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https://www.readbyqxmd.com/read/28214338/sciatic-neuropathy-due-to-popliteal-fossa-nerve-block
#1
Adam Aubuchon, W David Arnold, Anna Bracewell, J Chad Hoyle
INTRODUCTION: Sciatic neuropathy following popliteal nerve block (PNB) for regional anesthesia is considered uncommon but has been increasingly recognized in the literature. We identified a case of sciatic neuropathy that occurred after bunionectomy during which a PNB had been performed. METHODS: To understand the frequency of PNB-related sciatic neuropathy we performed a retrospective review of sciatic neuropathies at our center over a five year period. RESULTS: Forty-five cases of sciatic neuropathy were reviewed...
February 18, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/28153458/ten-year-trends-and-independent-risk-factors-for-unplanned-readmission-following-elective-total-joint-arthroplasty-at-a-large-urban-academic-hospital
#2
Matthew A Varacallo, Leah Herzog, Nader Toossi, Norman A Johanson
BACKGROUND: Total joint arthroplasty procedures continue to provide consistent, long-term success and high patient satisfaction scores. However, early unplanned readmission to the hospital imparts significant financial risks to individual institutions as we shift away from the traditional fee-for-service payment model. METHODS: Using a combination of our hospital's administrative database and retrospective chart reviews, we report the 30-day and 90-day readmission rates and all causes of readmission following all unilateral, primary elective total hip and knee arthroplasty procedures at a large, urban, academic hospital from 2004 to 2013...
December 27, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28106610/-opt-out-and-access-to-anesthesia-care-for-elective-and-urgent-surgeries-among-u-s-medicare-beneficiaries
#3
Eric C Sun, Franklin Dexter, Thomas R Miller, Laurence C Baker
BACKGROUND: In 2001, the Centers for Medicare and Medicaid Services issued a rule allowing U.S. states to "opt out" of the regulations requiring physician supervision of nurse anesthetists in an effort to increase access to anesthesia care. Whether "opt out" has successfully achieved this goal remains unknown. METHODS: Using Medicare administrative claims data, we examined whether "opt out" reduced the distance traveled by patients, a common measure of access, for patients undergoing total knee arthroplasty, total hip arthroplasty, cataract surgery, colonoscopy/sigmoidoscopy, esophagogastroduodenoscopy, appendectomy, or hip fracture repair...
March 2017: Anesthesiology
https://www.readbyqxmd.com/read/28094482/real-time-ultrasound-guided-spinal-anesthesia-in-patients-with-predicted-difficult-anatomy
#4
Hesham Elsharkawy, Ankit Maheshwari, Rovnat Babazade, Anahi Perlas, Sherif Zaky, Loran M Soliman
BACKGROUND: There are limited reports of lumbar neuraxial blocks using real-time ultrasound in patients with predicted difficulties. We compared the number of attempts to perform spinal anesthesia using real time ultrasound guidance versus landmark technique in patients meeting predefined criteria for difficult spinal anesthesia. We also compared procedure time, block success, patient satisfaction and difficulty scores between groups. METHODS: Following institutional review board approval patients scheduled for total hip or knee arthroplasty with expected difficulty to perform spinal anesthesia were included...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27903340/-the-clinical-application-of-lumbar-plexus-the-first-posterior-sacral-foramina-block-for-hip-arthroplasty-in-elderly-patients
#5
J Li, X J Ke, Y Liu, K Chen, M B Chen, W Mei
Objective: To evaluate the clinical efficacy of lumbar plexus-the first posterior sacral foramina block as an anesthesia technique for hip arthroplasty in elderly patients. Methods: Forty-four patients, aged 60-91 years, weighing 37-100 kg, American Society of Anesthesiologists (ASA) Ⅰ-Ⅲ, underwent elective hip arthroplasty in Tongji Hospital from February 2015 to January 2016.All patients received lumbar plexus and the first posterior sacral foramina block.The first posterior sacral foramina puncture point of 23 cases were located by traditional positioning method, the others were orientated via ultrasonic method...
November 22, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27898510/the-effect-of-implementation-of-preoperative-and-postoperative-care-elements-of-a-perioperative-surgical-home-model-on-outcomes-in-patients-undergoing-hip-arthroplasty-or-knee-arthroplasty
#6
Thomas R Vetter, Joydip Barman, James M Hunter, Keith A Jones, Jean-Francois Pittet
BACKGROUND: The Perioperative Surgical Home (PSH) seeks to remedy the currently highly fragmented and expensive perioperative care in the United States. The 2 specific aims of this health services research study were to assess the association between the preoperative and postoperative elements of an initial PSH model and a set of (1) clinical, quality, and patient safety outcomes and (2) operational and financial outcomes, in patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA)...
