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Knee arthroplasty analgesia

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https://www.readbyqxmd.com/read/27924199/in-plane-three-step-needle-insertion-technique-for-ultrasound-guided-continuous-femoral-nerve-block-after-total-knee-arthroplasty-a-retrospective-review-of-488-cases
#1
Hyeon Ju Shin, Jung Sub Soh, Hyong Hwan Lim, Bumjoon Joo, Hye Won Lee, Hae Ja Lim
BACKGROUND: Continuous femoral nerve block (CFNB) improves postoperative analgesia after total knee arthroplasty (TKA). The aim of this study was to investigate the clinical efficacy and complications of our in-plane three-step needle insertion technique that was devised to reduce the risk of direct femoral nerve injury during CFNB in anesthetized patients. METHODS: This retrospective study included 488 patients who had undergone TKA. Ultrasound (US)-guided CFNB was performed under general or spinal anesthesia using an in-plane, three-step needle insertion technique...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27910257/neurostimulation-for-postsurgical-analgesia-a-novel-system-enabling-ultrasound-guided-percutaneous-peripheral-nerve-stimulation
#2
Brian M Ilfeld, Stuart A Grant, Christopher A Gilmore, John Chae, Richard D Wilson, Amorn Wongsarnpigoon, Joseph W Boggs
While neurostimulation-stimulation of the nervous system using electrical current-has been used to treat chronic pain, its use treating postsurgical pain has been limited. Here we report on the clinical application of a novel investigational lead to provide analgesia following total knee arthroplasty. In 5 subjects, leads were inserted percutaneously using ultrasound guidance within 0.5 to 3.0 cm of the femoral and/or sciatic nerve(s). With the delivery of current, pain decreased an average of 63% at rest, with 4 of 5 subjects having relief of >50%...
December 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27871565/postoperative-analgesic-efficacy-of-fascia-iliaca-block-versus-periarticular-injection-for-total-knee-arthroplasty
#3
Cagla Bali, Ozlem Ozmete, H Evren Eker, Murat A Hersekli, Anis Aribogan
STUDY OBJECTIVE: This study evaluated the postoperative analgesic efficacies of fascia iliaca block and periarticular drug injection techniques after TKA (total knee arthroplasty) surgeries. DESIGN: Prospective, randomized clinical trial. SETTING: University Teaching and Research Center. PATIENTS: Seventy-one American Society of Anesthesiologists (ASA) I-III patients between 48 and 70 years of age who underwent total knee arthroplasty were randomized...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871518/continuous-ambulatory-adductor-canal-catheters-for-patients-undergoing-knee-arthroplasty-surgery
#4
Neil A Hanson, Phoebe H Lee, Stanley C Yuan, Daniel S Choi, Cindy Jo Allen, David B Auyong
STUDY OBJECTIVE: To determine after knee arthroplasty surgery the feasibility of discharging patients home on postoperative day 1 with continuous adductor canal blocks. DESIGN: Retrospective case series. SETTING: Outpatient setting after hospital discharge. PATIENTS: Patients undergoing knee arthroplasty surgery from October 2013 to August 2014. INTERVENTIONS: All patients received continuous adductor canal catheters for postoperative analgesia and were discharged to home on postoperative day 1...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27824434/a-randomized-multicenter-double-blind-study-of-local-infiltration-analgesia-with-liposomal-bupivacaine-for-postsurgical-pain-following-total-knee-arthroplasty-rationale-and-design-of-the-pillar-trial
#5
Stan Dysart, Mark A Snyder, Michael A Mont
INTRODUCTION: Liposomal bupivacaine, a prolonged-release formulation of bupivacaine hydrochloride, is indicated for infiltration into the surgical site for postsurgical analgesia. Results from previous total knee arthroplasty (TKA) studies suggest that analgesic efficacy associated with liposomal bupivacaine may be impacted by variability in infiltration technique. The PILLAR study is designed to assess liposomal bupivacaine efficacy in TKA using a standardized infiltration protocol. Materials and Methods/Design: This phase 4, multicenter, randomized, double-blind, controlled, parallel-group study will compare the safety and efficacy of infiltration with liposomal bupivacaine versus standard bupivacaine for postsurgical pain control in adults undergoing primary unilateral TKA...
