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Chronic pain in perioperative period

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https://www.readbyqxmd.com/read/28118255/smoking-may-increase-postoperative-opioid-consumption-in-patients-who-underwent-distal-gastrectomy-with-gastroduodenostomy-for-early-stomach-cancer-a-retrospective-analysis
#1
Doo Hwan Kim, Jun Young Park, Myong-Hwan Karm, Heon-Yong Bae, Jae-Young Lee, Ho Soo Ahn, Kunhee Lee, Jeong Gil Leem
OBJECTIVES: Although nicotine has an analgesic effect, the incidence and severity of chronic pain is higher in smokers than nonsmokers. Acute pain is more intense in smokers during the perioperative period. This study evaluated weather smokers require higher doses of opioid to reduce pain when they undergo surgery. METHODS: From October 2013 to September 2014, a retrospective review of 236 patients who had intravenous patient-controlled analgesia after distal gastrectomy with gastroduodenostomy was performed to analyze the difference in postoperative opioid requirements between smokers and nonsmokers...
January 23, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/28025740/long-term-follow-up-of-laparoscopic-total-extraperitoneal-tep-repair-in-inguinal-hernia-without-mesh-fixation
#2
S Golani, P Middleton
PURPOSE: From the current evidence, non-fixation of the mesh (NMF) in laparoscopic total extraperitoneal (TEP) repair appears to be a safe alternative for inguinal hernia patients in the short term. This study aims to demonstrate that NMF is as effective in the long term by following up a large number of patients with a mean follow-up of 6 years. The primary outcomes are chronic pain and recurrence rate. METHODS: A thorough review of medical records was conducted from a prospectively maintained database of 538 patients who underwent a laparoscopic TEP inguinal hernia repair by a single surgeon working in Sydney from the year 2005 to 2010...
December 26, 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/28002096/duloxetine-as-an-analgesic-reduces-opioid-consumption-after-spine-surgery-a-randomized-double-blind-controlled-study
#3
Antonio Bedin, Rafael Antonio Caldart Bedin, Joaquim Edson Vieira, Hazem Adel Ashmawi
OBJECTIVES: Multimodal analgesia is widely advocated for the control of perioperative pain in an effort to reduce the use of opioid. Duloxetine is a selective inhibitor of serotonin and norepinephrine reuptake with efficacy for chronic pain conditions. The primary objective of this study was to evaluate the efficacy of two 60 mg oral doses of duloxetine in terms of fentanyl consumption during the postoperative period in patients undergoing elective spine surgery. METHODS: This study was prospective, double blind, randomized, and placebo controlled...
December 19, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27909035/randomised-controlled-pilot-study-to-investigate-the-effectiveness-of-thoracic-epidural-and-paravertebral-blockade-in-reducing-chronic-post-thoracotomy-pain-topic-feasibility-study-protocol
#4
Joyce Yeung, Teresa Melody, Amy Kerr, Babu Naidu, Lee Middleton, Kostas Tryposkiadis, Jane Daniels, Fang Gao
INTRODUCTION: Open chest surgery (thoracotomy) is considered the most painful of surgical procedures. Forceful wound retraction, costochondral dislocation, posterior costovertebral ligament disruption, intercostal nerve trauma and wound movement during respiration combine to produce an acute, severe postoperative pain insult and persistent chronic pain many months after surgery is common. Three recent systematic reviews conclude that unilateral continuous paravertebral blockade (PVB) provides analgesia at least equivalent to thoracic epidural blockade (TEB) in the postoperative period, has a lower failure rate, and symptom relief that lasted months...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27767680/postoperative-urinary-retention-in-patients-undergoing-elective-spinal-surgery
#5
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...
