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Chronic postOP pain

Daniella C Parravano, Daniel A Ciampi, Erich T Fonoff, Bernardo Monaco, Jessie Navarro, Lin T Yeng, Manoel J Teixeira, Clement Hamani
BACKGROUND: Motor cortex stimulation (MCS) is routinely used for the treatment of chronic neuropathic pain but its effect on quality of life remains uncertain. OBEJCTIVE: To systematically review the published literature on MCS and quality of life and report the effects of this therapy in a series of patients prospectively followed in our center. METHODS: The systematic literature review was conducted using the search words "motor cortex stimulation and pain and neurosurgery" and "motor cortex stimulation and pain and quality of life...
March 14, 2018: Neurosurgery
Young Hak Roh, Young Do Koh, Jong Oh Kim, Kyu Ho Lee, Hyun Sik Gong, Goo Hyun Baek
BACKGROUND: Postoperative pillar pain (deep-seated wrist pain worsened by leaning on the heel of the hand) sometimes occurs after carpal tunnel release (CTR), leading to weakness in the hand and delayed return to work. Increased pain sensitivity has been found to be associated with worse symptoms and poorer treatment response in a number of chronic musculoskeletal conditions, but few studies have investigated the association of pain sensitization with pillar pain after CTR. QUESTIONS/PURPOSES: (1) Is preoperative pain sensitization in patients with carpal tunnel syndrome (CTS) associated with increased severity of pillar pain after open CTR? (2) What other demographic, electrophysiological, or preoperative clinical characteristics are associated with pillar pain after CTR? METHODS: Over a 35-month period, one surgeon performed 162 open carpal tunnel releases...
April 2018: Clinical Orthopaedics and related Research
Lucy Gee, Heather C Smith, Zohal Ghulam-Jelani, Hirah Khan, Julia Prusik, Paul J Feustel, Sarah E McCallum, Julie G Pilitsis
BACKGROUND: Chronic pain causes a significant burden to the US health care system, is difficult to treat, and remains a significant contributor to increased opioid use in the United States. Spinal cord stimulation (SCS) has been FDA approved for the treatment of chronic pain. OBJECTIVE: To evaluate the hypothesis that SCS reduces opioid use, and alone maintains clinical outcome measures of pain and psychosocial determinants of health. METHODS: In this prospective cohort study, we evaluated 86 patients undergoing SCS surgery for the treatment of chronic pain between September 2012 and August 2015...
March 12, 2018: Neurosurgery
L Z Wang, C N Wei, F Xiao, X Y Chang, Y F Zhang
BACKGROUND: China has one of the highest rates of caesarean delivery in the world. The aim of this study was to investigate the incidence and risk factors for chronic pain after caesarean delivery in a Chinese cohort. METHODS: Patients undergoing elective caesarean delivery with a Pfannenstiel incision under spinal anaesthesia were recruited prospectively at a Chinese tertiary women's hospital. The State Trait Anxiety Inventory was measured before surgery. Postoperative analgesia was provided by intravenous patient-controlled analgesia for 48 hours...
February 2, 2018: International Journal of Obstetric Anesthesia
P-A Bolze, P Paparel, F Golfier
Urinary tract involvement by endometriosis is reported in 1% of endometriosis patients (NP3). Consequences range from pelvic pain for bladder localizations to silent kidney loss in case of chronic ureteral obstruction (NP3). The feasibility of laparoscopic management was widely proven (NP3) and may reduce hospital stay length (NP4). Radical surgery with partial cystectomy for bladder localizations was shown to significantly and durably reduce pain symptoms with low risk of a severe postoperative complications (NP3)...
March 8, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Kurt Barnhart, Linda Giudice, Steve Young, Tracey Thomas, Michael P Diamond, James Segars, Wahid A Youssef, Stephen Krawetz, Nanette Santoro, Esther Eisenberg, Heping Zhang
OBJECTIVE: Endometriosis is a chronic, estrogen dependent condition that affects 5-10% of reproductive aged women and is associated with pelvic pain and infertility. As the approach to therapy shifts from surgical ablation to pharmacological control, a non-surgical mode of diagnosis would be desirable. The ENDOmarker study was designed by the NICHD Reproductive Medicine Network (RMN) to obtain well characterized and phenotyped bio specimens in a standardized fashion from women with and without endometriosis...
