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Joint surgery analgesia

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https://www.readbyqxmd.com/read/29750695/proximal-versus-distal-continuous-adductor-canal-blocks-does-varying-perineural-catheter-location-influence-analgesia-a-randomized-subject-masked-controlled-clinical-trial
#1
Jacklynn F Sztain, Bahareh Khatibi, Amanda M Monahan, Engy T Said, Wendy B Abramson, Rodney A Gabriel, John J Finneran, Richard H Bellars, Patrick L Nguyen, Scott T Ball, Francis B Gonzales, Sonya S Ahmed, Michael C Donohue, Jennifer A Padwal, Brian M Ilfeld
BACKGROUND: A continuous adductor canal block provides analgesia after surgical procedures of the knee. Recent neuroanatomic descriptions of the thigh and knee led us to speculate that local anesthetic deposited in the distal thigh close to the adductor hiatus would provide superior analgesia compared to a more proximal catheter location. We therefore tested the hypothesis that during a continuous adductor canal nerve block, postoperative analgesia would be improved by placing the perineural catheter tip 2-3 cm cephalad to where the femoral artery descends posteriorly to the adductor hiatus (distal location) compared to a more proximal location at the midpoint between the anterior superior iliac spine and the superior border of the patella (proximal location)...
May 9, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29721648/comparison-of-adductor-canal-block-and-ipack-block-interspace-between-the-popliteal-artery-and-the-capsule-of-the-posterior-knee-with-adductor-canal-block-alone-after-total-knee-arthroplasty-a-prospective-control-trial-on-pain-and-knee-function-in-immediate
#2
S R Sankineani, A R C Reddy, Krishna Kiran Eachempati, Ajit Jangale, A V Gurava Reddy
BACKGROUND: Adductor canal block (ACB) is a peripheral nerve blockade technique that provides good pain control in patients undergoing total knee arthroplasty which however does not relieve posterior knee pain. The recent technique of an ultrasound-guided local anesthetic infiltration of the interspace between popliteal artery and the capsule of posterior knee (IPACK) has shown promising results in providing significant posterior knee analgesia without affecting the motor nerves. MATERIALS AND METHODS: A prospective study was conducted from September 2016 to March 2017 in a total of 120 patients undergoing unilateral total knee arthroplasty...
May 2, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29698066/a-novel-technique-for-extracapsular-repair-of-the-intertarsal-joint-in-a-duck
#3
Hamish R Baron, David N Phalen, Mikel Sabater Gonzalez
The intertarsal joint is a synovial roll-and-glide joint. Ligament damage and luxations of this joint are often the result of traumatic injury or growth deformities and result in significant functional impairment. A 9-month-old female Pekin duck ( Anas platyrhynchos domesticus) was examined because of progressive, nonweight-bearing lameness of the left leg. Moderate effusive swelling was present at the level of the left intertarsal joint, without radiographic evidence of bone involvement. The duck failed to respond to nonsteroidal anti-inflammatory medications and analgesia and was diagnosed with rupture of the medial collateral ligament...
March 2018: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/29697507/population-pharmacokinetics-of-periarticular-ketorolac-in-adult-patients-undergoing-total-hip-or-total-knee-replacement-surgery
#4
Usha Gurunathan, Suzanne L Parker, Richard Maguire, Dale Ramdath, Manu Bijoor, Steven C Wallis, Jason A Roberts
BACKGROUND: Ketorolac tromethamine has been used for joint infiltration by the orthopedic surgeons as a part of postoperative multimodal analgesia. The objective of this study is to investigate the pharmacokinetic properties of S (-) and R (+) enantiomers of ketorolac in adult patients undergoing total hip (THA) and knee arthroplasty (TKA). METHODS: Adult patients with normal preoperative renal function received a periarticular infiltration of 30 mg of ketorolac tromethamine along with 100 mL of 0...
April 23, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29677062/opioid-oversupply-after-joint-and-spine-surgery-a-prospective-cohort-study
#5
Mark C Bicket, Elizabeth White, Peter J Pronovost, Christopher L Wu, Myron Yaster, G Caleb Alexander
BACKGROUND: Many patients receive prescription opioids at hospital discharge after surgery, yet little is known regarding how often these opioids go unused. We estimated the prevalence of unused opioids, use of nonopioid analgesics, and storage and disposal practices after same-day and inpatient surgery. METHODS: In this prospective cohort study at a large, inner-city tertiary care hospital, we recruited individuals ≥18 years of age undergoing elective same-day or inpatient joint and spine surgery from August to November 2016...
