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Chronic postOP pain

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https://www.readbyqxmd.com/read/28643329/analgesic-plasma-concentrations-of-oxycodone-after-surgery-for-breast-cancer-which-factors-matter
#1
K Cajanus, M Neuvonen, O Koskela, M A Kaunisto, P J Neuvonen, M Niemi, E Kalso
We investigated factors affecting analgesic oxycodone concentrations after breast cancer surgery in 1,000 women. Preoperatively, we studied heat and cold pain sensitivities and anxiety scores. Postoperatively, rest and motion pain intensities were measured and intravenous oxycodone was administered until satisfactory analgesia. At this point, the mean oxycodone concentration (variation coefficient) was 33.3 ng/ml (66%), and it was 21.7 ng/ml (69%) when the patient requested oxycodone again. At both time points, the concentrations varied >100-fold between individuals...
June 23, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28642060/microsurgically-assisted-inguinal-hernia-repair-and-simultaneous-male-fertility-procedures-rationale-technique-and-outcomes
#2
Michael L Schulster, Matthew R Cohn, Bobby B Najari, Marc Goldstein
PURPOSE: Inguinal herniorrhaphy is the most common general surgical procedure. It is associated with frequent complications such as recurrence (1.9% with mesh), post-operative hematoma (4.5%), reduced sensation (0 - 42.8%), chronic post-operative pain (5.1%), vasal injury (0.1 - 0.53%) and infection (3 - 6%)(1-5). Drawing on our experience utilizing the operating microscope for varicocelectomy, vasectomy reversal and repair of iatrogenic vasal obstruction from hernia repair, we employed it for inguinal hernia repair...
June 19, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28639336/classification-of-pancreaticobiliary-maljunction-and-clinical-features-in-children
#3
Naoto Urushihara, Yoshinori Hamada, Terumi Kamisawa, Hideki Fujii, Tsugumichi Koshinaga, Yoshiki Morotomi, Takeshi Saito, Takao Itoi, Kenitiro Kaneko, Hiroaki Fukuzawa, Hisami Ando
PURPOSE: In 2015, the Committee on Diagnostic Criteria of the Japanese Study Group on Pancreaticobiliary Maljunction (PBM) proposed a classification of PBM into four types: (A) stenotic type, (B) non-stenotic type, (C) dilated channel type, and (D) complex type. To validate this classification and clarify the clinical features of the four types of PBM, a retrospective multicenter study was conducted. METHODS: We divided the study group of 317 children with PBM into the four types of PBM...
June 21, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28631870/thalamic-deep-brain-stimulation-for-neuropathic-pain-efficacy-at-three-years-follow-up
#4
Vasco Abreu, Rui Vaz, Virgínia Rebelo, Maria José Rosas, Clara Chamadoira, Martin J Gillies, Tipu Z Aziz, Erlick A C Pereira
OBJECT: Chronic neuropathic pain is estimated to affect 3-4.5% of the worldwide population, posing a serious burden to society. Deep Brain Stimulation (DBS) is already established for movement disorders and also used to treat some "off-label" conditions. However, DBS for the treatment of chronic, drug refractory, neuropathic pain, has shown variable outcomes with few studies performed in the last decade. Thus, this procedure has consensus approval in parts of Europe but not the USA. This study prospectively evaluated the efficacy at three years of DBS for neuropathic pain...
June 20, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28630720/predictors-and-trajectories-of-chronic-postoperative-pain-following-hip-preservation-surgery
#5
Christine B Sieberg, Justyna Klajn, Cindy Wong, Garrett Bowen, Laura E Simons, Michael B Millis
Factors contributing to chronic postoperative pain (CPOP) are poorly defined in young people and developmental considerations are poorly understood. With over 5 million children undergoing surgery yearly and 25% of adults referred to chronic pain clinics identifying surgery as the antecedent, there is a need to elucidate factors that contribute to CPOP in surgical patients. The present study includes patients undergoing hip preservation surgery at a children's hospital. The HOOS and SF-12 Health Survey were administered to 614 pre-surgical patients with 421 patients completing follow-up (6-months, 1-year and 2-years post-surgery)...
