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Knee arthroplasty analgesia

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https://www.readbyqxmd.com/read/29145987/outpatient-total-knee-arthroplasty-are-we-there-yet-part-2
#1
REVIEW
Andrew Krause, Zain Sayeed, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The method by which surgeons conduct outpatient total knee procedures has yet to be fully elucidated. Literature demonstrates different experiences from various care protocols in place across the nation. This article reviews current recommendations for implementing successful total knee arthroplasty (TKA) and unicompartmental knee arthroplasty outpatient protocols. Specifically, information regarding anesthesia and analgesia modalities, perioperative care, operative technique, and postoperative care within outpatient TKA pathways is discussed...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145272/the-efficiency-of-intravenous-acetaminophen-for-pain-control-following-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#2
Limin Liang, Ying Cai, Aixiang Li, Chuangen Ma
BACKGROUND: This meta-analysis aimed to evaluate the efficiency and safety of intravenous acetaminophen as an adjunct to multimodal analgesia for pain control after total joint arthroplasty (TJA). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) and non-RCTs were included. Fixed/random effect model was used according to the heterogeneity tested by I statistic. Meta-analysis was performed using Stata 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29140959/comparison-of-continuous-proximal-versus-distal-adductor-canal-blocks-for-total-knee-arthroplasty-a-randomized-double-blind-noninferiority-trial
#3
Adam W Meier, David B Auyong, Stanley C Yuan, Shin-E Lin, James M Flaherty, Neil A Hanson
BACKGROUND AND OBJECTIVES: Adductor canal blocks (ACBs) are associated with improved analgesia, preserved quadriceps strength, and decreased length of hospitalization after total knee arthroplasty (TKA). However, controversy remains regarding the ideal location of a continuous block within the adductor canal, and it remains unclear whether similar clinical benefits are obtained irrespective of block location. In this randomized, double-blind, noninferiority study, we hypothesized that a continuous proximal ACB provides postoperative analgesia that is no worse than a continuous distal ACB...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#4
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29097242/correlation-between-catastrophizing-and-lequesne-index-in-case-of-osteoarthritis-of-the-knee-a-prospective-study
#5
Julien Lecorney, Frank Verhoeven, Mickaël Chouk, Xavier Guillot, Clément Prati, Daniel Wendling
OBJECTIVE: Catastrophizing is known to be associated with lower analgesia and results in total knee arthroplasty justifying its evaluation. The aim of this study is to evaluate the correlation between the functional status and the catastrophizing in patients with knee osteoarthritis. METHODS: We included patients consulting for knee osteoarthritis one of the three general practitioners participating in the study or a rheumatologist at University Hospital of Besançon...
October 30, 2017: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/29065753/perioperative-adjuvant-corticosteroids-for-postoperative-analgesia-in-knee-arthroplasty
#6
Hasan R Mohammad, Thomas W Hamilton, Louise Strickland, Marialena Trivella, David Murray, Hemant Pandit
Background and purpose - Immediate postoperative pain management offered in knee arthroplasty is suboptimal in up to one-third of patients resulting in high opiate consumption and delayed discharge. In this meta-analysis we investigate the analgesic effect and safety of perioperative adjuvant corticosteroids in knee arthroplasty. Methods - Databases Medline, Embase, and Central were searched for randomized studies comparing the analgesic effect of adjuvant perioperative corticosteroids in knee arthroplasty...
October 25, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/29055733/qx-oh-levobupivacaine-fixed-dose-combination-to-provide-a-long-acting-postoperative-pain-of-knee-surgery-in-rodents
#7
WenLing Zhao, Jun Yang, YuJun Zhang, Jin Liu, WenSheng Zhang
Although total knee arthroplasty (TKA) is a commonly performed procedure, anesthetic efficacy in post-surgical pain remains an issue. Exparel (45mM liposome bupivacaine), a relatively long-acting local anesthetic, has shown efficacy in blocking peripheral nerve or periarticular infiltration to achieve better post-TKA analgesia. In the present work, we tested whether a fixed-dose combination of QX-OH (35mM) and levobupivacaine (10mM) (QX-OH/LB) could confer longer-lasting pain relief and reduce periarticular tissue toxicity compared to liposome bupivacaine (45mM) after TKA operation...
October 18, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29053504/anesthesia-and-analgesia-practice-pathway-options-for-total-knee-arthroplasty-an-evidence-based-review-by-the-american-and-european-societies-of-regional-anesthesia-and-pain-medicine
#8
Sandra L Kopp, Jens Børglum, Asokumar Buvanendran, Terese T Horlocker, Brian M Ilfeld, Stavros G Memtsoudis, Joseph M Neal, Narinder Rawal, Jessica T Wegener
In 2014, the American Society of Regional Anesthesia and Pain Medicine in collaboration with the European Society of Regional Anaesthesia and Pain Therapy convened a group of experts to compare pathways for anesthetic and analgesic management for patients undergoing total knee arthroplasty in North America and Europe and to develop a practice pathway. This review is intended to be an analysis of the current literature to assist individuals and institutions in designing a pathway for total knee arthroplasty that is based on existing evidence and expert recommendation and may be customized according to individual settings...
