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Post-Operative pain control

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https://www.readbyqxmd.com/read/29680509/opioids-delay-healing-of-spinal-fusion-a-rabbit-posterolateral-lumbar-fusion-model
#1
Nikhil Jain, Khaled Himed, Jeffrey M Toth, Karen C Briley, Frank M Phillips, Safdar N Khan
BACKGROUND CONTEXT: Opioid use is prevalent for management of pre- and post-operative pain in patients undergoing spinal fusion. There is evidence that opioids downregulate osteoblasts in-vitro, and one previous study found that morphine delays the maturation and remodeling of callus in a rat femur fracture model. However, the effect of opioids on healing of spinal fusion has not been investigated before. Isolating the effect of opioid exposure in humans would be limited by the numerous confounding factors that affect fusion healing...
April 19, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29671866/isocapnic-hyperventilation-provides-early-extubation-after-head-and-neck-surgery-a-prospective-randomized-trial
#2
K Hallén, P Jildenstål, O Stenqvist, J Oras, S-E Ricksten, S Lindgren
BACKGROUND: Isocapnic hyperventilation (IHV) shortens recovery time after inhalation anaesthesia by increasing ventilation while maintaining a normal airway carbon dioxide (CO2 )-level. One way of performing IHV is to infuse CO2 to the inspiratory limb of a breathing circuit during mechanical hyperventilation (HV). In a prospective randomized study, we compared this IHV technique to a standard emergence procedure (control). METHODS: Thirty-one adult ASA I-III patients undergoing long-duration (>3 hours) sevoflurane anaesthesia for major head and neck surgery were included and randomized to IHV-treatment (n = 16) or control (n = 15)...
April 19, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29663509/patients-with-a-previous-total-hip-replacement-experience-less-reduction-of-back-pain-following-lumbar-back-surgery
#3
Ted Eneqvist, Erik Bülow, Szilárd Nemes, Helena Brisby, Göran Garellick, Peter Fritzell, Ola Rolfson
The coexistence of degenerative disorders from the hip joint and the lumbar spine, known as "the hip-spine syndrome", is a common encounter in clinical practice. These degenerative conditions may cause similar symptoms which often entail diagnostic challenges in determining the origin of pain. Low back surgery (LBS) with fusion and/or decompression, and total hip replacement (THR) are both often successful interventions. However, the knowledge is limited about the post-operative patient-reported outcome (PRO) following LBS in the presence of a prior THR...
April 16, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29662278/comparison-of-efficacy-of-bupivacaine-with-dexmedetomidine-versus-bupivacaine-alone-for-transversus-abdominis-plane-block-for-post-operative-analgesia-in-patients-undergoing-elective-caesarean-section
#4
A Ramya Parameswari, Prabha Udayakumar
Background: Increasing rate of Caesarean sections and inadequate pain relief following Caesarean section is seen in almost all parts of the world. Transversus abdominis plane block is gaining popularity as a part of multimodal analgesia for post-operative pain relief following abdominal surgeries. Aim: To compare bupivacaine and bupivacaine with dexmedetomidine in transversus abdominis plane block for pain relief after Caesarean section. Method: American Society of Anaesthesiologists I and II parturients with no comorbidities admitted for elective Caesarean section were included in the study...
April 2018: Journal of Obstetrics and Gynaecology of India
https://www.readbyqxmd.com/read/29659470/meta-analysis-of-perioperative-outcomes-of-acute-laparoscopic-vs-open-repair-of-perforated-gastroduodenal-ulcers
#5
Roberto Cirocchi, Kjetil Soreide, Salomone Di Saverio, Elena Rossi, Alberto Arezzo, Mauro Zago, Iosief Abraha, Nereo Vettoretto, Massimo Chiarugi
BACKGROUND: Surgery is the treatment of choice for perforated peptic ulcer disease (PUD). The aim of the present review is to compare the perioperative outcomes of acute laparoscopic versus open repair for PUD. METHODS: A systematic literature search was performed for randomized controlled trials (RCTs) published in PubMed, SCOPUS and Web of Science RESULTS: The search included eight RCTs: 615 patients comparing laparoscopic (307 patients) versus open peptic perforated ulcer repair (308 patients)...
