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https://www.readbyqxmd.com/read/28092334/is-enhanced-recovery-the-new-standard-of-care-in-microsurgical-breast-reconstruction
#1
Anoushka Afonso, Sabine Oskar, Kay See Tan, Joseph J Disa, Babak J Mehrara, Jihan Ceyhan, Joseph H Dayan
BACKGROUND: Enhanced recovery pathways (ERPs) have been shown to aid in patient recovery and improve outcomes in many surgical settings. At present, there is limited data available regarding the use and feasibility of ERPs for patients undergoing microsurgical breast reconstruction. We sought to assess patient outcomes before and after the introduction of an ERP that was adopted by multiple surgeons at a single cancer center. METHODS: A multidisciplinary ERP was developed for patients undergoing deep inferior epigastric perforator (DIEP) or muscle-sparing free transverse rectus abdominis myocutaneous (TRAM) flap breast reconstruction...
January 12, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28091438/caudal-analgesia-for-herniotomy-comparative-evaluation-of-two-dose-schemes-of-bupivacaine
#2
D D Akpoduado, C O Imarengiaye, N P Edomwonyi
OBJECTIVE: There is currently a wide range of volume schemes for bupivacaine caudal anesthesia. This study evaluated the quality of caudal analgesia achieved with a dosing scheme of 0.75 ml/kg compared with 0.5 ml/kg of 0.25% plain bupivacaine for herniotomy. METHODS: After the institutional approval, American Society of Anesthesiologists I-II patients aged between 1 and 6 years scheduled for unilateral inguinal herniotomy with consenting parents/guardian were recruited...
February 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28089496/cell-toxicity-in-fibroblasts-tenocytes-and-human-mesenchymal-stem-cells-a-comparison-of-necrosis-and-apoptosis-inducing-ability-in-ropivacaine-bupivacaine-and-triamcinolone
#3
Anja Z Zhang, Andreas Ficklscherer, Mehmet F Gülecyüz, Alexander C Paulus, Thomas R Niethammer, Volkmar Jansson, Peter E Müller
PURPOSE: To analyze the ability of ropivacaine, bupivacaine, and triamcinolone to induce apoptosis and necrosis in fibroblasts, tenocytes, and human mesenchymal stem cells. METHODS: Human dermal fibroblasts, adipose-derived human mesenchymal stem cells (hMSCs), and tenocytes gained from the rotator cuff tendon were seeded with a cell density of 0.5 × 10(4)/cm(2). One specimen of ropivacaine, bupivacaine, and triamcinolone was tested separately on the cells with separate concentrations of 0...
January 12, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28088107/gaas-laser-therapy-reestablishes-the-morphology-of-the-nmj-and-nachrs-after-injury-due-to-bupivacaine
#4
Cristiane Neves Alessi Pissulin, Paula Aiello Tomé de Souza Castro, Flávio Codina, Carina Guidi Pinto, Ivan Jose Vechetti-Junior, Selma Maria Michelin Matheus
BACKGROUND: Local anesthetics are used to relieve pre- and postoperative pain, acting on both sodium channels and nicotinic acetylcholine receptors (nAChR) at the neuromuscular junction (NMJ). Bupivacaine acts as a non-competitive antagonist and has limitations, such as myotoxicity, neurotoxicity, and inflammation. Low-level laser therapy (LLLT) has anti-inflammatory, regenerative, and analgesic effects. The aim of the present study was to evaluate the effects of a gallium arsenide laser (GaAs) on the morphology of the NMJ and nAChRs after application of bupivacaine in the sternomastoid muscle...
December 22, 2016: Journal of Photochemistry and Photobiology. B, Biology
https://www.readbyqxmd.com/read/28074028/assessment-of-postoperative-pain-control-with-an-elastomeric-pain-pump-following-cardiothoracic-surgery
#5
Anuvrat Chopra, Jeff Hurren, Susan Szpunar, Stephanie B Edwin
OBJECTIVE: To assess the effectiveness of local anesthesia, delivered via elastomeric pump to manage pain in patients undergoing cardiothoracic surgery. METHODS: A retrospective, comparative analysis evaluating adult cardiothoracic surgery patients (by median sternotomy) who received continuous infusion bupivacaine + traditional methods of pain control (N = 100) or traditional pain control alone (N = 100) from July 2011-October 2013. The primary efficacy end point was total postoperative opioid requirements for 96 hours following surgery...
