keyword
https://read.qxmd.com/read/38539076/the-value-of-local-dexmedetomidine-as-an-adjuvant-to-ultrasound-guided-wide-awake-local-anesthesia-no-tourniquet-walant-in-flexor-tendon-repair-surgeries-a-randomized-controlled-trial
#1
JOURNAL ARTICLE
Mahmoud Mohammed Alseoudy, Elsayed Mohamed Abdelkarime, Khaled Nour, May Elsherbiny Badr
BACKGROUND: The Wide-Awake Local Anesthesia No Tourniquet (WALANT) technique allows intraoperative motor assessment of tendon repair integrity of the hand compared with general anesthesia or brachial plexus block. No studies have tested the effect of adding dexmedetomidine to lidocaine on the analgesic properties of the WALANT technique, which is the aim of our study. METHODS: A total of 128 patients aged more than 18 years were scheduled for surgical flexor tendon injury repair using WALANT technique...
March 27, 2024: BMC Anesthesiology
https://read.qxmd.com/read/38497759/racial-and-ethnic-minorities-underrepresented-in-pain-management-guidelines-for-total-joint-arthroplasty-a-meta-analysis
#2
JOURNAL ARTICLE
Katherine Merk, Nicholas C Arpey, Alba M Gonzalez, Katia E Valdez, Anna Cohen-Rosenblum, Adam I Edelstein, Linda I Suleiman
BACKGROUND: Total joint arthroplasty aims to improve quality of life and functional outcomes for all patients, primarily by reducing their pain. This goal requires clinical practice guidelines (CPGs) that equitably represent and enroll patients from all racial/ethnic groups. To our knowledge, there has been no formal evaluation of the racial/ethnic composition of the patient population in the studies that informed the leading CPGs on the topic of pain management after arthroplasty surgery...
March 18, 2024: Clinical Orthopaedics and related Research
https://read.qxmd.com/read/38435310/analgesic-effect-and-safety-of-a-half-dose-transdermal-buprenorphine-patch-after-arthroscopic-rotator-cuff-repair
#3
JOURNAL ARTICLE
Libin Ni, Yingzhao Yan, Yang Fu, Jing Sheng, Hangbo Qu, Xuanliang Ru
OBJECTIVE: To retrospectively explore the effect of a half-dose buprenorphine transdermal patch for analgesia after arthroscopic rotator cuff repair (ARCR). METHODS: This analysis was performed with clinical data from patients who received unilateral ARCR in our hospital between October 2017 and December 2020. The patients were divided into three groups (30 cases each). In group A (control group), 100 mg flurbiprofen axetil (FA) was administered twice a day for 5 days after surgery...
June 2024: Journal of Orthopaedics
https://read.qxmd.com/read/38435030/effect-of-intravenous-magnesium-on-post-operative-pain-following-latarjet-shoulder-reconstruction
#4
JOURNAL ARTICLE
Paul Soeding, Alex Morris, Adam Soeding, Gregory Hoy
BACKGROUND: Single injection ropivacaine interscalene anesthesia (ISA) is frequently used in Latarjet reconstruction to enhance post-operative analgesia. A potential limitation is the occurrence of severe rebound pain on block resolution. We investigated the effect of intravenous magnesium on post-operative pain, particularly at the transition of block resolution to multimodal analgesia. METHODS: Elective patients ( n  = 40) having Latarjet open shoulder reconstruction were randomised to receive either intravenous magnesium sulphate 50 mg/kg (M) or normal saline (S) before induction...
February 2024: Shoulder & Elbow
https://read.qxmd.com/read/38423028/a-preoperative-package-of-care-for-osteoarthritis-consisting-of-weight-loss-orthotics-rehabilitation-and-topical-and-oral-analgesia-opportunity-a-two-centre-open-label-randomised-controlled-feasibility-trial
#5
JOURNAL ARTICLE
A Hamish R W Simpson, Nicholas D Clement, Sharon A Simpson, Hemandt Pandit, Susie Smillie, Anthony R Leeds, Philip G Conaghan, Sarah R Kingsbury, David Hamilton, Peter Craig, David Ray, Catriona Keerie, Elaine Kinsella, Anna Bell-Higgs, Arlene McGarty, Christine Beadle, Colin R Howie, John Norrie
BACKGROUND: Osteoarthritis of the knee is a major cause of disability worldwide. Non-operative treatments can reduce the morbidity but adherence is poor. We hypothesised that adherence could be optimised if behavioural change was established in the preoperative period. Therefore, we aimed to assess feasibility, acceptability, and recruitment and retention rates of a preoperative package of non-operative care in patients awaiting knee replacement surgery. METHODS: We did an open-label, randomised controlled, feasibility trial in two secondary care centres in the UK...
