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Postoperative analgesia

X L Wang, J Wang, D L Mu, D X Wang
Objective: To investigate the effect of dexmedetomidine adding to ropivacaine for continuous femoral nerve block on the improvement of postoperative sleep quality in elderly patients after total knee arthroplasty. Methods: One hundred and sixty patients aged 60 years or older in Jishuitan Hospital scheduled for single total knee arthroplasty between Nov. 2016 and Jun. 2017 were recruited. All patients received spinal anesthesia and were randomized to receive either combined ropivacaine and dexmedetomidine (0...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Blair Peters, Jennifer L Giuffre
PURPOSE: Treatment patterns of carpal tunnel surgery by members of the American Society of Surgery of the Hand (ASSH) have recently been published. The majority of cases in this study were performed in the general operating room with intravenous (IV) sedation or a Bier block. Patients were most commonly prescribed hydrocodone for postoperative pain. The majority of carpal tunnel releases at our center are performed under local anesthesia alone, with plain acetaminophen (Tylenol) or codeine prescribed for postoperative pain...
March 17, 2018: Journal of Hand Surgery
Marco Scardino, Tiziana D'Amato, Federica Martorelli, Giorgia Fenocchio, Vincenzo Simili, Berardo Di Matteo, Dario Bugada, Elizaveta Kon
BACKGROUND: Currently many TKA protocols rely on multimodal analgesic protocols with patient-controlled analgesia systems that administer opioids through a patient controlled IV infusion pump, in addition to concomitant peripheral nerve blocks and local anesthetics. Although effective, PCA IV opioids do not provide optimal results with fast track rehabilitation protocols. METHODS: The present is a retrospective study comparing the novel sublingual sufentanil PCA system (SSTS) to our standard of care foreseeing continuous femoral nerve block (cFNB) within a multimodal analgesic in a TKA fast-track protocol...
March 20, 2018: Journal of Experimental Orthopaedics
Qing Tu, Jianhui Gan, Jinlin Shi, Hong Yu, Shuangliang He, Jian Zhang
Transcutaneous electrical acupoint stimulation (TEAS) is an effective analgesic measure. We studied the analgesic effect of TEAS by applying it alone after ureteroscopic lithotripsy, rather than applying it as a supplementary analgesic measure. Participants (n = 120) scheduled to undergo ureteroscopic holmium laser lithotripsy, were enrolled and randomly assigned into Group T (TEAS n = 60) and Group C (Control, n = 60). The participants in Group T were treated with TEAS for postoperative analgesia...
March 20, 2018: Urolithiasis
Adam B King, Matthew D Spann, Patrick Jablonski, Jonathan P Wanderer, Warren S Sandberg, Matthew D McEvoy
BACKGROUND: Patients frequently remain in the hospital after bariatric surgery due to pain, nausea, and inability to tolerate oral intake. Enhanced recovery after surgery (ERAS) concepts address these perioperative complications and therefore improve length of stay for bariatric surgery patients. OBJECTIVES: To determine if ERAS concepts increase the proportion of patients discharged on postoperative day 1. Secondary objectives included mean length of stay, perioperative opioid use, emergency department visits, and readmissions...
February 13, 2018: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Briony D Smith, Krystal J Vail, Gwendolyn L Carroll, Maggie C Taylor, Nicholas D Jeffery, Tracy H Vemulapalli, James J Elliott
Often few alternative anesthetics for exotic species are available, due to the small numbers of these animals used in research. In this study, we evaluated the depth and duration of anesthesia in Xenopus laevis after their immersion in 3 doses of etomidate (15, 22.5, and 30 mg/L) and in 3 doses of benzocaine (0.1%, 0.5%, and 1%) compared with the 'gold standard,' tricaine methanesulfonate (MS222; 2 g/L). We then chose an optimal dose for each alternative anesthetic according to induction time, duration of surgical plane, and time to complete recovery...
