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Joint surgery analgesia

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https://www.readbyqxmd.com/read/28867907/preemptive-analgesia-in-thumb-basal-joint-arthroplasty-immediate-postoperative-pain-with-preincision-versus-postincision-local-anesthesia
#1
Joseph T Labrum, Asif M Ilyas
Purpose  Currently no guidelines exist for the timing of the injection of anesthetics in surgeries performed under general anesthesia to minimize postoperative pain. To better understand the role of timing of the injection of local anesthesia in hand surgery performed under general anesthesia, we evaluated the effect of pre- versus postincisional local analgesic injection on immediate postoperative pain experience. We hypothesize that the preincisional (preemptive) injection will result in decreased immediate postoperative pain experience and analgesic use when compared with postincisional injection...
August 2017: Journal of Hand and Microsurgery
https://www.readbyqxmd.com/read/28751437/enhanced-recovery-after-surgery-for-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#2
Shibai Zhu, Wenwei Qian, Chao Jiang, Canhua Ye, Xi Chen
OBJECTIVES: To collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: Relevant, published studies were identified using the following key words: arthroplasty, joint replacement, enhanced recovery after surgery, fast track surgery, multi-mode analgesia, diet management, or steroid hormones...
July 27, 2017: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/28638693/management-of-the-temporomandibular-joint-in-inflammatory-arthritis-involvement-of-surgical-procedures
#3
REVIEW
Rory C O'Connor, Fiona Fawthrop, Rami Salha, Andrew J Sidebottom
Many conditions may affect the temporomandibular joint (TMJ), but its incidence in individual joint diseases is low. However, inflammatory arthropathies, particularly rheumatoid and psoriatic arthritis and ankylosing spondylitis, appear to have a propensity for affecting the joint. Symptoms include pain, restriction in mouth opening, locking, and noises, which together can lead to significant impairment. Jaw rest, a soft diet, a bite splint, and medical therapy, including disease-modifying antirheumatic drugs (DMARDs) and simple analgesia, are the bedrock of initial treatment and will improve most symptoms in most patients...
June 2017: European Journal of Rheumatology
https://www.readbyqxmd.com/read/28623570/enhanced-recovery-protocols-in-total-joint-arthroplasty-a-review-of-the-literature-and-their-implementation
#4
REVIEW
A S Galbraith, E McGloughlin, J Cashman
BACKGROUND: During recent years, there has been an exponential demand for joint arthroplasty, which has coincided with the global economic recession. In response, the management of patients following arthroplasty is continuously evolving, with the average inpatient length of stay decreasing from weeks to days, and more recently, we have witnessed the development of "outpatient arthroplasty" as a novel concept which aims to address the high volume of patients. The reduction in length of stay has been made possible via implementation of "enhanced recovery programmes" encompassing each stage of the patient journey...
June 16, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28579047/surgical-procedures-of-the-distal-limb-for-treatment-of-sepsis-in-cattle
#5
REVIEW
David E Anderson, André Desrochers, Sarel R van Amstel
With a thorough knowledge of the anatomy of the foot, and basic surgical instruments, digit surgery can be performed in field situations. Sepsis of the distal interphalangeal and proximal interphalangeal joints should be treated surgically because conservative treatment is often ineffective. Most of the diseases described in this article are chronic and often the animals have been suffering for some time. Perioperative analgesia is important to alleviate the pain of those animals. All those procedures should be performed under local or regional anesthesia...
July 2017: Veterinary Clinics of North America. Food Animal Practice
https://www.readbyqxmd.com/read/28533694/the-improved-quality-of-postoperative-analgesia-after-intrathecal-morphine-does-not-result-in-improved-recovery-and-quality-of-life-in-the-first-6-months-after-orthopedic-surgery-a-randomized-controlled-pilot-study
#6
Nilufar Foadi, Matthias Karst, Anika Frese-Gaul, Niels Rahe-Meyer, Stefan Krömer, Christian Weilbach
OBJECTIVE: In orthopedic surgery, it is well known that the use of intrathecal morphine (ITM) leads to an improved quality of postoperative analgesia. Little is known how this improved analgesia affects the long-term course after surgery. STUDY DESIGN: A randomized, double-blind trial. SETTING: Academic medical center. SUBJECTS: Forty-nine patients undergoing total hip or knee replacement surgery in spinal anesthesia...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28500436/the-efficacy-of-a-multimodal-analgesia-protocol-in-preventing-heterotopic-ossification-after-acetabular-fractures-surgery
#7
Liang Cheng, Hai-Tao Long, Bu-Hua Sun, Shu-Shan Zhao, Yong Zhu
Background Heterotopic ossification (HO) after joint surgery is always a disturbing problem for patients and surgeons. Prophylaxis is the most effective therapy. Objective To assess the efficacy and safety of a multimodal analgesia protocol that included parecoxib and celecoxib in preventing HO after acetabular fracture surgery. Setting Selecting patients from trauma registry of our hospital. Method We identified 259 patients who had acetabular fracture surgery between January 2008 and December 2014. Hundredsixty-three patients received parecoxib and celecoxib (Group A) and 96 patients received no prophylaxis (Group B)...
August 2017: International Journal of Clinical Pharmacy
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
#8
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
#9
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
#10
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)...
July 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28291143/the-role-of-multimodal-analgesia-in-spine-surgery
#11
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
#12
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
#13
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
#14
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
#15
RANDOMIZED CONTROLLED TRIAL
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
#16
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
#17
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
#18
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
#19
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
#20
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
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