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Joint surgery analgesia

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https://www.readbyqxmd.com/read/28413629/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-1-from-the-preoperative-period-to-pacu
#1
Matthew D McEvoy, Michael J Scott, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia," which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multi-disciplinary, international group of clinicians, and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28413628/american-society-for-enhanced-recovery-aser-and-perioperative-quality-initiative-poqi-joint-consensus-statement-on-optimal-analgesia-within-an-enhanced-recovery-pathway-for-colorectal-surgery-part-2-from-pacu-to-the-transition-home
#2
Michael J Scott, Matthew D McEvoy, Debra B Gordon, Stuart A Grant, Julie K M Thacker, Christopher L Wu, Tong J Gan, Monty G Mythen, Andrew D Shaw, Timothy E Miller
BACKGROUND: Within an enhanced recovery pathway (ERP), the approach to treating pain should be multifaceted and the goal should be to deliver "optimal analgesia", which we define in this paper as a technique that optimizes patient comfort and facilitates functional recovery with the fewest medication side effects. METHODS: With input from a multidisciplinary, international group of experts and through a structured review of the literature and use of a modified Delphi method, we achieved consensus surrounding the topic of optimal analgesia in the perioperative period for colorectal surgery patients...
2017: Perioperative Medicine
https://www.readbyqxmd.com/read/28328756/pectoralis-and-serratus-fascial-plane-blocks-each-provide-early-analgesic-benefits-following-ambulatory-breast-cancer-surgery-a-retrospective-propensity-matched-cohort-study
#3
Faraj W Abdallah, David MacLean, Caveh Madjdpour, Tulin Cil, Anuj Bhatia, Richard Brull
BACKGROUND: Pectoralis and serratus blocks have been described recently for use in breast surgery, but evidence supporting their analgesic benefits is limited. This cohort study evaluates the benefits of adding a pectoralis or serratus block to conventional opioid-based analgesia (control) in patients who underwent ambulatory breast cancer surgery at Women's College Hospital between July 2013 and May 2015. We tested the joint hypothesis that adding a pectoralis or serratus block reduced postoperative in-hospital (predischarge) opioid consumption and nausea and vomiting (PONV)...
March 21, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28291143/the-role-of-multimodal-analgesia-in-spine-surgery
#4
Mark F Kurd, Tyler Kreitz, Gregory Schroeder, Alexander R Vaccaro
Optimal postoperative pain control allows for faster recovery, reduced complications, and improved patient satisfaction. Historically, pain management after spine surgery relied heavily on opioid medications. Multimodal regimens were developed to reduce opioid consumption and associated adverse effects. Multimodal approaches used in orthopaedic surgery of the lower extremity, especially joint arthroplasty, have been well described and studies have shown reduced opioid consumption, improved pain and function, and decreased length of stay...
April 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28267070/adherence-to-a-multimodal-analgesic-clinical-pathway-a-within-group-comparison-of-staged-bilateral-knee-arthroplasty-patients
#5
Rachel C Steckelberg, Natasha Funck, T Edward Kim, Tessa L Walters, Gregory Milo Lochbaum, Stavros G Memtsoudis, Nicholas J Giori, Pier F Indelli, Lorrie J Graham, Edward R Mariano
BACKGROUND AND OBJECTIVES: Multimodal analgesic clinical pathways for joint replacement patients often include perineural catheters, but long-term adherence to these pathways has not yet been investigated. Our primary aim was to determine adherence rate to a knee arthroplasty clinical pathway for patients undergoing staged bilateral procedures. METHODS: This study was performed at a hospital with a Perioperative Surgical Home program and knee arthroplasty clinical pathway using multimodal analgesia and adductor canal catheters...
May 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28261561/interventional-analgesic-management-of-lung-cancer-pain
#6
REVIEW
Uri Hochberg, Maria Francisca Elgueta, Jordi Perez
Lung cancer is one of the four most prevalent cancers worldwide. Comprehensive patient care includes not only adherence to clinical guidelines to control and when possible cure the disease but also appropriate symptom control. Pain is one of the most prevalent symptoms in patients diagnosed with lung cancer; it can arise from local invasion of chest structures or metastatic disease invading bones, nerves, or other anatomical structures potentially painful. Pain can also be a consequence of therapeutic approaches like surgery, chemotherapy, or radiotherapy...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28245680/-local-infiltration-analgesia-in-total-joint-replacement
#7
Tamás de Jonge, Szabolcs Görgényi, Gabriella Szabó, Miklós Bulcsú Torkos
INTRODUCTION: Total hip and knee replacment surgeries are characterized by severe postoperative pain. Local infiltration analgesia is proved to be very effective. However this method has not been widely used in Hungary. AIM: To evaluate the efficacy of the local infiltration analgesia with modified components in patients underwent total hip or knee replacement surgery. METHOD: Data of 99 consecutive patients underwent primary total hip or knee replacement surgery were evaluated prospectively...
