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Chronic postOP pain

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https://www.readbyqxmd.com/read/29164162/functional-outcomes-after-the-surgical-management-of-isolated-anterolateral-leg-chronic-exertional-compartment-syndrome
#1
Grace Gatenby, Samuel Haysom, Bruce Twaddle, Stewart Walsh
Background: Failure rates of up to 20% have been reported after fasciotomy for chronic exertional compartment syndrome (CECS). There is some evidence that postoperative failure and complication rates are higher in the posterior compartments of the lower leg than the anterolateral compartments. Isolated compartment surgery may put patients at risk of requiring revision surgery because of the risk of developing posterior compartment disease. Hypothesis: Isolated anterolateral fasciotomy for CECS, in the absence of posterior compartment symptoms, produces satisfactory functional outcomes...
November 2017: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/29163990/interventional-pain-management-in-multidisciplinary-chronic-pain-clinics-a-prospective-multicenter-cohort-study-with-one-year-follow-up
#2
Cláudia Gouvinhas, Dalila Veiga, Liliane Mendonça, Rute Sampaio, Luís Filipe Azevedo, José Manuel Castro-Lopes
Background: Interventional Pain Management (IPM) is performed in multidisciplinary chronic pain clinics (MCPC), including a range of invasive techniques to diagnose and treat chronic pain (CP) conditions. Current patterns of use of those techniques in MCPC have not yet been reported. Objective: We aimed to describe quantitatively and qualitatively the use of IPM and other therapeutic procedures performed on-site at four Portuguese MCPC. Methods: A prospective cohort study with one-year follow-up was performed in adult patients...
2017: Pain Research and Treatment
https://www.readbyqxmd.com/read/29159008/caroli-s-disease-as-a-cause-of-chronic-epigastric-abdominal-pain-two-case-reports-and-a-brief-review-of-the-literature
#3
REVIEW
Pedro Cabral Correia, Bruno Morgado
Caroli's disease is a very rare congenital malformation, currently included in cystic diseases of the biliary tract, and is characterized by ectasia and dilatation of the intrahepatic bile ducts. Two clinical entities can be distinguished, Caroli's disease in which congenital hepatic impairment is limited to cystic dilatation and Caroli's syndrome in which congenital hepatic fibrosis coexists. We present two cases of atypical presentations of Caroli's disease. Case one was a 76-year-old man who was referred to our hospital for chronic non-remitting epigastric pain prior to diagnosis...
September 20, 2017: Curēus
https://www.readbyqxmd.com/read/29151051/subclinical-propionibacterium-acnes-infection-estimation-in-the-intervertebral-disc-spine-id-protocol-for-a-prospective-cohort
#4
Nelson Astur, Delio E Martins, Marcelo Wajchenberg, Mario Ferretti, Fernando G Menezes, Andre M Doi, Laercio A Rosemberg, Durval C B Santos, Alexandre S Iutaka, Luciano M R Rodrigues, Marines D V Martino, Jorge R Pagura, Eduardo N Kihara Filho, Mario Lenza
INTRODUCTION: Low back pain and vertebral endplate abnormalities are common conditions within the population. Subclinical infection caused by indolent pathogens can potentially lead to these findings, with differentiation between them notably challenging from a clinical perspective. Progressive infection of the intervertebral disc has been extensively associated with increasing low back pain, with Propionibacterium acnes specifically implicated with in relation to sciatica. The main purpose of this study is to identify if the presence of an infective pathogen within the intervertebral disc is primary or is a result of intraoperative contamination, and whether this correlates to low back pain...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29149147/hypothalamic-pituitary-adrenocortical-axis-suppression-following-a-single-epidural-injection-of-methylprednisolone-acetate
#5
Aleem Jameel Abdul, Babita Ghai, Dipika Bansal, Naresh Sachdeva, Anil Bhansali, Saravdeep Singh Dhatt
BACKGROUND: Epidural injections (EIs) are the most commonly performed minimally invasive intervention in managing chronic low back pain (CLBP). There is inconsistency in data to accurately predict the degree of hypothalamic-piuitary-adrenal (HPA) axis suppression in patients receiving exogenous steroid therapy, especially in the form of epidural steroid injections (ESIs). OBJECTIVE: We aim to quantify the degree and duration of HPA axis suppression after a single ESI of 80 mg methyl prednisolone acetate in patients with CLBP...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#6
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29147587/dexmedetomidine-as-part-of-a-multimodal-analgesic-treatment-regimen-for-opioid-induced-hyperalgesia-in-a-patient-with-significant-opioid-tolerance
#7
Richard K Patch Iii, Jason S Eldrige, Susan M Moeschler, Matthew J Pingree
Acute postoperative pain in patients with opioid tolerance creates a significant management challenge for anesthesiologists and pain medicine physicians. A multimodal approach is key; however other factors can complicate management such as opioid induced hyperalgesia. We present the case of a patient on large amounts of intrathecal opioids for chronic pain syndrome with opioid induced hyperalgesia after an exploratory laparotomy. Dexmedetomidine was utilized successfully as part of a controlled multimodal analgesic plan and should be a consideration for opioid tolerant patients experiencing opioid induced hyperalgesia...