February 26, 2024: Lancet Rheumatology
https://read.qxmd.com/read/38413435/arthroscopic-distal-clavicle-resection-versus-conservation-in-patients-with-combined-rotator-cuff-tears-and-acromioclavicular-joint-osteoarthritis
#6
JOURNAL ARTICLE
Mohamed H Hashem, Mohamed Osama Hegazy, Mohamed Kamal A Mohamed, Moustafa Kamal A Mohamed, Ahmed Hany Khater
PURPOSE: The most common cause of shoulder pain originating from the acromioclavicular (AC) joint is osteoarthritis, causing pain and disability. Operative Management of AC arthritis includes arthroscopic distal clavicle resection (DCR) and open clavicle resection. This study was conducted to evaluate the outcomes of isolated rotator cuff repair with conservative treatment of ACJ arthritis versus the combined resection of the distal clavicle with the repair of a rotator cuff tear, in cases with acromioclavicular arthritis...
February 28, 2024: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://read.qxmd.com/read/38395809/safety-of-blood-reinfusion-drains-after-local-infiltration-analgesia-in-total-joint-replacement
#7
JOURNAL ARTICLE
Claudio Legnani, Enrica Torretta, Marco Attanasio, Cecilia Gelfi, Franco Parente, Alberto Ventura, Giorgio Oriani
BACKGROUND: Local infiltration analgesia (LIA) is frequently administered to patient undergoing joint replacement surgical procedures. The aim of the present research was to verify the safety of collected shed blood to be reinfused postoperatively, by measuring levobupivacaine levels in drainage blood in patients undergoing LIA during knee replacement surgery. PATIENTS AND METHODS: 24 patients who underwent total knee arthroplasty (TKA) and 12 scheduled for total hip arthroplasty (THA) who received intraoperative LIA were considered...
February 23, 2024: BMC Musculoskeletal Disorders
https://read.qxmd.com/read/38364243/improving-neuromuscular-monitoring-through-education-based-interventions-and-studying-its-association-with-adverse-postoperative-outcomes-a-retrospective-observational-study
#8
JOURNAL ARTICLE
Shane G Carr, Jacob C Clifton, Robert E Freundlich, Leslie C Fowler, Edward R Sherwood, Matthew D McEvoy, Amy Robertson, Brent A Dunworth, Karen Y McCarthy, Matthew S Shotwell, Miklos D Kertai
BACKGROUND: We assessed the association between education-based interventions, the frequency of train-of-four (TOF) monitoring, and postoperative outcomes. METHODS: We studied adults undergoing noncardiac surgery from February 1, 2020 through October 31, 2021. Our education-based interventions consisted of 3 phases. An interrupted time-series analysis, adjusting for patient- and procedure-related characteristics and secular trends over time, was used to assess the associations between education-based interventions and the frequency of TOF monitoring, postoperative pulmonary complications (PPCs), 90-day mortality, and sugammadex dosage...
March 1, 2024: Anesthesia and Analgesia
https://read.qxmd.com/read/38348363/flexor-pronator-slide-under-local-anesthesia-without-a-tourniquet-for-non-ischemic-contractures-of-the-forearm
#9
JOURNAL ARTICLE
J Terrence Jose Jerome
BACKGROUND: The flexor pronator slide is an effective treatment option for ischemic contracture and contracture related to spastic cerebral palsy, but little is known about the use of the flexor pronator slide in other non-ischemic contractures. I propose a flexor pronator slide to simultaneously correct wrist and finger flexor contractures and preserve the muscle resting length. To avoid overcorrection of the deformity, I propose the use of a wide-awake local anesthesia with no tourniquet (WALANT) procedure, in which the patient is able to continually assist the surgeon in assessing the contracture release and improvement in finger movement...
2024: JBJS Essential Surgical Techniques
https://read.qxmd.com/read/38301201/opiate-prescription-after-hip-and-knee-arthroplasty-a-retrospective-cohort-study
#10
JOURNAL ARTICLE
Bradley S Atkinson, William M Oldfield, Hannah M E Sim, Nemandra A Sandiford
AIMS: Excessive opiate analgesia in relation to orthopaedic surgery is associated with morbidity and mortality. Pre-operative use of opiates is associated with higher post-operative use. There is little information about opiate prescribing practices in relation to elective total joint arthroplasty (TJA) in New Zealand rural centres. The aims of this study were to describe opiate use before, immediately after and 1 year after TJA, and to compare prescribing practices with local guidelines...
