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Postoperative pain

Raed Tafish, Khaled I Abu El Aish, Walid Madi
BACKGROUND: General anaesthesia and spinal anaesthesia are commonly used for caesarean sections. The aim of this study was to compare the outcomes from caesarean sections with these two types of anaesthesia. METHODS: In this quasi-controlled trial, we enrolled women undergoing caesarean sections at Al-Helal Al-Emirati Hospital, Rafah, Gaza Strip. Women were assigned either to general anaesthesia (20% intravenous propofol for anaesthesia induction followed by atracurium for muscle relaxation, and nitrous oxide and oxygen for anaesthesia maintenance) or to spinal anaesthesia (0·5% hyperbaric solution bupivacaine with 20 μg fentanyl intrathecally)...
February 21, 2018: Lancet
Fabian Grass, Matthieu Cachemaille, David Martin, Nicolas Fournier, Dieter Hahnloser, Catherine Blanc, Nicolas Demartines, Martin Hübner
The purpose of this prospective cohort study was to compare multimodal pain management and pain perception after open vs. laparoscopic colorectal surgery within enhanced recovery care. Pain scores at rest and at mobilization were prospectively assessed in consecutive patients using Visual Analog Scales (VAS 0-10) and consumption of different analgesics was recorded daily until 96 hours postoperatively. Uni- and multivariate risk factors for pain peaks (≥ 4/10) were identified by logistic regression and compared between two propensity score matched groups (open vs...
2018: Bioscience Trends
Hitoshi Kameyama, Tatsuo Kanda, Yosuke Tajima, Yoshifumi Shimada, Hiroshi Ichikawa, Takaaki Hanyu, Takashi Ishikawa, Toshifumi Wakai
Gastrointestinal stromal tumor (GIST) is the most common mesenchymal neoplasm of the gastrointestinal tract. However, rectal GIST is rare, the incident rate of it is approximately 5% of all GISTs. Rectal GIST symptoms generally include bleeding and/or pain and occasionally, urinary symptoms. Immunohistochemical evaluation finds that most rectal GIST tumors are CD117 (KIT) positive, and are sometimes CD34, platelet-derived growth factor receptor alpha (PDGFRA), smooth muscle actin, S-100, or vimentin positive...
2018: Translational Gastroenterology and Hepatology
Habiba Hashimi, David T Cooke, Elizabeth A David, Lisa M Brown
Accurate staging for non-small cell lung cancer (NSCLC) is essential to guide therapy. While computed tomography (CT) and positron emission tomography (PET) scan can indicate whether mediastinal lymphadenopathy is present, histologic confirmation is required to complete the staging evaluation. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a minimally invasive technique associated with similar diagnostic yield and improved postoperative pain and complication rates compared to mediastinoscopy...
2018: Journal of Visualized Surgery
Wilson Wai Shun Hau, Tun Hing Lui, Wai Kit Ngai
Post-traumatic peroneal tendon subluxation or dislocation is most commonly due to injury to the superior peroneal retinaculum. Acute repair of the retinaculum is an option for active athletes who desire quick return of sport activity. In general, conventional open surgeries require extensive exposure of the injured superficial peroneal retinaculum and have potential risks of scar formation, sural nerve injury, limited range of movement, peroneal tendon re-subluxation, and tendon irritation. The purpose of this Technical Note is to describe the details of endoscopic superior peroneal retinaculum reconstruction...
January 2018: Arthroscopy Techniques
Fahad Syed Naseerullah, Hemangkumar Javaiya, Avinash Murthy
Primary tumours of the heart are often encountered in clinical practice. Different autopsy series estimate the incidence to be anywhere from 0.001% to 0.19%. Cardiac lipoma is a rare type of tumour of the heart and pericardium. It comprises approximately 10-19% of all cardiac tumours. We present a case of a large cardiac lipoma in a fifty-year-old female. She presented with sharp chest pains, palpitations, and dizziness. Acute coronary syndrome was ruled out. A transthoracic echocardiogram showed an abnormal, large, fixed right atrial mass...
2018: Case Reports in Cardiology
Anna Suñol, Patricia Montoliu, Marta López, Joan Mascort, Carles Morales
Case summary: A 12-year-old neutered male domestic shorthair cat was presented to our referral hospital with a chronic history of tenesmus and lumbosacral pain. A diagnosis of degenerative lumbosacral stenosis (DLSS) was made and a standard dorsal L7-S1 laminectomy was performed uneventfully, with complete recovery within 1 month. The cat was brought back 4 months later for investigation of lumbosacral pain after having suffered a minor traumatic event. Neurological examination identified a low tail carriage, weakness, exercise intolerance, left pelvic limb lameness and diminished withdrawal reflexes in both pelvic limbs with severe sacrocaudal pain...
