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Knee arthroplasty analgesia

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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
#1
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...
September 14, 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
#2
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...
September 6, 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
#3
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
#4
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
#5
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
#6
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
https://www.readbyqxmd.com/read/28816906/comparison-of-liposomal-bupivacaine-with-bupivicaine-pain-pump-in-tka-patients-commentary-on-an-article-by-eric-b-smith-md-et-al-periarticular-liposomal-bupivacaine-injection-versus-intra-articular-bupivacaine-infusion-catheter-for-analgesia-after-total-knee
#7
https://www.readbyqxmd.com/read/28816893/periarticular-liposomal-bupivacaine-injection-versus-intra-articular-bupivacaine-infusion-catheter-for-analgesia-after-total-knee-arthroplasty-a-double-blinded-randomized-controlled-trial
#8
RANDOMIZED CONTROLLED TRIAL
Eric B Smith, Gregory S Kazarian, Mitchell G Maltenfort, Jess H Lonner, Peter F Sharkey, Robert P Good
BACKGROUND: Intra-articular bupivacaine hydrochloride (HCl) infusion catheters and periarticular injections of liposomal bupivacaine are often used as postoperative local anesthetics. The purpose of this study was to compare the efficacies of these local anesthetics following total knee arthroplasty. METHODS: This study was a superiority trial with a randomized, controlled, double-blinded design. Patients were randomly assigned to either delivery of bupivacaine HCl by the ON-Q* Pain Relief System pump (n = 96) or by an injection of Exparel (liposomal bupivacaine) (n = 104)...
August 16, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28813550/drug-free-interventions-to-reduce-pain-or-opioid-consumption-after-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#9
Dario Tedesco, Davide Gori, Karishma R Desai, Steven Asch, Ian R Carroll, Catherine Curtin, Kathryn M McDonald, Maria P Fantini, Tina Hernandez-Boussard
Importance: There is increased interest in nonpharmacological treatments to reduce pain after total knee arthroplasty. Yet, little consensus supports the effectiveness of these interventions. Objective: To systematically review and meta-analyze evidence of nonpharmacological interventions for postoperative pain management after total knee arthroplasty. Data Sources: Database searches of MEDLINE (PubMed), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, Web of Science (ISI database), Physiotherapy Evidence (PEDRO) database, and ClinicalTrials...
August 16, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28802777/local-infiltration-analgesia-with-liposomal-bupivacaine-improves-pain-scores-and-reduces-opioid-use-after-total-knee-arthroplasty-results%C3%A2-of-a-randomized-controlled-trial
#10
Michael A Mont, Walter B Beaver, Stanley H Dysart, John W Barrington, Daniel J Del Gaizo
BACKGROUND: Local infiltration analgesia (LIA) with liposomal bupivacaine (LB) in patients undergoing total knee arthroplasty (TKA) has yielded mixed results. The PILLAR study, which was designed to minimize limitations associated with previous studies, compared the effects of LIA with or without LB on pain scores, opioid consumption, including proportion of opioid-free patients, time to first opioid rescue, and safety after primary unilateral TKA. METHODS: Patients (N = 140) were randomized to LIA with LB 266 mg/20 mL (admixed with bupivacaine HCl 0...
July 25, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28799964/the-effect-of-adductor-canal-block-on-knee-extensor-muscle-strength-6-weeks-after-total-knee-arthroplasty-a-randomized-controlled-trial
#11
Nicolas Rousseau-Saine, Stephan R Williams, François Girard, Luc J Hébert, Florian Robin, Luc Duchesne, Frédéric Lavoie, Monique Ruel
BACKGROUND: Total knee arthroplasty (TKA) reduces knee extensor muscle strength (KES) in the operated limb for several months after the surgery. Immediately after TKA, compared to either inguinal femoral nerve block or placebo, adductor canal block (ACB) better preserves KES. Whether this short-term increase in KES is maintained several weeks after surgery remains unknown. We hypothesized that 48 hours of continuous ACB immediately after TKA would improve KES 6 weeks after TKA, compared to placebo...
August 9, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28767456/effects-of-anaesthesia-and-analgesia-on-long-term-outcome-after-total-knee-replacement-a-prospective-observational-multicentre-study
#12
Dario Bugada, Massimo Allegri, Marco Gemma, Andrea L Ambrosoli, Giuseppe Gazzerro, Fernando Chiumiento, Doriana Dongu, Fiorella Nobili, Andrea Fanelli, Paolo Ferrua, Massimo Berruto, Gianluca Cappelleri
BACKGROUND: Perioperative regional anaesthesia may protect from persistent postsurgical pain (PPSP) and improve outcome after total knee arthroplasty (TKA). OBJECTIVES: Aim of this study was to evaluate the impact of regional anaesthesia on PPSP and long-term functional outcome after TKA. DESIGN: A web-based prospective observational registry. SETTING: Five Italian Private and University Hospitals from 2012 to 2015. PATIENTS: Undergoing primary unilateral TKA, aged more than 18 years, informed consent, American Society of Anesthesiologists (ASA) physical status classes 1 to 3, no previous knee surgery...