March 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28235533/comparison-of-ropivacaine-with-and-without-fentanyl-vs-bupivacaine-with-fentanyl-for-postoperative-epidural-analgesia-in-bilateral-total-knee-replacement-surgery
#8
Ashish Khanna, Rakesh Saxena, Amitabh Dutta, Neelam Ganguly, Jayashree Sood
STUDY OBJECTIVES: Pain after total knee replacement (TKR) interferes with early rehabilitation. Although the use of epidural bupivacaine in post-TKR patients is associated with effective analgesia, the associated motor blockade effect delays functional recovery. We compared analgesic efficacy and side effects of postoperative patient-controlled epidural analgesia (PCEA) with plain ropivacaine 0.1% with/without fentanyl 2.5 μg/mL vs plain bupivacaine 0.0625% with fentanyl 2.5 μg/mL in patients undergoing bilateral TKR...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28213879/arthrogryposis-multiplex-congenita-classification-diagnosis-perioperative-care-and-anesthesia
#9
REVIEW
Lulu Ma, Xuerong Yu
Arthrogryposis multiplex congenita (AMC) is a rare disorder characterized by non-progressive, multiple contractures. In addition to affected extremities, patients may also present microstomia, decreased temporomandibular joint mobility. Although the etiology of AMC is unclear, any factor that decreases fetal movement is responsible for AMC. Thus, accurate diagnosis and classification are crucial to the appropriate treatment of AMC. The development of ultrasound technology has enabled prenatal diagnosis. Very early treatment is favorable, and multidisciplinary treatment is necessary to improve the function of AMC patients...
March 2017: Frontiers of Medicine
https://www.readbyqxmd.com/read/28158156/percutaneous-sacroplasty-for-non-neoplastic-osteoporotic-sacral-insufficiency-fractures
#10
Dong-Hwa Heo, Choon-Keun Park
BACKGROUND: Osteoporosis is an important problem in those of advanced age. Osteoporosis can induce sacral insufficiency fractures (SIFs). As average life expectancy increases, the number of patients with osteoporotic SIFs also increases. Osteoporotic SIFs cause severe low back pain and immobilization. Treatment of SIFs varies from analgesia to surgery. OBJECTIVES: To describe our experience and assess the safety and effectiveness of minimally invasive percutaneous sacroplasty in patients with osteoporotic SIFs...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28143397/retrospective-case-control-non-inferiority-analysis-of-intravenous-lidocaine-in-a-colorectal-surgery-enhanced-recovery-program
#11
Bhiken I Naik, Siny Tsang, Anne Knisely, Sandeep Yerra, Marcel E Durieux
BACKGROUND: Enhanced recovery after surgery (ERAS) programs typically utilizes multi-modal analgesia to reduce perioperative opioid consumption. Systemic lidocaine is used in several of these ERAS algorithms and has been shown to reduce opioid use after colorectal surgery. However it is unclear how much the other components of an ERAS protocol contribute to the final outcome. Using a noninferiority analysis we sought to assess the role of perioperative lidocaine in an ERAS program for colorectal surgery, using pain and opioid consumption as outcomes...
January 31, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28005122/opioid-sparing-pain-control-in-outpatient-total-joint-arthroplasty
#12
John W Barrington
Postoperative pain management is vital to promoting recovery and improving clinical outcomes. Although improved understanding of pain pathways has led to the development of varied approaches for controlling pain after surgery, some approaches are associated with potentially harmful side effects. Several lines of evidence have demonstrated that opioid analgesics can have unwanted adverse effects on patients having surgery. Similarly, risks associated with femoral nerve blocks have outweighed the benefits. Liposomal bupivacaine has shown efficacy in reducing the need for opioid analgesics and nerve blocks...
November 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27941477/diaphragm-sparing-nerve-blocks-for-shoulder-surgery
#13
De Q H Tran, Maria Francisca Elgueta, Julian Aliste, Roderick J Finlayson
Shoulder surgery can result in significant postoperative pain. Interscalene brachial plexus blocks (ISBs) constitute the current criterion standard for analgesia but may be contraindicated in patients with pulmonary pathology due to the inherent risk of phrenic nerve block and symptomatic hemidiaphragmatic paralysis. Although ultrasound-guided ISB with small volumes (5 mL), dilute local anesthetic (LA) concentrations, and LA injection 4 mm lateral to the brachial plexus have been shown to reduce the risk of phrenic nerve block, no single intervention can decrease its incidence below 20%...
January 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27940457/enhanced-recovery-after-surgery-for-primary-hip-and-knee-arthroplasty-a-review-of-the-evidence
#14
E M Soffin, J T YaDeau
Enhanced recovery after surgery (ERAS) protocols produce significant clinical and economic benefits in a range of surgical subspecialties. There is a long tradition of applying clinical pathways to the perioperative care of joint arthroplasty patients. Enhanced recovery after surgery represents the next step in the evolution of standardized care. To date, reports of full ERAS pathways for hip or knee arthroplasty are lacking. In this narrative review, we present the evidence base that can be usefully applied to constructing ERAS pathways for hip or knee arthroplasty...