April 13, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29657848/medial-subvastus-versus-the-medial-parapatellar-approach-for-total-knee-replacement-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
James R Berstock, James R Murray, Michael R Whitehouse, Ashley W Blom, Andrew D Beswick
Twenty randomized controlled trials comprising 1893 primary total knee replacements were included in this review.The subvastus approach conferred superior results for mean difference (MD) in time to regain an active straight leg raise (1.7 days, 95% confidence interval [CI] 1.0 to 2.3), visual analogue score for pain on day one (0.8 points on a scale out of 10, 95% CI 0.2 to 1.4) and total range of knee movement at one week (7°, 95% CI 3.2 to 10.7). The subvastus approach also resulted in fewer lateral releases (odds ratio 0...
March 2018: EFORT Open Reviews
https://www.readbyqxmd.com/read/29645356/patients-with-a-previous-total-hip-replacement-experience-less-reduction-of-back-pain-following-lumbar-back-surgery
#7
Ted Eneqvist, Erik Bülow, Szilárd Nemes, Helena Brisby, Göran Garellick, Peter Fritzell, Ola Rolfson
The coexistence of degenerative disorders from the hip joint and the lumbar spine, known as "the hip-spine syndrome", is a common encounter in clinical practice. These degenerative conditions may cause similar symptoms which often entail diagnostic challenges in determining the origin of pain. Low back surgery (LBS) with fusion and/or decompression, and total hip replacement (THR) are both often successful interventions. However, the knowledge is limited about the post-operative patient-reported outcome (PRO) following LBS in the presence of a prior THR...
April 12, 2018: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
https://www.readbyqxmd.com/read/29643902/is-there-difference-in-chronic-pain-after-suture-and-stapler-fixation-method-of-mesh-in-ventral-hernia-is-stapler-fixation-method-quicker-a-randomized-controlled-trial
#8
Noureen Shaukat, Farhat Jaleel, Masood Jawaid, Imrana Zulfiqar
Background & Objective: Chronic pain occurs in 20-30% of patients after hernia surgery. As a consequence of this chronic pain, almost one third of patients have limitations in daily activities. Frequency and severity of this pain varies with different techniques of hernia repair. The objective of this study was to compare polypropylene suture and skin staples for securing mesh in uncomplicated ventral hernioplasty in terms of acute and chronic postoperative pain and to compare the time taken for mesh fixation between polypropylene sutures and skin stapler in ventral hernioplasty...
January 2018: Pakistan Journal of Medical Sciences Quarterly
https://www.readbyqxmd.com/read/29643551/role-of-dexmedetomidine-as-an-anaesthetic-adjuvant-in-breast-cancer-surgery-as-a-day-care-procedure-a-randomised-controlled-study
#9
Rekha Das, Rajat Kumar Das, Sushrita Sahoo, Suchismita Nanda
Background and Aims: Breast cancer surgery can be carried out as day-care procedure to increase patient turnover, decrease disease progression and financial burden. The present study was carried out to assess the role of dexmedetomidine in breast cancer surgery as a day-care procedure. Methods: This prospective randomised, double-blind study was carried out on 100 patients screened for day-care breast cancer surgery. They were divided into two groups of 50 each; who received either normal saline (Group NS) or 0...
March 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628845/patient-satisfaction-and-experience-with-anesthesia-a-multicenter-survey-in-saudi-population
#10
Abdulrahman Alsaif, Saleh Alqahtani, Farhan Alanazi, Faris Alrashed, Abdullah Almutairi
Background and Objectives: Patients' satisfaction of anesthesia outcomes is a major part of the overall quality of health care. The aim of this study is to evaluate patient's satisfaction whether pre- or post-operative as well as overall impression using a multicenter prespecified survey tool. Methods: Three hundred and three patients who underwent surgery regardless the type of anesthesia were surveyed. The interview conducted face-to-face before surgery then within the first 24 h of surgery...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628683/short-term-outcomes-of-long-duration-versus-short-duration-tourniquet-in-primary-total-knee-arthroplasty-a-randomized-controlled-trial
#11
Raju Vaishya, Amit Kumar Agarwal, Vipul Vijay, Manish Kumar Tiwari
Introduction: A tourniquet is used during the total knee replacement surgery to improve the visibility, to reduce the blood loss and for better cementation. Indirectly it decreases the duration of surgery and enhances the recovery of the patient. Their use however is controversial due to some side effects associated with the use of tourniquet. They may increase the risk of deep vein thrombosis and pulmonary embolism by causing venous stasis, endothelial damage and increased platelet adhesion secondary to distal limb ischemia...