November 11, 2016: Surgical Technology International
https://www.readbyqxmd.com/read/27793238/pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#6
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
November 2016: Brazilian Journal of Anesthesiology
https://www.readbyqxmd.com/read/27792212/postoperative-analgesia-for-elective-total-knee-arthroplasty-under-subarachnoid-anesthesia-with-opioids-comparison-between-epidural-femoral-block-and-adductor-canal-block-techniques-with-and-without-perineural-adjuvants-a-prospective-randomized-clinical-trial
#7
José R Ortiz-Gómez, Marta Perepérez-Candel, José M Vázquez-Torres, José M Rodriguez-Del Río, Berta Torrón-Abad, Inocencia Fornet-Ruiz, Francisco J Palacio-Abizanda
BACKGROUND: Optimal control of acute postoperative pain and prevention of chronic persistent pain in total knee arthroplasty (TKA) remain a challenge. The main hypothesis was that nerve blocks improve postoperative analgesia especially if perineural adjuvants are added. METHODS: Immediate postoperative pain (24 h) was evaluated every hour in 639 patients using a verbal rating 11-point scale for patient self-reporting of pain (VRS-11). All patients received subarachnoid anesthesia and were randomly allocated in 8 groups: control group, epidural (EA) and single shots femoral (FNB) or adductor canal blocks (ACB), both with and without adjuvants: dexamethasone (+Dexa) or dexmedetomidine (+Dexm)...
October 28, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27776098/single-dose-adductor-canal-block-with-local-infiltrative-analgesia-compared-with-local-infiltrate-analgesia-after-total-knee-arthroplasty-a-randomized-double-blind-placebo-controlled-trial
#8
Antoun Nader, Mark C Kendall, David W Manning, Matthew Beal, Rohit Rahangdale, Robert Dekker, Gildasio S De Oliveira, Eric Kamenetsky, Robert J McCarthy
BACKGROUND AND OBJECTIVES: A single-dose adductor canal block can provide postoperative analgesia for patients undergoing total knee arthroplasty (TKA). The purpose of this study was to assess postoperative opioid consumption after ultrasound-guided single-injection bupivacaine compared with saline adductor canal block for patients undergoing TKA. METHODS: After institutional review board approval, written informed consent was obtained from patients (>18 years old) undergoing elective TKA...
November 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27749351/optimizing-pain-and-rehabilitation-after-knee-arthroplasty-a-two-center-randomized-trial
#9
Stephen Choi, Turlough O'Hare, Jeffrey Gollish, James E Paul, Hans Kreder, Kevin E Thorpe, Joel D Katz, Muhammad Mamdani, Peter Moisiuk, Colin J McCartney
BACKGROUND: This randomized trial compared (1) continuous femoral nerve block (cFNB), (2) single femoral nerve block (sFNB), and (3) local infiltration analgesia (LIA) with respect to analgesic and functional outcomes after primary tricompartmental knee arthroplasty (TKA). METHODS: One hundred twenty patients undergoing primary tricompartmental knee arthroplasty were randomly assigned to 1 of 3 interventions for postoperative analgesia: (1) cFNB-preoperative bolus of ropivacaine 0...
November 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27732710/efficacy-of-liposomal-bupivacaine-infiltration-on-the-management-of-total-knee-arthroplasty
#10
Bryan Sakamoto, Shelly Keiser, Russell Meldrum, Gene Harker, Andrew Freese
Importance: Liposomal bupivacaine is a novel extended-duration anesthetic that has recently been used for local infiltration in total knee arthroplasty (TKA). Athough liposomal bupivacaine is widely used, it is unknown if the benefits justify the cost in the veteran population at our institution. Objective: To evaluate a change in practice: the effect of local infiltration of liposomal bupivacaine on perioperative outcomes in patients undergoing primary TKA. Design, Setting, and Participants: A retrospective cohort study was conducted among patients who underwent primary TKA at a Veterans Affairs Medical Center before (March 3, 2013-March 2, 2014) and after (March 3, 2014-March 2, 2015) the implementation of liposomal bupivacaine for local infiltration in TKA...