November 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29046778/ultrasound-guided-percutaneous-cryoneurolysis-providing-postoperative-analgesia-lasting-many-weeks-following-a-single-administration-a-replacement-for-continuous-peripheral-nerve-blocks-a-case-report
#9
Brian M Ilfeld, Rodney A Gabriel, Andrea M Trescot
Cryoneurolysis entails using low temperatures to reversibly ablate nerves, with a subsequent analgesia duration measured in weeks or months. Previously, clinical applications for acute pain were limited because treatment originally required exposing the target nerve surgically. However, three developments have now made it possible to provide prolonged postoperative analgesia by cryoneurolysis: 1) new portable, hand-held cryoneurolysis devices, 2) ultrasound machine proliferation, and, 3) anesthesiologists trained in ultrasound-guided peripheral nerve block administration...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29046771/a-comparison-of-palonosetron-and-dexamethasone-for-postoperative-nausea-and-vomiting-in-orthopedic-patients-receiving-patient-controlled-epidural-analgesia
#10
Byung-Gun Kim, Hyunzu Kim, Hyun-Kyoung Lim, Chunwoo Yang, Sora Oh, Byung-Wook Lee
BACKGROUND: Postoperative nausea and vomiting (PONV) is one of the major concerns after anesthesia and surgery, and it may be more frequent in orthopedic patients receiving patient-controlled epidural analgesia (PCEA). The purpose of this study was to compare the effect of palonosetron and dexamethasone on the prevention of PONV in patients undergoing total joint arthroplasty and receiving PCEA. METHODS: Patients scheduled for total hip or knee arthroplasty under spinal anesthesia/PCEA were randomly allocated to receive either intravenous palonosetron (0...
October 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/29043004/efficacy-of-perineural-dexamethasone-with-ropivacaine-in-adductor-canal-block-for-post-operative-analgesia-in-patients-undergoing-total-knee-arthroplasty-a-randomized-controlled-trial
#11
Cun-Jin Wang, Feng-Yun Long, Liu-Qing Yang, You-Jing Shen, Fang Guo, Tian-Feng Huang, Ju Gao
Adductor canal block (ACB) is an effective analgesic alternative to femoral nerve block after total knee arthroplasty (TKA). The aim of the present study was to investigate whether addition of dexamethasone to ropivacaine for ACB is able to prolong analgesia and reduce pain. Study participants were randomized into groups receiving ACB with either 0.5% ropivacaine + normal saline (control group; n=93) or 0.5% ropivacaine + 8 mg dexamethasone (dexamethasone group; n=93). All patients were subjected to identical peri-operative management...
October 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29026354/novel-regional-techniques-for-total-knee-arthroplasty-promote-reduced-hospital-length-of-stay-an-analysis-of-106-patients
#12
Salman Thobhani, Lauren Scalercio, Clint E Elliott, Bobby D Nossaman, Leslie C Thomas, Dane Yuratich, Kim Bland, Kristie Osteen, Matthew E Patterson
BACKGROUND: Novel regional techniques, including the adductor canal block (ACB) and the local anesthetic infiltration between the popliteal artery and capsule of the knee (IPACK) block, provide an alternative approach for controlling pain following total knee arthroplasty (TKA). This study compared 3 regional techniques (femoral nerve catheter [FNC] block alone, FNC block with IPACK, and ACB with IPACK) on pain scores, opioid consumption, performance during physical therapy, and hospital length of stay in patients undergoing TKA...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/28971169/evaluation-of-analgesic-regimens-in-total-knee-arthroplasty-retrospective-study
#13
Serkan Tulgar, Onur Selvi, Ozgur Senturk, Talat Ercan Serifsoy, Selim Sanel, Sertac Meydaneri
OBJECTIVE: Analgesic therapies have an immense role in early rehabilitation period after total knee arthroplasty (TKA) and multimodal approaches should be considered as the first choice of treatment. In this retrospective study, the aim was to evaluate the effectiveness of multimodal analgesic therapies for TKA, including femoral nerve block (FNB) and patient controlled analgesia (PCA). METHODS: The data of 79 patients who underwent TKA between January and December 2016 were retrospectively evaluated...