January 2018: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29627848/fixation-augmentation-using-calcium-phosphate-bone-substitute-improves-outcomes-of-complex-tibial-plateau-fractures-a-matched-cohort-study
#12
Matthieu Ollivier, Yassine Bulaïd, Christophe Jacquet, Sebastien Pesenti, Jean-Noel Argenson, Sebastien Parratte
INTRODUCTION: Injectable cements have been developed to improve fixation's stability and thus obtain early return to adequate joint function. We aimed to compare post-operative radiographic and clinical outcomes of patients suffering from a complex tibial plateau fracture (TPF) fixed with calcium-phosphate bone substitutes (CPBS) augmentation to a matched group of patients with identical fracture pattern, treated with the same fixation's type, but augmented with bone grafting. METHODS: After local ethic committee approval, we retrospectively identified in a prospectively collected database, patients with complex comminuted metaphyseal and epiphysial bicondylar TPF (Schatzker type VI) admitted in our emergency department between January 2011 and December 2013...
April 7, 2018: International Orthopaedics
https://www.readbyqxmd.com/read/29617078/complete-supine-percutaneous-nephrolithotomy-with-gopro%C3%A2-ten-steps-for-success
#13
Fabio Carvalho Vicentini, Hugo Daniel Barone Dos Santos, Carlos Alfredo Batagello, Julia Rothe Amundson, Evaristo Peixoto Oliveira, Giovanni Scala Marchini, Miguel Srougi, Willian Carlos Nahas, Eduardo Mazzucchi
OBJECTIVE: To show a video of a complete supine Percutaneous Nephrolithotomy (csPCNL) performed for the treatment of a staghorn calculus, from the surgeon's point of view. The procedure was recorded with a GoPro® camera, demonstrating the ten essential steps for a successful procedure. MATERIALS AND METHODS: The patient was a 38 years-old woman with 2.4cm of left kidney lower pole stone burden who presented with 3 months of lumbar pain and recurrent urinary tract infections...
March 15, 2018: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29603299/efficacy-of-chlorhexidine-as-a-final-irrigant-in-one-visit-root-canal-treatment-a-prospective-comparative-study
#14
S M Kurt, M K Çalışkan
AIM: To evaluate postoperative pain and radiographic evidence of periapical healing in teeth with apical periodontitis treated in one-visit with an additional final irrigation using 2% chlorhexidine (CHX) and to compare the results with conventional two-visit root canal treatment (RCT) with an intracanal calcium hydroxide (CH) dressing as a control group. METHODOLOGY: Ninety asymptomatic maxillary anterior teeth with periapical lesions were treated by a single operator...
March 30, 2018: International Endodontic Journal
https://www.readbyqxmd.com/read/29601950/association-between-mdr-1-cyp3a4-oprm-1-gene-polymorphisms-and-the-post-caesarean-fentanyl-analgesic-effect-on-chinese-women
#15
Jingliang Zhang, Li Zhang, Xia Zhao, Sheliang Shen, Xiaopan Luo, Yunlong Zhang
OBJECTIVE: Our study aimed to evaluate the association between the multidrug resistance 1 (MDR1 )/cytochrome P450 3A4 (CYP3A4)/μ-opioid receptor (OPRM1 ) gene polymorphisms and the post-caesarean analgesic effect of fentanyl on Chinese women. METHODS: We recruited 240 patients who received lower segment caesarean section surgeries. Sanger sequencing was used to analyze the MDR1 1236C > T/CYP3A4*1G/OPRM1 A118G polymorphisms. We evaluated post-operative fentanyl consumption and the effect of intravenous analgesia in patients with different genotypes...