October 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28763413/ultrasound-guided-motor-sparing-knee-blocks-for-postoperative-analgesia-following-total-knee-arthroplasty-a-randomized-blinded-study
#13
Olawale A Sogbein, Rakesh V Sondekoppam, Dianne Bryant, David F Johnston, Edward M Vasarhelyi, Steven MacDonald, Brent Lanting, Sugantha Ganapathy, James L Howard
BACKGROUND: Pain following total knee arthroplasty (TKA) is often severe and can inhibit rehabilitation. Motor-sparing analgesic techniques such as periarticular infiltrations and adductor canal blocks have been popularized for knee analgesia since they preserve motor strength and permit early mobilization. Our primary objective was to compare the duration of analgesia from motor-sparing blocks with that of a standard periarticular infiltration. We used the time to first rescue analgesia as the end point...
August 2, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28757829/effect-of-dexmedetomidine-as-an-adjuvant-to-bupivacaine-in-femoral-nerve-block-for-perioperative-analgesia-in-patients-undergoing-total-knee-replacement-arthroplasty-a-dose-response-study
#14
Senthil K Packiasabapathy, Lokesh Kashyap, Mahesh K Arora, Ravinder Kumar Batra, V K Mohan, Ganga Prasad, C S Yadav
CONTEXT: Dexmedetomidine is being increasingly used in nerve blocks. However, there are only a few dose determination studies. AIMS: To compare two doses of dexmedetomidine, in femoral nerve block, for postoperative analgesia after total knee arthroplasty (TKA). SETTINGS AND DESIGN: A prospective, randomized, controlled trial was conducted in the Department of Anesthesia at AIIMS, a Tertiary Care Hospital. MATERIALS AND METHODS: Sixty American Society of Anesthesiologists I-II patients undergoing TKA under subarachnoid block were randomized to three Groups A, B, and C...
July 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28751437/enhanced-recovery-after-surgery-for-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#15
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/28732754/what-is-the-quality-of-online-resources-about-pain-control-after-total-knee-arthroplasty
#16
William W Schairer, Cynthia A Kahlenberg, Peter K Sculco, Benedict U Nwachukwu
BACKGROUND: With the growing opioid crisis in the United States, there has been a push to reduce the utilization of opioids in favor of multimodal analgesia options. The purpose of this study was to evaluate the quality of online resources that patients may use to learn about pain control after total knee arthroplasty (TKA). METHODS: We identified websites using a combination of search terms about TKA and pain control. A novel grading rubric was created with 25 maximum points, consisting of items that were deemed important for patients to know about the subject...
June 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28729306/hospital-variation-in-allogeneic-transfusion-and-extended-length-of-stay-in-primary-elective-hip-and-knee-arthroplasty-a-cross-sectional-study
#17
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Cynthia So-Osman, M Elske van den Akker-van Marle, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
OBJECTIVES: Outcomes in total hip and knee arthroplasty (THA and TKA), such as allogeneic transfusions or extended length of stay (LoS), can be used to compare the performance of hospitals. However, there is much variation in these outcomes. This study aims to rank hospitals and to assess hospital differences of two outcomes in THA and TKA: allogeneic transfusions and extended LoS, and to additionally identify factors associated with these differences. DESIGN: Cross-sectional medical record review study...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706951/effectiveness-of-different-pain-control-methods-in-patients-with-knee-osteoarthritis-after-knee-arthroplasty
#18
Jin-Lain Ming, Shiao-Pei Hung, Hui-Mei Huang, Li-Hua Tseng, Chiung-Hui Huang, I-Chun Chen, Yu-Ping Chen, Chien-Kun Ting, Chen-Yin Tung
The number of patients with knee osteoarthritis has increased in tandem with population aging. Consequently, the number of knee arthroplasties has also risen. The postoperative pain is the biggest challenge faced by patients soon after knee arthroplasty; therefore, this study is among different methods for post-knee arthroplasty pain control. A prospective longitudinal research design was employed; 177 adult patients who proposed for primary knee arthroplasty were enrolled and recruited. The patients were divided into conventional Group 1 (n = 120) and patient-controlled analgesia (PCA) Group 2 (n = 57) according to the treatment methods they received...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28705543/oral-multimodal-analgesia-for-total-joint-arthroplasty
#19
Gregory J Golladay, Karl R Balch, David F Dalury, Jibanananda Satpathy, William A Jiranek
BACKGROUND: Oral multimodal analgesia for hip and knee arthroplasty is increasingly used as part of enhanced recovery protocols designed to minimize early postoperative pain and to facilitate early discharge, while minimizing undesirable side effects related to single-agent opioid administration. METHODS: This article is a review of previously published data evaluating the use of various oral medications in the management of postoperative pain after lower extremity arthroplasty and was presented as part of a symposium at the November 2016 AAHKS Annual Meeting...
September 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28697780/local-infiltration-of-analgesia-and-sciatic-nerve-block-provide-similar-pain-relief-after-total-knee-arthroplasty
#20
Hidenori Tanikawa, Kengo Harato, Ryo Ogawa, Tomoyuki Sato, Shu Kobayashi, So Nomoto, Yasuo Niki, Kazunari Okuma
BACKGROUND: Although femoral nerve block provides satisfactory analgesia after total knee arthroplasty (TKA), residual posterior knee pain may decrease patient satisfaction. We conducted a randomized controlled trial to clarify the efficacy of the sciatic nerve block (SNB) and local infiltration of analgesia with steroid (LIA) regarding postoperative analgesia after TKA, when administrated in addition to femoral nerve block (FNB). METHODS: Seventy-eight patients were randomly allocated to the two groups: concomitant administration of FNB and SNB or FNB and LIA...
July 11, 2017: Journal of Orthopaedic Surgery and Research
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