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Pain surgery

Gulay Erdogan Kayhan, Mukadder Sanli, Ulku Ozgul, Ramazan Kirteke, Saim Yologlu
STUDY OBJECTIVE: Multimodal analgesic strategies are recommended to decrease opioid requirements and opioid-induced respiratory complications in patients undergoing laparoscopic bariatric surgery. Recent studies have demonstrated that intravenous ibuprofen decreases opioid consumption compared with placebo. The primary aim of this study was to compare the effect of intravenous ibuprofen and intravenous acetaminophen on opioid consumption. We also aimed to compare postoperative pain levels and side effects of the drugs...
June 20, 2018: Journal of Clinical Anesthesia
Christina Williams, Alicia J Long, Heather Noga, Catherine Allaire, Mohamed A Bedaiwy, Sarka Lisonkova, Paul J Yong
STUDY OBJECTIVE: To investigate ethnic differences for moderate-to-severe endometriosis DESIGN: Analysis of a prospective registry, December 2013 - December 2016 ( # NCT02911090). INCLUSION CRITERIA: Women presenting to tertiary referral center for pelvic pain and/or endometriosis. EXCLUSION CRITERIA: Age greater than 50, menopausal, or mixed ethnicity. Logistic regression analysis was used to obtain adjusted odds ratios (aOR) and 95% confidence intervals (CI) adjusting for potential confounders (e...
June 20, 2018: Journal of Minimally Invasive Gynecology
Pierre Bertho, Adrien Pauvert, Thomas Pouderoux, Henri Robert
BACKGROUND: Osteo-chondral defects due to advanced osteochondritis of the knee eventually cause osteoarthritis. Autologous matrix-induced chondrogenesis (AMIC) may hold potential for overcoming the treatment challenges raised by defects larger than 2 cm2 . The primary objective of this study was to assess medium-term functional outcomes of AMIC. The secondary objective was to confirm the absence of adverse events. HYPOTHESIS: AMIC significantly improves knee function in patients with osteochondritis responsible for osteo-chondral defects grade III or IV in the International Cartilage Repair Society (ICRS) classification...
June 20, 2018: Orthopaedics & Traumatology, Surgery & Research: OTSR
Gilbert G G Donders, Gert Bellen, Kateryna S Ruban
Localized provoked vulvodynia (LPV) causes introital dyspareunia in up to 14% of premenopausal women. Vaginal infections like candidosis may play a initiating role. The aim of this study was to test a possible association of vaginal microbiota alternations such as Candida vaginitis (CV), aerobic vaginitis (AV) and bacterial vaginosis (BV) with severity of vulvodynia and painful intercourse. In an observational study, Q-tip touch test (score 1 (no pain) to 10 (worst possible pain)) was performed on seven vestibular locations in 231 LPV patients presenting in the Vulvovaginal Disease Clinics in Tienen, Leuven and Antwerp, Belgium...
June 22, 2018: European Journal of Clinical Microbiology & Infectious Diseases
R Sturkenboom, A A van der Wilt, S M J van Kuijk, A Ahmad, P T Janssen, L P S Stassen, J Melenhorst, S O Breukink
PURPOSE: The aim of the study was to assess the long-term outcome of a Malone antegrade continence enema (MACE) procedure for fecal incontinence or constipation in adults. METHODS: This retrospective single-center study assessed the long-term outcome and quality of life (QoL) of patients who underwent a MACE procedure between 2005 and 2014 at the Maastricht University Medical Centre. Success rate was quantified by using Malone's continence scale. Quality of life was assessed by validated questionnaires covering general quality of life (SF-36 and Karnofsky scale), current pain level (visual analog scale), fecal incontinence (Vaizey incontinence survey), or constipation (Cleveland Clinic Constipation Score)...
June 22, 2018: International Journal of Colorectal Disease
Katsuhiro Okuda, Hiroshi Haneda, Keisuke Yokota, Tsutomu Tatematsu, Tadashi Sakane, Risa Oda, Takuya Watanabe, Ryoichi Nakanishi
An open approach by sternotomy is still selected for locally advanced anterior mediastinal tumors. Technical and instrumental improvements to video-assisted thoracic surgery (VATS) have enabled the treatment of anterior mediastinal tumor in the last decade, and the indications of VATS for an anterior mediastinal tumor are thus expanding. Recently, a single-port thymectomy procedure using the subxiphoid approach has gained popularity worldwide because of its low invasiveness. Improvements to the thoracoscopic instruments and the development of a single-port device are expanding the adoption of single-port VATS in the thoracic surgical field, including resection of anterior mediastinal tumors...
