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Knee arthroplasty analgesia

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https://www.readbyqxmd.com/read/29782451/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#1
Cecilia Otten, Karen S Dunn
BACKGROUND: Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty. PURPOSE: The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29769140/local-infiltration-anesthesia-versus-epidural-analgesia-for-postoperative-pain-control-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#2
Chen Li, Ji Qu, Su Pan, Yang Qu
BACKGROUND: We performed a systematic review and meta-analysis of randomized controlled trials (RCTs) to evaluate the efficacy and safety of local infiltration anesthesia (LIA) versus epidural analgesia (EPA) for postoperative pain control in total knee arthroplasty (TKA). METHODS: In December 2017, a systematic computer-based search was conducted in Pubmed, EMBASE, Web of Science, and Cochrane Database of Systematic Reviews. RCTs of patients prepared for spine surgery that compared LIA versus EPA for postoperative pain control in TKA were retrieved...
May 16, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29758039/effects-of-palonosetron-for-prophylaxis-of-postoperative-nausea-and-vomiting-in-high-risk-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-double-blind-placebo-controlled-study
#3
Jung-Hee Ryu, Young-Tae Jeon, Byunghun Min, Jin-Young Hwang, Hye-Min Sohn
BACKGROUND: The preemptive multimodal pain protocols used in total knee arthroplasty (TKA) often cause emesis postoperatively. We investigated whether palonosetron prophylaxis reduces postoperative nausea and vomiting (PONV) in high-risk patients after TKA. METHODS: We randomized 120 female patients undergoing TKA to receive either palonosetron (0.075 mg, intravenous) or no antiemetic prophylaxis (0.9% saline, control group). All patients were given spinal anesthesia, a continuous femoral nerve block, and fentanyl-based intravenous patient controlled analgesia...
2018: PloS One
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
#4
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/29725506/comparison-of-adductor-canal-block-versus-local-infiltration-analgesia-on-postoperative-pain-and-functional-outcome-after-total-knee-arthroplasty-a-randomized-controlled-trial
#5
W Kampitak, A Tanavalee, S Ngarmukos, C Amarase, B Songthamwat, A Boonshua
Introduction: Total knee arthroplasty (TKA) is associated with intense postoperative pain for which effective analgesia is essential to facilitate early postoperative recovery. Adductor canal block (ACB) and local infiltration analgesia (LIA) have become increasingly involved in postoperative pain management after TKA. We aimed to compare their efficacy and outcomes in patients undergoing TKA. Materials and Methods: Sixty patients undergoing unilateral TKA were randomized to receive either postoperative single-injection ACB (Group A) or LIA (Group L) during the operation...
March 2018: Malaysian Orthopaedic Journal
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
#6
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/29716492/extended-duration-regional-analgesia-for-total-knee-arthroplasty-a-randomised-controlled-trial-comparing-five-days-to-three-days-of-continuous-adductor-canal-ropivacaine-infusion
#7
S C Sargant, M J Lennon, R J Khan, D Fick, H Robertson, S Haebich
There is a growing body of evidence in favour of continuous adductor canal block (CACB) for total knee arthroplasty. However, there are no studies describing the optimal duration of the infusion. At our institution the usual practice was to stop the infusion on day three. Our hypothesis was that extending the infusion to five days would improve analgesia and quality of recovery. A prospective, non-blinded, randomised trial was undertaken. Patients received a continuous infusion of 0.2% ropivacaine via an adductor canal catheter for either three or five days...
May 2018: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29705075/effectiveness-of-continuous-versus-single-injection-femoral-nerve-block-for-total-knee-arthroplasty-a-double-blinded-randomized-trial
#8
Varun Dixit, Samreen Fathima, Stephen M Walsh, Alexandru Seviciu, Ivan Schwendt, Karl-Heinz Spittler, Dana Briggs
BACKGROUND: Effective analgesia following total knee arthroplasty (TKA) is important for maximizing patient satisfaction, early participation in physical therapy and reducing the hospital stay. This trial compared continuous catheter femoral nerve block (cFNB) to single injection femoral nerve block (sFNB) in terms of analgesia, opioid consumption, and participation in physical therapy and associated side effects. METHODS: This randomized, double blinded trial was conducted in a non-university hospital setting, without major changes to anesthesia or surgical clinical pathways...
