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https://www.readbyqxmd.com/read/28387892/anesthesia-and-analgesia-in-breast-surgery-the-benefits-of-peripheral-nerve-block
#1
L Calì Cassi, F Biffoli, D Francesconi, G Petrella, O Buonomo
Breast surgery is frequently associated with postoperative pain, nausea and vomiting, that result in increased patient's suffering, prolongation of hospital stays and related costs. Thoracic paravertebral nerve block (TPVB) is a viable option to the classic multimodal analgesia in breast surgery as it enhances surgical anesthesia and postoperative analgesia. In this review, we report the results of a number of studies on the role of TPVB in breast surgery. This technique is associated with a superior control of the pain, a reduction in opioids consumption after surgery, a decrease in postoperative nausea and vomiting, and an overall decrease in length of hospital stay...
March 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28226340/oral-oxycodone-for-acute-postoperative-pain-a-review-of-clinical-trials
#2
Chi Wai Cheung, Stanley Sau Ching Wong, Qiu Qiu, Xianyu Wang
BACKGROUND: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. OBJECTIVES: To evaluate the use of oral oxycodone for acute postoperative pain management. STUDY DESIGN: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. METHODS: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28192247/comparison-of-peri-articular-liposomal-bupivacaine-and-standard-bupivacaine-for-postsurgical-analgesia-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#3
REVIEW
Xi Wang, Lin Xiao, Zhiyuan Wang, Guanghui Zhao, Jianbing Ma
OBJECTIVE: This meta-analysis aimed to compare the efficacy and safety of intraoperative peri-articular liposomal bupivacaine and standard bupivacaine in patients undergoing total knee arthroplasty. METHODS: A systematic search was performed in Medline (1966-2016.9), PubMed (1966-2016.9), Embase (1980-2016.9), ScienceDirect (1985-2016.9) and the Cochrane Library. Only high-quality studies were selected. Meta-analysis was performed using Stata 11.0 software. RESULTS: Three randomized controlled trials (RCTs) and two non-randomized controlled trials (Non-RCTs), including 1214 patients met the inclusion criteria...
March 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/27977335/fatty-acid-amide-hydrolase-morphine-interaction-influences-ventilatory-response-to-hypercapnia-and-postoperative-opioid-outcomes-in-children
#4
Vidya Chidambaran, Valentina Pilipenko, Kristie Spruance, Raja Venkatasubramanian, Jing Niu, Tsuyoshi Fukuda, Tomoyuki Mizuno, Kejian Zhang, Kenneth Kaufman, Alexander A Vinks, Lisa J Martin, Senthilkumar Sadhasivam
AIM: Fatty acid amide hydrolase (FAAH) degrades anandamide, an endogenous cannabinoid. We hypothesized that FAAH variants will predict risk of morphine-related adverse outcomes due to opioid-endocannabinoid interactions. PATIENTS & METHODS: In 101 postsurgical adolescents receiving morphine analgesia, we prospectively studied ventilatory response to 5% CO2 (HCVR), respiratory depression (RD) and vomiting. Blood was collected for genotyping and morphine pharmacokinetics...
January 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/27940680/wernicke-encephalopathy-in-adolescents-after-bariatric-surgery-case-report-and-review
#5
Amy Armstrong-Javors, Janey Pratt, Sigmund Kharasch
Roughly 1% of all weight loss surgery is performed in adolescents. There is strong evidence demonstrating significant postsurgical weight loss, improvement in quality of life, and reduction in comorbidities such as hypertension and diabetes. Reports of postoperative complications in adolescents are few because of the small sample size in most series. Despite vitamin supplementation, nutritional deficiencies requiring hospitalization occur occasionally after Roux-en-Y gastric bypass. Wernicke encephalopathy, a triad of ophthalmoplegia, ataxia, and altered mental status, is a serious consequence of thiamine (vitamin B1) deficiency...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27898605/initial-results-of-a-safety-and-feasibility-study-of-auditory-brainstem-implantation-in-congenitally-deaf-children
#6
Eric P Wilkinson, Laurie S Eisenberg, Mark D Krieger, Marc S Schwartz, Margaret Winter, Jamie L Glater, Amy S Martinez, Laurel M Fisher, Robert V Shannon
OBJECTIVE: To determine the safety and feasibility of the auditory brainstem implant (ABI) in congenitally deaf children with cochlear aplasia and/or cochlear nerve deficiency. STUDY DESIGN: Phase I feasibility clinical trial of surgery in 10 children, ages 2 to 5 years, over a 3-year period. SETTING: Tertiary children's hospital and university-based pediatric speech/language/hearing center. INTERVENTION(S): ABI implantation and postsurgical programming...