April 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29648413/joint-consensus-on-abdominal-robotic-surgery-and-anaesthesia-from-a-task-force-of-the-siaarti-and-sic
#6
Antonio Corcione, Pierluigi Angelini, Lapo Bencini, Elisabetta Bertellini, Felice Borghi, Claudio Buccelli, Giuseppe Coletta, Clelia Esposito, Vincenzo Graziano, Fabio Guarracino, Domenico Marchi, Pasquale Misitano, Anna M Mori, Mariano Paternoster, Vincenzo Pennestrì, Vittorio Perrone, Luigi Pugliese, Stefano Romagnoli, Luigia Scudeller, Francesco Corcione
BACKGROUND: Minimally invasive surgical procedures have revolutionized the world of surgery in the past decades. While laparoscopy, the first minimally invasive surgical technique to be developed, is widely used and has been addressed by several guidelines and recommendations, the implementation of robotic-assisted surgery is still hindered by the lack of consensus documents that support healthcare professionals in the management of this novel surgical procedure. Here we summarize the available evidence and provide expert opinion aimed at improving the implementation and resolution of issues derived from robotic abdominal surgery procedures...
April 12, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29644050/correction-to-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
#7
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
[This corrects the article DOI: 10.1186/s13741-017-0063-6.].
2018: Perioperative Medicine
https://www.readbyqxmd.com/read/29628549/comparison-of-efficacy-of-epidural-ropivacaine-versus-bupivacaine-for-postoperative-pain-relief-in-total-knee-replacement-surgeries
#8
Sidharth Bhasin, Mridul Dhar, Deepak Kumar Sreevastava, Rajiv Nair, Saurabh Chandrakar
Background: Epidural analgesia has become the standard of care for knee replacement surgeries worldwide. Bupivacaine has been used successfully for many years. Epidural ropivacaine is now being used increasingly and seems to have benefits other than just pain relief, in terms of a better safety profile. Aim: To compare the efficacy of bupivacaine 0.125% (Group B) versus two concentrations of ropivacaine 0.1% (Group R1) and 0.2% (Group R2), in terms of pain scores, requirement of rescue analgesia, related adverse effects, and duration of postoperative (PO) hospital stay...
January 2018: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/29589417/blocking-around-the-transversalis-fascia-behind-the-scene
#9
Francesco Vasques, Carla Stecco, Raffaele Mitri, Raffaele DE Caro, Pierfrancesco Fusco, Astrid U Behr
BACKGROUND: The transversalis fascia plane and the quadratus lomborum blocks target the branches of T12-L1 nerves and provide analgesia in patients undergoing surgery involving the corresponding dermatomes. The transversalis fascia is believed to contribute to determine the spread of local anesthetic in such blocks. Nonetheless, the anatomy of this fascia and its possible role in these blocks still have to be precisely defined. METHODS: We conducted a series of 10 dissections and full-thickness specimens were obtained from one side for the microscopic analysis...
March 27, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29549021/prevalence-nature-and-management-of-oral-stage-dysphagia-in-adults-with-temporomandibular-joint-disorders-findings-from-an-irish-cohort
#10
Órla Gilheaney, Leo Fa Stassen, Margaret Walshe
PURPOSE: Temporomandibular disorders (TMDs) are caused by changes in the structure and/or function of the temporomandibular joint, masticatory muscles, and/or osseous components. TMDs can result in oral stage dysphagia (OD) with potential effects on function and patient well-being. Little is known about the prevalence, nature, and management of TMD-related OD. The aims of the present study were to estimate the prevalence and nature of OD in adult TMD patients and to identify the common management techniques used to manage the signs and symptoms of TMD-related OD...