March 7, 2018: Contemporary Clinical Trials
Yoko Sugiyama, Hiroki Iida, Fumimasa Amaya, Kanako Matsuo, Yutaka Matsuoka, Keiko Kojima, Fumitaka Matsuno, Takayuki Hamaguchi, Masako Iseki, Keisuke Yamaguchi, Yoshika Takahashi, Atsuko Hara, Yusuke Sugasawa, Mikito Kawamata, Satoshi Tanaka, Yoshimi Inagaki, Akihiro Otsuki, Mitsuaki Yamazaki, Hisakatsu Ito
We performed a multicenter observational study to assess the prevalence and risk factors of persistent pain after lung cancer surgery and total knee arthroplasty (TKA) in the Japanese population. After receiving Ethics Committee approval, a retrospective chart review was performed for patients who underwent surgery at seven university hospitals in Japan in 2013. A total of 511 patients who underwent lung cancer surgery and 298 patients who underwent TKA were included. The prevalence of chronic postsurgical pain (CPSP) at 3 and 6 months was 18 and 12% after lung surgery and 49 and 33% after TKA, respectively...
March 9, 2018: Journal of Anesthesia
Richard A Deyo, Sara E Hallvik, Christi Hildebran, Miguel Marino, Nicole OʼKane, Jody Carson, Joshua Van Otterloo, Dagan A Wright, Lisa M Millet, Wayne Wakeland
Lumbar fusion surgery is usually prompted by chronic back pain, and many patients receive long-term preoperative opioid analgesics. Many expect surgery to eliminate the need for opioids. We sought to determine what fraction of long-term preoperative opioid users discontinue or reduce dosage postoperatively; what fraction of patients with little preoperative use initiate long-term use; and what predicts long-term postoperative use. This retrospective cohort study included 2,491 adults undergoing lumbar fusion surgery for degenerative conditions, using Oregon's prescription drug monitoring program to quantify opioid use before and after hospitalization...
March 6, 2018: Pain
Patricia Lavand'homme
PURPOSE OF REVIEW: Cesarean section is the most common surgical procedure performed in the world. Postoperative pain management remains a challenge, particularly in a context of enhanced recovery after surgery. Several barriers related to the specific condition of 'postpartum recovery' may prevent application of effective analgesia in this population. The present review focuses on novel approaches of cesarean section postoperative pain assessment, beyond pain-rating intensity, including objective patient-centered recovery parameters...
March 7, 2018: Current Opinion in Anaesthesiology
Abdulhadi A AlAmodi, Mohamad H Farhoud, Najwa Mohammad, Rawan Alatassi, Dana Alolayet, Noor AlQeshtaini, Raghad AlMamlouk, Mohamed Hussein Ahmed, Mahmoud Ashour, Sara S Kayyali, Abdullah AlShammari
BACKGROUND Leiomyomas are benign neoplasms of the smooth muscle. When found in the pulmonary system, a rare occurrence, leiomyomas can result in hypertrophic osteoarthropathy, or significant clubbing, associated with proliferation of long bone periosteum. Bronchopulmonary fistulas, or communications between the bronchial tree and pleural space, are an uncommon postoperative complication of pneumonectomies. Even more infrequent is the presence of a bronchopulmonary fistula that is determined to be sterile. CASE REPORT The patient presented in the current case report is a 40-year-old previously healthy woman who presented with a 5-year history of chronic cough, right-sided chest discomfort, and dyspnea associated with back pain, and lower leg pain...
March 9, 2018: American Journal of Case Reports
Kwan-Sub Kim, Nam-Kyung Yeo, Seong-Su Kim, Woong-Sub Park, Su-Hyun Kwak, Sang-Hyeon Cho, Gyu-Wan Sung, Hae-Sook Kim, Sang-Wook Yi, Hae Jun Cho
PURPOSE: Nasal packing is an option for bleeding control after endoscopic sinus surgery and septoplasty. Although new packing materials have been developed, patients still suffer from pain and require additional analgesics treatments. In this study, a prospective, randomized, and double-blind controlled trial was designed to evaluate the effect of fentanyl-soaked packing on pain after endoscopic sinus surgery and septoplasty. METHODS: One hundred fifty-two patients who underwent nasal surgeries due to chronic rhinosinusitis or nasal septal deviation were enrolled in this study...
March 1, 2018: Annals of Otology, Rhinology, and Laryngology
Lei Zhang, Zhiyao Li
Medial patellofemoral ligament (MPFL) reconstruction is a satisfactory technique for patellar instability, and the anatomical double bundle variant is recommended for better clinical results. However, long-term outcomes are still uncharacterized. This study aimed to assess the effectiveness of double bundle reconstruction of the MPFL for patellar instability by means of established scores. A total of 68 patients with chronic patellar instability who underwent surgery from May 2005 to February 2010 were included prospectively...
