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anesthesia and analgesia

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https://www.readbyqxmd.com/read/28634320/comparison-of-2-analgesia-modalities-in-total-knee-replacement-surgery-is-there-an-effect-on-knee-function-rehabilitation
#1
Janis Zinkus, Lina Mockutė, Arūnas Gelmanas, Ramūnas Tamošiūnas, Arūnas Vertelis, Andrius Macas
BACKGROUND We compared the effects of continuous femoral nerve block (CFNB) and continuous intraarticular block (CIAB) on pain, functional recovery and adverse effects after total knee arthroplasty (TKA). MATERIAL AND METHODS We prospectively randomized 54 patients undergoing TKA into 2 groups: CFNB (Group F) and CIAB (Group I). Surgery was performed under spinal anesthesia. All patients received patient-controlled analgesia (PCA) with morphine, diclofenac, and acetaminophen for the first 72 h postoperatively...
June 20, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28634094/regional-anesthesia-in-total-joint-arthroplasty-what-is-the-evidence
#2
Dalia H Elmofty, Asokumar Buvanendran
Total joint arthroplasty is one of the most common surgical procedures performed for end-stage osteoarthritis. The increasing demand for knee and hip arthroplasties along with the improvement in life expectancy has created a substantial medical and economic impact on the society. Effective planning of health care for these individuals is vital. The best method for providing anesthesia and analgesia for total joint arthroplasty has not been defined. Yet, emerging evidence suggests that the type of anesthesia can affect morbidity and mortality of patients undergoing these procedures...
May 18, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28632541/hospital-based-acute-care-within-7-days-of-discharge-after-outpatient-arthroscopic-shoulder-surgery
#3
Jiabin Liu, David N Flynn, Wai-Man Liu, Lee A Fleisher, Nabil M Elkassabany
BACKGROUND: The rate of hospital-based acute care (defined as hospital transfer at discharge, emergency department [ED] visit, or subsequent inpatient hospital [IP] admission) after outpatient procedure is gaining momentum as a quality metric for ambulatory surgery. However, the incidence and reasons for hospital-based acute care after arthroscopic shoulder surgery are poorly understood. METHODS: We studied adult patients who underwent outpatient arthroscopic shoulder procedures in New York State between 2011 and 2013 using the Healthcare Cost and Utilization Project database...
June 16, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28631050/analgesia-nociception-index-ani-monitoring-in-patients-with-thoracic-paravertebral-block-a-randomized-controlled-study
#4
Nurseda Dundar, Alparslan Kus, Yavuz Gurkan, Kamil Toker, Mine Solak
The goal of the study was to evaluate the effectiveness of analgesia nociception index (ANI) monitoring during intraoperative period for patients with thoracic paravertebral block (TPVB) undergoing breast surgery under general anesthesia. This prospective randomized trial was performed after receiving ethics committee approval in 44 patients who were scheduled to undergo breast surgery under general anesthesia. TPVB was performed in the preoperative period using 20 mL of bupivacaine 0.25% at T4 level. Anesthesia maintenance was provided with sevoflurane in O2: air mixture and remifentanil infusion...
June 19, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28627290/continuous-adductor-canal-block-added-to-local-infiltration-analgesia-lia-after-total-knee-arthroplasty-has-no-additional-benefits-on-pain-and-ambulation-on-postoperative-day-1-and-2-compared-with-lia-alone
#5
Svava Gudmundsdottir, Jonas L Franklin
Background and purpose - The additional effects of a continuous adductor canal block (ACB) compared with a single-dose local infiltration anesthesia (LIA) after total knee arthroplasty (TKA) has not been widely researched. Both methods have good effect individually. We hypothesized that a continuous ACB added to a single-dose LIA would lower pain scores while ambulating on postoperative day 1 (POD1) and postoperative day 2 (POD2). Patients and methods - 69 participants were included in this prospective, randomized, double-blind, placebo-controlled trial...
June 19, 2017: Acta Orthopaedica
https://www.readbyqxmd.com/read/28625307/postcesarean-delivery-analgesia
#6
REVIEW
Brendan Carvalho, Alexander J Butwick
Effective pain management should be a key priority in women undergoing cesarean delivery. Suboptimal perioperative pain management is associated with chronic pain, greater opioid use, delayed functional recovery, impaired maternal-fetal bonding, and increased postpartum depression. Severe acute postoperative pain is also strongly associated with persistent pain after cesarean delivery. Multimodal analgesia is the core principle for cesarean delivery pain management. The use of neuraxial morphine and opioid-sparing adjuncts such as scheduled nonsteroidal anti-inflammatory medications and acetaminophen is recommended for all women undergoing cesarean delivery with neuraxial anesthesia unless contraindicated...
