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Anesthesia and pain management

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https://www.readbyqxmd.com/read/29790369/an-innovative-perioperative-pain-program-for-chronic-opioid-users-an-academic-medical-center-s-response-to-the-opioid-crisis
#1
Marie N Hanna, Traci J Speed, Ronen Shechter, Michael C Grant, Rosanne Sheinberg, Elizabeth Goldberg, Claudia M Campbell, Nicholas Theodore, Colleen G Koch, Kayode Williams
Increased utilization of prescription opioids for pain management has led to a nationwide public health crisis with alarming rates of addiction and opioid-related deaths. In the surgical setting, opioid prescriptions have been implicated as a contributing factor to the opioid epidemic. The authors developed an innovative model to address aspects of pain management and opioid utilization during preoperative evaluation, acute surgical hospitalization, and postoperative follow-up for chronic opioid users. This program involves multidisciplinary teams that include acute and chronic pain specialists, psychiatrists, integrative medicine specialists, and physical medicine and rehabilitation services...
May 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29782451/the-efficacy-of-regional-anesthesia-techniques-to-control-postoperative-pain-after-total-knee-arthroplasty
#2
Cecilia Otten, Karen S Dunn
BACKGROUND: Choosing the most effective type of anesthesia for controlling postoperative pain is paramount for improving patient outcomes and patient satisfaction. Most often, the type of anesthesia selected is dependent on the duration and type of surgical procedure and anesthesiologist/surgeon preference. Using a combination of regional anesthesia techniques, however, remains the cornerstone of multimodal analgesia for postoperative pain management after total knee arthroplasty. PURPOSE: The purpose of this study was to determine what regional anesthesia techniques and/or combinations of regional anesthesia techniques provided the best postoperative pain control in patients who had undergone a total knee arthroplasty...
May 2018: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29763977/transforming-care-to-evidence-based-practice-with-scripted-messages-an-improvement-project-for-pain-management-in-outpatient-surgical-patients
#3
Lanell M Bellury, Karen Mullinax, Judi Mozingo, Berta Dantzler, Nancy McGee
BACKGROUND: Outpatient surgeries are common and most patients experience pain postoperatively requiring nursing attention to pain management. Scripting, recommended for consistent, targeted communication to improve patient satisfaction, has limited evidence to support its use. AIMS: To explore the effect of scripted messages on self-reported pain control and patient satisfaction with care in outpatient surgical patients. METHODS: A retrospective medical record review pre- and postintervention evaluated a pain management scripted message delivered at two time points (preoperatively and postoperatively)...
May 15, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29758372/percutaneous-endoscopic-lumbar-surgery-via-transfacet-approach-for-lumbar-synovial-cyst
#4
Hsuan-Han Wu, Lei Chu, Yong-Jian Zhu, Chun-Yuan Cheng, Chien-Min Chen
BACKGROUND: There are currently no high-quality studies on the optimal therapeutic approach for juxtafacet cyst as treatment guidelines have not been developed. Herein, a novel technique in which using an endoscopic transfacet approach to treat a patient with symptomatic lumbar synovial cyst was presented. . CASE DESCRIPTION: A 87-year-old man presented with severe dull pain in the right anterior thigh had developed. Lumbar magnetic resonance imaging (MRI) revealed disc extrusion over the central canal zone at the L2-3 and L4-L5 level, and an ovoid lesion with a hyperintense center plus a hypointense rim on the T2-weighted image...
May 11, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29758039/effects-of-palonosetron-for-prophylaxis-of-postoperative-nausea-and-vomiting-in-high-risk-patients-undergoing-total-knee-arthroplasty-a-prospective-randomized-double-blind-placebo-controlled-study
#5
Jung-Hee Ryu, Young-Tae Jeon, Byunghun Min, Jin-Young Hwang, Hye-Min Sohn
BACKGROUND: The preemptive multimodal pain protocols used in total knee arthroplasty (TKA) often cause emesis postoperatively. We investigated whether palonosetron prophylaxis reduces postoperative nausea and vomiting (PONV) in high-risk patients after TKA. METHODS: We randomized 120 female patients undergoing TKA to receive either palonosetron (0.075 mg, intravenous) or no antiemetic prophylaxis (0.9% saline, control group). All patients were given spinal anesthesia, a continuous femoral nerve block, and fentanyl-based intravenous patient controlled analgesia...
2018: PloS One
https://www.readbyqxmd.com/read/29737920/does-promethazine-shorten-the-length-of-stay-in-the-post-anesthesia-care-unit
#6
Jonathan P Eskander, Yury Rapoport, Elyse Cornett, Sonja Gennuso, Michael Franklin, Alan D Kaye, Charles J Fox
The combination of promethazine and opioids is known to have an opioid-sparing effect, thereby facilitating a reduction in total patient opioid consumption. In recent years, this practice has fallen out of favor in many healthcare facilities, except primarily in the post anesthesia care unit (PACU). The goal of this study was to highlight the potential of promethazine as a direct or indirect adjuvant medication in acute pain management. The present investigation was undertaken with a case series of adult female patients who underwent open total abdominal hysterectomies...