June 22, 2018: Surgery Today
Harsha Shanthanna, James Paul, Peter Lovrics, P J Devereaux, Mohit Bhandari, Lehana Thabane
INTRODUCTION: There has been an exponential increase in the number of ambulatory surgeries (AS). Pain and postoperative nausea vomiting (PONV) affects the recovery, discharge and overall satisfaction of patients having AS. Opioids remain the primary modality for moderate to severe pain. Since there is no perfect opioid, physicians should ideally use the opioid that optimally balances benefits and risks. Present decisions on the choice between morphine (M) and hydromorphone (HM) are based on individual experience and observation...
June 22, 2018: BMJ Open
Robert S Namba, Elizabeth W Paxton, Maria C Inacio
BACKGROUND: Improved narcotic pain management after total joint arthroplasty (TJA) is necessary to help battle the opioid epidemic. The goal of this study was to determine the sources of prescriptions prescribed to TJA patients. METHODS: An evaluation of opioid use in patients undergoing primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) was performed between 2008 and 2012. Using a Total Joint Replacement Registry and pharmacy data, opioids dispensed to TJA patients were identified...
May 30, 2018: Journal of Arthroplasty
Özgül Aydemir, Fatma Eti Aslan, Ükke Karabacak, Özlem Akdaş
BACKGROUND: The exaggerated lithotomy position with the expertise of nurses can be successful solution for the patients who have the postoperative shoulder pain after laparoscopic cholecystectomy. AIMS: This study aimed to determine the effect of applying an exaggerated lithotomy positions to patients who had laparoscopic cholecystectomy to relieve shoulder pain. The study was conducted on nonrandomized groups and made as a semiexperimental study with a pretest/post-test control group design...
June 19, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Eliza E Moskowitz, Lucin Garabedian, Kimberly Harden, Emily Perkins-Pride, Menilik Asfaw, Candice Preslaski, Kiara N Liasia, Ryan Lawless, Clay Cothren Burlew, Fredric Pieracci
INTRODUCTION: Achieving adequate pain control for rib fractures remains challenging; prescription of alternatives to narcotics is imperative to curtail the current opioid epidemic. Although gabapentin has shown promise following elective thoracic procedures, its efficacy in patients with rib fractures remains unstudied. We hypothesized that gabapentin, as compared to placebo, would both improve acute pain control and decrease narcotic use among critically ill patients with rib fractures...
June 9, 2018: Injury
Sami H Tuffaha, Amy Quan, Shar Hashemi, Pranay Parikh, Devin M O'Brien-Coon, Justin M Broyles, A Lee Dellon, Scott D Lifchez
PURPOSE: To determine the innervation pattern to the thumb carpometacarpal (CMC) joint and assess the safety and efficacy of selective joint denervation for the treatment of pain and impairment associated with thumb CMC arthritis. METHODS: Cadaveric dissections were performed in 10 fresh upper extremities to better define the innervation patterns to the CMC joint and guide the surgical approach for CMC joint denervation. Histologic confirmation of candidate nerves was performed with hematoxylin and eosin staining...
June 19, 2018: Journal of Hand Surgery
Daniel E Hess, Patricia Drace, Michael J Franco, A Bobby Chhabra
Carpometacarpal (CMC) arthroplasty surgery, although modifications have occurred over time, continues to be commonly performed and has provided patients with their desired pain relief and return of function. The complications of primary surgery, although relatively rare, can present in various clinical ways. An understanding of the underlying anatomy, pathology of coexisting conditions, and specific techniques used in the primary surgery is required to make the best recommendation for a patient with residual pain following primary CMC arthroplasty...
June 19, 2018: Journal of Hand Surgery
Jeffrey E Otte, James E Popp, Julie Balch Samora
PURPOSE: To evaluate the surgical outcomes in a series of Madelung wrists treated with a Vicker ligament release at a young age. We hypothesize that early treatment of Madelung deformity with Vicker ligament release is safe and may minimize progression of deformity. METHODS: A retrospective review was performed at a single large pediatric institution from 2013 to 2016 of patients with a diagnosis of Madelung deformity treated with Vicker ligament release and radial physiolysis...