January 10, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28070147/liposomal-bupivacaine-in-total-hip-arthroplasty-do-the-results-justify-the-cost
#6
Jason A Beachler, Daniel M Kopolovich, Creighton C Tubb, Siraj A Sayeed
INTRODUCTION: Liposomal bupivacaine has a paucity of data regarding narcotic requirements and hospital length of stay in comparison to other peri-articular injections, specifically in the total hip arthroplasty (THA) population. METHODS: 69 patients who underwent THA by a single surgeon were divided into two cohorts over a 3 year period in this retrospective study comparing narcotic requirements, hospital length of stay and cost. The study group (n = 29) received liposomal bupivacaine whereas a matched control group (n = 40) received a pharmacy-mixed cocktail in peri-articular structures...
March 2017: Journal of Orthopaedics
https://www.readbyqxmd.com/read/28067707/dural-puncture-epidural-technique-improves-labor-analgesia-quality-with-fewer-side-effects-compared-with-epidural-and-combined-spinal-epidural-techniques-a-randomized-clinical-trial
#7
Anthony Chau, Carolina Bibbo, Chuan-Chin Huang, Kelly G Elterman, Eric C Cappiello, Julian N Robinson, Lawrence C Tsen
BACKGROUND: The dural puncture epidural (DPE) technique is a modification of the combined spinal epidural (CSE) technique, where a dural perforation is created from a spinal needle but intrathecal medication administration is withheld. The DPE technique has been shown to improve caudal spread of analgesia compared with epidural (EPL) technique without the side effects observed with the CSE technique. We hypothesized that the onset of labor analgesia would follow this order: CSE > DPE > EPL techniques...
January 5, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28059913/liposomal-bupivacaine-use-in-transversus-abdominis-plane-blocks-reduces-pain-and-postoperative-intravenous-opioid-requirement-after-colorectal-surgery
#8
Audrey L Stokes, Sanjib D Adhikary, Ashley Quintili, Frances J Puleo, Christine S Choi, Christopher S Hollenbeak, Evangelos Messaris
BACKGROUND: Enhanced recovery protocols frequently use multimodal postoperative analgesia to improve postoperative outcomes in patients undergoing colorectal surgery. OBJECTIVE: The purpose of this study was to evaluate liposomal bupivacaine use in transversus abdominis plane blocks on postoperative pain scores and opioid use after colorectal surgery. DESIGN: This was a retrospective cohort study comparing outcomes between patients receiving nonliposomal anesthetic (n = 104) and liposomal bupivacaine (n = 303) blocks...
February 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28059870/epinephrine-deteriorates-pulmonary-gas-exchange-in-a-rat-model-of-bupivacaine-induced-cardiotoxicity-a-threshold-dose-of-epinephrine
#9
Quan-Guang Wang, Cong Wu, Yun Xia, Jiao-Jiao Dong, Ting-Ting Lin, Qiao-Yan Liu, Thomas J Papadimos, Xu-Zhong Xu
BACKGROUND AND OBJECTIVE: The study goal was to compare the effect of epinephrine in different doses on pulmonary gas exchange in a rat model of bupivacaine-induced cardiac depression. METHODS: Twenty-four adult male Sprague-Dawley rats were divided into 4 groups (n = 6), and each group received a bupivacaine infusion (2.5 mg/kg per minute, 6 minutes) via the left femoral vein to induce cardiac depression. At the end of the bupivacaine infusion, each group was immediately given either isotonic sodium chloride solution (normal saline; NS group), 5-μg/kg epinephrine (Epi5 group), 10-μg/kg epinephrine (Epi10 group), or 20 μg/kg epinephrine (Epi20 group)...
January 3, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28059804/bupivacaine-increases-the-rate-of%C3%A2-motoneuron-death-following-peripheral%C3%A2-nerve-injury
#10
Susanna C Byram, Scott W Byram, Nicholas M Miller, Keith N Fargo
BACKGROUND: Appropriate management of pain after an injury or surgical procedure has been shown to improve patient outcomes. While infrequent, nerve damage resulting from regional anesthesia can be devastating, however the mechanism remains unknown. Local anesthetics are neurotoxic yet are frequently applied to sites where peripheral nerves are regenerating. Therefore, understanding their effects on injured and growing neurons may have important implications for clinical practice. OBJECTIVE: The purpose of this study was to determine if local anesthetics exacerbate the rate of motoneuron death following axotomy...
