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disparities pain perioperative

Olubukola O Nafiu, Wilson T Chimbira, Margaret Stewart, Kathleen Gibbons, L Kareen Porter, Paul I Reynolds
BACKGROUND: When pain management has been studied in settings such as pediatric emergency departments, racial disparities have been clearly identified. To our knowledge, this has not been studied in the pediatric perioperative setting. We sought to determine whether there are differences based on race in the administration of analgesia to children suffering from pain in the postanesthesia care unit. METHODS: This is a prospective, observational, study of 771 children aged 4-17 years who underwent elective outpatient surgery...
July 2017: Paediatric Anaesthesia
Anai N Kothari, Matthew A C Zapf, Robert H Blackwell, Talar Markossian, Victor Chang, Zhiyong Mi, Gopal N Gupta, Paul C Kuo
OBJECTIVE: We hypothesized that perioperative hospital resources could overcome the "weekend effect" (WE) in patients undergoing emergent/urgent surgeries. SUMMARY BACKGROUND DATA: The WE is the observation that surgeon-independent patient outcomes are worse on the weekend compared with weekdays. The WE is often explained by differences in staffing and resources resulting in variation in care between the week and weekend. METHODS: Emergent/urgent surgeries were identified using the Healthcare Cost and Utilization Project State Inpatient Database (Florida) from 2007 to 2011 and linked to the American Hospital Association (AHA) Annual Survey Database to determine hospital level characteristics...
October 2015: Annals of Surgery
Jamie D Murphy, Janaki Paskaradevan, Lisa L Eisler, Jean-Pierre P Ouanes, Vicente A Garcia Tomas, Elizabeth A Freck, Christopher L Wu
BACKGROUND: The efficacy of perioperative intravenous magnesium administration on postoperative opioid use, opioid-related side effects (e.g., nausea and vomiting) and pain are uncertain, as randomized controlled trials on this topic have reported disparate results. The objective of this systematic review is to determine if perioperative magnesium reduces opioid use, opioid-related side effects, and postoperative pain. METHODS: An electronic search was conducted using the Library of Medicine's PubMed and EMBASE databases...
February 2013: Middle East Journal of Anesthesiology
Senthilkumar Sadhasivam, Vidya Chidambaran, Pornswan Ngamprasertwong, Hope R Esslinger, Cynthia Prows, Xue Zhang, Lisa J Martin, John McAuliffe
BACKGROUND: Interindividual variability in pain perception and analgesic response is a major problem in perioperative practice. Adult studies suggest pain management is influenced by patient's race. The objective of this study is to evaluate the influence of race on perioperative pain treatment in children. METHODS: Prospective observational study evaluating effect of race on analgesia and opioid related adverse effects after tonsillectomy in African American and Caucasian children...
May 2012: Pediatrics
Ashish K Jain, Gabriela Velazquez-Ramirez, Philip P Goodney, Matthew S Edwards, Matthew A Corriere
We analyzed gender-based differences in preoperative factors, procedural characteristics, and 30-day outcomes after lower extremity bypass (LEB). LEB procedures were identified from the American College of Surgeons National Surgical Quality Improvement Program Participant User File. Groupwise comparisons of preoperative and procedural variables were made using chi square, t tests, and nonparametric methods; gender influences on mortality, systemic, and surgical site complications were evaluated using logistic regression...
July 2011: American Surgeon
Pervez Sultan, Maria Cristina Gutierrez, Brendan Carvalho
Morphine is a drug commonly administered via the epidural or intrathecal route, and is regarded by many as the 'gold-standard' single-dose neuraxial opioid due to its postoperative analgesic efficacy and prolonged duration of action. However, respiratory depression is a recognized side effect of neuraxial morphine administered in the perioperative setting. We conducted an extensive review of articles published since 1945 that examine respiratory depression or failure associated with perioperative intrathecal or epidural morphine use...
October 1, 2011: Drugs
Peter Nau, Sebastian Demyttenaere, Peter Muscarella, Vimal Narula, Jeffrey W Hazey, E Christopher Ellison, W Scott Melvin
BACKGROUND: Laparoscopic adrenalectomy (LA) has become the standard approach to an adrenal mass. This technique provides for decreased convalescence, less postoperative pain, and improved cosmesis. The use of LA for pheochromocytoma (PHE) has been questioned due to concerns of increased morbidity and negative hemodynamic sequelae. This study aimed to compare the outcomes of LA for PHE with the results of LA for other adrenal pathologies. METHODS: A retrospective chart review was performed for an 11-year period from July 1997 to December 2008...
November 2010: Surgical Endoscopy
Nathalia Jimenez, Kristy Seidel, Lynn D Martin, Frederick P Rivara, Anne M Lynn
PURPOSE: Adult studies suggest pain treatment is influenced by patient's race/ ethnicity. The present study aims to evaluate the effect of the patient's race/ethnicity on pain treatment in children. METHODS: Retrospective cohort study comparing perioperative analgesic administration for tonsillectomy and adenoidectomy (T&A) surgery in Latino and Caucasian patients younger than 18 years of age. RESULTS: Ninety-four (94) patients were included (47 Latino, 47 Caucasian), mean age 8...
February 2010: Journal of Health Care for the Poor and Underserved
James O Sanders, Richard Haynes, Don Lighter, Mark Niederpruem, Cheri Hollenback, Lillie Johnson, Stan Nomura, David Arndt, Pat Bush, Julius Santiago, Ron King, Tammy Trottier
STUDY DESIGN: Survey. OBJECTIVE: To understand the variation in scoliosis surgery and perioperative care among spinal deformity surgeons. SUMMARY OF BACKGROUND DATA: While variation in care has been well described in many spinal disorders, the degree of variation has not been described for spinal deformity. METHODS: Clinical histories and radiographs of 4 typical spinal deformity patients were sent to spinal deformity surgeons for review...
June 1, 2007: Spine
(no author information available yet)
OBJECTIVE: To provide health care providers, patients, and the general public with a responsible assessment of currently available data regarding total knee replacement. PARTICIPANTS: A non-DHHS, non-advocate 11-member panel representing the fields of orthopaedics, rheumatology, internal medicine, nursing, physical therapy, rehabilitation, biostatistics, epidemiology, and health services research, as well as a TKR patient. In addition, 21 experts in related fields presented data to the panel and to the conference audience...
December 8, 2003: NIH Consensus and State-of-the-science Statements
C W Lillehei, J E Mayer, R C Shamberger, D A Waltz
During the past decade, lung transplantation has emerged as the definitive treatment for children with end-stage lung disease. Pediatric transplantation presents unique challenges with respect to diagnostic indications, donor-recipient size disparities, perioperative management, and growth. Lessons from the early development of cardiac surgery at the University of Minnesota (Green Surgical Service) provide a useful model for novel surgical challenges. Since 1990, 25 lung transplantations have been performed at our institution, including 4 heart-lung, 3 single-lung, 17 bilateral-lung, and 1 living-related lobar allograft...
September 1999: Annals of Thoracic Surgery
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