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Tourniquet pain

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https://www.readbyqxmd.com/read/28922709/non-drainage-versus-drainage-in-tourniquet-free-knee-arthroplasty-a-prospective-trial
#1
Kai Zhou, Haoyang Wang, Jinglong Li, Duan Wang, Zongke Zhou, Fuxing Pei
BACKGROUND: It is still unknown whether drainage is necessary and non-drainage is safe and acceptable after tourniquet-free total knee arthroplasty (TKA). We aim to investigate whether non-drainage use is accepted in TKA that is performed without a tourniquet. METHODS: Clinical data of 80 adult patients who did or did not receive drainage in our centres from August 2015 to December 2015 were prospective investigated. RESULTS: The drainage group exhibited reduced hidden blood loss (47...
September 18, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28879617/high-but-not-moderate-intensity-endurance-training-increases-pain-tolerance-a-randomised-trial
#2
Thomas J O'Leary, Johnny Collett, Ken Howells, Martyn G Morris
PURPOSE: To examine the effect of high-intensity interval training (HIIT) compared to volume-matched moderate-intensity continuous training (CONT) on muscle pain tolerance and high-intensity exercise tolerance. METHODS: Twenty healthy adults were randomly assigned (1:1) to either 6 weeks of HIIT [6-8 × 5 min at halfway between lactate threshold and maximal oxygen uptake (50%Δ)] or volume-matched CONT (~60-80 min at 90% lactate threshold) on a cycle ergometer...
September 6, 2017: European Journal of Applied Physiology
https://www.readbyqxmd.com/read/28867906/open-carpal-tunnel-release-outcomes-performed-wide-awake-versus-with-sedation
#3
Jacob E Tulipan, Nayoung Kim, Jack Abboudi, Christopher Jones, Frederic Liss, William Kirkpatrick, Michael Rivlin, Mark L Wang, Jonas Matzon, Asif M Ilyas
Background  Carpal tunnel release (CTR) is the most common surgery of the hand, and interest is growing in performing it under local anesthesia without tourniquet. To better understand differences, we hypothesized that patients undergoing CTR under wide-awake local anesthesia with no tourniquet (WALANT) versus sedation (monitored anesthesia care [MAC]) would not result in a difference in outcome. Methods  Consecutive cases of electrodiagnostically confirmed open CTR across multiple surgeons at a single center were prospectively enrolled...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28865632/back-to-basics-pneumatic-tourniquet-use
#4
Lisa Spruce
Pneumatic tourniquets are commonly used in surgeries involving the limbs to achieve a nearly bloodless surgery and an optimal operating field or when administering regional anesthesia during surgery on a limb. Complications can arise from the use of tourniquets, including nerve injuries, pain, compartment syndrome, pressure injuries, chemical burns, and tissue necrosis. More serious injuries-including deep vein thrombosis, thermal damage to tissues, severe ischemic injuries, and rhabdomyolysis-also can occur...
September 2017: AORN Journal
https://www.readbyqxmd.com/read/28853118/occlusion-training-pilot-study-for-postoperative-lower-extremity-rehabilitation-following-primary-total-knee-arthroplasty
#5
Christopher L Gaunder, Michael P Hawkinson, David J Tennent, Creighton C Tubb
With continued emphasis on the value of healthcare, factors such as quality of life and patient reported outcomes are critical in evaluating high-demand procedures such as knee replacement surgery. Equally important to the surgery itself is maximizing the effectiveness and efficiency of the treatment, both preoperatively and postoperatively, which can have a significant effect the final outcome. Technical outcomes of total knee replacement are generally considered excellent; however, many patients continue to have postoperative pain, functional limitations, and low treatment satisfaction...
