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Anesthesia and pain management

Harold S Minkowitz, David Leiman, Timothy Melson, Neil Singla, Karen DiDonato, Pamela P Palmer
BACKGROUND: Results from a phase-3, prospective, randomized, double-blind, placebo-controlled trial evaluating sufentanil sublingual tablet 30 mcg (SST) for the management of pain after ambulatory abdominal surgery are presented. METHODS: Adults with American Society of Anesthesiologists status 1 - 3 scheduled to undergo abdominoplasty, open tension-free inguinal hernioplasty, or laparoscopic abdominal surgery under general or spinal anesthesia that did not include intrathecal opioids during the operation were eligible...
October 26, 2016: Pain Practice: the Official Journal of World Institute of Pain
Jeong-Min Hong, Eunsoo Kim, Hae-Kyu Kim, Do-Won Lee, Ji-Seok Baik, Ji-Youn Lee
INTRODUCTION: Interstitial lung disease (ILD), which is the most common form of respiratory involvement of Sjȍgren syndrome (SS), is highly associated with postoperative pulmonary complications after surgery. We report the successful anesthetic management of a cervical cancer patient with SS and ILD under combined spinal-epidural anesthesia (CSE) to avoid postoperative pulmonary complications. CASE DESCRIPTION: A 41-year-old woman with SS complicated by recently progressive ILD was scheduled for an elective radical hysterectomy under the diagnosis of cervical cancer...
2016: SpringerPlus
Kristy Bultema, Sara Fowler, Melissa Drum, Al Reader, John Nusstein, Mike Beck
INTRODUCTION: In the treatment of patients with symptomatic irreversible pulpitis, endodontic debridement is a predictable method to relieve pain. However, there are clinical situations in which emergency care cannot be provided immediately. An unexplored treatment option in these cases may be the use of a long-acting anesthetic to reduce pain in untreated irreversible pulpitis. Some medical studies have shown potential for infiltrations of liposomal bupivacaine (Exparel; Pacira Pharmaceuticals, San Diego, CA) to prolong pain relief and reduce opioid use postoperatively...
October 18, 2016: Journal of Endodontics
David Altschul, Andrew Kobets, Jonathan Nakhla, Ajit Jada, Rani Nasser, Merritt D Kinon, Reza Yassari, John Houten
OBJECTIVE Postoperative urinary retention (POUR) is a common problem leading to morbidity and an increased hospital stay. There are limited data regarding its baseline incidence in patients undergoing spinal surgery and the risk factors with which it may be associated. The purpose of this study was to evaluate the incidence of POUR in elective spine surgery patients and determine the factors associated with its occurrence. METHODS The authors retrospectively reviewed the records of patients who had undergone elective spine surgery and had been prospectively monitored for POUR during an 18-month period...
October 21, 2016: Journal of Neurosurgery. Spine
Silvana Granado Nogueira da Gama, Elaine Fernandes Viellas, Jacqueline Alves Torres, Maria Helena Bastos, Odaléa Maria Brüggemann, Mariza Miranda Theme Filha, Arthur Orlando Correa Schilithz, Maria do Carmo Leal
BACKGROUND: The participation of nurses and midwives in vaginal birth care is limited in Brazil, and there are no national data regarding their involvement. The goal was to describe the participation of nurses and nurse-midwives in childbirth care in Brazil in the years 2011 and 2012, and to analyze the association between hospitals with nurses and nurse-midwives in labor and birth care and the use of good practices, and their influence in the reduction of unnecessary interventions, including cesarean sections...
October 17, 2016: Reproductive Health
H Liu, R Tariq, G L Liu, H Yan, A D Kaye
The intrathecal space has become an important anatomic site for medical intervention not only in anesthesia practice, but also in many other medical specialties. Undesired/inadvertent intrathecal injections (UII) are generally rare. There is tremendous variation in reported inadvertent administrations via an intrathecal route in the literature, mainly as individual cases and very small case-series reports. This review aims to identify potential sources of UII, its clinical presentations, and appropriate management...