March 27, 2018: Gene
https://www.readbyqxmd.com/read/29599696/merits-of-trabeculectomy-in-advanced-and-end-stage-glaucoma
#16
Rayees Ahmad Sofi, Shahnawaz Shafi, Waseem Qureshi, Sehrish Ashraf
Objectives: The aim of the study was to evaluate intraocular pressure (IOP) control, potential benefits, and associated complications in advanced cases of glaucoma (visual acuity of <6/60) after trabeculectomy. Although many studies of trabeculectomy in glaucoma patients have been done, very few in such advanced cases. Methods: The study was done on 60 cases of advanced primary open-angle glaucoma (POAG). Trabeculectomy was done and IOP control was assessed. Pre-operative workup included a detailed history, slit lamp biomicroscopy, Goldmann applanation tonometry, gonioscopy using Goldmann 2 mirror lens, and detailed fundus examination with the 78D lens...
March 2018: International Journal of Health Sciences
https://www.readbyqxmd.com/read/29595873/pain-management-for-first-trimester-uterine-aspiration
#17
Ghazaleh Moayedi, Mary Tschann
Importance: First-trimester uterine aspiration can easily be performed in the office setting if adequate pain management for the patient is achieved. It is important for clinicians to understand evidence-based approaches for pain control to ensure a safe and efficient procedure. Objective: This article reviews the literature regarding pharmacologic and nonpharmacologic pain control options for first-trimester abortion performed in the clinical setting. Preoperative, procedural, and postoperative pain control are all reviewed...
March 2018: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/29595671/effect-of-intravenous-lidocaine-infusion-on-long-term-postoperative-pain-after-spinal-fusion-surgery
#18
Abdelrady Ibrahim, Mohamed Aly, Waleed Farrag
BACKGROUND: Intravenous lidocaine infusion is known to reduce postoperative pain for days or weeks beyond the infusion time, and plasma half-life in several types of surgical procedures. OBJECTIVES: To evaluate the effect of intravenous (IV) lidocaine infusion on long term postoperative pain intensity for 3 months in patients undergoing spinal fusion surgery. STUDY DESIGN: Prospective randomized, double-blinded study. SETTING: Assiut University Hospital, Assiut, Egypt...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29576642/comparative-study-for-evaluating-efficacy-of-fascia-iliaca-compartment-block-for-alleviating-pain-of-positioning-for-spinal-anesthesia-in-patients-with-hip-and-proximal-femur-fractures
#19
Nirav Jentilal Kacha, Chetna A Jadeja, Pooja J Patel, Harshda B Chaudhari, Jatin R Jivani, Vandana S Pithadia
Background: Patient positioning for performing spinal blockade causes severe pain in hip and femur fracture. Adequate pain relief before administrating spinal blockade will increase patient's cooperation. This study was done to assess analgesic effect of fascia iliaca compartment block (FICB) for positioning for spinal anesthesia. Materials and Methods: This was a randomized, double blind, controlled prospective study that included 100 patients of the American Society of Anesthesiologists physical statuses I to III, of either sex, between 30 and 90 years, posted for hip or proximal femoral surgery, with visual analogue scale (VAS) >3 in preoperative period...
March 2018: Indian Journal of Orthopaedics
https://www.readbyqxmd.com/read/29573108/metronidazole-following-excisional-haemorrhoidectomy-a-systematic-review-and-meta-analysis
#20
REVIEW
Weisi Xia, James P R Manning, Ahmed W H Barazanchi, Bruce Su'a, Andrew G Hill
BACKGROUND: Post-operative pain is a major issue following excisional haemorrhoidectomy. Although metronidazole by both oral and topical administration routes has been shown to reduce pain after haemorrhoidectomy, its use remains a contentious issue. This systematic review and meta-analysis aims to investigate the effect of metronidazole on post-operative pain after excisional haemorrhoidectomy. METHODS: A systematic review of the literature was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines...
March 23, 2018: ANZ Journal of Surgery
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