April 26, 2018: Knee
https://www.readbyqxmd.com/read/29701041/-acupuncture-combined-with-femoral-nerve-block-for-postoperative-analgesia-after-total-knee-arthroplasty-and-functional-rehabilitation-a-randomized-controlled-trial
#9
Yonghui Zhang, Lin Zhang, Min Lu
OBJECTIVE: To observe the therapeutic effects on the postoperative analgesia after total knee arthroplasty (TKA) and functional rehabilitation with acupuncture at the distal points along the affected meridians and femoral nerve block. METHODS: A total of 60 patients with knee prosthesis were collected and randomized into an observation group and a control group, 30 cases in each one. All of the patients received the femoral nerve block before operation. The analgesia pump was used for analgesia after operation and TKA postoperative rehabilitation was adopted...
March 12, 2018: Zhongguo Zhen Jiu, Chinese Acupuncture & Moxibustion
https://www.readbyqxmd.com/read/29697507/population-pharmacokinetics-of-periarticular-ketorolac-in-adult-patients-undergoing-total-hip-or-total-knee-replacement-surgery
#10
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/29668658/anesthesia-and-analgesia-for-total-knee-arthroplasty-where-is-the-evidence
#11
Henrik Kehlet
No abstract text is available yet for this article.
May 2018: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29643876/clinical-effects-of-single-femoral-nerve-block-in-combination-with-general-anesthesia-on-geriatric-patients-receiving-total-knee-arthroplasty
#12
Jing Zhang, Yan Yuan, Yongjun Zhang, Ying Wang
Objective: To evaluate the clinical effects of single femoral nerve block (sFNB) combined with general anesthesia on geriatric patients receiving unilateral total knee arthroplasty (UTKA). Methods: Sixty geriatric UTKA patients who were treated in The First People's Hospital of Changzhou from January 2015 to August 2015 were randomly divided into an sFNB + laryngeal mask airway (FLA) group, an sFNB + tracheal intubation (FGA) group and a tracheal intubation (GA) group...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29624535/comparison-of-intraoperative-sedation-with-dexmedetomidine-versus-propofol-on-acute-postoperative-pain-in-total-knee-arthroplasty-under-spinal-anesthesia-a-randomized-trial
#13
Hyun-Jung Shin, Sang-Hwan Do, Jae-Sung Lee, Tae-Kyun Kim, Hyo-Seok Na
BACKGROUND: In patients undergoing total knee arthroplasty under spinal anesthesia, we compared the postoperative analgesic effect of intraoperative sedation with dexmedetomidine versus propofol. We hypothesized that sedation with dexmedetomidine would result in lower postoperative opioid analgesic consumption than with propofol. METHODS: Forty-eight patients were enrolled and randomly assigned to either a dexmedetomidine group (n = 24), which received a loading dose of 1 μg/kg dexmedetomidine over 10 minutes, followed by a continuous infusion of 0...
April 5, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29580593/multimodal-perioperative-analgesia-regimen-to-improve-patient-outcomes-after-total-knee-arthroplasty-a-multidisciplinary-quality-improvement-project
#14
Rebecca E Donahue, George R Bradbury, Michael E Zychowicz, Virginia C Muckler
PURPOSE: The primary aim of this quality improvement project was to improve mobilization for patients after total knee arthroscopy by developing and implementing a standardized, evidence-based, multimodal analgesia regimen and patient-educational video. Secondary outcomes included opioid consumption, pain, and length of stay. DESIGN: A pre-post implementation design was used to compare two independent samples. METHODS: Patients were screened based on inclusion and exclusion criteria 1-2 weeks before surgery...
April 2018: Journal of Perianesthesia Nursing: Official Journal of the American Society of PeriAnesthesia Nurses
https://www.readbyqxmd.com/read/29562395/-dexmedetomidine-combined-with-ropivacaine-for-continuous-femoral-nerve-block-improved-postoperative-sleep-quality-in-elderly-patients-after-total-knee-arthroplasty
#15
X L Wang, J Wang, D L Mu, D X Wang
Objective: To investigate the effect of dexmedetomidine adding to ropivacaine for continuous femoral nerve block on the improvement of postoperative sleep quality in elderly patients after total knee arthroplasty. Methods: One hundred and sixty patients aged 60 years or older in Jishuitan Hospital scheduled for single total knee arthroplasty between Nov. 2016 and Jun. 2017 were recruited. All patients received spinal anesthesia and were randomized to receive either combined ropivacaine and dexmedetomidine (0...