2017: Northern Clinics of Istanbul
https://www.readbyqxmd.com/read/28930857/adductor-canal-block-with-local-infiltrative-analgesia-compared-with-local-infiltrate-analgesia-for-pain-control-after-total-knee-arthroplasty-a-meta-analysis-of-randomized-controlled-trials
#14
Qiujuan Xing, Weiwei Dai, Dongfeng Zhao, Ji Wu, Chunshui Huang, Yun Zhao
BACKGROUND: This meta-analysis aimed to evaluate the efficiency and safety of the combined adductor canal block with peri-articular infiltration versus periarticular infiltration alone for pain control after total knee arthroplasty (TKA). METHODS: PubMed, Medline, Embase, Web of Science, and the Cochrane Library were searched to identify articles comparing the combined adductor canal block with peri-articular infiltration and periarticular infiltration alone for pain control after TKA...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28919091/intravenous-acetaminophen-as-an-adjunct-to-multimodal-analgesia-after-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#15
REVIEW
Liqing Yang, Shuai Du, Yuefeng Sun
BACKGROUND: This meta-analysis aimed to perform a meta-analysis to investigate the impact of additional intravenous acetaminophen for pain management after total joint arthroplasty (TJA). METHODS: We conducted electronic searches of Medline (1966-2017.07), PubMed (1966-2017.07), Embase (1980-2017.07), ScienceDirect (1985-2017.07) and the Cochrane Library. Randomized controlled trials (RCTs) and non-RCTs were included. The quality assessments were performed according to the Cochrane systematic review method...
November 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28917592/prefrontal-versus-motor-cortex-transcranial-direct-current-stimulation-tdcs-effects-on-post-surgical-opioid-use
#16
Jeffrey J Borckardt, Scott T Reeves, Cole Milliken, Brittan Carter, Thomas I Epperson, Ryan J Gunselman, Alok Madan, H Del Schutte, Harry A Demos, Mark S George
BACKGROUND: Pain is often a complaint that precedes total knee arthroplasty (TKA), however the procedure itself is associated with considerable post-operative pain lasting days to weeks which can predict longer-term surgical outcomes. Previously, we reported significant opioid-sparing effects of motor cortex transcranial direct current stimulation from a single-blind trial. In the present study, we used double-blind methodology to compare motor cortex tDCS and prefrontal cortex tDCS to both sham and active-control (active electrodes over non-pain modulating brain areas) tDCS...
November 2017: Brain Stimulation
https://www.readbyqxmd.com/read/28893014/comparison-of-continuous-femoral-nerve-block-versus-local-infiltration-analgesia-as-a-postoperative-analgesia-in-unilateral-total-knee-arthroplasty
#17
Deepika Chaubey, Hari Krishan Mahajan, Parshu Ram Chauhan, Preeti S Govind, Pushpinder Singh, Ravinder Dhanevar, Abhinav Gupta
INTRODUCTION: Local infiltration of knee joint in arthroplasty, provide postoperative analgesia and preserves motor power of quadriceps, which helps in early mobilisation, as compared to femoral nerve block which paralyses vastus medialis. AIM: To compare the quality of postoperative analgesia provided by femoral nerve block and local infiltration in unilateral Total Knee Arthroplasty (TKA). MATERIALS AND METHODS: A prospective study was conducted on 60 patients (25-65 years) of ASA I and II, which were randomly(using random number table) divided into two groups - Group 1-femoral nerve block (FNB) and Group 2-Local Infiltration Analgesia (LIA)...
July 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28870301/perioperative-pain-management-and-anesthesia-a-critical-component-to-rapid-recovery-total-joint-arthroplasty
#18
REVIEW
Matthew W Russo, Nancy L Parks, William G Hamilton
Multimodal pain management has become the standard of care following total hip and knee replacement. The advantages include decreasing opioid consumption and its associated side effects, facilitating earlier mobilization, and faster return to function. An effective rapid recovery protocol includes the use of multiple different types of medications targeting each area of the pain pathway, preemptive analgesia, regional nerve blockade, and local infiltration analgesia.
October 2017: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/28835871/multimodal-pain-management-in-older-elective-arthroplasty-patients
#19
Elaine Brooks, Susan H Freter, Susan K Bowles, David Amirault
BACKGROUND: Pain management after elective arthroplasty in older adults is complicated due to the risk of undertreatment of postoperative pain and potential adverse effects from analgesics, notably opioids. Using combinations of analgesics has been proposed as potentially beneficial to achieve pain control with lower opioid doses. OBJECTIVE: We compared a multimodal pain protocol with a traditional one, in older elective arthroplasty patients, measuring self-rated pain, incidence of postoperative delirium, quantity and cost of opioid analgesics consumed...
September 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28828882/medication-equipment-and-supply-costs-for-common-interventions-providing-extended-post-surgical-analgesia-following-total-knee-arthroplasty-in-us-hospitals
#20
Shelby Corman, Nishant Shah, Simon Dagenais
AIMS: To estimate the cost to hospitals of materials (i.e. medications, equipment, and supplies) required to administer common interventions for post-surgical analgesia after total knee arthroplasty (TKA), including single-injection peripheral nerve block (sPNB), continuous peripheral nerve block (cPNB), periarticular infiltration of multi-drug cocktails, continuous epidural analgesia, intravenous patient-controlled analgesia (IV PCA), and local infiltration of bupivacaine liposome injectable suspension (BLIS)...
September 18, 2017: Journal of Medical Economics
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