2017: Case Reports in Anesthesiology
https://www.readbyqxmd.com/read/29146094/is-balloon-kyphoplasty-a-better-treatment-than-percutaneous-vertebroplasty-for-chronic-obstructive-pulmonary-disease-copd-patients-with-osteoporotic-vertebral-compression-fractures-ovcfs
#8
Xinjie Wu, Xiangsheng Tang, Mingsheng Tan, Ping Yi, Feng Yang
BACKGROUND: Although several studies reported that Balloon kyphoplasty (BK) or percutaneous vertebroplasty (PVP) could improve pulmonary functions, there is no study to compare the efficacy and safety of 2 procedures in COPD patients with osteoporotic vertebral compression fractures (OVCFs) and investigate the reason why they could improve pulmonary functions. METHOD: Two procedures, including BK and PVP were performed in 61 COPD patients with single-level OVCFS...
November 13, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/29145033/is-chronic-postsurgical-pain-surgery-induced-a-study-of-persistent-postoperative-pain-following-breast-reconstruction
#9
Randy S Roth, Ji Qi, Jennifer B Hamill, Hyungjin M Kim, Tiffany N S Ballard, Andrea L Pusic, Edwin G Wilkins
BACKGROUND: Chronic postsurgical pain (CPSP) is a reported risk for women undergoing breast reconstruction, but it remains unclear that such persistent pain is induced by reconstructive surgery. To address this concern, this prospective cohort study examined the prevalence of and risk factors associated with CPSP among women undergoing breast reconstruction. MATERIALS AND METHODS: Women (n = 1996) recruited for the Mastectomy Reconstruction Outcomes Consortium (MROC) Study were assessed preoperatively and at two-years postoperatively for relevant medical/...
November 13, 2017: Breast: Official Journal of the European Society of Mastology
https://www.readbyqxmd.com/read/29141613/determinants-of-patient-satisfaction-following-reconstructive-shoulder-surgery
#10
Sascha J Baettig, Karl Wieser, Christian Gerber
BACKGROUND: Obtaining patient satisfaction is a key goal of surgical treatment. It was the purpose of this study to identify pre-, peri- and postoperative factors determining patient satisfaction after shoulder surgery, quantify their relative importance and thereby allow the surgeon to focus on parameters, which will influence patient satisfaction. METHODS: We retrospectively reviewed 505 patients, who underwent either rotator cuff repair (n = 216) or total shoulder arthroplasty (n = 289)...
November 15, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29139566/patient-reported-rates-of-chronic-pain-and-recurrence-after-groin-hernia-repair
#11
K-J Lundström, H Holmberg, A Montgomery, P Nordin
BACKGROUND: The effectiveness of different procedures in routine surgical practice for hernia repair with respect to chronic postoperative pain and reoperation rates is not clear. METHODS: This was prospective cohort study based on a unique combination of patient-reported outcomes and national registry data. Virtually all patients with a groin hernia repair in Sweden between September 2012 and April 2015 were sent a questionnaire 1 year after surgery. Persistent pain, defined as at least 'pain present, cannot be ignored, and interferes with concentration on everyday activities' in the past week was the primary outcome...
November 15, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/29129802/treatment-of-paget-schroetter-syndrome-with-a-three-stage-approach-including-thoracoscopic-rib-resection-at-the-second-stage
#12
Osman Mahmoud, Eero Sihvo, Jari Räsänen, Leena Vikatmaa, Pirkka Vikatmaa, Maarit Venermo
OBJECTIVE: Young, active persons may suffer lifelong consequences of subclavian vein thrombosis, but the best treatment options remain unclear. On introduction of more active pharmacomechanical thrombus removal and thoracoscopic rib resection in our institution, we planned a diagnostic and treatment protocol and aimed to analyze the early, midterm, and intermediate-term results. METHODS: The study included 72 patients who were diagnosed with an upper limb deep venous thrombosis and underwent phlebography between 2006 and 2013...
November 9, 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/29128611/intrathecal-administration-of-antisense-oligonucleotide-against-p38%C3%AE-but-not-p38%C3%AE-map-kinase-isoform-reduces-neuropathic-and-postoperative-pain-and-tlr4-induced-pain-in-male-mice
#13
Xin Luo, Bethany Fitzsimmons, Apoorva Mohan, Linlin Zhang, Niccolo Terrando, Holly Kordasiewicz, Ru-Rong Ji
p38 mitogen-activated protein kinase (MAPK) consists of two major isoforms: p38α and p38β; however, it remains unclear which isoform is more important for chronic pain development. Recently, we developed potent, long-lasting, and p38 MAPK subtype-specific antisense oligonucleotides (ASOs). We examined the therapeutic effects of isoform-specific ASOs in several chronic pain models following single intrathecal injection (300 μg/10 μl) in CD1 mice. In the chronic constriction injury (CCI) model, p38α MAPK ASO, given on post-operative day 5, reduced CCI-induced mechanical allodynia in male but not female mice...
