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Tourniquet pain

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
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
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
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
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
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...
February 14, 2018: Burns: Journal of the International Society for Burn Injuries
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
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
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
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
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
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
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
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)
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
Robert J Tamai, Brian T Sullivan, Rushyuan J Lee
BACKGROUND: Peripheral nerve blocks (PNBs) provide excellent pain control and reduce the need for systemic analgesics in orthopaedic surgery. PNBs rarely cause complications; however, a few studies of adults have reported neurological complications during the early postoperative period. We investigated complications associated with the use of PNBs during pediatric knee surgery. METHODS: We reviewed the medical records of all 121 children (aged ≤18 y) who underwent knee surgery by 1 orthopaedic surgeon between October 2014 and September 2016...
March 2018: Journal of Pediatric Orthopedics
Alexander Franz, Fina Pauline Queitsch, Michael Behringer, Constantin Mayer, Rüdiger Krauspe, Christoph Zilkens
Osteoarthritis of the knee is one of the most commonly diagnosed joint ailments and responsible for increased rates of total knee arthroplasty surgeries worldwide. Whereas the surgical approach is able to diminish the perceived knee pain of concerned patients', the postoperative recovery is often accompanied by persistent skeletal muscle dysfunctions and atrophy, which is responsible for functional deficits for up to several years. Recent findings indicate that surgery induced adverse effects on skeletal muscles are largely associated with the use of pneumatic tourniquets, wherefore several studies try to reduce tourniquet use in orthopedic surgery...
January 2018: Medical Hypotheses
Joseph Meyerson, Yangshu L Pan, Maya Spaeth, Gregory Pearson
BACKGROUND: Ganglion cysts are the most common type of soft tissue tumors of the hand. In the pediatric population, monitoring may be appropriate unless cysts are painful, interfering with range of motion or parental concerns exist. Reported recurrence rates after surgical removal of pediatric ganglion cysts vary widely in the literature. Notably, recurrence rates are higher for children than adults, ranging from as low as 6% to as high as 35%. METHODS: A retrospective review was performed of a single pediatric hand surgeon's patients undergoing excision of primary and recurrent ganglion cysts from 2010 to 2015...
January 1, 2018: Hand: Official Journal of the American Association for Hand Surgery
Chamnanni Rungprai, Phinit Phisitkul
PURPOSE: To review functional and clinical outcomes as well as complications in patients who underwent endoscopically assisted percutaneous Achilles tendon repair using 4-strand core suture configuration via a 6-portal technique. METHODS: A retrospective chart review with prospectively collected data was performed in 23 consecutive patients who underwent endoscopically assisted percutaneous Achilles tendon repair between 2008 and 2015. The minimum follow-up to be included in the study was 24 months...
December 19, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
Zhirui Li, Daohong Liu, Gong Long, Gong Ke, An Xiao, Peifu Tang, Jiyuan Dong
Obesity not only gives rise to more blood loss volume but also correlates with postoperative rehabilitation and complications in surgical patients. It is not clear at present whether tourniquet utilization is associated with blood loss, rehabilitation, and complications, and it is imperative to ascertain the tactics of utilizing tourniquet in obese patients undergoing total knee arthroplasty (TKA). The present study was designed to explore the association of tourniquet utilization with blood loss, rehabilitation, and complications, and ascertain the tactics of utilizing tourniquet in obese patients undergoing TKA...
December 2017: Medicine (Baltimore)
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