March 7, 2018: Journal of Knee Surgery
Rikke Vibeke Nielsen
Increasing evidence indicate that pain is insufficiently treated following surgical procedures. It is essential that pain treatment is effective with a minimum of side effects in order to promote postoperative rehabilitation. Multimodal analgesia is most likely an important strategy in reducing postoperative pain. Combinations of different analgesics with different mechanisms of action may have an additive analgesic effect with fewer side effects compared to using a single drug. However, there is still a pronounced lack of documentation for the effect and side effects of these multimodal analgesic regimes...
March 2018: Danish Medical Journal
Kristoffer Andresen
Inguinal hernias are a protrusion of the peritoneum through a weakening in the groin in which abdominal content (intestines or fat) can herniate and cause a bulge. Inguinal hernias can be painful and require surgery. Worldwide, approximately 20 million patients are operated each year, with 10,000 in Denmark. The repair of inguinal hernias causes pain and 16% of patients experience chronic pain six months after the standard, open, mesh-based Lichtenstein technique. Therefore, surgeons are trying to improve the techniques by finding new ways of operating...
March 2018: Danish Medical Journal
Morten Rune Blichfeldt-Eckhardt
The thesis comprises an overview and four papers, all published or submitted for publication in international peer-reviewed scientific journals.
Chronic pain after surgery is a common and debilitating complication after many types of surgery. The cause and pathology behind is still mainly uncovered, though several risk factors have been proposed. One of the strongest risk factors for persistent postsurgical pain is the intensity of the acute pain response though the mechanisms involved remain unsettled...
March 2018: Danish Medical Journal
Yanfang Duan, Jing Qian, Kun Chen, Zhuo Zhang
RATIONALE: Pigmented villonodular synovitis (PVNS) is an idiopathic, proliferative disorder lesion of synovial tissue, which is regarded as a benign disease, but has a local invasion. Up to now, these are no consensus about the etiology and pathogenesis of PVNS. Because of the lack of typical clinical features, misdiagnosis and delayed diagnosis are not uncommon, magnetic resonance imaging (MRI) can assist diagnosis and histopathological examination is recognized as the gold standard for the final diagnosis...
January 2018: Medicine (Baltimore)
Saif Yousif, Martin Wood
Bertolotti syndrome describes lower back pain secondary to an anatomical lumbosacral transitional vertebrae. We present the case of a 37 year old female with chronic lower back pain with radiological evidence of an anatomical lumbosacral pseudojoint. The patient underwent minimally invasive resection of her pseudojoint with complete resolution of symptoms postoperatively. We, as the authors would like to highlight that in patients with pain secondary to an aberrant lumbosacral articulation, consideration should be given to treatment via a minimally invasive technique...
March 1, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Stephanie Voss, Albrecht Will, Rüdiger Lange, Bernhard Voss
BACKGROUND: Sternal dehiscence after median sternotomy is a challenging problem in cases of frail bone, fractures or complete sternectomy. Plate osteosynthesis offers a promising approach to restore sternal integrity. However, there is only scarce data on mid-term outcome. METHODS: Mid-term data on 34 patients with unstable thorax after open-heart surgery, requiring sternal refixation with the Synthes™ Titanium Sternal Fixation System© (TSFS) between 2005 and 2011 were analyzed...
February 26, 2018: Annals of Thoracic Surgery
Shuichi Chida, Hitoshi Suzuki, Moto Kobayashi, Tsutomu Sakuraba, Hideji Kura, Naohisa Miyakoshi, Yoichi Shimada
BACKGROUND: We reconstructed a chronically ruptured Achilles tendon and the associated scar tissue using braided polyblend polyethylene sutures (FiberWire; Arthrex Inc.; Naples, FL, USA) and anchors. CASE PRESENTATION: A 68-year-old Japanese man, who was being treated for right Achilles tendinosis, felt pain in his Achilles tendon when walking and started to find plantar flexion of his ankle joint difficult. As his symptoms persisted, he visited us after 4 weeks...
March 2, 2018: Journal of Medical Case Reports
Vikki Wylde, Jane Dennis, Rachael Gooberman-Hill, Andrew David Beswick
OBJECTIVE: Approximately 20% of patients experience chronic pain after total knee replacement (TKR). The aim of this systematic review was to evaluate the effectiveness of postdischarge interventions commenced in the first 3 months after surgery in reducing the severity of chronic pain after TKR. DESIGN: The protocol for this systematic review was registered on PROSPERO (registration number: CRD42017041382). MEDLINE, Embase, CINAHL, PsycINFO and The Cochrane Library were searched from inception to November 2016...
February 28, 2018: BMJ Open
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