February 20, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29541841/much-ado-about-nothing-the-effect-of-tourniquet-time-on-an-accelerated-rehabilitation-programme-following-total-knee-replacement-tkr
#11
William Wynell-Mayow, Muhammad Zahid Saeed
BACKGROUND: The WHO includes osteoarthritis as a disease of priority, owing to its significant impact on quality of life, and globally increasing prevalence. Hospital budgets are under pressure to ration knee replacements and shorten inpatient stays. Prolonged tourniquet application has been hypothesised to extend recovery through pain and reduced mobility. PATIENTS AND METHODS: A total of 123 elective total knee replacements meeting inclusion criteria took place from July 2015 to October 2017 at the Royal Free Hospital...
March 14, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29534382/-effects-and-safety-of-quadratus-lumborum-block-in-analgesia-after-hip-arthroplasty
#12
J He, X Q Zheng, C H Luo, Z X Huang, W Y He, H B Wang, C X Yang
Objective: To evaluate the efficacy of ultrasound guided quadratus lumborum block combined with non-steroidal anti-inflammatory drugs for postoperative analgesia in patients undergoing total hip arthroplasty. Methods: From January to June 2017, sixty American Society of Anesthesiologists (ASA) physical status Ⅰ to Ⅲ patients, aged 55-75 yr, scheduled for total hip arthroplasty, were randomly divided into control group(group N) and quadratus lumborum block (group R). Ultrasound guided quadratus lumborum block was implemented on the affected side at the end of operation...
February 27, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29511031/effect-of-perioperative-opioids-on-cancer-relevant-circulating-parameters-mu-opioid-receptor-and-toll-like-receptor-4-activation-potential-and-proteolytic-profile
#13
Nan Xie, Nicholas Matigian, Tharindu Vithanage, Kye Gregory, Zeyad D Nassar, Peter J Cabot, Paul N Shaw, Carl M J Kirkpatrick, Kim-Anh Lê Cao, David Sturgess, Marie-Odile Parat
Purpose: The purpose of this study is to investigate the potential interplay between opioid analgesia and tumor metastasis through modulation of μ-opioid receptor (MOR), Toll-like receptor 4 (TLR4) activation, and matrix degradation potential. Experimental Design: Plasma samples were collected from 60 patients undergoing elective lower limb joint replacement preoperatively and at 3, 6, and 24 hours after surgery; pain scores were documented at the same time points. Opioid administration was recorded and converted into morphine IV equivalents...
May 15, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
https://www.readbyqxmd.com/read/29349988/-comparison-of-analgesic-effects-between-multimodal-and-patient-controlled-intravenous-analgesia-in-patients-with-rheumatoid-arthritis-in-the-perioperative-period-of-total-knee-arthroplasty
#14
Hua-Li Gao, Lian-Bo Xiao, Wei-Tao Zhai, Yong He, Fei Zhu, Lin Zheng, Xiu-Wei Han
OBJECTIVE: To compare the analgesic effect between multimodal and patient-controlled intravenous analgesia(PCIA) in patients with rheumatoid arthritis(RA) in the perioperative period of knee joint replacement. METHODS: From June 2015 to June 2016, 40 RA patients undergoing total knee arthroplasty were randomly divided into two groups. There were 20 patients in PCIA group, including 3 males and 17 females, with an average age of(59.6±2.3) years old, who received controlled instillation of sufentanil analgesia controlled by an intravenous analgesia pump...
April 25, 2017: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
https://www.readbyqxmd.com/read/29319718/effects-of-periarticular-injection-on-analgesic-effects-and-nsaid-use-in-total-knee-arthroplasty-and-total-hip-arthroplasty
#15
Wen-Rui Ban, Ery-Ang Zhang, Lei-Feng Lv, Xiao-Qian Dang, Chen Zhang
OBJECTIVES: This study examined periarticular multimodal drug injection and the use of nonsteroidal anti-inflammatory drugs for an early analgesic effect after total knee arthroplasty and total hip arthroplasty. Patient satisfaction and benefits from the treatment were also assessed. METHODS: A total of 110 patients who were scheduled to undergo total knee arthroplasty and 86 patients who were scheduled to undergo total hip arthroplasty were divided into two groups, the study group and the control group...