February 2017: Otology & Neurotology
https://www.readbyqxmd.com/read/27687344/dose-ranging-effect-of-systemic-diphenhydramine-on-postoperative-quality-of-recovery-after-ambulatory-laparoscopic-surgery-a-randomized-placebo-controlled-double-blinded-clinical-trial
#7
Gildasio S De Oliveira, Jane Bialek, R-J Marcus, Robert McCarthy
STUDY OBJECTIVE: Diphenhydramine is an antihistamine with previously demonstrated analgesic and antiemetic properties. However, it is unknown if the beneficial perioperative properties of diphenhydramine can translate to a better quality of postsurgical recovery. The main objective of the current investigation was to investigate dose-ranging effects of diphenhydramine on quality of recovery after surgery. SETTING: Tertiary hospital in the United States. DESIGN: A prospective, randomized, double-blind trial...
November 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27530760/domperidone-to-treat-symptoms-of-gastroparesis-benefits-and-side-effects-from-a-large-single-center-cohort
#8
Ron Schey, Mohammed Saadi, Deena Midani, Aaron C Roberts, Rahul Parupalli, Henry P Parkman
BACKGROUND: There is increased awareness about risks and benefits of using domperidone to treat gastroparesis. AIM: To describe the outcome of treating patients with refractory gastroparesis symptoms with domperidone. METHODS: Domperidone 10 mg QID or TID was prescribed to patients with refractory gastroparesis symptoms; follow-up obtained at 2-3 months assessing symptoms and side effects. Patients filled out Patient Assessment of Upper GI Symptoms prior to treatment and at follow-up along with Clinical Patient Grading Assessment Scale (CPGAS, +7 = completely better; 0 = no change)...
December 2016: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/27186526/a-case-of-cushing-ulcer-in-an-8-month-old-patient-with-medulloblastoma
#9
Walavan Sivakumar, Heather S Spader, Eric Scaife, Robert J Bollo
The authors present the first case of a Cushing ulcer in an infant with medulloblastoma who, despite being administered stress ulcer prophylaxis, worsened after corticosteroids were initiated. An 8-month-old boy presented with progressive vomiting, lethargy, and decreased oral intake. Imaging revealed a heterogeneous fourth ventricular mass. Preoperatively, the patient was started on dexamethasone. The patient underwent an uncomplicated external ventricular drain placement and suboccipital craniotomy for resection of the lesion...
April 2016: Translational pediatrics
https://www.readbyqxmd.com/read/27042786/reducing-opioid-adverse-events-a-safe-way-to-improve-outcomes
#10
COMPARATIVE STUDY
Jay A Redan, Tina Wells, Sandra Reeder, Steven D McCarus
INTRODUCTION: Opioids are commonly used in the postoperative period to manage postsurgical pain. However, adverse side effects of opioids include respiratory depression, urinary retention, pruritus, vomiting, nausea, constipation, and increased risk of falls. Surgical site infiltration with extended release liposomal bupivacaine is effective in the multimodal care plan of managing postsurgical patients. The purpose of the present study was to examine the possible effects of liposomal bupivacaine on postoperative opioid adverse events following open hernia repair and laparoscopic colon resection surgery...
April 2016: Surgical Technology International
https://www.readbyqxmd.com/read/26904968/the-experience-of-setting-up-a-resident-managed-acute-pain-service-a-descriptive-study
#11
Tommaso Borracci, Daniela Prencipe, Anita Masotti, Alessandra Nella, Germana Tuccinardi, Lucia Margiacchi, Gianluca Villa, Fulvio Pinelli, Stefano Romagnoli, Angelo Raffaele De Gaudio, Giovanni Zagli
BACKGROUND: The benefits of an Acute Pain Service (APS) for pain management have been widely reported, but its diffusion is still limited. There are two APS models: anesthesiologist-based and a nurse-based model. Here we describe the development of a different APS model managed by anesthesia residents, and we report the first year of activity in a tertiary Italian university hospital (Careggi University Hospital, Florence, IT). METHODS: Patients were included in the APS were those undergoing abdominal and urologic surgery causing moderate or severe postsurgical pain...