January 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28628521/experiences-of-acute-pain-in-children-who-present-to-a-healthcare-facility-for-treatment-a-systematic-review-of-qualitative-evidence
#6
Nicole Pope, Mary Tallon, Ruth McConigley, Gavin Leslie, Sally Wilson
BACKGROUND: Pain is a universal and complex phenomenon that is personal, subjective and specific. Despite growing knowledge in pediatric pain, management of children's pain remains sub-optimal and is linked to negative behavioral and physiological consequences later in life. As there is no synthesis of these studies, it was timely to undertake a systematic review. OBJECTIVES: To identify, evaluate and synthesize the existing qualitative evidence on children's experiences of acute pain, including pain management, within a healthcare facility...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28625669/role-of-language-discordance-in-complication-and-readmission-rate-after-infrainguinal-bypass
#7
Elica Inagaki, Alik Farber, Jeffrey Kalish, Jeffrey J Siracuse, Clara Zhu, Denis V Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Studies have shown that language discordance between treatment teams and patients leads to worse patient outcomes, including longer hospital stays, higher rates of readmission, impaired comprehension of discharge instructions, and lower treatment adherence. Yet, there is a paucity of data evaluating the effects of language discordance on postoperative outcomes among vascular surgery patients. This study compared 30-day postoperative complications and readmissions after nonemergent infrainguinal bypass between non-English-speaking (NES) and English-speaking (ES) patients...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#8
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28622743/endovascular-treatment-for-chronic-lower-extremity-ischaemia-with-sub-acute-deterioration
#9
Liangxi Yuan, Songlin Guo, Jian Dong, Jian Zhou, Qingsheng Lu, Junmin Bao, Zaiping Jing
OBJECTIVES: The purpose of this study is to report the efficacy of endovascular treatment for patients with sub-acute (14-day to 2-month) deterioration of chronic lower extremity ischaemia. MATERIALS AND METHODS: Between June 2013 and May 2015, 26 consecutive patients (22 men, 4 women; mean age, 68.6 years; range, 50-86 years) were treated for sub-acute deterioration of chronic lower extremity ischaemia in our hospital. All patients were treated with catheter-directed thrombolysis initially and then adjunctive percutaneous transluminal angioplasty and/or stenting was performed to correct underlying lesions...
July 2017: Diabetes & Vascular Disease Research
https://www.readbyqxmd.com/read/28622274/a-role-for-neurokinin-1-receptor-neurons-in-the-rostral-ventromedial-medulla-in-the-development-of-chronic-postthoracotomy-pain
#10
Sergey G Khasabov, Jeffrey Chi-Fei Wang, Donald A Simone, Gary R Strichartz
Thoracotomy results in chronic postoperative pain (CPTP) in half of the cases. Earlier findings in rat models of persistent post-surgical pain suggest that spinal pathways are critical for pain onset but not its maintenance. Descending systems from the brain stem modulate nociceptive transmission in the spinal cord and contribute to persistent pain, but their role in chronic postoperative pain has not been studied. Here, we ablated pronociceptive neurokinin-1 receptor (NK-1R)-expressing neurons in the rat rostral ventromedial medulla (RVM) to identify their role in CPTP...
July 2017: Pain
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#11
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, though there is no published data on postoperative outcomes in Spain. We evaluated 2922 patients in the first day after surgery in thirteen tertiary care Spanish Hospitals, using the PAIN-OUT questionnaire. Aims were to: assess postoperative outcomes, and anesthetic/analgesic management in orthopedics (ORT) and general (GEN) surgery patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management by surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28617517/selective-fasciotomy-for-chronic-exertional-compartment-syndrome-detected-with-exercise-magnetic-resonance-imaging
#12
Sehan Park, Ho Seong Lee, Sang Gyo Seo
Chronic exertional compartment syndrome that is refractory to conservative management should be treated with surgical fasciotomy. However, owing to the limitations of intracompartmental needle manometry in reaching a definite diagnosis, the appropriate timing for fasciotomy and on which compartment remain unclear. The authors report the case of a 22-year-old male military cadet who reported pain in his left calf when running or walking for long distances. The pain was located at the lateral aspect of the calf, from the mid-calf level to the ankle...
June 15, 2017: Orthopedics
https://www.readbyqxmd.com/read/28616651/comparison-of-efficacy-of-transversus-abdominis-plane-block-and-iliohypogastric-ilioinguinal-nerve-block-for-postoperative-pain-management-in-patients-undergoing-inguinal-herniorrhaphy-with-spinal-anesthesia-a-prospective-randomized-controlled-open-label-study
#13
Onur Okur, Zeki Tuncel Tekgul, Nazif Erkan
PURPOSES: The purpose of this study was to compare the effects of lateral abdominal transversus abdominis plane block (TAP block) and iliohypogastric/ilioinguinal nerve block (IHINB) under ultrasound guidance for postoperative pain management of inguinal hernia repair. Secondary purposes were to compare the complication rates of the two techniques and to examine the effects of TAP block and IHINB on chronic postoperative pain. METHODS: This was a prospective randomized controlled open-label study...