November 28, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27879955/hypobaric-versus-isobaric-spinal-levobupivacaine-for-total-hip-arthroplasty
#7
Alessandro Vergari, Luciano Frassanito, Roberta Nestorini, Cosimo T Caputo, Angelo Chierichini, Enrico DI Stasio, Marco Rossi
BACKGROUND: Spinal anesthesia (SA) in the lateral decubitus position is often used to perform total hip arthroplasty (THA). Hypobaric local anesthetic ensures enhanced and prolonged sensory and motor block in the involved side. The aim of this study was to compare the intraoperative anesthetic efficacy of hypobaric with isobaric levobupivacaine solutions for THA. METHODS: Forty patients scheduled to elective THA were allocated into two groups: isobaric levobupivacaine group (IL group) and hypobaric levobupivacaine group (HL group)...
November 23, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27843042/low-risk-of-thromboembolic-events-after-routine-administration-of-tranexamic-acid-in-hip-and-knee-arthroplasty
#8
Rune V Madsen, Christian S Nielsen, Thomas Kallemose, Henrik Husted, Anders Troelsen
BACKGROUND: The blood-conserving effect of intravenous (IV) tranexamic acid (TXA) is well-documented for total hip arthroplasty (THA) and total knee arthroplasty (TKA). However, the risk of thromboembolic (TE) events after routine use of TXA is unclear and the safety profile is debated. This retrospective study investigates patient characteristics, occurrences, and predictors of TE events after routine administration of IV TXA in THA and TKA. METHODS: Three thousand one hundred fifty-nine THA or TKA procedures performed from 2007-2013 at our institution were included...
October 20, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27793238/pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#9
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/27788137/postoperative-mortality-after-hip-fracture-surgery-a-3-years-follow-up
#10
Oya Kilci, Canan Un, Ozlem Sacan, Mehmet Gamli, Semih Baskan, Mustafa Baydar, Bulent Ozkurt
BACKGROUND AND AIMS: To determine mortality rates and predisposing factors in patients operated for a hip fracture in a 3-year follow-up period. METHODS: The study included patients who underwent primary surgery for a hip fracture.The inclusion criteria were traumatic, non-traumatic, osteoporotic and pathological hip fractures requiring surgery in all age groups and both genders. Patients with periprosthetic fractures or previous contralateral hip fracture surgery and patients who could not be contacted by telephone were excluded...
2016: PloS One
https://www.readbyqxmd.com/read/27783839/intraoperative-hypothermia-in-total-hip-and-knee-arthroplasty
#11
Nicholas B Frisch, Andrew M Pepper, Edward Rooney, Craig Silverton
Total hip arthroplasty (THA) and total knee arthroplasty (TKA) are common and successful orthopedic procedures, and as their frequency continues to increase substantially, the focus on limiting perioperative complications heightens. Intraoperative normothermia is recommended to minimize additional complications, but limited evidence exists regarding the effect of hypothermia on orthopedic patients. The purpose of this retrospective study was to determine the incidence of perioperative hypothermia in the setting of TKA and THA, and to evaluate its impact on complications and outcomes...
October 25, 2016: Orthopedics
https://www.readbyqxmd.com/read/27684871/efficacy-of-ultrasound-guided-fascia-iliaca-compartment-block-after-hip-hemiarthroplasty-a-prospective-randomized-trial
#12
RANDOMIZED CONTROLLED TRIAL
Seunguk Bang, Jihyun Chung, Jaejung Jeong, Hahyeon Bak, Dongju Kim
BACKGROUND: The fascia iliaca compartment block (FICB) provides an analgesic effect in patients with femur fractures. However, the postoperative pain after hip surgery is different from that after femur fracture, because of the difference in the degree and location of tissue trauma. Whether FICB provides effective postoperative analgesia in patients undergoing total hip arthroplasty is not well understood. Moreover, there is no prospective randomized study to evaluate FICB as a postoperative analgesia in hemiarthroplasty...
September 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27643835/the-impact-of-peripheral-nerve-blocks-on-perioperative-outcome-in-hip-and-knee-arthroplasty-a-population-based-study
#13
Stavros G Memtsoudis, Jashvant Poeran, Crispiana Cozowicz, Nicole Zubizarreta, Umut Ozbek, Madhu Mazumdar
The role of anesthesia techniques on perioperative outcomes on a population level has recently gained widespread interest. Although mainly neuraxial vs general anesthesia has been addressed, population-level data on the impact of peripheral nerve blocks (PNBs) are still lacking. Therefore, we investigated the association between PNB use and outcomes using retrospective data on 1,062,152 recipients of hip and knee arthroplasties (total hip arthroplasty [THA]/total knee arthroplasty [TKA]) from the national Premier Perspective database (2006-2013)...