February 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/27736284/continuous-perioperative-sublingual-buprenorphine
#6
Marcelina Jasmine Silva, Andrea Rubinstein
Buprenorphine, a semisynthetic thebaine derivative, is a unique opioid, as it has activity at multiple receptors, including mu (partial agonist), kappa (antagonist), OLR-1 (agonist), and delta (antagonist). Because buprenorphine's pharmacology is relatively complex, misconceptions about its actions are common. Most other opioids act solely or predominately as full mu receptor agonists. Common practice at many institutions calls for the cessation of regular buprenorphine use 48-72 hours prior to surgery. This practice is based on three foundational theories that have come from scant data about the properties of buprenorphine: (1) that buprenorphine is only a partial mu agonist and therefore is not a potent analgesic; (2) because buprenorphine has a ceiling effect on respiratory depression, it also has a ceiling effect on analgesia; and (3) that buprenorphine acts as a "blockade" to the analgesic effects of other opiates when coadministered due to its strong binding affinity...
December 2016: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/27651509/the-influence-of-type-of-anesthesia-perioperative-pain-and-preoperative-health-status-on-chronic-pain-six-months-after-thoracotomy-a-prospective-cohort-study
#7
Sandra Kampe, Bianca Geismann, Gerhard Weinreich, Georgios Stamatis, Uwe Ebmeyer, Hans J Gerbershagen
BACKGROUND:  Chronic post-thoracotomy pain (CPP) has a high incidence. However, less is known about risk factors and the influence of different analgesia therapies. METHODS:  In this prospective cohort study, patients either received standardized epidural analgesia or began an oral analgesic protocol with controlled-release oxycodone immediately postoperatively. Patients answered a baseline questionnaire on the day before surgery and a follow-up questionnaire six months postoperatively...
September 20, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27566812/pain-management-in-patients-with-vascular-disease
#8
M Seretny, L A Colvin
Vascular disease covers a wide range of conditions, including arterial, venous, and lymphatic disorders, with many of these being more common in the elderly. As the population ages, the incidence of vascular disease will increase, with a consequent increase in the requirement to manage both acute and chronic pain in this patient population. Pain management can be complex, as there are often multiple co-morbidities to be considered. An understanding of the underlying pain mechanisms is helpful in the logical direction of treatment, particularly in chronic pain states, such as phantom limb pain or complex regional pain syndrome...
September 2016: British Journal of Anaesthesia
https://www.readbyqxmd.com/read/27523659/peripheral-nerve-crushing-to-relieve-chronic-pain-in-diabetic-and-ischaemic-foot-ulcers
#9
K Nagasaki, H Obara, K Tanaka, K Koyano, A Asamia, Y Kitagawa
OBJECTIVE: We retrospectively assessed the effectiveness of peripheral nerve crushing (Smithwick operation) in relieving intractable chronic pain associated with foot ulcers caused by diabetes mellitus (DM) or atherosclerosis. METHOD: From April 2009 to April 2012, patients underwent peripheral nerve crushing in the leg affected by foot ulceration. The cause of ulceration was either DM alone, atherosclerosis alone, or both DM and atherosclerosis. Because sensation in the foot is associated with five nerves: the tibial, deep peroneal, superficial peroneal, sural, and saphenous, one or more of these nerves were crushed over a length of 1...
August 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27426445/management-of-neuropathic-pain-after-knee-surgery
#10
Pascale Vergne-Salle
Chronic postsurgical pain (CPSP) affects 10 to 30% of surgical patients overall and 16 to 20% of patients after knee surgery. Patients report persistent pain in the absence of infection, mechanical disorders, or complex regional pain syndrome type I. In many cases, the mechanism is neuropathic pain related to an intraoperative nerve injury or impaired pain modulation with central sensitization. The clinical risk factors and pathophysiology of CPSP are being actively investigated. Risk factors include preoperative pain; diffuse pain; severe pain during the immediate postoperative period; anxiety, depression, or cognitive distortions such as catastrophizing; and comorbidities...