February 22, 2016: BMC Anesthesiology
https://www.readbyqxmd.com/read/26633002/liposome-bupivacaine-for-postsurgical-analgesia-in-patients-undergoing-robotically-assisted-cardiac-surgery
#12
Husam H Balkhy, Susan Arnsdorf, Dorothy Krienbring, John Urban
OBJECTIVE: Despite the advantages of robotically assisted cardiac surgery over conventional open sternotomy, robotically assisted surgery may be associated with substantial postsurgical pain arising from multiple incisions and access ports. This single-site, retrospective chart review evaluated the impact of liposome bupivacaine compared with bupivacaine HCl on postsurgical pain management in patients undergoing robotically assisted endoscopic cardiac surgery. METHODS: Sequential patient cohorts undergoing robotically assisted cardiac surgery received either 0...
November 2015: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/26612989/a-fatal-twist-volvulus-of-the-small-intestine-in-a-46-year-old-woman
#13
Jared Klein, Kathryn Baxstrom, Stephen Donnelly, Patrick Feasel, Paul Koles
A 46-year-old woman presented to two emergency departments within 12 hours because of acute abdominal pain. Physical exam demonstrated tenderness and epigastric guarding. An ultrasound was interpreted as negative; she was discharged home. Later that evening, she was found dead. Postmortem exam revealed acute hemorrhagic necrosis of a segment of jejunum secondary to volvulus. Clinical clues suggesting presentations of small bowel volvulus are usually nonspecific; the diagnosis is typically confirmed at surgery...
2015: Case Reports in Medicine
https://www.readbyqxmd.com/read/26579802/efficacy-of-pregabalin-in-acute-postoperative-pain-under-different-surgical-categories-a-meta-analysis
#14
REVIEW
David M H Lam, Siu-Wai Choi, Stanley S C Wong, Michael G Irwin, Chi-Wai Cheung
The efficacy of pregabalin in acute postsurgical pain has been demonstrated in numerous studies; however, the analgesic efficacy and adverse effects of using pregabalin in various surgical procedures remain uncertain. We aim to assess the postsurgical analgesic efficacy and adverse events after pregabalin administration under different surgical categories using a systematic review and meta-analysis of randomized controlled trials.A search of the literature was performed between August 2014 to April 2015, using PubMed, Ovid via EMBASE, Google Scholar, and ClinicalTrials...
November 2015: Medicine (Baltimore)
https://www.readbyqxmd.com/read/26481741/does-early-postsurgical-temozolomide-plus-concomitant-radiochemotherapy-regimen-have-any-benefit-in-newly-diagnosed-glioblastoma-patients-a-multi-center-randomized-parallel-open-label-phase-ii-clinical-trial
#15
RANDOMIZED CONTROLLED TRIAL
Ying Mao, Yu Yao, Li-Wei Zhang, Yi-Cheng Lu, Zhong-Ping Chen, Jian-Min Zhang, Song-Tao Qi, Chao You, Ren-Zhi Wang, Shu-Yuan Yang, Xiang Zhang, Ji-Sheng Wang, Ju-Xiang Chen, Qun-Ying Yang, Hong Shen, Zhi-Yong Li, Xiang Wang, Wen-Bin Ma, Xue-Jun Yang, Hai-Ning Zhen, Liang-Fu Zhou
BACKGROUND: The radiochemotherapy regimen concomitantly employing temozolomide (TMZ) chemotherapy and radiotherapy (RT) 4 weeks after surgery, followed by 6 cycles of TMZ is a common treatment for glioblastoma (GBM). However, its median overall survival (OS) is only 14.6 months. This study was to explore the effectiveness and safety of early TMZ chemotherapy between surgery and chemoradiotherapy plus the standard concomitant radiochemotherapy regimen. METHODS: A randomized, parallel group, open-label study of 99 newly diagnosed GBM patients was conducted at 10 independent Chinese neurosurgical departments from June 2008 to June 2012...