March 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Vanessa L Oliver, Sarah E Thurston, Jennifer L Lofgren
Recent studies have revealed some of the most frequently used analgesics in mice are not effectively treating postoperative pain. Our laboratory sought to compare and assess the validity and reliability of 2 cageside pain assessments that we recently developed for use in mice-nesting consolidation and grooming transfer tests. We then applied these tests to compare the efficacy of commonly used analgesics-buprenorphine (0.1 mg/kg SC every 12 h for 48 h) and carprofen (30 mg/kg in drinking water for 72 h)-alone and in multimodal combination as a refinement for treating postoperative pain in mice...
March 1, 2018: Journal of the American Association for Laboratory Animal Science: JAALAS
Richard A Pollak, Ira J Gottlieb, Fardin Hakakian, John C Zimmerman, Stewart W McCallum, Randall J Mack, Rosemary Keller, Alex Freyer, Wei Du
OBJECTIVE: To evaluate the analgesic efficacy and safety of a novel intravenous (IV) formulation of meloxicam (30▒mg) in subjects with moderate-to-severe pain following a standardized, unilateral bunionectomy with first metatarsal osteotomy and internal fixation. METHODS: Subjects who met the criteria for moderate-to-severe postoperative pain were randomized to receive bolus injections of meloxicam IV 30▒mg (n=100) or placebo (n=101) administered once daily...
March 16, 2018: Clinical Journal of Pain
Daniel J Pak, Amitabh Gulati
The placement of thoracic epidural catheters is complicated by the layering of the vertebral lamina. Therefore, traditional blind palpation techniques require insertion of an epidural needle with likely contact of lamina with redirections into the epidural space. We discuss a safe and consistent technique using true real-time ultrasound visualization of the needle with a paramedian sagittal oblique view to improve the consistency of placing an epidural in the thoracic spine for postoperative analgesia. Successful epidural placement was achieved in every patient...
March 16, 2018: Regional Anesthesia and Pain Medicine
Raed Tafish, Khaled I Abu El Aish, Walid Madi
BACKGROUND: General anaesthesia and spinal anaesthesia are commonly used for caesarean sections. The aim of this study was to compare the outcomes from caesarean sections with these two types of anaesthesia. METHODS: In this quasi-controlled trial, we enrolled women undergoing caesarean sections at Al-Helal Al-Emirati Hospital, Rafah, Gaza Strip. Women were assigned either to general anaesthesia (20% intravenous propofol for anaesthesia induction followed by atracurium for muscle relaxation, and nitrous oxide and oxygen for anaesthesia maintenance) or to spinal anaesthesia (0·5% hyperbaric solution bupivacaine with 20 μg fentanyl intrathecally)...
February 21, 2018: Lancet
Joseph D Tobias
The preoperative evaluation is the first step in ensuring the safe conduct of anesthetic care in pediatric patients of all ages. Over time, this process has changed significantly from a time when patients were admitted to the hospital the night before surgery to a time when the majority of patients, including those scheduled for major surgical procedures, arrive the day of surgery. For most patients, the preoperative examiantion can be conducted over the phone by a trained nurse or on-line via a survey thereby eliminating the need for a separate visit merely for the preoperative evaluation...
April 2018: Seminars in Pediatric Surgery
Young Dong Yu, Jin Ho Hwang, Young Eun Seo, Byung Do Song, Yeon Soo Jung, Dong Hwan Lee, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, Jong Jin Oh
This study aimed to evaluate the effects of ketorolac, a commonly used non-steroidal anti-inflammatory drug (NSAID) as patient controlled intravenous infusion analgesia (PCIA) for the patients underwent radical cystectomy (RC) due to bladder cancer regarding post-operational indices of recovery. Total seventy patients who underwent radical cystectomy for the treatment of bladder cancer were included in the study. 35 patients received ketorolac as PCIA (NSAIDS group) and 35 patients had morphine infusion as PCIA (morphine group)...
March 15, 2018: Scientific Reports
M Aly, A Ibrahim, W Farrag, K Abdelsalam, H Mohamed, A Tawfik
BACKGROUND: Pruritus is the most common side effect of intrathecal morphine, especially in parturients. The exact mechanism is not clear and many possible mechanisms have been suggested. Among these is the activation of the 5-hydroxytryptamine sub-type-3 receptors by intrathecal morphine. METHODS: Forty parturients who underwent elective cesarean delivery under spinal anesthesia were divided into two groups of 20 each in this prospective, randomized study. Both groups received an intrathecal injection of 0...