December 2016: Joint, Bone, Spine: Revue du Rhumatisme
https://www.readbyqxmd.com/read/27398889/prolonged-perioperative-low-dose-ketamine-does-not-improve-short-and-long-term-outcomes-after-pediatric-idiopathic-scoliosis-surgery
#11
Marina Perelló, David Artés, Cristina Pascuets, Elisabeth Esteban, Ana M Ey Batlle
STUDY DESIGN: A randomized, double-blind, placebo-controlled study, with a six-month follow-up period. OBJECTIVES: The aim of this study was to test the hypothesis that a 72-hour dose of subanesthetic ketamine in this surgical procedure reduces postoperative morphine use and to assess whether there are fewer adverse effects, if postoperative recovery is faster, if there is less peri-incisional hyperalgesia, or if there is lower incidence of persistent postsurgical pain...
March 2017: Spine
https://www.readbyqxmd.com/read/27387697/gastric-bypass-reversal-a-7-year-experience
#12
Luise I M Pernar, Julie J Kim, Scott A Shikora
BACKGROUND: After gastric bypass, some patients develop conditions that ultimately require reversal of the bypass. There are currently few publications on the topic to guide clinicians. OBJECTIVES: To describe the indications, techniques, and outcomes for gastric bypass reversal. SETTING: Two academic medical centers. METHODS: We conducted a retrospective chart review of all patients who underwent gastric bypass reversal at our institutions between 2008 and 2015...
September 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/27327927/shoulder-arthroplasty-disposition-and-perioperative-outcomes-in-patients-with-and-without-rheumatoid-arthritis
#13
Jeffrey H Weinreb, Mark P Cote, Michael B O'Sullivan, Augustus D Mazzocca
Shoulder arthroplasty (SA) is used to treat pain and disability associated with rheumatoid arthritis (RA). Although SA is an effective procedure in patients with RA, more investigation of perioperative outcomes is needed. We conducted a study to compare the perioperative complication rates and demographics of patients with and without RA. Given the potential for anemia of chronic disease and the systemic inflammatory nature of RA, we hypothesized that the perioperative complication profile of RA patients would be worse than that of non-RA patients...
May 2016: American Journal of Orthopedics
https://www.readbyqxmd.com/read/27212741/delayed-recovery-from-anesthesia-a-postgraduate-educational-review
#14
REVIEW
Ullhas Sudhakarrao Misal, Suchita Annasaheb Joshi, Mudassir Mohd Shaikh
Delayed awakening from anesthesia remains one of the biggest challenges that involve an anesthesiologist. With the general use of fast-acting anesthetic agents, patients usually awaken quickly in the postoperative period. The time to emerge from anesthesia is affected by patient factors, anesthetic factors, duration of surgery, and painful stimulation. The principal factors responsible for delayed awakening following anesthesia are anesthetic agents and medications used in the perioperative period. Nonpharmacological causes may have a serious sequel, hence recognizing these organic conditions is important...
May 2016: Anesthesia, Essays and Researches
https://www.readbyqxmd.com/read/27200311/a-clinical-study-on-the-trocar-guided-mesh-repair-system-for-pelvic-organ-prolapse-surgery
#15
Seul Gi Bak, Jeong Beom Moon, Sang Ki Hong, Kyoung Jin Kim, Kyoung A Kim, Ju Hyang Lee
OBJECTIVE: To evaluate the complication and recurrence rates in patients undergoing trocar-guided mesh implant for pelvic organ prolapse (POP) treatment. METHODS: A retrospective study was performed based on the medical records of patients who had undergone mesh implant by one surgeon from May 2006 to August 2013 at the Presbyterian Medical Center in Korea. We evaluated perioperative complications such as bladder injury, mesh exposure, urinary symptoms, infections, and chronic pelvic pain...