October 2016: Pain
https://www.readbyqxmd.com/read/27639506/-pain-after-major-elective-orthopedic-surgery-of-the-lower-limb-and-type-of-anesthesia-does-it-matter
#14
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/27585725/effects-of-positive-suggestions-on-the-need-for-red-blood-cell-transfusion-in-orthopedic-surgery
#15
Csenge Szeverényi, Zoltán Csernátony, Ágnes Balogh, Tünde Simon, Katalin Varga
This study examined whether positive suggestions applied without a hypnotic induction in the perioperative period reduces the need for red blood cell transfusions in patients who underwent total hip or knee arthroplasties with spinal anesthesia. No hypnotic assessment was performed. Ninety-five patients were randomly assigned to the suggestion group (n = 45) and to the control group (n = 50). Patients in the suggestion group received verbal suggestions before and audiotaped suggestions during the surgery for reducing blood loss, anxiety, postoperative pain, and fast recovery...
October 2016: International Journal of Clinical and Experimental Hypnosis
https://www.readbyqxmd.com/read/27578537/early-outcomes-of-primary-total-hip-arthroplasty-after-prior-lumbar-spinal-fusion
#16
Jeffrey J Barry, David C Sing, Thomas P Vail, Erik N Hansen
BACKGROUND: The coexistence of degenerative hip disease and spinal pathology is not uncommon with the number of surgical treatments performed for each condition increasing annually. The limited research available suggests spinal pathology portends less pain relief and worse outcomes after total hip arthroplasty (THA). We hypothesize that primary THA patients with preexisting lumbar spinal fusions (LSF) experience worse early postoperative outcomes. METHODS: This study is a retrospective matched cohort study...
August 8, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27577731/risk-factors-for-mortality-in-geriatric-hip-fractures-a-compressional-study-of-different-surgical-procedures-in-785-consecutive-patients
#17
Ersin Ercin, M Gokhan Bilgili, Cihangir Sari, S Hakan Basaran, Bulent Tanriverdi, Erdem Edipoglu, K Mumtaz Celen, Halil Cetingok, Cemal Kural
BACKGROUND: Only a little is known about whether type of surgical intervention has an effect on mortality of these patients. Our primary objective was to assess whether different type of surgical procedures has an effect on mortality among elderly patients with hip fracture. A secondary objective was to examine factors that are related to mortality in our patient population. Our hypothesis is that type of surgical procedure, especially external fixation, should have an influence on mortality outcomes...
January 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/27577065/what-are-the-risk-factors-for-dislocation-of-hip-bipolar-hemiarthroplasty-through-the-anterolateral-approach-a-nested-case-control-study
#18
Lianhua Li, Jixin Ren, Jia Liu, Hao Wang, Qinghua Sang, Zhi Liu, Tiansheng Sun
BACKGROUND: Hip dislocation after treatment of a femoral neck fracture with a hemiarthroplasty remains an important problem in the treatment of hip fractures, but the associations between patient factors and surgical factors, and how these factors contribute to dislocation in patients who have undergone bipolar hemiarthroplasty through an anterolateral approach for femoral neck fracture currently are only poorly characterized. QUESTIONS/PURPOSES: We evaluated patients with bipolar hemiarthroplasty dislocation after surgery for femoral neck fracture treated through an anterolateral approach and asked: (1) What are the frequency, characteristics, and risk factors of bipolar hemiarthroplasty dislocations? (2) What are the frequency, characteristics, and risk factors of bipolar hemiarthroplasty dissociations? METHODS: A review of hospital records for patients who underwent bipolar hip hemiarthroplasty for femoral neck fracture at one hospital between July 2004 and August 2014 was conducted...
December 2016: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/27547384/recent-advances-in-the-treatment-of-hip-fractures-in-the-elderly
#19
REVIEW
Joshua C Rozell, Mark Hasenauer, Derek J Donegan, Mark Neuman
The treatment of hip fractures in the elderly represents a major public health priority and a source of ongoing debate among orthopaedic surgeons and anesthesiologists. Most of these injuries are treated with surgery in an expedient fashion. From the surgical perspective, there are certain special considerations in this population including osteoporosis, pre-existing arthritis, age, activity level, and overall health that contribute to the type of surgical fixation performed. Open reduction and internal fixation versus arthroplasty remain the two major categories of treatment...
2016: F1000Research
https://www.readbyqxmd.com/read/27546475/reflective-blankets-are-as-effective-as-forced-air-warmers-in-maintaining-patient-normothermia-during-hip-and-knee-arthroplasty-surgery
#20
Clarissa Tjoakarfa, Vikram David, Atlas Ko, Raphael Hau
BACKGROUND: The use of forced air warming devices in the operating room has been shown to cause disruption of laminar airflow and a potential for increase in surgical site contamination. In contrast, conductive warming devices such as reflective blankets do not disrupt airflow and therefore have no potential for this increase in surgical site infection. However, some studies have shown them to be inferior to forced air warming devices in maintaining normothermia. We tested the hypothesis that the use of reflective blankets is as effective as forced air warming devices in maintaining intraoperative normothermia after adequate prewarming...
July 21, 2016: Journal of Arthroplasty
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