July 2017: U.S. Army Medical Department Journal
https://www.readbyqxmd.com/read/28852453/myomectomies-for-massive-hemoperitoneum-from-spontaneous-bleeding-of-a-uterine-myoma
#6
I Kassegne, K Kolani, B Tchangai, K Kanassoua, K Adabra, F Alassani, A K Amavi, E D J Dosseh
Massive hemoperitoneum from spontaneous bleeding of uterine myoma is an extremely rare condition, that needs urgent surgical exploration. We report a 40-year-old woman, admitted for acute onset of abdominal pain. Physical examination revealed hypovolemic shock. The hemoglobin level was of 5 g/dL. Ultrasonography revealed hemoperitoneum. Emergency surgical exploration was planned. There was hemoperitoneum of 3 L, uterine myomas with multiple subserous myomas, bleeding from superficial ruptured varice overlying the most largest subserous myoma, which measured 15 cm...
July 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28832392/ischemic-preconditioning-blunts-muscle-damage-responses-induced-by-eccentric-exercise
#7
Alexander Franz, Michael Behringer, Jan-Frieder Harmsen, Constantin Mayer, Rüdiger Krauspe, Christoph Zilkens, Moritz Schumann
PURPOSE: Ischemic preconditioning (IPC) is known to reduce muscle damage induced by ischemia and reperfusion-injury (I/R-Injury) during surgery. Due to similarities between the pathophysiological formation of I/R-injury and eccentric exercise-induced muscle damage (EIMD), as characterized by an intracellular accumulation of Ca, an increased production of reactive oxygen species and increased pro-inflammatory signaling, the purpose of the present study was to investigate whether IPC performed prior to eccentric exercise may also protect against EIMD...
August 22, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28830402/tourniquet-use-in-arthroscopic-anterior-cruciate-ligament-reconstruction-a-systematic-review-and-meta-analysis-of-randomised-controlled-trials
#8
Liang-Tseng Kuo, Pei-An Yu, Chi-Lung Chen, Wei-Hsiu Hsu, Ching-Chi Chi
BACKGROUND: To assess the effects of tourniquet use in arthroscopic anterior cruciate ligament (ACL) reconstruction surgery. METHODS: We conducted a systematic review and meta-analysis of randomised controlled trials (RCTs) that compared surgical outcomes following tourniquet use against non-tourniquet use during ACL reconstruction surgery. We searched the Cochrane Central Register of Controlled Trials, MEDLINE, and EMBASE for relevant RCTs. We used the Cochrane Collaboration's tool to assess the risk of bias of included RCTs, and performed a random-effects meta-analysis in calculating the pooled risk estimates...
August 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28826968/-comparison-of-granisetron-and-lidocaine-on-reducing-injection-pain-of-etomidate-a-controlled-randomized-study
#9
Alireza Saliminia, Omid Azimaraghi, Amir Javadi, Maryam Abdoulahpoor, Ali Movafegh
BACKGROUND AND OBJECTIVES: Reducing pain on injection of anesthetic drugs is of importance to every anesthesiologist. In this study we pursued to define if pretreatment by granisetron reduces the pain on injection of etomidate similar to lidocaine. METHODS: Thirty patients aged between 18 and 50 years of American Society of Anesthesiologists physical status class I or II, whom were candidates for elective laparoscopic cholecystectomy surgery were enrolled in this study...