May 2016: Obstetrics & Gynecology Science
https://www.readbyqxmd.com/read/26985446/opioid-system-modulates-the-immune-function-a-review
#16
Xuan Liang, Renyu Liu, Chunhua Chen, Fang Ji, Tianzuo Li
Opioid receptors and their ligands produce powerful analgesia that is effective in perioperative period and chronic pain managements accompanied with various side effects including respiratory depression, constipation and addiction etc. Opioids can also interfere with the immune system, not only participating in the function of the immune cells, but also modulating innate and acquired immune responses. The traditional notion of opioids is immunosuppressive. Recent studies indicate that the role of opioid receptors on immune function is complicated, working through various different mechanisms...
2016: Translational Perioperative and Pain Medicine
https://www.readbyqxmd.com/read/26972832/etiology-of-postanesthetic-and-postsedation-events-on-the-inpatient-ward-data-from-a-rapid-response-team-at-a-tertiary-care-children-s-hospital
#17
N'Diris Barry, Karen M Miller, Gregory Ryshen, Joshua Uffman, Thomas A Taghon, Joseph D Tobias
INTRODUCTION: The goal of this study was to identify the etiology of events and demographics of patients that experience complications requiring activation of the Rapid Response Team (RRT) during the first 24 h following anesthetic care. METHODS: We performed a retrospective review of the Quality Improvement database from the Department of Anesthesiology & Pain Medicine at Nationwide Children's Hospital. The database was searched to identify those patients who had a RRT evaluation activated within 24 h of receiving anesthesia or procedural sedation...
May 2016: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/26924311/tailored-anterior-tension-free-repair-for-the-treatment-of-recurrent-inguinal-hernia-previously-repaired-by-anterior-approach
#18
E Erdas, F Medas, L Gordini, S Licheri, G Pisano, A Nicolosi, P G Calò
PURPOSE: The purpose of this study is to describe our policy in selecting different types of anaesthesia and anterior tension-free techniques for the repair of recurrent inguinal hernias previously treated by anterior approach and to evaluate early and late outcomes. METHODS: The medical records of 111 patients who underwent recurrent inguinal hernia repair by anterior approach in the period 2000-2013 were reviewed. Fifty patients (45 %) were over 70 years old and 63 (56...
June 2016: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/26861893/long-term-pain-reduction-does-not-imply-improved-functional-outcome-in-patients-treated-with-combined-supraorbital-and-occipital-nerve-stimulation-for-chronic-migraine
#19
Shannon W Clark, Chengyuan Wu, David W Boorman, Nohra Chalouhi, Mario Zanaty, Michael Oshinsky, William B Young, Stephen D Silberstein, Ashwini D Sharan
BACKGROUND: Dual supraorbital and occipital nerve stimulation (SONS and ONS) have shown promising efficacy in treating primary headaches. However, its functional outcome is not well studied. OBJECTIVE: To present functional outcome studies of combined SONS and ONS for chronic migraine using verified metrics. METHOD: Consecutive patients with both SONS and ONS assessed with Migraine Disability Assessment (MIDAS) and Beck Depression Index (BDI) both preoperatively and postoperatively were studied...
July 2016: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/26803543/current-strategies-in-anesthesia-and-analgesia-for-total-knee-arthroplasty
#20
REVIEW
Calin Stefan Moucha, Mitchell C Weiser, Emily J Levin
Total knee arthroplasty is associated with substantial postoperative pain that may impair mobility, reduce the ability to participate in rehabilitation, lead to chronic pain, and reduce patient satisfaction. Traditional general anesthesia with postoperative epidural and patient-controlled opioid analgesia is associated with an undesirable adverse-effect profile, including postoperative nausea and vomiting, hypotension, urinary retention, respiratory depression, delirium, and an increased infection rate. Multimodal anesthesia--incorporating elements of preemptive analgesia, neuraxial perioperative anesthesia, peripheral nerve blockade, periarticular injections, and multimodal oral opioid and nonopioid medications during the perioperative and postoperative periods--can provide superior pain control while minimizing opioid-related adverse effects, improving patient satisfaction, and reducing the risk of postoperative complications...
February 2016: Journal of the American Academy of Orthopaedic Surgeons
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