January 4, 2017: Restorative Neurology and Neuroscience
https://www.readbyqxmd.com/read/28058142/comparison-of-intraabdominal-and-trocar-site-local-anaesthetic-infiltration-on-postoperative-analgesia-after-laparoscopic-cholecystectomy
#11
Gülsüm Altuntaş, Ömer Taylan Akkaya, Derya Özkan, Mehmet Murat Sayın, Şener Balas, Elif Özlü
OBJECTIVE: This study aimed to compare the efficacy of local anaesthetic infiltration to trocar wounds and intraperitoneally on postoperative pain as a part of a multimodal analgesia method after laparoscopic cholecystectomies. METHODS: The study was performed on 90 ASA I-III patients aged between 20 and 70 years who underwent elective laparoscopic cholecystectomy. All patients had the same general anaesthesia drug regimen. Patients were randomized into three groups by a closed envelope method: group I (n=30), trocar site local anaesthetic infiltration (20 mL of 0...
December 2016: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28042634/anesthesia-methods-used-by-anesthetic-specialists-for-circumcision-cases-national-survey-study-for-turkey
#12
Cafer Altaş, Gamze Küçükosman, Bülent S Yurtlu, Rahşan D Okyay, Bengü G Aydın, Özcan Pişkin, Murat Çimencan, Hilal Ayoğlu, Volkan Hancı, Işıl Özkoçak-Turan
To examine the anesthesiologist's choice for anesthesia techniques and drugs in circumcision and determine the preoperative examination, intraoperative monitoring techniques, postoperative analgesia methods, and common complications among anesthesiologists working in Turkey. Methods: This cross-sectional study was conducted at Bulent Ecevit University Hospital, Zonguldak, Turkey, between May and July 2012. Survey data were obtained via survey forms through electronic data over the web. The questionnaire consists of 20 questions...
January 2017: Saudi Medical Journal
https://www.readbyqxmd.com/read/28040125/preoperative-measurement-of-maternal-abdominal-circumference-relates-the-initial-sensory-block-level-of-spinal-anesthesia-for-cesarean-section-an-observational-study
#13
Chi-Hang Kuok, Chung-Hsin Huang, Pei-Shan Tsai, Yuan-Pi Ko, Wei-Shih Lee, Yung-Wei Hsu, Fang-Yu Hung
OBJECTIVE: Lumbosacral cerebrospinal fluid volume is decreased as the enlarging uterus compresses the inferior vena cava during pregnancy. A subsequent greater cephalad spread of sensory blockade is observed. Gravid uterus plays a crucial role in affecting the spinal anesthesia level. We hypothesized that maternal abdominal circumference can reflect compressive effect of the uterus and investigated the relationship between abdominal circumference and the level of sensory blockade, and incidence of hypotension following spinal anesthesia with hyperbaric bupivacaine in term parturients...
December 2016: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28033159/effect-of-perineural-dexamethasone-on-the-duration-of-single-injection-saphenous-nerve-block-for-analgesia-after-major-ankle-surgery-a-randomized-controlled-study
#14
Siska Bjørn, Frank Linde, Kristian K Nielsen, Jens Børglum, Rasmus Wulff Hauritz, Thomas Fichtner Bendtsen
BACKGROUND AND OBJECTIVES: Patients undergoing major elective ankle surgery often experience pain from the saphenous nerve territory persisting beyond the duration of a single-injection saphenous nerve block. We hypothesized that perineural dexamethasone as an adjuvant for the saphenous nerve block prolongs the duration of analgesia and postpones as well as reduces opioid-requiring pain. METHODS: Forty patients were included in this prospective, randomized, controlled study...
December 29, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/28032304/l-carnitine-reduces-susceptibility-to-bupivacaine-induced-cardiotoxicity-an-experimental-study-in-rats
#15
Gail K Wong, Carolyne Pehora, Mark W Crawford
BACKGROUND: The primary aim of this study was to evaluate the effect of acute administration of L-carnitine 100 mg·kg(-1) iv on susceptibility to bupivacaine-induced cardiotoxicity in rats. METHODS: In the first of two experiments, L-carnitine 100 mg·kg(-1) iv (n = 10) or saline iv (n = 10) was administered to anesthetized and mechanically ventilated Sprague-Dawley rats following which an infusion of bupivacaine 2.0 mg·kg(-1)·min(-1) iv was given until asystole occurred...