February 2, 2024: New Zealand Medical Journal
https://read.qxmd.com/read/38269598/protocol-for-surgery-or-cast-of-the-epicondyle-in-children-s-elbows-science
#11
JOURNAL ARTICLE
Juul Achten, Duncan Appelbe, Louise Spoors, Nicholas Peckham, Rebecca Kandiyali, James Mason, David Ferguson, James Wright, Nicola Wilson, Jennifer Preston, Amy Moscrop, Matthew Costa, Daniel C Perry
AIMS: The management of fractures of the medial epicondyle is one of the greatest controversies in paediatric fracture care, with uncertainty concerning the need for surgery. The British Society of Children's Orthopaedic Surgery prioritized this as their most important research question in paediatric trauma. This is the protocol for a randomized controlled, multicentre, prospective superiority trial of operative fixation versus nonoperative treatment for displaced medial epicondyle fractures: the Surgery or Cast of the EpicoNdyle in Children's Elbows (SCIENCE) trial...
January 25, 2024: Bone & joint open
https://read.qxmd.com/read/38226987/-fast-track-arthroplasty
#12
RANDOMIZED CONTROLLED TRIAL
Felix Greimel, Julia Schiegl, Matthias Meyer, Joachim Grifka, Günther Maderbacher
INTRODUCTION: Essential components of fast-track or enhanced recovery programs in arthroplasty are the optimization of interdisciplinary organizational processes, as well as pre-, intra- and postoperative procedures in everyday clinical practice. The early postoperative mobilization of patients after joint replacement surgery is of central importance, with the aim of avoiding pain and complications. This article provides a detailed overview of fast-track procedures that have already been established in many units...
February 2024: Orthopadie (Heidelb)
https://read.qxmd.com/read/38225834/-evaluation-of-early-effectiveness-of-local-infiltration-anesthesia-with-compound-betamethasone-in-total-knee-arthroplasty
#13
JOURNAL ARTICLE
Yuhang Zheng, Yang Li, Hua Tian
OBJECTIVE: To evaluate the early effectiveness of local infiltration anesthesia (LIA) with compound betamethasone in total knee arthroplasty (TKA). METHODS: The clinical data of 102 patients with knee osteoarthritis who were treated by TKA and met the selection criteria between May 2022 and March 2023 were retrospectively analyzed. They were divided into control group and study group according to whether LIA preparation was added with compound betamethasone, with 51 cases in each group...
January 15, 2024: Chinese Journal of Reparative and Reconstructive Surgery
https://read.qxmd.com/read/38204364/pain-management-after-total-hip-arthroplasty-comparative-study-of-analgesic-efficacy-and-tolerability-between-oral-tramadol-dexketoprofen-and-injectable-paracetamol-tramadol
#14
JOURNAL ARTICLE
George A Macheras, Dimitrios Tzefronis, Chrysoula Argyrou, Elena Nikolakopoulou, Alejandro Gálvez Miravete, Thefilos S Karachalios
BACKGROUND: Multimodal analgesia for total hip arthroplasty (THA) is increasingly employed to reduce early postoperative pain and promote fast patient discharge. The aim of this study was to compare the efficacy and tolerability of tramadol/dexketoprofen (TRAM/DKP, Group A) versus paracetamol + tramadol (PARA+TRAM, Group B) in patients undergoing THA using minimally invasive direct anterior approach (DAA). METHODS: A single-centre, randomised, single-blind, parallel, interventional study conducted in 323 patients undergoing primary THA with DAA was performed...
January 10, 2024: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
https://read.qxmd.com/read/38194592/nausea-and-vomiting-after-posterior-spinal-fusion-in-adolescent-idiopathic-scoliosis-a-systematic-and-critical-analysis-review
#15
JOURNAL ARTICLE
Akbar Nawaz Syed, Soroush Baghdadi, Wallis T Muhly, Keith D Baldwin
BACKGROUND: Postoperative nausea and vomiting (PONV) affects patient satisfaction, health care costs, and hospital stay by complicating the postoperative recovery period after adolescent idiopathic scoliosis (AIS) spinal fusion surgery. Our goal was to identify recommendations for optimal management of PONV in AIS patients undergoing posterior spinal fusion (PSF). METHODS: We performed a systematic review in June 2022, searching the PubMed and Embase electronic databases using search terms "(Adolescent idiopathic scoliosis) AND (Postoperative) AND (Nausea) AND (Vomiting)...