January 1, 2018: Journal of Perioperative Practice
https://www.readbyqxmd.com/read/29735858/comparison-of-the-analgesic-effects-of-pulse-radiofrequency-and-cryoablation-in-rabbits-with-mental-nerve-neuropathic-pain
#7
D G Canpolat, E Soylu, F Dogruel, N Kütük, F Ugur
Purpose: After mental nerve injury, several sensory disorders may occur. The alterations in sensation may differ from mild paresthesia to complete anesthesia, or neuropathic pain. Neuropathic pain is a difficult clinical condition to manage. The aim of this study was to compare the analgesic effects of pulsed radiofrequency (PRF) and cryoablation in an experimental mental nerve neuropathic pain model in rabbits. Materials and Methods: Fifteen rabbits were divided into three groups...
May 2018: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/29731586/piercing-ear-keloid-excision-using-loupe-magnification-and-topical-liquid-silicone-gel-as-adjuvant
#8
Bellam A Ramesh, J Mohan
Background: Keloid is an abnormal growth of scar at the site of skin injury, which usually does not regress. It proliferates beyond the original scar. The ear keloid usually develops after piercing injury to wear ornaments. A patient usually asks for removal of keloid, as it is aesthetically unpleasant. Patient may sometimes complain of itching and pain. Aim: The study was conducted to analyze results following excision of keloid with its tract and topical silicone gel as the postsurgical adjuvant...
January 2018: Journal of Cutaneous and Aesthetic Surgery
https://www.readbyqxmd.com/read/29730359/emerging-trends-in-pain-medication-management-back-to-the-future-a-focus-on-ketamine
#9
REVIEW
Meredith W Crumb, Candace Bryant, Timothy J Atkinson
Providers face many challenges when faced with pain management. Pain is complex, difficult to understand, diagnose, and especially enigmatic to manage. The discovery of non-opioid agents for pain management has become particularly important considering the on-going opioid epidemic. This review is focused on revisiting Ketamine, an agent that has historically been used for anesthesia in new ways to manage pain. Ketamine has unique pharmacologic properties that may prevent the development of pain as well as reduce chronic pain...
May 3, 2018: American Journal of Medicine
https://www.readbyqxmd.com/read/29728240/adaptive-median-binary-patterns-for-fully-automatic-nerves-tracking-in-ultrasound-images
#10
Mohammad Alkhatib, Adel Hafiane, Omar Tahri, Pierre Vieyres, Alain Delbos
BACKGROUND AND OBJECTIVE: In the last decade, Ultrasound-Guided Regional Anesthesia (UGRA) gained importance in surgical procedures and pain management, due to its ability to perform target delivery of local anesthetics under direct sonographic visualization. However, practicing UGRA can be challenging, since it requires high skilled and experienced operator. Among the difficult task that the operator can face, is the tracking of the nerve structure in ultrasound images. Tracking task in US images is very challenging due to the noise and other artifacts...
July 2018: Computer Methods and Programs in Biomedicine
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#11
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29720210/endoscopic-release-of-congenital-muscular-torticollis-with-radiofrequency-in-teenagers
#12
Jun-Liang Wang, Wei Qi, Yu-Jie Liu
BACKGROUND: Congenital muscular torticollis (CMT) is due to contracture of the sternocleidomastoid muscle which may cause activity limitations of the neck, tilt of the head, craniofacial asymmetry, and deformity of the skull. The authors present their experience of arthroscopic tight fibrous band release with radiofrequency in teenagers under local anesthesia and evaluate the clinical results. METHODS: A total of 69 patients who underwent arthroscopic release of CMT with radiofrequency under local anesthesia by a single surgeon could participate in this study...
May 3, 2018: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/29719126/randomized-controlled-trial-comparing-the-supraglottic-airway-to-use-of-an-endotracheal-tube-in-sinonasal-surgery
#13
Austin S Adams, Todd J Wannemuehler, Benjamin Hull, Jeffanie Wu, Rakesh K Chandra, Kate VonWahlde, Matthew S Shotwell, Stephen Harvey, Michael Higgins, Kelly McQueen, Justin H Turner
BACKGROUND: The supraglottic airway (SGA) represents an alternative to endotracheal intubation (endotracheal tube [ETT]) in many types of ambulatory surgery. Adoption of the SGA has progressed slowly in sinonasal surgery due to concerns about airway protection. The purpose of this study was to compare quality of life measures and indices of airway protection between patients undergoing sinonasal surgery who were ventilated via an SGA or ETT. METHODS: Patients undergoing outpatient sinonasal surgery were enrolled into a randomized, single-blind study in which patients would be ventilated with either an SGA or ETT...