March 13, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29535279/intra-operative-periarticular-multimodal-injection-in-total-knee-arthroplasty-a-local-hospital-experience-in-hong-kong
#16
J Ch Fan
INTRODUCTION: Data from a local report revealed the superior outcome of regional anaesthesia and analgesia compared with general anaesthesia and intravenous patient-controlled analgesia in total knee arthroplasty. This retrospective study aimed to assess the efficacy of intra-operative periarticular multimodal injection in improving postoperative pain and reducing morphine consumption with patient-controlled analgesia after total knee arthroplasty in patients with knee osteoarthritis...
April 2018: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/29530519/systematic-review-of-three-electrical-stimulation-techniques-for-rehabilitation-after-total-knee-arthroplasty
#17
REVIEW
Chen Yue, Xue Zhang, Yingjie Zhu, Yudong Jia, Huichao Wang, Youwen Liu
BACKGROUND: The comparative effectiveness of neuromuscular electrical stimulation (NMES), transcutaneous electrical nerve stimulation (TENS), and electroacupuncture (EA) for improving patient rehabilitation following total knee arthroplasty (TKA) is controversial. Therefore we conducted this systematic review to assess the available evidence. METHODS: The PubMed, OVID, and ScienceDirect databases were comprehensively searched and studies were selected and analyzed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations...
February 6, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29520522/the-role-of-sciatic-nerve-block-to-complement-femoral-nerve-block-in-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#18
Andres Zorrilla-Vaca, Jinlei Li
INTRODUCTION: Femoral nerve block (FNB) appears to have higher postoperative analgesic benefits compared with the patient-controlled analgesia (PCA) in total knee arthroplasty (TKA). However, the role of sciatic nerve block (SNB) as a complement to FNB remains controversial. We performed a meta-analysis assessing the benefits of the SNB as a complement to FNB, as well as comparing the efficacy of single-injection versus continuous SNB in TKA. METHODS: Our group conducted a systematic literature search in PubMed, EMBASE and Google Scholar...
March 8, 2018: Journal of Anesthesia
https://www.readbyqxmd.com/read/29514376/contemporary-perioperative-analgesia-in-total-knee-arthroplasty-multimodal-protocols-regional-anesthesia-and-peripheral-nerve-blockade
#19
Jacob M Drew, Jonathan Neilio, Lisa Kunze
Perioperative care of the total knee arthroplasty (TKA) patient has evolved considerably over the past decade. Among the changes driving this evolution toward shorter hospitalization and accelerated rehabilitation have been regional anesthesia, peripheral nerve blockade, and multimodal analgesia protocols. These complementary techniques are increasingly supported by scientific evidence, though considerable uncertainty persists regarding the optimal combination of strategies. Continued refinement of technique and critical evaluation is trending toward greater characterization of the comparative effectiveness of myriad options...
March 7, 2018: Journal of Knee Surgery
https://www.readbyqxmd.com/read/29508066/local-infiltration-analgesia-combined-with-a-standardized-multimodal-approach-including-an-adductor-canal-block-in-total-knee-arthroplasty-a-prospective-randomized-placebo-controlled-double-blinded-clinical-trial
#20
Dimitra Tziona, Marianna Papaioannou, Argyro Mela, Styliani Potamianou, Alexandros Makris
PURPOSE: Total knee arthroplasty (TKA) is associated with moderate to severe postoperative pain. This study evaluates the technique of local infiltration analgesia (LIA), by comparing it to saline injections in addition to a standardized multimodal regimen including an adductor canal block. METHODS: Between September 2015 and March 2016, forty patients aged 18 years and older, ASA I-III, undergoing primary unilateral cemented TKA under spinal anesthesia were randomized to receive either LIA (LIA group) or normal saline (sham LIA group)...
March 5, 2018: Journal of Anesthesia
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