January 2018: JFMS Open Reports
Yuanshan Yao, Haibo Shen, Yinjie Zhou, Zhenhua Yang, Hongbo Huang
The aim of this study was to investigate the feasibility and safety of thoracoscopic surgery in the treatment of lung cancer and its effect on serum D-dimer. A total of 218 patients with lung cancer treated in the Department of Thoracic Surgery of Ningbo No. 2 Hospital from January 1, 2013 to December 31, 2016, were retrospectively analyzed. Of the 218 patients, 120 patients underwent thoracotomy (thoracotomy group) and 98 patients underwent thoracoscopic surgery (thoracoscopy group). The clinical efficacy in the perioperative period and serum D-dimer level were compared between the two groups...
April 2018: Oncology Letters
Yongrui Liu
Objective : To investigate the clinical effect of fast track surgery (FTS) in perioperative nursing of colorectal cancer surgery. Background : In recent years, many complicated surgery began to develop in the direction of low invasion and short hospital time, which provides an unprecedented opportunity for the development of fast track surgery (FTS). Methods : According to different nursing measures, 156 cases of colorectal cancer patients treated in our hospital were divided into FTS nursing group (86 cases) and traditional nursing group (70 cases)...
December 2017: Saudi Journal of Biological Sciences
Ruifu Yang, Mingwu Zhou, Chaofeng Xing, Shimin Li, Li Song, Jia Chen, Yingjie Xiong, Kai Zhang
Objective: To expound the clinical effect of a new operation by transplanting double segment triangular fibula flap with vascular pedicle to repair the forefoot with lateral bone defect, and to study how to improve the operation method in the following stage. Methods: The inclusion criteria: More than 2 phalangeal and metatarsal bones defects of the lateral forefoot, widespread skin and soft tissue defects on pelma and dorsal foot, and destruction of the anterior aspect of foot arch, which seriously affects the foot function...
December 2017: Saudi Journal of Biological Sciences
Jennifer Luk, Yong Lu, Amanda Ackermann, Xiaoxue Peng, Diane Bogdan, Michelino Puopolo, David E Komatsu, Simon Tong, Iwao Ojima, Mario J Rebecchi, Martin Kaczocha
Background: Metabolism of the endocannabinoid 2-arachidonoylglycerol (2-AG) yields arachidonic acid (AA), the precursor to proalgesic eicosanoids including prostaglandin E2 (PGE2 ). Diacylglycerol lipase β (DAGLβ) is an enzyme that synthesizes 2-AG and its inhibition reduces eicosanoid levels and produces antinociceptive effects in models of inflammatory pain. Here we test whether inhibition of DAGLβ produces antinociceptive effects in a model of postoperative pain. Methods: Rats were administered the selective DAGLβ inhibitor KT109 or vehicle and underwent plantar incision...
2018: Journal of Pain Research
Luis R Ramos-Pascua, Víctor Bárcena-Tricio, Sergio Sánchez Herráez, Paula Casas-Ramos, Francisco M Izquierdo-García
PURPOSE: To describe the results of nonsurgical and surgical treatment of enchondromas of the distal phalanx of the hand. METHODS: Eleven enchondromas of the distal phalanx were retrospectively reviewed. Five patients underwent surgery (curettage and autogenous cancellous bone graft from the iliac crest) and 6 patients were treated nonsurgically. Clinical records and radiographs were reviewed for each patient. We recorded complications and cosmetic and functional results...
March 15, 2018: Journal of Hand Surgery
J Boujenah, P Santulli, E Mathieu-d'Argent, C Decanter, C Chauffour, P Poncelet
INTRODUCTION: Using the structured methodology of French guidelines (HAS-CNGOF), the aim of this chapter was to formulate good practice points (GPP), in relation to optimal non-ART management of endometriosis related to infertility, based on the best available evidence in the literature. MATERIALS AND METHODS: This guideline was produced by a group of experts in the field including a thorough systematic search of the literature (from January 1980 to March 2017)...
March 15, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Ava D Segal, Krista M Cyr, Christina J Stender, Eric C Whittaker, Michael E Hahn, Michael S Orendurff, William R Ledoux, Bruce J Sangeorzan
BACKGROUND: End-stage ankle arthritis is a debilitating condition that often requires surgical intervention after failed conservative treatments. Ankle arthrodesis is a common surgical option, especially for younger and highly active patients; however, ankle arthroplasty has become increasingly popular as advancements in implant design improve device longevity. The longitudinal differences in biomechanical outcomes between these surgical treatments remain indistinct, likely due to the challenges associated with objective study of a heterogeneous population...