November 8, 2017: Brain, Behavior, and Immunity
https://www.readbyqxmd.com/read/29124992/efficacy-of-ketamine-for-postoperative-pain-following-robotic-thyroidectomy-a-prospective-randomised-study
#14
Jiwon Lee, Hee-Pyoung Park, Mu-Hui Jeong, Je-Do Son, Hyun-Chang Kim
Objective Although robotic thyroidectomy (RoT) is a minimally invasive surgery, percutaneous tunneling causes moderate to severe pain immediately postoperatively. We evaluated the efficacy of ketamine for postoperative pain management in patients following RoT. Methods Sixty-four patients scheduled for RoT were randomly divided into two groups. In the ketamine group (n = 32), ketamine was infused from induction of anaesthesia until the end of the procedure (0.15-mg/kg bolus with continuous infusion at 2 µg/kg/min)...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/29123854/local-anesthetic-toxicity-acute-and-chronic-management
#15
REVIEW
Kenichi Sekimoto, Masaru Tobe, Shigeru Saito
Local anesthetics are commonly used medicines in clinical settings. They are used for pain management during minor interventional treatments, and for postoperative care after major surgeries. Cocaine is the well-known origin of local anesthetics, and the drug and related derivatives have long history of clinical usage for more than several centuries. Although illegal use of cocaine and its abuse are social problem in some countries, other local anesthetics are safely and effectively used in clinics and hospitals all over the world...
April 2017: Acute Medicine & Surgery
https://www.readbyqxmd.com/read/29123664/chronic-post-amputation-pain-peri-operative-management-review
#16
Devjit Srivastava
Study design: Narrative review. Method: Eight bibliographic databases were searched for studies published in the (last five years up until Feb 2017). For the two database searches (Cochrane and DARE), the time frame was unlimited. The review involved keyword searches of the term 'Amputation' AND 'chronic pain'. Studies selected were interrogated for any association between peri-operative factors and the occurrence of chronic post amputation pain (CPAP). Results: Heterogeneity of study populations and outcome measures prevented a systematic review and hence a narrative synthesis of results was undertaken...
November 2017: British Journal of Pain
https://www.readbyqxmd.com/read/29121211/external-validation-and-update-of-the-ricp-a-multivariate-model-to-predict-chronic-postoperative-pain
#17
Tim Mathes, Carolina Pape-Köhler, Lena Moerders, Eberhard Lux, Edmund A M Neugebauer
Objective: The development of chronic postsurgical pain (CPSP) is influenced by several factors. The risk index for chronic pain (RICP) was developed to identify patients at high risk for CPSP. The aim of this study was the external validation and update of the RICP. Design: Prospective cohort study. Setting: Two German hospitals. Subjects: Participants who underwent orthopedic surgery, general surgery, visceral surgery, and neurosurgery...
November 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29120931/perioperative-neurocognition-in-elderly-patients
#18
Huiqun Fu, Long Fan, Tianlong Wang
PURPOSE OF REVIEW: The extrinsic risk factors for postoperative cognitive disturbance have been a source of concern during the perioperative period, and these risk factors remain the subject of controversy. This review of recent studies focuses on the effect of these factors on postoperative cognitive disturbance during the perioperative period. RECENT FINDINGS: Impairment of cerebral autoregulation may predispose patients to intraoperative cerebral malperfusion, which may subsequently induce postoperative cognitive disturbance...
November 7, 2017: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29117657/%C3%A2-plug-free%C3%A2-connector-placement-modification-of-a-bilayer-patch-device-in-male-indirect-inguinal-hernioplasty
#19
Miroslav D Ilić, Srdjan S Putnik
The bilayer patch device (Ethicon, Prolen Hernia System®) for inguinal hernia repair has a connector that acts as a ‚plug‘ in the internal inguinal ring. The position of this ‚plug‘ component may be responsible for higher incidence of chronic pain and intestinal damage. We assumed that changing the position of the connector of a bilayer patch device (PHS®) and placing it medially in Hesselbach triangle would contribute to lower incidence of chronic pain and would not result in intestinal damage, with good clinical outcome following indirect inguinal hernioplasty...
December 2016: Acta Clinica Croatica
https://www.readbyqxmd.com/read/29114334/anesthesia-and-analgesia-in-the-patient-with-an-unstable-shoulder
#20
Ismael Acevedo Bambaren, Fernando Dominguez, Maria Elena Elias Martin, Silvia Domínguez
Introduction: The patient with an unstable shoulder represents a challenge for the anesthesiologist. Most patients will be young individuals in good health but both shoulder dislocation reduction, a procedure that is usually performed under specific analgesia in an urgent setting, and instability surgery anesthesia and postoperative management present certain peculiarities. Material and Methods: For the purpose of the article, 78 references including clinical trials and reviews were included...
2017: Open Orthopaedics Journal
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