December 28, 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/28029532/role-of-periarticular-liposomal-bupivacaine-infiltration-in-patients-undergoing-total-knee-arthroplasty-a-meta-analysis-of-comparative-trials
#16
Preet Mohinder Singh, Anuradha Borle, Anjan Trikha, Lia Michos, Ashish Sinha, Basavana Goudra
BACKGROUND: Over last 2 years, many trials have evaluated newly approved liposomal bupivacaine for periarticular infiltration in total knee arthroplasty (TKA) with mixed results. Our meta-analysis attempts to consolidate the results and make evidence-based conclusions. METHODS: Trails comparing periarticular infiltration of liposomal bupivacaine to conventional analgesic regimens for total knee arthroplasty published till June 2016 were searched in medical database...
October 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28027453/pethidine-efficacy-in-achieving-the-ultrasound-guided-oblique-subcostal-transversus-abdominis-plane-block-in-laparoscopic-cholecystectomy-a-prospective-study
#17
Caius Mihai Breazu, Lidia Ciobanu, Adrian Bartos, Raluca Bodea, Petru Adrian Mircea, Daniela Ionescu
Pethidine is a synthetic opioid with local anesthetic properties. Our goal was to evaluate the analgesic efficacy of pethidine for achieving the ultrasound-guided oblique subcostal transversus abdominis plane (OSTAP) block in laparoscopic cholecystectomy. This prospective, double-blind study included 79 patients of physical status I and II according to American Society of Anesthesiologists, scheduled for elective laparoscopic cholecystectomy. The patients were randomly allocated into three groups, depending on the drug used to achieve preoperative bilateral OSTAP block: 1) OSTAP-Placebo (treated with normal saline); 2) OSTAP-Bupivacaine (treated with 0...
December 27, 2016: Bosnian Journal of Basic Medical Sciences
https://www.readbyqxmd.com/read/28025352/chronic-whiplash-associated-disorders-wad-responses-to-nerve-blocks-of-cervical-zygapophyseal-joints
#18
Mats Persson, Jan Sörensen, Björn Gerdle
OBJECTIVE: This study explores the prevalence of facet joint pain in chronic Whiplash Associated Disorder (WAD). DESIGN: Forty-seven patients with chronic WAD were scheduled for medial branch blocks of the cervical spine. METHODS: The patient's localization of the pain together with established pain maps guided to the first level of zygapophyseal joint to be tested. The joint was anesthetized by injecting bupivacaine (0.5 ml; 5 mg/ml) to the medial branches of the cervical dorsal rami above and below the joint...
December 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28018759/could-the-use-of-an-enhanced-recovery-protocol-in-laparoscopic-donor-nephrectomy-be-an-incentive-for-live-kidney-donation
#19
Aparna Rege, Harold Leraas, Deepak Vikraman, Kadiyala Ravindra, Todd Brennan, Tim Miller, Julie Thacker, Debra Sudan
INTRODUCTION AND BACKGROUND: Gastrointestinal (GI) recovery after major abdominal surgery can be delayed from an ongoing need for narcotic analgesia thereby prolonging hospitalization. Enhanced recovery after surgery (ERAS) is a multimodal perioperative care pathway designed to facilitate early recovery after major surgery by maintaining preoperative body composition and physiological organ function and modifying the stress response induced by surgical exposure. Enhanced recovery programs (ERPs) in colorectal surgery have decreased the duration of postoperative ileus and the hospital stay while showing equivalent morbidity, mortality, and readmission rates in comparison to the traditional standard of care...
November 22, 2016: Curēus
https://www.readbyqxmd.com/read/28009223/development-of-an-enhanced-recovery-after-surgery-eras-approach-for-lumbar-spinal-fusion
#20
Michael Y Wang, Peng-Yuan Chang, Jay Grossman
OBJECTIVE Over the past decade, Enhancing Recovery After Surgery (ERAS) programs have been implemented throughout the world across multiple surgical disciplines. However, to date no spinal surgery equivalent has been described. In this report the authors review the development and implementation of a "fast track" surgical approach for lumbar fusion. METHODS The first 42 consecutive cases in which patients were treated with the new surgical procedure were reviewed. A combination of endoscopic decompression, expandable cage deployment, and percutaneous screw placement were performed with liposomal bupivacaine anesthesia to allow the surgery to be performed without general endotracheal anesthesia...
December 23, 2016: Journal of Neurosurgery. Spine
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