October 12, 2016: JAMA Surgery
https://www.readbyqxmd.com/read/27685346/the-optimal-analgesic-block-for-total-knee-arthroplasty
#11
Thomas Fichtner Bendtsen, Bernhard Moriggl, Vincent Chan, Jens Børglum
Peripheral nerve block for total knee arthroplasty is ideally motor sparing while providing effective postoperative analgesia. To achieve these goals, one must understand surgical dissection techniques, distribution of nociceptive generators, sensory innervation of the knee, and nerve topography in the thigh.
September 28, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27673141/poster-391-prospective-double-blind-randomized-clinical-trial-to-compare-single-shot-adductor-canal-nerve-block-versus-femoral-nerve-block-combined-with-local-infiltration-analgesia-postoperative-functional-outcomes-after-total-knee-arthroplasty
#12
George Macrinici, Michelle Drescher, James Ascan, Krzysztof Babicz, Janet Clark, Paul Lagomarcino
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/27639506/-pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#13
Diogo Luís Pereira, Hugo Lourenço Meleiro, Inês Araújo Correia, Sara Fonseca
BACKGROUND AND OBJECTIVES: Total knee arthroplasty and total hip arthroplasty are associated with chronic pain development. Of the studies focusing on perioperative factors for chronic pain, few have focused on the differences that might arise from the anesthesia type performed during surgery. METHODS: This was a prospective observational study performed between July 2014 and March 2015 with patients undergoing unilateral elective total knee arthroplasty (TKA) or total hip arthroplasty (THA) for osteoarthritis...
September 14, 2016: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/27603376/femoral-nerve-block-for-patient-undergoing-total-knee-arthroplasty-prospective-randomized-double-blinded-study-evaluating-analgesic-effect-of-perineural-fentanyl-additive-to-local-anesthetics
#14
Bong Ha Heo, Hyeon Jung Lee, Hyung Gon Lee, Man Young Kim, Keun Suk Park, Jeong Il Choi, Myung Ha Yoon, Woong Mo Kim
BACKGROUND: The existence of peripheral opioid receptors and its effectiveness in peripheral nerve block remain controversial. The aim of this prospective, randomized, double-blinded study was to examine the analgesic effects of adding fentanyl to ropivacaine for continuous femoral nerve block (CFNB) using patient-controlled analgesia after total knee arthroplasty (TKA). METHODS: The patients were divided into 2 groups, each with n = 40 in ropivacaine (R) group and n = 42 in R with fentanyl (R + F) group...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27595078/comparative-effects-of-periarticular-multimodal-drug-injection-and-single-shot-femoral-nerve-block-on-pain-following-total-knee-arthroplasty-and-factors-influencing-their-effectiveness
#15
Shuji Nakagawa, Yuji Arai, Hiroaki Inoue, Hiroyuki Kan, Manabu Hino, Shohei Ichimaru, Kazuya Ikoma, Hiroyoshi Fujiwara, Fumimasa Amaya, Teiji Sawa, Toshikazu Kubo
PURPOSE: This study compared the analgesic effects of local infiltration analgesia (LIA) and femoral nerve block (FNB) after total knee arthroplasty (TKA) and assessed factors associated with analgesia obtained by these two methods. MATERIALS AND METHODS: Study subjects included 66 patients (72 knees) who underwent TKA for osteoarthritis of the knee. Pain visual analogue scale (VAS), the amount of analgesics used, number of days to achieve 90° of flexion of the knee joint, date of initiating parallel-bar walking, range of motion of the knee joint at discharge, and adverse events were investigated...
