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Knee arthroplasty analgesia

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https://www.readbyqxmd.com/read/28546014/-anesthetic-requirements-measured-by-bilateral-bispectral-analysis-and-femoral-blockade-in-total-knee-arthroplasty
#1
Maylin Koo, Javier Bocos, Antoni Sabaté, Vinyet López, Carmina Ribes
BACKGROUND AND OBJECTIVES: A continuous peripheral nerve blockade has proved benefits on reducing postoperative morphine consumption; the combination of a femoral blockade and general anesthesia on reducing intraoperative anesthetic requirements has not been studied. The objective of this study was to determine the relevance of timing in the performance of femoral block to intraoperative anesthetic requirements during general anesthesia for total knee arthroplasty. METHODS: A single-center, prospective cohort study on patients scheduled for total knee arthroplasty, were sequentially allocated to receive 20mL of 2% mepivacaine throughout a femoral catheter, prior to anesthesia induction (Preoperative) or when skin closure started (Postoperative)...
May 22, 2017: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/28545172/femoral-nerve-block-versus-adductor-canal-block-for-analgesia-after-total-knee-arthroplasty
#2
REVIEW
In Jun Koh, Young Jun Choi, Man Soo Kim, Hyun Jung Koh, Min Sung Kang, Yong In
Inadequate pain management after total knee arthroplasty (TKA) impedes recovery, increases the risk of postoperative complications, and results in patient dissatisfaction. Although the preemptive use of multimodal measures is currently considered the principle of pain management after TKA, no gold standard pain management protocol has been established. Peripheral nerve blocks have been used as part of a contemporary multimodal approach to pain control after TKA. Femoral nerve block (FNB) has excellent postoperative analgesia and is now a commonly used analgesic modality for TKA pain control...
June 1, 2017: Knee Surgery & related Research
https://www.readbyqxmd.com/read/28499420/continuous-femoral-nerve-blockade-and-single-shot-sciatic-nerve-block-promotes-better-analgesia-and-lower-bleeding-for-total-knee-arthroplasty-compared-to-intrathecal-morphine-a-randomized-trial
#3
Nora Elizabeth Rojas Álvarez, Rosemberg Jairo Gomez Ledesma, Adilson Hamaji, Marcelo Waldir Mian Hamaji, Joaquim Edson Vieira
BACKGROUND: Knee arthroplasty leads to postoperative pain. This study compares analgesia and postoperative bleeding achieved by intrathecal morphine with a continuous femoral plus single-shot sciatic nerve block. METHODS: A randomized non-blinded clinical trial enrolled patients aged over 18 years old, ASA I to III who underwent total knee arthroplasty. All patients underwent spinal anesthesia with isobaric bupivacaine, 20 mg. One group received 100 mcg of intrathecal morphine (M group), and the other received a femoral nerve block by continuous infusion plus a "single shot" block of the sciatic nerve at the end of the surgery (FI group)...
May 12, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28489762/comparison-of-local-infiltration-analgesia-and-sciatic-nerve-block-as-an-adjunct-to-femoral-nerve-block-for-pain-control-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#4
Zhi Zhang, Qing Yang, Wenqi Xin, Yixuan Zhang
BACKGROUND: To perform a meta-analysis to assess the efficiency and safety between local infiltration analgesia (LIA) and sciatic nerve block (SNB) when combined with femoral nerve block (FNB) for pain control following total knee arthroplasty (TKA). METHODS: We systemically searched the following electronic databases for potentially relevant articles: Embase (1980-2017.01), Medline (1966-2017.01), PubMed (1966-2017.01), ScienceDirect (1985-2017.01), web of science (1950-2017...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28478713/continuous-infusion-ketorolac-for-postoperative-analgesia-following-unilateral-total-knee-arthroplasty
#5
Amy J Schwinghammer, Alex N Isaacs, Rodney W Benner, Heather Freeman, Jacob A O'Sullivan, Sarah A Nisly
BACKGROUND: Previous clinical trials have demonstrated benefit with the addition of continuous infusion (CI) ketorolac to a multimodal pain regimen in surgical patients. Data following major orthopedic surgery are minimal and conflicting. OBJECTIVES: To evaluate CI ketorolac use following unilateral total knee arthroplasty (TKA) through assessment of patient-reported pain scores, opioid consumption, and safety outcomes. METHODS: This was a retrospective, open-label cohort study that included patients undergoing unilateral TKA at a single-center teaching hospital...
June 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28475475/preemptive-analgesia-by-using-celecoxib-combined-with-tramadol-apap-alleviates-post-operative-pain-of-patients-undergoing-total-knee-arthroplasty
#6
Zhongwei Xu, Hua Zhang, Jiao Luo, Aiguo Zhou, Jian Zhang
OBJECTIVE: This study was aimed to evaluate the efficacy of preemptive analgesia (PA) by using celecoxib combined with low-dose tramadol/acetaminophen (tramadol/APAP) in treating post-operative pain of patients undergoing unilateral total knee arthroplasty (TKA). METHODS: A total of 132 patients scheduled for TKA were included in this study. Three-day pre-operative medication was administrated in PA group with subsequent effective intra- and post-operative multimodal analgesia, while control patients received multimodal analgesia without PA...