August 18, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28810992/two-new-effective-tourniquets-for-potential-use-in-the-military-environment-a-serving-soldier-study
#10
Alastair Beaven, Rob Briard, Mark Ballard, Paul Parker
BACKGROUND: Limb tourniquets have been used extensively during modern Middle Eastern conflicts. Despite its undeniable successes, the combat applied tourniquet (C-A-T) has some shortfalls, principally its inability to reliably control lower limb bleeding when applied to the mid-thigh. We tested two tourniquets which may represent an improvement to the combat applied tourniquet; the tactical mechanical tourniquet and the tactical pneumatic tourniquet. METHODS: We recruited 12 healthy service personnel and applied the tactical mechanical tourniquet and tactical pneumatic tourniquet to both lower limbs in a randomly generated sequence...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28793978/patellofemoral-arthroplasty-conversion-to-total-knee-arthroplasty-retrieval-analysis-and-clinical-correlation
#11
Alexander B Christ, Elexis Baral, Chelsea Koch, Beth E Shubin Stein, Alejandro Gonzalez Della Valle, Sabrina M Strickland
BACKGROUND: Patellofemoral arthroplasty (PFA) can be a successful, bone-sparing treatment for isolated patellofemoral arthritis. However, progression of tibio-femoral arthritis or incorrect indications may predispose patients to early conversion to total knee arthroplasty (TKA). The purpose of this study was to review the clinical cases and perform retrieval analysis of PFA conversions to TKA at our institution. METHODS: Twenty one patellofemoral arthroplasties in 18 patients that were converted to TKA were identified through our implant retrieval registry...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28789655/efficacy-and-safety-of-a-new-elastic-tourniquet-cuff-in-total-knee-arthroplasty-a-prospective-randomized-controlled-study
#12
O-Sung Lee, Myung Chul Lee, Hyuk-Soo Han
BACKGROUND: The effects of cuff shape, timing of tourniquet application, and automated systems using limb occlusion pressure (LOP) have been reported to minimize the appropriate tourniquet pressure. However, studies on the raw material of the cuff itself to reduce the complications related to the tourniquet have been very rarely reported. The purpose of this study is to report the efficacy and safety of a tourniquet system with a new elastic cuff in which pressure is set with LOP in total knee arthroplasty (TKA)...
August 8, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28780595/preventive-effect-of-a-vapocoolant-spray-on-propofol-induced-pain-a-prospective-double-blind-randomized-study
#13
Young Eun Moon, Michael Y Lee, Dong Hyun Kim
PURPOSE: Propofol causes injection pain. Although lidocaine pre-treatment via venous occlusion is known to be the most effective way, it still has some inconvenience. We implemented this study to compare the effect of a vapocoolant spray with lidocaine pre-treatment. METHODS: Participants (n = 90) were randomized to one of three groups. Group V: after placebo injection and tourniquet, the vapocoolant spray was applied; group L: after lidocaine injection and tourniquet, the placebo spray was applied; group C: after placebo injection and tourniquet, the placebo spray was applied...
August 5, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28774238/wide-awake-hand-surgery
#14
Line Lied, Grethe E Borchgrevink, Vilhjalmur Finsen
BACKGROUND: "Wide awake hand surgery", where surgery is performed in local anaesthesia with adrenaline, without sedation or a tourniquet, has become widespread in some countries. It has a number of potential advantages and we wished to evaluate it among our patients. METHODS: All 122 patients treated by this method during one year were evaluated by the surgeons and the patients on a numerical scale from 0 (best/least) to 10 (worst/most). Theatre time was compared to that recorded for a year when regional or general anaesthesia had been used...
September 2017: Journal of Hand Surgery Asian-Pacific Volume
https://www.readbyqxmd.com/read/28747231/different-patient-satisfaction-levels-between-the-first-and-second-knee-in-the-early-stage-after-simultaneous-bilateral-total-knee-arthroplasty-tka-a-comparison-between-subjective-and-objective-outcome-assessments
#15
Shuai Huang, Xing Li, Yubo Tang, Sunny Stiphan, Bin Yan, Peiheng He, Dongliang Xu
BACKGROUND: Simultaneous bilateral total knee arthroplasty (TKA) is an effective treatment option and safe for properly selected patients. The purpose of this study was to evaluate whether patients have different satisfaction levels between the first and second knee in the early stage after simultaneous bilateral TKA. METHODS: We retrospectively reviewed 46 patients who underwent simultaneous bilateral TKA by a single surgeon in our department between March 2013 and March 2015...