March 2017: Best Practice & Research. Clinical Anaesthesiology
https://www.readbyqxmd.com/read/28623089/optimal-intrathecal-hyperbaric-bupivacaine-dose-with-opioids-for-cesarean-delivery-a-prospective-double-blinded-randomized-trial
#7
Eiko Onishi, Mamoru Murakami, Keiji Hashimoto, Miho Kaneko
BACKGROUND: Single-shot spinal anesthesia is commonly used for cesarean delivery. Achieving adequate anesthesia throughout surgery needs to be balanced with associated complications. We investigated the optimal dose of intrathecal hyperbaric bupivacaine, co-administered with opioids, for anesthesia for cesarean delivery. METHODS: This prospective, randomized, double-blinded, dose-ranging trial included parturients scheduled to undergo cesarean delivery under spinal anesthesia...
April 13, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28621258/evaluation-of-pain-assessment-techniques-and-analgesia-efficacy-in-a-female-guinea-pig-cavia-porcellus-model-of-surgical-pain
#8
Vanessa L Oliver, Stephanie Athavale, Katherine E Simon, Lon V Kendall, Jean A Nemzek, Jennifer L Lofgren
Guinea pigs (Cavia porcellus) are a frequently used species in research, often involving potentially painful procedures.Therefore, evidence-based recommendations regarding analgesia are critically needed to optimize their wellbeing. Ourlaboratory examined the efficacy of carprofen and extended-release (ER) buprenorphine, alone and as a multimodal combination,for relieving postsurgical pain in guinea pigs. Animals were assessed by using evoked (mechanical hypersensitivity),nonevoked (video ethogram, cageside ethogram, time-to-consumption test), and clinical (weight loss) measurements for 96 h during baseline, anesthesia-analgesia, and hysterectomy conditions...
June 15, 2017: Journal of the American Association for Laboratory Animal Science: JAALAS
https://www.readbyqxmd.com/read/28620916/ketamine-does-not-enhance-the-quality-of-recovery-following-laparoscopic-cholecystectomy-a-randomized-controlled-trial
#9
E T Moro, I M P S S Feitosa, R G de Oliveira, G F P Saraiva, R Rosalino, V P Marossi, J A Bloomstone, L H C Navarro
BACKGROUND: Ketamine has been used as part of the multimodal analgesia technique in the acute perioperative period. The effect of perioperative intravenous small-dose ketamine on the quality of recovery from the patient point-of-view has not been assessed. We hypothesized that low-dose ketamine would enhance recovery following laparoscopic cholecystectomy under total intravenous anesthesia. METHODS: One hundred thirty five patients undergoing laparoscopic cholecystectomy were enrolled in this randomized, double-blind placebo-controlled trial...
June 15, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28620251/physiological-alteration-quality-of-anesthesia-and-economy-of-isoflurane-in-domestic-chickens-gallus-domesticus
#10
Parag Deori, Kushal Konwar Sarma, Parsha Jyoti Nath, Chandan Kumar Singh, Rita Nath
AIM: Aim of the study was to evaluate the effect of isoflurane anesthesia on physiological parameters, assessment of anesthetic qualities, and economy of use of isoflurane in domestic chickens (Gallus domesticus). MATERIALS AND METHODS: In this study, 18 apparently healthy adult domestic chickens were selected randomly and divided into three groups. The birds were anesthetized by masked induction with isoflurane at a dose rate of 3.5%, 4%, and 5% and were maintained with 1...
May 2017: Veterinary World
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#11
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, though there is no published data on postoperative outcomes in Spain. We evaluated 2922 patients in the first day after surgery in thirteen tertiary care Spanish Hospitals, using the PAIN-OUT questionnaire. Aims were to: assess postoperative outcomes, and anesthetic/analgesic management in orthopedics (ORT) and general (GEN) surgery patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management by surgical procedure...
June 12, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28618198/effect-of-intravenous-paracetamol-as-pre-emptive-compared-to-preventive-analgesia-in-a-pediatric-dental-setting-a-prospective-randomized-study
#12
Johny Kharouba, Nasir Hawash, Benjamin Peretz, Sigalit Blumer, Yara Srour, Marry Nassar, Mulham Sabbah, Anan Safadi, Alexey Khorev, Mostafa Somri
BACKGROUND: Efficacy of pre-emptive analgesia compared to preventive regimen, managing postoperative pain is still controversial. AIM: Evaluating the efficacy of intravenous (IV) paracetamol as pre-emptive analgesia compared to preventive post-treatment administration in pediatric dental setting. DESIGN: In a prospective trial, 60 noncooperative children of ASA I, II aged 3-10 years who underwent dental rehabilitation under general anesthesia were randomly divided into two groups...
June 15, 2017: International Journal of Paediatric Dentistry
https://www.readbyqxmd.com/read/28615506/modified-protocol-for-enhanced-recovery-after-surgery-is-beneficial-for-chinese-cancer-patients-undergoing-pancreaticoduodenectomy
#13
Xiaxing Deng, Xi Cheng, Zhen Huo, Yuan Shi, Zhijian Jin, Haoran Feng, Yue Wang, Chenlei Wen, Hao Qian, Ren Zhao, Weihua Qiu, Baiyong Shen, Chenghong Peng
Radical surgical resection remains the only effective treatment for advanced pancreatic cancer. Effective protocols for recovery from post-operative complications that result in high rates of morbidity and mortality are therefore essential. The enhanced recovery after surgery (ERAS) protocol is an interdisciplinary multimodal concept based on modern anesthesia and analgesia combined with other fast rehabilitation parameters. It was first applied in the field of elective colorectal surgery, and eventually extended to several surgical diseases...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28614112/serratus-anterior-plane-block-to-address-postthoracotomy-and-chest-tube-related-pain-a-report-on-3-cases
#14
George M Chu, G Craig Jarvis
In this case report, the serratus anterior plane block was used in conjunction with multilevel continuous thoracic paravertebral blocks (TPVB) and general anesthesia in 3 thoracotomy cases. All blocks were accompanied by use of catheters that allowed continuous local anesthetic infusions and intermittent local anesthetic bolus injections to address postoperative pain. In all 3 patients, the serratus anterior plane block provided analgesia for chest tube-related pain that was not provided by the TPVB alone.