October 21, 2016: Acta Anaesthesiologica Scandinavica
Samina Ismail, Aliya Ahmed, Muhammad Qamarul Hoda, Muhammad Sohaib, Zia-Ur-Rehman
All laparoscopic cholecystectomy (LC) patients in our hospital setting are admitted overnight. This article assesses the contribution of factors like postoperative nausea and vomiting (PONV), postoperative pain and surgical complications to overnight stay after elective LC. This 1-year observational study included patients having normal liver functions undergoing elective LC before 1400 h. The collected data included patient demographics, co-morbidities, PONV, pain scores, complications, surgical time, anesthesia technique, use of prophylactic antiemetics, analgesics, patient satisfaction and desire to have this surgery as day case or in-patient procedure...
October 20, 2016: Updates in Surgery
Liehua Liu, Shiming Cheng, Rui Lu, Qiang Zhou
Aim. This report introduces extrapedicular infiltration anesthesia as an improved method of local anesthesia for unipedicular percutaneous vertebroplasty or percutaneous kyphoplasty. Method. From March 2015 to March 2016, 44 patients (11 males and 33 females) with osteoporotic vertebral compression fractures with a mean age of 71.4 ± 8.8 years (range: 60 to 89) received percutaneous vertebroplasty or percutaneous kyphoplasty. 24 patients were managed with conventional local infiltration anesthesia (CLIA) and 20 patients with both CLIA and extrapedicular infiltration anesthesia (EPIA)...
2016: BioMed Research International
Chris Durkin, Travis Schisler, Jens Lohser
PURPOSE OF REVIEW: Despite marked improvements in perioperative outcomes, esophagectomy continues to be a high-risk operation associated with significant morbidity and mortality. Progress has been achieved through evidence-based changes in preoperative optimization, intraoperative ventilation strategies, fluid therapy, and analgesia, as well as expedited postoperative recovery pathways. This review will summarize the recent literature on the anesthetic management of patients undergoing esophageal resection...
October 18, 2016: Current Opinion in Anaesthesiology
Ashutosh Sahu, Rajnish Kumar, Mumtaz Hussain, Ajit Gupta, K H Raghwendra
BACKGROUND: Regional anesthesia using paravertebral block has been suggested as an ideal adjunct to general anesthesia for modified radical mastectomy. Paravertebral block is an effective management of peri-operative pain for Modified radical mastectomy, however, there are no established guidelines regarding what is the most suitable strategy when varying drugs and dosages between different groups. AIM: To evaluate the effectiveness of paravertebral block comparing the most frequently employed drugs in this procedure (bupivacaine vs ropivacaine)...
September 2016: Anesthesia, Essays and Researches
S Parthasarathy, R Sripriya, N Krishnaveni
Intestinal obstruction is associated with significant morbidity and mortality. Scientific assessment of the cause, site of obstruction, appropriate correction of the fluid deficit and electrolyte imbalance with preoperative stabilization of blood gases is ideal as a preoperative workup. Placement of a preoperative epidural catheter especially in the thoracic interspace takes care of perioperative pain and stress reduction. Intraoperative management by controlled general anesthesia administering a relative high inspired fraction of oxygen with invasive monitoring in selected sick cases is mandatory...
September 2016: Anesthesia, Essays and Researches
Fernanda Pacella, Enzo Agostinelli, Sandra Cinzia Carlesimo, Marcella Nebbioso, Roberto Secondi, Michele Forastiere, Elena Pacella
BACKGROUND: Ozurdex is a 700 mcg dexamethasone intravitreal implant, approved for the management of macular edema secondary to retinal vein occlusion, and other related pathoglogiesAnterior chamber dislocation of Ozurdex represents an uncommon complication of the intravitreal injection, which can be managed by repositioning the implant into the vitreous cavity. We describe the case of a successful repositioning of an Ozurdex implant by mobilization and subsequent balanced saline solution injection in the anterior chamber...
October 13, 2016: Journal of Medical Case Reports
Keith Willett, David J Keene, Dipesh Mistry, Julian Nam, Elizabeth Tutton, Robert Handley, Lesley Morgan, Emma Roberts, Andrew Briggs, Ranjit Lall, Timothy J S Chesser, Ian Pallister, Sarah E Lamb
Importance: Ankle fractures cause substantial morbidity in older persons. Surgical fixation is the contemporary intervention but is associated with infection and other healing complications. Objective: To determine whether initial fracture treatment with close contact casting, a molded below-knee cast with minimal padding, offers outcome equivalent to that with immediate surgery, with fewer complications and less health resource use. Design, Setting, and Participants: This was a pragmatic, equivalence, randomized clinical trial with blinded outcome assessors...