July 26, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28725505/long-volar-plating-for-metadiaphyseal-fractures-of-distal-radius-study-comparing-minimally-invasive-plate-osteosynthesis-versus-conventional-approach
#16
Emilie Pire, Juan José Hidalgo Diaz, Santiago Salazar Botero, Sybille Facca, Philippe A Liverneaux
Background  Minimally invasive plate osteosynthesis (MIPO) has been used in wrist surgery for several years. The purpose of this retrospective study was to compare clinical and radiologic outcomes of MIPO technique with those of a conventional approach in the treatment of metadiaphyseal distal radius fracture by long volar plating. Materials and Methods  Our series consisted of 32 fractures in 31 patients, mean age 63.9 years, including 16 men and 15 women. MIPO technique was used in 15 wrists (group 1) and conventional approach (> 60 mm of skin incision) in 17 wrists (group 2)...
August 2017: Journal of Wrist Surgery
https://www.readbyqxmd.com/read/28718308/ulnar-shortening-versus-distal-radius-corrective-osteotomy-in-the-management-of-ulnar-impaction-after-distal-radius-malunion
#17
William R Aibinder, Ali Izadpanah, Bassem T Elhassan
BACKGROUND: Distal radius malunions lead to functional deficits. This study compares isolated ulnar shortening osteotomy (USO) to distal radius osteotomy (DRO) for the treatment of ulnar impaction syndrome following distal radius malunion. METHODS: We retrospectively reviewed 11 patients with extra-articular distal radius malunions treated for ulnar impaction with isolated USO. This group was compared to a 1:1 age- and sex-matched cohort treated with isolated DRO for the same indication...
January 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28657396/preoperative-methylprednisolone-does-not-reduce-loss-of-knee-extension-strength-after-total-knee-arthroplastya-randomized-double-blind-placebo-controlled-trial-of-61-patients
#18
RANDOMIZED CONTROLLED TRIAL
Viktoria Lindberg-Larsen, Thomas Q Bandholm, Camilla K Zilmer, Jens Bagger, Mette Hornsleth, Henrik Kehlet
Background and purpose - Patients undergoing total knee arthroplasty (TKA) face challenges related to postoperative reduction in knee-extension strength. We evaluated whether inhibition of the inflammatory response by a single preoperative dose of methylprednisolone (MP) reduces the pronounced loss of knee-extension strength at discharge after fast-track TKA. Patients and methods - 70 patients undergoing elective unilateral TKA were randomized (1:1) to preoperative intravenous (IV) MP 125 mg (group MP) or isotonic saline IV (group C)...
October 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28654613/evidence-based-medicine-current-evidence-in-the-diagnosis-and-management-of-carpal-tunnel-syndrome
#19
Steven J Hermiz, Loree K Kalliainen
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Create a safe and effective plan for management of carpal tunnel syndrome. 2. Support his or her rationale for the use of diagnostic tests. 3. Discuss elements of management that have been controversial, including anesthesia, the use of a tourniquet, postoperative pain control, and cost of care. SUMMARY: This is the fourth MOC-PS CME article on carpal tunnel syndrome. Each of the prior three has had a slightly different focus, and the reader is invited to review all to generate a comprehensive view of the management of this common, and often controversial, topic...
July 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28598560/effects-of-unilateral-tourniquet-used-in-patients-undergoing-simultaneous-bilateral-total-knee-arthroplasty
#20
Pei-Lai Liu, De-Qiang Li, Yuan-Kai Zhang, Qun-Shan Lu, Liang Ma, Xue-Zhi Bao, Meng Zhang
OBJECTIVE: To assess the benefits of use of a tourniquet in one limb in patients undergoing simultaneous bilateral total knee arthroplasty (TKA). METHODS: A prospective randomized trial was designed to evaluate the outcomes of unilateral tourniquet use during simultaneous bilateral TKA. A total of 52 (36 women and 16 men) patients with osteoarthritis who underwent simultaneous bilateral primary TKA between January 2010 and January 2015 were assigned randomly to tourniquet (TG) or non-tourniquet (NG) groups prior to surgery...
May 2017: Orthopaedic Surgery
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