June 15, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/28611929/epidural-anesthesia-for-cesarean-section-in-a-pregnant-woman-with-marfan-syndrome-and-dural-ectasia
#15
Franco Pepe, Mariagrazia Stracquadanio, Francesco De Luca, Agata Privitera, Elisabetta Sanalitro, Puccio Scarpinati
Marfan syndrome (MFS) is a genetic disorder of connective tissue, characterized by variable clinical features and multisystem complications. The anesthetic management during delivery is debated. Regional anesthesia has been used with success during cesarean delivery, but in some MFS patients there is a probability of erratic and inadequate spread of intrathecal local anesthetics as a result of dural ectasia. In these cases, epidural anesthesia may be a particularly useful technique during cesarean delivery because it allows an adequate spread and action of local anesthetic with a controlled onset of anesthesia, analgesia, and sympathetic block and a low risk of perioperative complications...
2017: Case Reports in Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28611004/an-in-situ-forming-phospholipid-based-phase-transition-gel-prolongs-the-duration-of-local-anesthesia-for-ropivacaine-with-minimal-toxicity
#16
Hanmei Li, Tao Liu, Yuxuan Zhu, Qiang Fu, Wanxia Wu, Jie Deng, Li Lan, Sanjun Shi
An injectable, phospholipid-based phase transition gel (PPTG) has been developed for prolonging the release of ropivacaine (RO) for local anesthesia. PPTG was prepared by mixing phospholipids, medium-chain triglyceride and ethanol. Prior to injection, the PPTG is in a sol state with low viscosity. After subcutaneous injection, the PPTG rapidly forms a gel in situ, which acts as a drug release depot as verified by in vitro release profiles and in vivo pharmacokinetics. Administering RO-PPTG to rats led to a significantly smaller initial burst release than administering RO solution or RO base suspension...
June 10, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28610706/ultrasound-guided-bilateral-rectus-sheath-block-vs-conventional-local-analgesia-in-single-port-laparoscopic-appendectomy-for-children-with-nonperforated-appendicitis
#17
Caroline Maloney, Michelle Kallis, Ibrahim Abd El-Shafy, Aaron M Lipskar, John Hagen, Michelle Kars
INTRODUCTION: Despite its minimally invasive approach, laparoscopic surgery can cause considerable pain. Regional analgesic techniques such as the rectus sheath block (RSB) offer improved pain management following elective umbilical hernia repair in the pediatric population. This effect has not been examined in laparoscopic single-incision surgery in children. We sought to compare the efficacy of bilateral ultrasound-guided RSB versus local anesthetic infiltration (LAI) in providing postoperative pain relief in pediatric single-incision transumbilical laparoscopic assisted appendectomy (TULA) with same-day discharge...
June 2, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28607339/anesthesia-and-postoperative-analgesia-for-a-patient-with-amyotrophic-lateral-sclerosis
#18
Juan Gu, Xuemei Lin
No abstract text is available yet for this article.
June 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28601480/the-trajectory-of-postoperative-pain-following-mastectomy-with-and-without-paravertebral-block
#19
Rochelle Wynne, Natalie Lui, Kristen Tytler, Carol Koffsovitz, Victor Kirwa, Bernhard Riedel, Shane Ryan
Evidence to support the argument that general anesthesia (GA) with paravertebral block (PVB) provides better pain relief for mastectomy patients than GA alone is contradictory. The aim of this study was to explore pain and analgesia after mastectomy with or without PVB during acute inpatient recovery. A retrospective study was conducted in a single hospital providing specialist cancer services in metropolitan Melbourne, Australia. We explored pain and concomitant analgesic administration in 80 consecutive women recovering from mastectomy who underwent GA with (n = 40) or without (n = 40) PVB...
June 7, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/28600029/racial-and-ethnic-disparities-in-obstetric-anesthesia
#20
Elizabeth M S Lange, Suman Rao, Paloma Toledo
Racial and ethnic disparities are prevalent within healthcare and have persisted despite advances in medicine and public health. Disparities have been described in the use of neuraxial labor analgesia, with minority women being less likely to use neuraxial labor analgesia than non-minority white women. Minority women are also more likely to have a general anesthetic for cesarean delivery than non-minority women. The origins of these disparities are likely multi-factorial, with patient-, provider-, and systems-level contributors...
June 6, 2017: Seminars in Perinatology
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