September 2016: Knee Surgery & related Research
https://www.readbyqxmd.com/read/27587519/the-technique-of-delivery-of-peri-operative-analgesia-does-not-affect-the-rehabilitation-or-outcomes-following-total-knee-arthroplasty
#16
D A McDonald, A H Deakin, B M Ellis, Y Robb, T E Howe, A W G Kinninmonth, N B Scott
AIMS: This non-blinded randomised controlled trial compared the effect of patient-controlled epidural analgesia (PCEA) versus local infiltration analgesia (LIA) within an established enhanced recovery programme on the attainment of discharge criteria and recovery one year after total knee arthroplasty (TKA). The hypothesis was that LIA would increase the proportion of patients discharged from rehabilitation by the fourth post-operative day but would not affect outcomes at one year. PATIENTS AND METHODS: A total of 242 patients were randomised; 20 were excluded due to failure of spinal anaesthesia leaving 109 patients in the PCEA group and 113 in the LIA group...
September 2016: Bone & Joint Journal
https://www.readbyqxmd.com/read/27578313/impact-of-preemptive-analgesia-on-inflammatory-responses-and-rehabilitation-after-primary-total-knee-arthroplasty-a-controlled-clinical-study
#17
Xu Jianda, Qu Yuxing, Gao Yi, Zhao Hong, Peng Libo, Zhao Jianning
The aim of this study was to investigate the effects of preemptive analgesia on the inflammatory response and rehabilitation in TKA. 75 patients with unilateral primary knee osteoarthritis were conducted in this prospective study. All patients were randomly divided into two groups (MMA with/without preemptive analgesia group). The following parameters were used to evaluate analgesic efficacy: knee flexion, pain at rest and walking, functional walking capacity (2 MWT and 6 MWT), WOMAC score, and hs-CRP level...
2016: Scientific Reports
https://www.readbyqxmd.com/read/27574260/preoperative-ropivacaine-with-or-without-tramadol-for-femoral-nerve-block-in-total-knee-arthroplasty
#18
Q Tang, X Li, L Yu, Y Hao, G Lu
PURPOSE: To compare the analgesic effect of preoperative ropivacaine with or without tramadol for femoral nerve block in total knee arthroplasty (TKA). METHODS: 14 men and 46 women aged 59 to 80 years who were American Society of Anesthesiologists (ASA) grade I or II and were scheduled for TKA were randomised to receive preoperative femoral nerve block with 20 ml of 0.375% ropivacaine plus tramadol 0 mg (n=15), 50 mg (n=15), or 100 mg (n=15), or no preoperative femoral nerve block (control) [n=15]...
August 2016: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/27557955/effects-of-multi-site-infiltration-analgesia-on-pain-management-and-early-rehabilitation-compared-with-femoral-nerve-or-adductor-canal-block-for-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-controlled-trial
#19
Donghai Li, Zhen Tan, Pengde Kang, Bin Shen, Fuxing Pei
PURPOSE: The aim of this study was to combine intra-articular and peri-articular with wound infiltration analgesia (multi-site infiltration analgesia, MIA) for patients undergoing total knee arthroplasty (TKA) and compare its pain management and early rehabilitation effect with the commonly used nerve block including adductor cannel block (FNB) and femoral nerve block (ACB). METHOD: We conducted a prospective randomized controlled trial and 77 patients were included for analysis...
August 25, 2016: International Orthopaedics
https://www.readbyqxmd.com/read/27555206/addition-of-buprenorphine-to-local-anesthetic-in-adductor-canal-blocks-after-total-knee-arthroplasty-improves-postoperative-pain-relief-a-randomized-controlled-trial
#20
Sandeep H Krishnan, Lisa A Gilbert, Farhad Ghoddoussi, Daniel J Applefield, Safa S Kassab, Terry A Ellis
BACKGROUND AND OBJECTIVES: For the hundreds of thousands of patients who undergo total knee arthroplasty (TKA) in the United States each year, early mobilization has been demonstrated to improve functional outcomes and reduce complications. Management of postoperative pain is a critical factor in achieving early mobilization. Recent studies have shown that the use of an adductor canal block (ACB) after TKA results in increased preservation of quadriceps muscle strength, without significant difference in postoperative pain when compared to femoral nerve block...
September 2016: Journal of Clinical Anesthesia
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