May 17, 2017: Physician and Sportsmedicine
https://www.readbyqxmd.com/read/28464196/does-addition-of-adductor-canal-blockade-to-multimodal-periarticular-analgesia-improve-discharge-status-pain-levels-opioid-use-and-length-of-stay-after-total-knee-arthroplasty
#7
Chukwuweike U Gwam, Jaydev B Mistry, Ifie V Richards, Dhrudeep Patel, Nirav G Patel, Melbin Thomas, Hephzibah Adamu, Ronald E Delanois
Total knee arthroplasty (TKA) can be associated with substantial postoperative pain that may affect satisfaction and return to function. Various forms of pain control have been used; however, multimodal periarticular analgesia (MPA) and adductor canal block (ACB) have recently gained popularity. The purpose of this study was to compare (1) discharge status, (2) pain levels, (3) postoperative opioid consumption, and (4) length of stay (LOS) between TKA patients who received MPA only and those who received both MPA and ACB...
May 2, 2017: Journal of Knee Surgery
https://www.readbyqxmd.com/read/28442852/perioperative-systemic-glucocorticoids-in-total-hip-and-knee-arthroplasty-a-systematic-review-of-outcomes
#8
REVIEW
Jeffrey Hartman, Vickas Khanna, Anthony Habib, Forough Farrokhyar, Muzammil Memon, Anthony Adili
BACKGROUND: Perioperative systemic glucocorticoids are frequently included in multimodal analgesia and antiemetic regimens administered to patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). The objective of this systematic review was to evaluate the available randomized controlled trials (RCTs) to determine the effect of perioperative systemic glucocorticoids on postoperative nausea and vomiting (PONV), pain, narcotic consumption, antiemetic consumption, length of stay in hospital, and major complications in patients undergoing elective THA or TKA...
June 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28440034/role-of-transcranial-direct-current-stimulation-on-reduction-of-postsurgical-opioid-consumption-and-pain-in-total-knee-arthroplasty-double-randomized-clinical-trial
#9
E M Khedr, E S A Sharkawy, A M A Attia, N M Ibrahim Osman, Z M Sayed
BACKGROUND: Postoperative pain control is an important factor in determining recovery in total knee arthroplasty (TKA).The aim of the study was to assess the efficacy of 4 sessions of transcranial direct current stimulation (tDCS) over primary motor cortex (M1) in patients undergoing unilateral TKA. MATERIALS: Fifty patients undergoing TKA were included in the study. They were divided randomly into two groups (25 patients for each, using closed envelopes): real tDCS (2 mA, 20 min, with anodal stimulation applied over M1 postoperative for 4 consecutive days) and sham tDCS...
April 25, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28435149/regional-anesthesia-did-not-delay-diagnosis-of-compartment-syndrome-a-case-report-of-anterior-compartment-syndrome-in-the-thigh-not-masked-by-an-adductor-canal-catheter
#10
Arissa Torrie, Jyoti Sharma, Mark Mason, Hillenn Cruz Eng
BACKGROUND Acute compartment syndrome (ACS) of the thigh after elective primary total knee arthroplasty is rare. If not recognized and treated promptly, devastating consequences may result. Certain regional anesthesia techniques are thought to mask the symptoms of acute compartment syndrome, but there are no cases reported of adductor canal catheters masking the symptoms of thigh compartment syndrome. We report a case where symptoms and diagnosis of acute anterior thigh compartment syndrome were not masked by a functioning adductor canal catheter...
April 24, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28418963/optimizing-analgesia-for-total-knee-arthroplasty-a-networked-comparison
#11
Jonathan P Wanderer, James P Rathmell
No abstract text is available yet for this article.