May 2, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29714650/real-time-view-of-anesthetic-solution-spread-during-an-ultrasound-guided-thoracic-paravertebral-block
#14
Domenico P Santonastaso, Annabella de Chiara, Marco Rispoli, Giovanni Musetti, Vanni Agnoletti
BACKGROUND: Thoracic paravertebral block is a technique for perioperative analgesia in patients undergoing thoracic, chest wall, or breast surgery, or for pain management with rib fractures, which can be performed with or without ultrasound guidance. The ultrasound guidance technique can be used to identify the thoracic paravertebral space, guide needle placement, monitor the spread of local anesthetic (LA) solution, and reduce complications such as pleural puncture and pneumothorax. The possibility of assessing anesthetic spread in real time using ultrasound guidance during paravertebral block offers numerous advantages, including the immediate and accurate identification of the extent of nervous block, with a consequent reduction of LA dose...
March 1, 2018: Tumori
https://www.readbyqxmd.com/read/29703617/hazards-of-improper-dispensary-literature-review-and-report-of-an-accidental-chloroform-injection
#15
Prashant Verma, Patricia Tordik, Ali Nosrat
Several clear, transparent solutions are used in endodontics. Inappropriate dispensing methods can lead to accidental injection or accidental irrigation. These accidents can cause permanent tissue damage including damage to the bone, periodontium, nerves, and vasculature. This article reports on the consequences of an accidental chloroform injection. Nonsurgical retreatment of tooth #8 was planned as part of a restorative treatment plan in a 69-year-old woman. The dentist accidentally injected chloroform instead of local anesthesia because chloroform was loaded into the anesthetic syringe...
April 24, 2018: Journal of Endodontics
https://www.readbyqxmd.com/read/29696301/-radical-cystectomy-and-urinary-diversion-what-is-important
#16
REVIEW
J Noldus, G Niegisch, A Pycha, A Karl
BACKGROUND: In Germany, radical cystectomy with urinary diversion is the primary therapeutic option for localized muscle invasive urothelial bladder cancer. Modifications in the pre-, peri-, and postoperative phase have significantly improved outcomes. OBJECTIVES: Different factors and parameters are directly associated with patients' outcome. An overview on how to best approach this procedure is provided in this article. MATERIALS AND METHODS: The data regarding preparation and the procedure for the radical cystectomy followed by urinary diversion are separately analyzed...
April 25, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29696118/anesthetic-considerations-for-angelman-syndrome-case-series-and-review-of-the-literature
#17
Mary Ellen Warner, David P Martin, Mark A Warner, Ralitza H Gavrilova, Juraj Sprung, Toby N Weingarten
Background: Angelman syndrome is a rare neurodevelopmental disorder characterized by intellectual disability, severe speech impairment, ataxia, seizures, happy demeanor, distinctive craniofacial features, high vagal tone, and gamma-amino butyric acid receptor abnormalities. The aim of this report is to review our experience of patients with Angelman syndrome undergoing anesthetic management. Methods: We retrospectively reviewed perioperative course of patients with Angelman syndrome who underwent procedures under anesthesia from 2000 to 2016...
October 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/29691098/improved-patency-after-axillofemoral-bypass-for-aortoiliac-occlusive-disease
#18
Russell H Samson, David P Showalter, Michael R Lepore, Deepak G Nair, Douglas A Dorsay, Ricardo E Morales
OBJECTIVE: Axillofemoral bypasses (AxFBs) have been used since 1962 to treat aortoiliac disease. In the past, reported patency rates (37%-76%) for these extra-anatomic grafts have been inferior to those for anatomic aortic grafting. Reported low survival rates after AxFB (40%-50%) have confirmed that these procedures have been used primarily in patients at high risk for complications from aortofemoral bypass. However, modern medical and anesthesia management, preoperative scanning, donor artery preparation, postoperative graft surveillance, and graft technology may improve outcomes after AxFB, possibly supporting expansion of its use...
April 21, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29687529/lymphatic-imaging-and-intervention-in-a-pediatric-population-anesthetic-considerations
#19
David R Jobes, Lauren A Brown, Yoav Dori, Maxim Itkin, Susan C Nicolson
The recent adoption of an improved lymphatic access technique coupled with Dynamic Contrast-enhanced Magnetic Resonance Lymphangiography has introduced the ability to diagnose and treat severe lymphatic disorders unresponsive to other therapies. All pediatric patients presenting for lymphatic procedures require general anesthesia presenting challenges in managing highly morbid and comorbid conditions both from logistical as well as medical aspects. General anesthesia is used because of the procedural requirement for immobility to accurately place needles and catheters, treat pain secondary to contrast and glue injections, and to accommodate additional procedures...
April 23, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29686989/enhanced-recovery-after-surgery-protocols-in-major-urologic-surgery
#20
REVIEW
Natalija Vukovic, Ljubomir Dinic
The purpose of the review: The analysis of the components of enhanced recovery after surgery (ERAS) protocols in urologic surgery. Recent findings: ERAS protocols has been studied for over 20 years in different surgical procedures, mostly in colorectal surgery. The concept of improving patient care and reducing postoperative complications was also applied to major urologic surgery and especially procedure of radical cystectomy. This procedure is technically challenging, due to a major surgical resection and high postoperative complication rate that may reach 65%...
2018: Frontiers in Medicine
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