December 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27687351/new-technique-targeting-the-c5-nerve-root-proximal-to-the-traditional-interscalene-sonoanatomical-approach-is-analgesic-for-outpatient-arthroscopic-shoulder-surgery
#15
Katherine H Dobie, Yaping Shi, Matthew S Shotwell, Warren S Sandberg
STUDY OBJECTIVE: Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. DESIGN: Prospective case series. SETTING: Vanderbilt Bone and Joint Surgery Center. PATIENTS: Patients undergoing shoulder arthroscopy at an ambulatory surgery center...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27613814/a-randomized-controlled-trial-assessing-the-effect-of-a-continuous-subcutaneous-infusion-of-local-anesthetic-following-elective-surgery-to-the-great-toe
#16
Barry Rose, Kumar Kunasingam, Tristan Barton, James Walsh, Karen Fogarty, Andrew Wines
Local anesthetic use for wound infusions, single injection, and continuous nerve blocks for postoperative analgesia is well established. No study has investigated the effect of a continuous block of the saphenous and superficial peroneal nerves at the level of the ankle joint following first ray surgery. A double blind randomized controlled trial was designed. One hundred patients with hallux valgus and rigidus requiring surgical correction were recruited and randomized to receive a postoperative continuous infusion at the ankle of normal saline or ropivacaine for 24 hours...
April 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/27592218/meta-analysis-of-epidural-analgesia-versus-peripheral-nerve-blockade-after-total-knee-joint-replacement
#17
REVIEW
Adam Daniel Gerrard, Ben Brooks, Peter Asaad, Shahab Hajibandeh, Shahin Hajibandeh
BACKGROUND: Postoperative pain after major knee surgery can be severe. Our aim was to compare the outcomes of epidural analgesia and peripheral nerve blockade (PNB) in patients undergoing total knee joint replacement (TKR). Moreover, we aimed to compare outcomes of adductor canal block (ACB) with those of femoral nerve block (FNB) after TKR. METHODS: We conducted a systematic search of electronic information sources, including MEDLINE; EMBASE; CINAHL; and the Cochrane Central Register of Controlled Trials (CENTRAL)...
January 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27533913/pain-management-for-blunt-thoracic-trauma-a-joint-practice-management-guideline-from-the-eastern-association-for-the-surgery-of-trauma-and-trauma-anesthesiology-society
#18
Samuel Michael Galvagno, Charles E Smith, Albert J Varon, Erik A Hasenboehler, Shahnaz Sultan, Gregory Shaefer, Kathleen B To, Adam D Fox, Darrell E R Alley, Michael Ditillo, Bellal A Joseph, Bryce R H Robinson, Elliot R Haut
INTRODUCTION: Thoracic trauma is the second most prevalent nonintentional injury in the United States and is associated with significant morbidity. Analgesia for blunt thoracic trauma was first addressed by the Eastern Association for the Surgery of Trauma (EAST) with a practice management guideline published in 2005. Since that time, it was hypothesized that there have been advances in the analgesic management for blunt thoracic trauma. As a result, updated guidelines for this topic using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework recently adopted by EAST are presented...
November 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27518727/a-nomogram-for-predicting-the-need-for-sciatic-nerve-block-after-total-knee-arthroplasty
#19
Rovnat Babazade, Thilak Sreenivasalu, Pankaj Jain, Matthew T Hutcherson, Amanda J Naylor, Jing You, Hesham Elsharkawy, Ali Sakr Esa Wael, Alparslan Turan
PURPOSE: Sciatic nerve block (SNB) is commonly performed in combination with femoral nerve block (FNB) for postoperative analgesia following total knee arthroplasty (TKA). Despite the fact that 10-20 % of TKA patients require SNB for postoperative posterior knee pain, there are no existing studies that suggest a model to predict the need for SNB. The aim of our study was to develop a prediction tool to measure the likelihood of patients undergoing TKA surgery requiring a postoperative SNB...
October 2016: Journal of Anesthesia
https://www.readbyqxmd.com/read/27501614/femoral-nerve-block-versus-intra-articular-infiltration-a-preliminary-study-of-analgesic-effects-and-quadriceps-strength-in-patients-undergoing-arthroscopic-anterior-cruciate-ligament-reconstruction
#20
RANDOMIZED CONTROLLED TRIAL
Arissara Iamaroon, Suwitcha Tamrongchote, Busara Sirivanasandha, Pathom Halilamien, Pisit Lertwanich, Sudkanoung Surachetpong, Paweenus Rungwattanakit
BACKGROUND: Adequate analgesia and early rehabilitation is necessary for arthroscopic anterior cruciate ligament reconstruction (A CLR) surgery. OBJECTIVE: To compare analgesia and quadriceps strength after femoral nerve block (FNB) with intra-articular infiltration (IA) using 0.25% bupivacaine for ACLR with patella tendon graft. MATERIAL AND METHOD: Forty patients were randomized to receive FNB under ultrasound guidance with 20 mL of bupivacaine or IA with 15 mL of bupivacaine into the knee joint and 5 mL infiltrated along the incision sites including portal sites at the end of surgery...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
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