January 1, 2024: JBJS Reviews
https://read.qxmd.com/read/38178208/systemic-and-local-antiinflammatory-effect-of-magnesium-chloride-in-experimental-arthritis
#16
JOURNAL ARTICLE
Ana Carolina Matias Dinelly Pinto, Rodolfo de Melo Nunes, Waleska Vidal de Freitas Carvalho, Virgínia Claudia Carneiro Girão, Francisco Airton Castro Rocha
OBJECTIVE: Despite some knowledge gaps in scientific evidence, MgCl2 is largely used for pain relief in musculoskeletal diseases. Mg salts were shown to provide analgesia postoperatively in orthopedic surgery and low Mg levels were linked to arthritis development and severity. We determined the anti-inflammatory activity of MgCl2 in an acute arthritis model. METHODS: Mice received 0.1 mg/25µL Zymosan (Zy) or saline into the knees. Joint pain was evaluated using von Frey test; cell influx, and interleukin (IL)-1 level were assessed in joint lavage at 6 h...
January 4, 2024: Advances in Rheumatology
https://read.qxmd.com/read/38149653/effects-of-contralateral-versus-ipsilateral-electroacupuncture-for-analgesia-and-rehabilitation-after-unilateral-total-knee-arthroplasty-a-randomized-controlled-trial
#17
JOURNAL ARTICLE
Hai Huang, Kangmin Tang, Xiuling Song, Ling Zhao, Yongying Liang, Hui Xu, Lianbo Xiao, Yuelai Chen
PURPOSE: Total knee arthroplasty (TKA) is a treatment for advanced knee osteoarthritis. Since postoperative pain affects rehabilitation, this study aimed to determine whether electroacupuncture (EA) contralateral to the surgical site is more effective than ipsilateral EA or sham EA in terms of relieving postoperative pain and promoting post-TKA rehabilitation. METHODS: In this parallel, single-blind randomized controlled trial, 114 patients undergoing unilateral TKA were assigned to the contralateral EA (EA on the contralateral side + sham EA on the ipsilateral), ipsilateral EA (EA on the ipsilateral + sham EA on the contralateral side), or sham EA (sham EA on both sides) groups (n = 38 each)...
December 27, 2023: Acupuncture in Medicine: Journal of the British Medical Acupuncture Society
https://read.qxmd.com/read/38137764/severe-postoperative-pain-in-total-knee-arthroplasty-patients-risk-factors-insights-and-implications-for-pain-management-via-a-digital-health-approach
#18
JOURNAL ARTICLE
Julien Lebleu, Andries Pauwels, Hervé Poilvache, Philippe Anract, Anissa Belbachir
Up to 25% of patients undergoing knee arthroplasty report chronic pain postoperatively. Early identification of high-risk individuals can enhance pain management strategies. This retrospective analysis investigates the incidence of severe postoperative pain and its associated risk factors among 740 patients who underwent total knee arthroplasty. Utilizing a digital application, patients provided comprehensive data encompassing pre- and postoperative pain levels, analgesic usage, and completed a chronic pain risk assessment...
December 15, 2023: Journal of Clinical Medicine
https://read.qxmd.com/read/38100612/optimizing-preoperative-chronic-pain-management-in-elective-spine-surgery-patients-a-narrative-review-of-outcomes-with-opioid-and-adjuvant-pain-therapies
#19
REVIEW
Emily Arciero, Josephine R Coury, Alexandra Dionne, Justin Reyes, Joseph M Lombardi, Zeeshan M Sardar
» Chronic preoperative opioid use negatively affects outcomes after spine surgery, with increased complications and reoperations, longer hospital stays, decreased return-to-work rates, worse patient-reported outcomes, and a higher risk of continued opioid use postoperatively.» The definition of chronic opioid use is not consistent across studies, and a more specific and consistent definition will aid in stratifying patients and understanding their risk of inferior outcomes.» Preoperative weaning periods and maximum dose thresholds are being established, which may increase the likelihood of achieving a meaningful improvement after surgery, although higher level evidence studies are needed...
December 1, 2023: JBJS Reviews
https://read.qxmd.com/read/38094554/a-comprehensive-review-of-postoperative-analgesics-used-in-orthopedic-practice
#20
REVIEW
Sachin Goel, Sanjay V Deshpande, Vivek H Jadawala, Anmol Suneja, Rahul Singh
Orthopedic surgeries, ranging from joint replacements to fracture fixations, are integral procedures that enhance the quality of life for countless individuals. Effective postoperative pain management is crucial in ensuring optimal patient recovery and satisfaction. This comprehensive review analyzes the diverse array of analgesic modalities employed in orthopedic practice for postoperative pain relief. The review systematically explores the pharmacological landscape of analgesics commonly used in orthopedic settings, including opioids, non-steroidal anti-inflammatory drugs, acetaminophen, and adjuvant medications...
November 2023: Curēus
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