to 60 years, 23 each were randomly allocated to low-dose (0.04% + 2%) and high-dose (0.1% + 5%) CLON + PTX groups. Both of these groups also received their corresponding placebos in one of 2 treatment periods separated by at least 48 hours...
October 2016: Pain
Sergio Barroso Rosa, Dugal James, Brent David Matthews
PURPOSE: To determine that when the patient chooses their intervention, whether there is any difference in duration of surgery, effectiveness, patient satisfaction and recovery time between two methods of anaesthesia, local anaesthetic (LA) and general anaesthesia (GA) in knee arthroscopy (KA). METHODS: Inclusion criteria were medically fit, adults, undergoing unilateral KA, in a native knee as a day case. Exclusion criteria were requirement for ligament reconstruction or meniscal repair, pre-existing regional sensory impairment or active psychiatric condition...
August 2016: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
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