October 11, 2016: JAMA: the Journal of the American Medical Association
Sung Kwan Choi, Myung Ha Yoon, Jung Il Choi, Woong Mo Kim, Bong Ha Heo, Keun Seok Park, Ji A Song
BACKGROUND: Although intraoperative opioids provide more comfortable anesthesia and reduce the use of postoperative analgesics, it may cause opioid induced hyperalgesia (OIH). OIH is an increased pain response to opioids and it may be associated with N-methyl-D-aspartate (NMDA) receptor. This study aimed to determine whether intraoperative nefopam or ketamine, known being related on NMDA receptor, affects postoperative pain and OIH after continuous infusion of intraoperative remifentanil...
October 2016: Korean Journal of Anesthesiology
Romeo Patini, Edoardo Staderini, Patrizia Gallenzi
Cowden's Syndrome (CS) is a rare congenital autosomal dominant disorder that affects around 1/200000 patients with an incomplete penetrance and variable expressivity, characterized by alterations in a tumor suppressor gene. A 14-year-old Caucasian male patient came to the attention of the authors complaining of palm nodules, gingival bleeding and painful pedunculated lesions on the lips and on the labial side of anterior sextants. After genetic investigation the final diagnosis of a Cowden Syndrome was made...
October 2016: Journal of Clinical and Experimental Dentistry
Iman Khalil, Saad E Itani, Zeina Naja, Ahmad Salah Naja, Fouad M Ziade, Jean-Marc Ayoubi, Mariam A El-Rajab, Zoher M Naja
STUDY OBJECTIVE: Compare the effectiveness of nerve stimulator-guided pudendal nerve block (PNB) vs general anesthesia (GA) for anterior and posterior (AP) colporrhaphy in terms of pain relief and analgesic consumption within 24 and 48 hours postoperatively. DESIGN: Prospective randomized trial. PATIENTS: Fifty-seven patients whose ages ranged between 20 and 53 years scheduled to undergo AP colporrhaphy due to the presence of cystorectocele...
November 2016: Journal of Clinical Anesthesia
Adriana D Oprea, Christopher J Noto, Thomas M Halaszynski
As a result of the aging US population and the subsequent increase in the prevalence of coronary disease and atrial fibrillation, therapeutic use of anticoagulants has increased. Perioperative and periprocedural management of anticoagulated patients has become routine for anesthesiologists, who frequently mediate communication between the prescribing physician and the surgeon and assess the risks of both thromboembolic complications and hemorrhage. Data from randomized clinical trials on perioperative management of antithrombotic therapy are lacking...
November 2016: Journal of Clinical Anesthesia
Marcus Hards, Arisa Harada, Isobel Neville, Sheelagh Harwell, Mahwash Babar, Abdulsatar Ravalia, Giles Davies
STUDY OBJECTIVES: To determine the effectiveness of serratus plane block performed under direct vision on postoperative pain after mastectomy. DESIGN: We performed a retrospective study of elective breast surgery patients undergoing mastectomy over 6 months. We collected data on the outcomes for the pain score and use of analgesia in recovery, the use of analgesia and antiemetics overnight, and the pain score and mobilization status of the patient 1 day after the operation...
November 2016: Journal of Clinical Anesthesia
Stephen King, Elizabeth S Roberts, Jonathan N King
BACKGROUND: Few pharmaceuticals are registered in cats for the management of post-operative pain and inflammation. The objective of this study was to assess the field efficacy and safety of an injectable formulation of the nonsteroidal anti-inflammatory drug robenacoxib in cats undergoing surgery. The study was a multi-center, prospective, randomized, masked, parallel-group, placebo-controlled clinical trial. A total of 349 cats were enrolled and underwent surgery comprising forelimb onychectomy, as an example of orthopedic surgery, plus either ovariohysterectomy or castration...
September 29, 2016: BMC Veterinary Research
Bohdan W Chopko
BACKGROUND: Spondylytic degeneration of the axial lumbar spine is a major cause of pain and disability. Recent advances in spinal surgical instrumentation, including percutaneous access and fusion techniques, have made possible the performance of instrumented fusion through small incisions. By blending strategies of interventional pain management, neuroradiology, and conventional spine surgery, it is now feasible to treat spinal axial pain using permanent fixation techniques and local anesthesia in the setting of a fluoroscopy suite using mild sedation and local anesthesia...
June 2016: J Spine Surg
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