June 19, 2018: Journal of Hand Surgery
Jingyan Yang, Virginie Lafage, Renaud Lafage, Justin Smith, Eric O Klineberg, Christopher I Shaffrey, Gregory Mundis, Richard Hostin, Douglas Burton, Christopher P Ames, Shay Bess, Han Jo Kim, Frank Schwab
STUDY DESIGN: Retrospective review of prospective multicenter database. OBJECTIVE: To investigate the determinants of patient satisfaction with respect to changes in functional limitations two-year after spinal deformity surgery. SUMMARY OF BACKGROUND DATA: For operatively treated adult spine deformity (ASD), patient satisfaction has become an important component of evaluating quality of care. METHODS: 430 operative ASD patients with two-year follow-up were analyzed...
June 21, 2018: Spine
Zhiping Hu, Xiaoling Zhou, Weiwei Duan, Wenge Lei, Min Zhang, Lingxia Zeng
BACKGROUND: Maintenance of good functional status and improvement of quality of life (QOL) in patients with head and neck cancer help to determine the efficacy of anticancer therapies. OBJECTIVE: The aims of this study were to describe the profile of QOL changing over time and evaluate the correlation between anxiety, pain severity, and shoulder and neck function with QOL in patients. METHODS: A prospective cohort study was conducted. Quality of life, neck and shoulder function, anxiety, and pain were assessed at the time of presurgery, 1 week, and 3 and 6 months postsurgery...
June 22, 2018: Cancer Nursing
Daiki Kato, Takashi Suto, Hideaki Obata, Shigeru Saito
BACKGROUND: Although endogenous analgesia plays an important role in controlling pain states, chronic pain patients exhibit decreased endogenous analgesia compared to healthy individuals. In rats, noxious stimulus-induced analgesia (NSIA), which is an indicator of endogenous analgesia, diminished 6 weeks after spinal nerve ligation (SNL6W). A recent study in rats with deleted noradrenergic fibers demonstrated that the noradrenergic fibers were essential to NSIA. It has also been reported that brain-derived neurotrophic factor increased spinal noradrenergic fibers...
June 20, 2018: Anesthesia and Analgesia
Luca Ferrario, Pietro Zerbi, Maria Rachele Angiolini, Alberto Agarossi, Eliana Riggio, Andrea Bondurri, Piergiorgio Danelli
INTRODUCTION: Leiomyomatosis peritonealis disseminata (LPD) is an uncommon disease featured by the presence of multiple nodules of smooth muscle cells scattered in the abdominal cavity. To date only about 150 cases have been reported in literature. We report a case of recurrent LPD after laparotomy. CASE PRESENTATION: In March 2016 a 36-year-old female, with a history of multiple previous laparoscopic myomectomies, consulted her gynaecologist complaining abdominal pain; a MRI was performed and reported multiple pelvic masses, subsequently excised during laparotomy...
June 18, 2018: International Journal of Surgery Case Reports
Nicole Del Gaudio, Geraldo Vaz, Thierry Duprez, Christian Raftopoulos
OBJECT: Chiari malformation type I (CM-I) is featured by the downwards herniation of the cerebellar tonsils through the foramen magnum which can impede cerebrospinal fluid (CSF) circulation and may lead to syringomyelia. Usual symptoms in the condition are neck pain and posterior headaches at Valsalva maneuver. Different surgical procedures have been described for cranio-cervical decompression (CCD), without reaching a consensus about the best suited technique. The primary endpoint of this study was to compare efficacy and complications rate of CCD using adural peeling (DPe) versus duraplasty (DP)...
June 19, 2018: World Neurosurgery
Hong Zhang, Bing Qing, Jian Zheng
BACKGROUND: Gastroparesis following resection of a fourth ventricle tumor has never been reported in the literature. We report a unique case of gastroparesis following resection of a fourth ventricle ependymoma in a child. CASE DESCRIPTION: A 14-year-old boy presented with 12-day history of headache, nausea and vomiting. Magnetic resonance imaging revealed a tumor in the fourth ventricle. He underwent a posterior median craniotomy and total removal was achieved...
June 19, 2018: World Neurosurgery
Faraj W Abdallah, Tulin Cil, David MacLean, Caveh Madjdpour, Jaime Escallon, John Semple, Richard Brull
BACKGROUND AND OBJECTIVES: Serratus fascial plane block can reduce pain following breast surgery, but the question of whether to inject the local anesthetic superficial or deep to the serratus muscle has not been answered. This cohort study compares the analgesic benefits of superficial versus deep serratus plane blocks in ambulatory breast cancer surgery patients at Women's College Hospital between February 2014 and December 2016. We tested the joint hypothesis that deep serratus block is noninferior to superficial serratus block for postoperative in-hospital (pre-discharge) opioid consumption and pain severity...
July 2018: Regional Anesthesia and Pain Medicine
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