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28413514/effect-of-pre-emptive-analgesia-by-continuous-femoral-nerve-block-on-early-postoperative-cognitive-function-following-total-knee-arthroplasty-in-elderly-patients
#12
Li-Qin Deng, Lei-Na Hou, Feng-Xiang Song, Han-Yue Zhu, Hai-Ying Zhao, Gang Chen, Jing-Jing Li
To the best of our knowledge, the effect of pre-emptively blocking pain transmission on acute postoperative cognitive dysfunction (POCD) has not yet been assessed. Therefore, the present study aimed to investigate the effect of pre-emptive analgesia via a continuous femoral nerve block (CFNB) on postoperative pain and early cognitive function following total knee arthroplasty (TKA) surgery in elderly patients. CFNB was performed prior to TKA surgery in the pre-emptive analgesia group (n=30) and following TKA surgery in the control group (n=30)...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28385937/multimodal-infiltration-of-local-anaesthetic-in-total-knee-arthroplasty-is-posterior-capsular-infiltration-worth-the-risk-a-prospective-double-blind-randomised-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
P Pinsornsak, S Nangnual, K Boontanapibul
AIMS: Multimodal infiltration of local anaesthetic provides effective control of pain in patients undergoing total knee arthroplasty (TKA). There is little information about the added benefits of posterior capsular infiltration (PCI) using different combinations of local anaesthetic agents. Our aim was to investigate the effectiveness of the control of pain using multimodal infiltration with and without infiltration of the posterior capsule of the knee. PATIENTS AND METHODS: In a double-blind, randomised controlled trial of patients scheduled for unilateral primary TKA, 86 were assigned to be treated with multimodal infiltration with (Group I) or without (Group II) PCI...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28348503/gabapentin-does-not-appear-to-improve-postoperative-pain-and-sleep-patterns-in-patients-who-concomitantly-receive-regional-anesthesia-for-lower-extremity-orthopedic-surgery-a-randomized-control-trial
#14
Jean Daniel Eloy, Christy Anthony, Shawn Amin, Moorice Caparó, Mark C Reilly, Steven Shulman
In recent years, gabapentin has gained popularity as an adjuvant therapy for the treatment of postoperative pain. Numerous studies have shown a decrease in pain score, even with immediate postoperative activity, which is significant for early post-op ambulation and regaining functionality sooner. However, studies have been in conclusive in patients undergoing lower extremity orthopedic surgery. For this reason, we hoped to study the effect of gabapentin on postoperative pain in patients undergoing total knee arthroplasty, total hip arthroplasty, or a hip fracture repair...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28343821/use-of-chronic-methadone-before-total-knee-arthroplasty
#15
Ferdinand J Chan, Andrew M Schwartz, Jason Wong, Cynthia Chen, Bharat Tiwari, Sun Jin Kim
BACKGROUND: A subset of patients who undergo total knee arthroplasty (TKA) are on methadone maintenance. They require more and often unpredictable quantities of opioids to function as effective painkillers. This study aims to compare the opioid requirements and the immediate postoperative course for patients on methadone maintenance with those who are not, after a TKA. METHODS: A retrospective, case-control study was performed. From 2005 to 2010, 36 patients, who underwent a unilateral TKA, on chronic methadone maintenance were identified...
February 28, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28331362/anesthesia-for-the-patient-undergoing-total-knee-replacement-current-status-and-future-prospects
#16
REVIEW
Zachary A Turnbull, Dahniel Sastow, Gregory P Giambrone, Tiffany Tedore
Total knee arthroplasty (TKA) has become one of the most common orthopedic surgical procedures performed nationally. As the population and surgical techniques for TKAs have evolved over time, so have the anesthesia and analgesia used for these procedures. General anesthesia has been the dominant form of anesthesia utilized for TKA in the past, but regional anesthetic techniques are on the rise. Multiple studies have shown the potential for regional anesthesia to improve patient outcomes, such as a decrease in intraoperative blood loss, length of stay, and patient mortality...
2017: Local and Regional Anesthesia
https://www.readbyqxmd.com/read/28301415/analgesia-for-total-knee-arthroplasty-what-is-the-best-option
#17
Brian Vaughan
No abstract text is available yet for this article.
May 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28288053/searching-for-the-optimal-pain-management-technique-after-knee-arthroplasty-analgesia-is-just-the-tip-of-the-iceberg
#18
Brian M Ilfeld, Colin J L McCartney
No abstract text is available yet for this article.
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28288050/pain-management-modalities-after-total-knee-arthroplasty-a-network-meta-analysis-of-170-randomized-controlled-trials
#19
Abdullah Sulieman Terkawi, Dimitris Mavridis, Daniel I Sessler, Megan S Nunemaker, Khaled S Doais, Rayan Sulieman Terkawi, Yazzed Sulieman Terkawi, Maria Petropoulou, Edward C Nemergut
BACKGROUND: Optimal analgesia for total knee arthroplasty remains challenging. Many modalities have been used, including peripheral nerve block, periarticular infiltration, and epidural analgesia. However, the relative efficacy of various modalities remains unknown. The authors aimed to quantify and rank order the efficacy of available analgesic modalities for various clinically important outcomes. METHODS: The authors searched multiple databases, each from inception until July 15, 2016...
May 2017: Anesthesiology
https://www.readbyqxmd.com/read/28277593/pain-management-with-adductor-canal-blockade-or-multimodal-periarticular-analgesia-in-elderly-total-knee-arthroplasty-patients
#20
Chukwuweike U Gwam, Nequesha Mohamed, Jaydev B Mistry, Melbin Thomas, Morad Chughtai, Sabahat Khan, Anton Khlopas, Michael A Mont, Ronald E Delanois
INTRODUCTION: Post-operative pain management in elderly total knee arthroplasty (TKA) patients has traditionally included opioids, epidurals, and femoral nerve blocks. Although these modalities are effective, they are often associated with adverse side effects, which may have a greater impact on this population. Alternative modalities, such as adductor canal blocks (ACB) and multimodal periarticular analgesia (MPA) have demonstrated great efficacy with a low side effect profile. However, it is unknown if one modality is advantageous over the other in the elderly...
March 9, 2017: Surgical Technology International
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