February 16, 2018: International Journal of Obstetric Anesthesia
Kenneth C Cummings Iii, Nicole M Zimmerman, Kamal Maheshwari, Gregory S Cooper, Linda C Cummings
STUDY OBJECTIVE: Epidural analgesia may be associated with fewer postoperative complications and is associated with improved survival after colon cancer resection. This study used the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) to assess any association between epidural analgesia (versus non-epidural) and complications after colectomy. DESIGN: Retrospective cohort study. SETTING: 603 hospitals in the United States reporting data to NSQIP...
March 12, 2018: Journal of Clinical Anesthesia
I-Ting Kuo, Kuang-Yi Chang, De-Fong Juan, Steen J Hsu, Chia-Tai Chan, Mei-Yung Tsou
Pain relief always plays the essential part of perioperative care and an important role of medical quality improvement. Patient-controlled analgesia (PCA) is a method that allows a patient to self-administer small boluses of analgesic to relieve the subjective pain. PCA logs from the infusion pump consisted of a lot of text messages which record all events during the therapies. The dosage information can be extracted from PCA logs to provide easily understanding features. The analysis of dosage information with time has great help to figure out the variance of a patient's pain relief condition...
2018: PloS One
R W Radwan, A Gardner, H Jayamanne, B M Stephenson
Introduction The open prosthetic repair of inguinal hernias under local anaesthesia (LA) is well established, with the concept of intraoperative 'pre-emptive analgesia' evolving so that patients are as comfortable as possible. We used a peri-incisional LA solution in patients undergoing day-case inguinal hernioplasty under general anaesthesia (GA) and recorded use of analgesia in the immediate postoperative period. Methods In this observational cohort study, 100 consecutive unselected men underwent open inguinal hernia repair as a day case...
March 15, 2018: Annals of the Royal College of Surgeons of England
Han Eol Park, Min Ki Kim, Won-Kyung Kang
Purpose: A laparoscopic colectomy in colorectal-cancer patients is usually associated with a high risk of postoperative nausea and vomiting (PONV). The purpose of this study is to evaluate the efficacy of injection of long-acting 5-hydroxytryptamine type 3 (5-HT3 ) receptor antagonist for the reduction of PONV in patients with colorectal cancer. Methods: A total of 48 patients scheduled to undergo a laparoscopic colectomy for colorectal cancer were randomized in a double-blinded fashion...
February 2018: Annals of Coloproctology
Mariana Takaku, Andre Carnevali da Silva, Nathalie Izumi Iritsu, Pedro Thadeu Galvao Vianna, Yara Marcondes Machado Castiglia
Parecoxib, a selective COX-2 inhibitor, is used to improve analgesia in postoperative procedures. Here we evaluated whether pretreatment with a single dose of parecoxib affects the function, cell injury, and inflammatory response of the kidney of rats subjected to acute hemorrhage. Inflammatory response was determined according to serum and renal tissue cytokine levels (IL-1 α , IL-1 β , IL-6, IL-10, and TNF- α ). Forty-four adult Wistar rats anesthetized with sevoflurane were randomized into four groups: placebo/no hemorrhage (Plc/NH); parecoxib/no hemorrhage (Pcx/NH); placebo/hemorrhage (Plc/H); and parecoxib/hemorrhage (Pcx/H)...
2018: Pain Research and Treatment
Xiaoyu Zheng, Yu Wang, Linlin Dong, Su Zhao, Liping Wang, Hong Chen, Yang Xu, Guonian Wang
Background: Several kinds of cancer surgeries with propofol-based total intravenous anesthesia (TIVA) have been shown to have better outcomes than those with sevoflurane-based inhalational anesthesia (INHA). However, the effects of this anesthetic technique have not been investigated in patients with gastric cancer. In this study, the authors retrospectively examined the link between the choice of anesthetic technique and overall survival in patients undergoing gastric cancer resection...
2018: OncoTargets and Therapy
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
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