October 20, 2015: Chinese Medical Journal
https://www.readbyqxmd.com/read/26431130/improving-analgesic-efficacy-and-safety-of-thoracic-paravertebral-block-for-breast-surgery-a-mixed-effects-meta-analysis
#16
REVIEW
Abdullah S Terkawi, Siny Tsang, Daniel I Sessler, Rayan S Terkawi, Megan S Nunemaker, Marcel E Durieux, Ashley Shilling
BACKGROUND: While most trials of thoracic paravertebral nerve blocks (TPVB) for breast surgery show benefit, their effect on postoperative pain intensity, opioid consumption, and prevention of chronic postsurgical pain varies substantially across studies. Variability may result from use of different drugs and techniques. OBJECTIVES: To examine the use of TPVB in breast surgery, and to determine which method(s) provide optimal efficacy and safety. STUDY DESIGN: Mixed-Effects Meta-Analysis...
September 2015: Pain Physician
https://www.readbyqxmd.com/read/26421810/perioperative-duloxetine-to-improve-postoperative-recovery-after-abdominal-hysterectomy-a-prospective-randomized-double-blinded-placebo-controlled-study
#17
RANDOMIZED CONTROLLED TRIAL
Lucas J Castro-Alves, Andrea Cristina Pereira Oliveira de Medeiros, Saulo Pimentel Neves, Camila Lucena Carneiro de Albuquerque, Norma Sueli Modolo, Vera Lucia De Azevedo, Gildasio S De Oliveira
BACKGROUND: Postsurgical quality of recovery is worse in female than that in male patients. Duloxetine has been used successfully for the treatment of chronic pain conditions, but its use for preventing acute postoperative pain has been limited to a single previous study. More importantly, the effect of preoperative duloxetine on global postoperative quality of recovery has yet to be evaluated. The main objective of the current investigation was to evaluate the effect of perioperative duloxetine on postoperative quality of recovery in women undergoing abdominal hysterectomy...
January 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/26204387/safety-and-side-effect-profile-of-liposome-bupivacaine-exparel-in-peripheral-nerve-blocks
#18
RANDOMIZED CONTROLLED TRIAL
Brian M Ilfeld, Eugene R Viscusi, Admir Hadzic, Harold S Minkowitz, Michael D Morren, Janice Lookabaugh, Girish P Joshi
BACKGROUND: Liposome bupivacaine (Exparel) is a multivesicular liposomal formulation of bupivacaine currently approved in the United States for single-dose administration into the surgical site to provide postsurgical analgesia. This retrospective analysis examined safety data from clinical trials involving the off-label use of this formulation in peripheral nerve blocks. METHODS: Data from 6 controlled (phases I-III) studies were compiled involving single-injection ankle, femoral nerve, and intercostal nerve blocks (2 each)...
September 2015: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/26202558/local-infiltration-of-liposomal-bupivacaine-for-pain-control-in-patients-undergoing-mastectomy-with-immediate-tissue-expander-reconstruction
#19
Jad M Abdelsattar, Amy C Degnim, Tina J Hieken, Michel Saint-Cyr, Judy C Boughey
Mastectomy with immediate tissue expander reconstruction is associated with postoperative pain, nausea, and vomiting. Various techniques of perioperative and postoperative pain control have been described. Our standard of care for postsurgical pain management in patients undergoing mastectomy with immediate tissue expander reconstruction has been preoperative ultrasound-guided paravertebral block. Recent literature demonstrating the opioid-sparing benefits of liposomal bupivacaine has directed two of our plastic surgeons to pilot its use in immediate tissue expander reconstruction...
October 2015: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/25940143/-gastroparesis-definition-diagnostics-and-therapy
#20
REVIEW
U von Arnim
Gastroparesis is characterized by a constellation of upper gastrointestinal symptoms in association with delayed gastric emptying in the absence of mechanical outlet obstruction from the stomach. Major symptoms are nausea, vomiting, early satiety or postprandial fullness, bloating, and abdominal or epigastric pain. Idiopathic, diabetic, and postsurgical causes represent the most common etiologies. Diagnostic procedures for the evaluation of gastroparesis comprise gastric emptying scintigraphy (gold standard), (13)C-octanoate breath testing, and a wireless motility capsule...
June 2015: Der Internist
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