March 5, 2018: Clinical Biomechanics
Yun-Sik Dho, Hyoungmin Kim, Kyu-Chang Wang, Seung-Ki Kim, Ji Yeoun Lee, Hee Young Shin, Kyung Duk Park, Hyoung Jin Kang, Il Han Kim, Sung-Hye Park, Ji Hoon Phi
PURPOSE: s: Spinal epidural lymphoma with compressive myelopathy is a rarely found condition. The aims of this study are to describe the clinical features and to analyze its treatment outcome and prognostic factors. MATERIALS & METHODS: We searched for all pediatric patients with newly diagnosed spinal epidural lymphoma from 1999 to 2014 in our institution. We evaluated the clinical features, including neurological status, time interval to treatment, treatment modality, and outcomes...
March 14, 2018: World Neurosurgery
Joceline S Fuchs, Nabeel Shakir, Maxim J McKibben, Shawn Mathur, Sloan Teeple, Jeremy M Scott, Allen F Morey
BACKGROUND: For prolonged ischemic priapism, outcomes after distal shunt are poor, with only 30% success for priapic episodes lasting longer than 48 hours. AIM: To present a novel, glans-sparing approach of corporal decompression through a penoscrotal approach for cases of refractory ischemic priapism (RIP) after failed distal shunt procedures. METHODS: We describe the technique and present our initial experience with penoscrotal decompression (PSD) for treatment of RIP after failed distal shunt...
March 14, 2018: Journal of Sexual Medicine
P Collinet, X Fritel, C Revel-Delhom, M Ballester, P A Bolze, B Borghese, N Bornsztein, J Boujenah, N Bourdel, T Brillac, N Chabbert-Buffet, C Chauffour, N Clary, J Cohen, C Decanter, A Denouël, G Dubernard, A Fauconnier, H Fernandez, T Gauthier, F Golfier, C Huchon, G Legendre, J Loriau, E Mathieu-d'Argent, B Merlot, J Niro, P Panel, P Paparel, C A Philip, S Ploteau, C Poncelet, B Rabischong, H Roman, C Rubod, P Santulli, M Sauvan, I Thomassin-Naggara, A Torre, J M Wattier, C Yazbeck, M Canis
First-line investigations to diagnose endometriosis are clinical examination and pelvic ultrasound. Second-line investigations include pelvic examination performed by a referent clinician, transvaginal ultrasound performed by a referent, and pelvic MRI. It is recommended to treat endometriosis when it is symptomatic. First-line hormonal treatments recommended for the management of painful endometriosis are combined hormonal contraceptives or levonorgestrel 52mg IUD. There is no evidence to recommend systematic preoperative hormonal therapy for the unique purpose of preventing the risk of surgical complications or facilitating surgery...
March 14, 2018: Gynecologie, Obstetrique, Fertilite & Senologie
Meagan E Tibbo, Cody C Wyles, Peter S Rose, Franklin H Sim, Matthew T Houdek, Michael J Taunton
BACKGROUND: Synovial chondromatosis (SC) is a rare disease involving cartilaginous metaplasia of synovial tissue. Treatment via synovectomy and loose body removal alone results in elevated recurrence rates, with up to 1 in 5 patients requiring conversion to a hip arthroplasty. The purpose of this study is to investigate outcomes of hip arthroplasty in the setting of SC, focusing on (1) disease-specific survival, (2) implant survivorship and complications, and (3) clinical outcomes. METHODS: We identified 26 patients with histologically confirmed SC who underwent hip arthroplasty between 1970 and 2015...
February 15, 2018: Journal of Arthroplasty
Josefine E Naili, Eva W Broström, Elena M Gutierrez-Farewik, Michael H Schwartz
This study aimed to evaluate whether the trajectory of the body's Centre of Mass (CoM) is a sensitive and responsive measure of functional compensations in individuals with knee osteoarthritis (OA) performing the Five Times Sit-to-Stand test (5STS). This prospective study included 21 individuals with OA and 21 age- and gender-matched controls. Motion analysis data was collected while participants performed the 5STS, one month prior and one year after total knee arthroplasty (TKA). Pain was evaluated using a visual analogue scale...
March 6, 2018: Gait & Posture
Ferid Krupić, Sahmir Sadić, Nail Seffo, Mirza Bišćevic, Mirsad Fazlić, Svemir Čustović, Kristian Samuelsson
Aim To explore the experience of registered nurses in assessing pain in hip fracture in patients with dementia in the postoperative setting. Methods The study questionnaire contained 23 items mainly addressing demographic and social data, information about communication and pain assessment, attention and awareness of the health-care professionals on the ward and suggestions for improving nursing. Results The nurses claimed that they began their assessment of pain in patients with dementia first by observing the patient and making a visual assessment of pain, after which they began to communicate with these patients; majority of dementia patients with hip fractures displayed more facial expressions of pain than patients without dementia...
February 1, 2018: Medicinski Glasnik
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