June 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28607894/impact-of-co-existing-vascular-headache-on-symptom-relief-after-endoscopic-sinus-surgery
#14
Shilpa Chandrashekarappa, Sandeep Shetty, T Shivaram Shetty, Amjad Khan, Parijat Joshi
Vascular headache and chronic rhinosinusitis (CRS) are diseases that share similar symptoms and demographics, including headache, facial pain and nasal symptoms. Contribution of chronic sinusitis as a cause of chronic headache is controversial, as there are scarce studies to know incidence of vascular headache in patients with CRS. To evaluate incidence of vascular headache in patients with CRS. Using descriptive study design, group of 100 patients with symptoms of CRS with headache were included in study. Patients underwent surgical management and 3% managed medically...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28605003/outcomes-of-gluteus-maximus-and-tensor-fascia-lata-transfer-for-primary-deficiency-of-the-abductors-of-the-hip
#15
Sivashankar Chandrasekaran, Nader Darwish, S Pavan Vemula, Parth Lodhia, Carlos Suarez-Ahedo, Benjamin G Domb
PURPOSE: This study aims to present 3 patients' results after undergoing gluteus maximus and tensor fascia lata (TFL) transfer for chronic abductor tears unable to be repaired primarily. METHODS: 3 patients were identified intraoperatively as having an abductor tear unable to be repaired primarily. The anterior 1/3 of the gluteus maximus and the posterior 1/3 of the TFL were mobilised and transferred to the greater trochanter in order to reproduce the normal force vector of the gluteus medius and minimus...
June 6, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://www.readbyqxmd.com/read/28603719/prospective-study-of-quality-of-life-after-lung-cancer-resection
#16
Kathleen G Hopkins, Peter F Ferson, Manisha R Shende, Neil A Christie, Matthew J Schuchert, Arjun Pennathur
BACKGROUND: Surgical resection with curative-intent remains the gold standard for clinically operable early-stage non-small cell lung cancer (NSCLC). This goal can be accomplished using a minimally invasive option, e.g., video assisted thoracic surgery (VATS) or standard thoracotomy. Surgical techniques continue to evolve and few studies have compared the QOL of patients managed with these procedures using current approaches. The primary goal of this study was to investigate differences between patients managed surgically via VATS compared to thoracotomy with respect to ratings of chronic pain, anxiety/depression and quality of life (QOL)...
May 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28602896/indications-and-outcomes-of-open-inferior-vena-cava-filter-removal
#17
Kristofer M Charlton-Ouw, Shaikh Afaq, Samuel S Leake, Harleen K Sandhu, Cristina N Sola, Naveed U Saqib, Ali Azizzadeh, Hazim J Safi
INTRODUCTION: Despite recommendations for retrieval of inferior vena cava (IVC) filters, most are not removed in a timely manner. Longer IVC filter dwell times are associated with caval wall perforation and tilting that make percutaneous retrieval more difficult. Open IVC filter removal is generally reserved for patients with symptoms referable to the filter, such as chronic back and abdominal pain. We present our management algorithm and review of cases of open IVC filter removal. METHODS: Patients referred for management of implanted IVC filters from May 2010 to May 2016 were included...
June 7, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28597350/short-and-long-term-outcomes-of-the-frey-procedure-for-chronic-pancreatitis-a-single-center-experience-and-summary-of-outcomes-in-japan
#18
Kazuhiro Suzumura, Etsuro Hatano, Toshihiro Okada, Yasukane Asano, Naoki Uyama, Ikuo Nakamura, Seikan Hai, Jiro Fujimoto
PURPOSE: To evaluate the short- and long-term outcomes of the Frey procedure for chronic pancreatitis (CP). METHODS: The subjects of this study were 12 patients who underwent the Frey procedure for CP between January, 2000 and December, 2016. We assessed pain relief, weight gain, and exocrine/endocrine insufficiency during follow-up. RESULTS: The study population comprised 11 men and 1 woman (91.7% vs. 8.3%; mean age, 50.3 ± 6.8 years; range 39-61 years)...
June 8, 2017: Surgery Today
https://www.readbyqxmd.com/read/28594766/postdischarge-opioid-use-after-cesarean-delivery
#19
Sarah S Osmundson, Leslie A Schornack, Jennifer L Grasch, Lisa C Zuckerwise, Jessica L Young, Michael G Richardson
OBJECTIVE: To characterize postdischarge opioid use and examine factors associated with variation in opioid prescribing and consumption. METHODS: We conducted a prospective observational cohort study by recruiting all women undergoing cesarean delivery during an 8-week period, excluding those with major postoperative morbidities or chronic opioid use. Starting on postoperative day 14, women were queried weekly regarding number of opioid pills used, amount remaining, and their pain experience until they had stopped opioid medication...
June 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28594747/groin-pain-characteristics-and-recurrence-rates-three-year-results-of-a-randomized-controlled-trial-comparing-self-gripping-progrip-mesh-and-sutured-polypropylene-mesh-for-open-inguinal-hernia-repair
#20
Willem A R Zwaans, Tim Verhagen, Luuk Wouters, Maarten J A Loos, Rudi M H Roumen, Marc R M Scheltinga
OBJECTIVE: The aim of this study was to investigate long-term groin pain and inguinal hernia recurrence rates of 2 types of mesh and to describe the evolution of postoperative groin sensory disturbances. SUMMARY OF BACKGROUND DATA: Some patients with an inguinal hernia develop chronic pain following open mesh insertion. Previous trials comparing a semi-resorbable, self-gripping Progrip mesh with a standard sutured polypropylene mesh found conflicting results regarding recurrence rates and residual groin pain...
June 7, 2017: Annals of Surgery
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