December 2017: Clinics
https://www.readbyqxmd.com/read/29318860/-effect-of-transcutaneous-acupoint-electrical-stimulation-on-hemodynamic-fluctuation-caused-by-loosing-tourniquet-in-elderly-patients-undergoing-knee-joint-replacement
#16
Han-Sheng Liang, Yi Feng
OBJECTIVE: To observe the effect of transcutaneous acupoint electrical stimulation (TAES) on hemodynamic fluctuation caused by loosing tourniquet in the elderly patients undergoing knee joint replacement. METHODS: A total of 60 ASA (America Society Anesthesiologist) I or II elderly patients for elective knee joint replacement surgery were randomly divided into control group (30 cases) and TAES group (30 cases). Patients of both groups were treated by intravenous anesthesia, and monitored with bispectral index (BIS, between 45-60) for anesthesia depth, stroke volume variation (SVV) for fluid management, mean arterial pressure (MAP) and cardiac index (CI) for hemodynamic fluctuation evaluation, and with analgesia nociception index (ANI, between 50-70) for remifentanil dosage adjustment...
December 25, 2017: Zhen Ci Yan Jiu, Acupuncture Research
https://www.readbyqxmd.com/read/29279135/pain-after-ortho-plastic-reconstruction-of-lower-limb-injuries-a-snapshot-study
#17
Luke Harries, Ahmed Emam, Umraz Khan
INTRODUCTION: The incidence of pain after flap reconstruction of complex lower limb injury is poorly reported in the literature, and yet represents a significant source of morbidity in these patients. In our centre (Southmead Hospital, Bristol, England) patients who have had flap reconstruction for complex lower limb injury are followed up at a joint ortho-plastics lower limb clinic run weekly. The aim of this study was to report the incidence of pain in such patients at follow-up in the specialist clinic...
February 2018: Injury
https://www.readbyqxmd.com/read/29242798/anterior-elbow-pain-caused-by-compression-of-the-lateral-antebrachial-cutaneous-nerve
#18
Sean M Booth, Abdulbaset Abosala, Chris Peach
Introduction: The complex anatomy and biomechanics of the elbow joint can lead to diagnostic uncertainty when a clinician is determining the cause of a patient's anterior elbow pain. We present a case of anterior elbow pain with an uncommon and often overlooked etiology. Elbow pain due to compression of the lateral antebrachial nerve (LACN) has an unknown incidence or prevalence. Case Report: A 27-year-old left-hand dominant male presented to our orthopedic elbow clinic complaining of bilateral elbow clicking and discomfort which had been present for several years...
September 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/29046771/a-comparison-of-palonosetron-and-dexamethasone-for-postoperative-nausea-and-vomiting-in-orthopedic-patients-receiving-patient-controlled-epidural-analgesia
#19
Byung-Gun Kim, Hyunzu Kim, Hyun-Kyoung Lim, Chunwoo Yang, Sora Oh, Byung-Wook Lee
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the major concerns after anesthesia and surgery, and it may be more frequent in orthopedic patients receiving patient-controlled epidural analgesia (PCEA). The purpose of this study was to compare the effect of palonosetron and dexamethasone on the prevention of PONV in patients undergoing total joint arthroplasty and receiving PCEA. METHODS: Patients scheduled for total hip or knee arthroplasty under spinal anesthesia/PCEA were randomly allocated to receive either intravenous palonosetron (0...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29035643/role-of-bone-modifying-agents-in-metastatic-breast-cancer-an-american-society-of-clinical-oncology-cancer-care-ontario-focused-guideline-update
#20
Catherine Van Poznak, Mark R Somerfield, William E Barlow, J Sybil Biermann, Linda D Bosserman, Mark J Clemons, Sukhbinder K Dhesy-Thind, Melissa S Dillmon, Andrea Eisen, Elizabeth S Frank, Reshma Jagsi, Rachel Jimenez, Richard L Theriault, Theodore A Vandenberg, Gary C Yee, Beverly Moy
Purpose To update, in collaboration with Cancer Care Ontario (CCO), key recommendations of the American Society of Clinical Oncology (ASCO) guideline on the role of bone-modifying agents (BMAs) in metastatic breast cancer. This focused update addressed the new data on intervals between dosing and the role of BMAs in control of bone pain. Methods A joint ASCO-CCO Update Committee conducted targeted systematic literature reviews to identify relevant studies. Results The Update Committee reviewed three phase III noninferiority trials of dosing intervals, one systematic review and meta-analysis of studies of de-escalation of BMAs, and two randomized trials of BMAs in control of pain secondary to bone metastases...
December 10, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
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