The Addition Of An Adductor Canal Block To Local Infiltration Analgesia Following Total Knee Arthroplasty Delays The Attainment Of Physical Therapy Milestones

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The Addition Of An Adductor Canal Block To Local Infiltration Analgesia Following Total Knee Arthroplasty Delays The Attainment Of Physical Therapy Milestones

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Book Rating : 4.:/5 (125 download)

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Book Synopsis The Addition Of An Adductor Canal Block To Local Infiltration Analgesia Following Total Knee Arthroplasty Delays The Attainment Of Physical Therapy Milestones by :

Download or read book The Addition Of An Adductor Canal Block To Local Infiltration Analgesia Following Total Knee Arthroplasty Delays The Attainment Of Physical Therapy Milestones written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: BACKGROUND AND GOAL OF STUDY: Prior studies and retrospective data have suggested an additive analgesic effect of adding an Adductor Canal Blockade (ACB) to Local Infiltration Analgesia (LIA) compared to LIA alone. We endeavored to determine whether Physical Therapy (PT) milestones were reached faster with ACB + LIA vs. LIA alone.MATERIALS AND METHODS: Following IRB approval, ASA I-III patients scheduled for unilateral primary TKA were randomized to receive either ACB or a sham ACB (saline) in addition to the routine LIA administered by the surgeon. Exclusion criteria included chronic pain and substance abuse. Anesthetic (spinal) and postoperative pain management were standardized. ACB was performed at the mid-thigh level with 30 mL of 2.5 mg/mL bupivacaine with 1:200K epinephrine. LIA was performed by the surgeon using bupivacaine, ketorolac, epinephrine and morphine, as well as liposomal bupivacaine.Data collected included passive and active ROM knee flexion and extension, quadriceps strength, bed mobility skill, transfer skill, 2-minute walk test, and pain complaints via VAS before, during and after physical therapy sessions, as well as total distance ambulated on the day of surgery as well as the first and second third post-operative days, ability to climb stairs, and readiness for discharge.RESULTS AND DISCUSSION: Preliminary results of 51 patients out of 150 planned to be enrolled are reported. While pain scores, measured as an AUC for the initial 48 hours, was not different between groups (198 +/- 75 vs. 196 +/- 79), total distances ambulated and 2-minute walk tests suggested that the group that received the ACB in addition to LIA achieved less on PT at each of the time points than the group that received LIA alone (total distances ambulated: DOS: 109 +/- 94 vs. 132 +/- 85 ft; POD1 am: 75 +/- 106 vs. 287 +/- 78 ft; POD1 pm: 100 +/- 141 vs. 255 +/- 50 ft; POD2 am: 125 +/- 177 vs. 215 +/- 50 ft; 2-minute walk test: DOS: 55 +/- 51 vs. 74 +/- 58 ft; POD1 am: 20 +/- 14 vs. 139 +/- 134 ft; POD1 pm: 45 +/- 64 vs. 140 +/- 99 ft; POD2 am: 75 +/- 107 vs. 128 +/- 83 ft).While we were surprised to see that, contrary to our expectations and to prior publications, patients who received a block were able to walk less at every one of the time points than the patients who received LIA alone, we will complete the study and investigate the possible causes for this discrepancy.CONCLUSION: While these preliminary results remain to be confirmed, these data suggest that LIA alone is preferable to LIA + ACB.REFERENCES:u2022tNader A, Kendall MC, Manning DW, et al. Single-Dose Adductor Canal Block With Local Infiltrative Analgesia Compared With Local Infiltrate Analgesia After Total Knee Arthroplasty: A Randomized, Double-Blind, Placebo-Controlled Trial. Reg Anesth Pain Med. 2016 Nov/Dec;41(6):678-684.u2022tPerlas A, Kirkham KR, Billing R, et al. The impact of analgesic modality on early ambulation following total knee arthroplasty. Reg Anesth Pain Med. 2013 Jul-Aug;38(4):334-9.

DELAYED ATTAINMENT OF PHYSICAL THERAPY MILESTONES WITH THE ADDITION OF AN ADDUCTOR CANAL BLOCK TO LOCAL INFILTRATION ANALGESIA FOLLOWING TOTAL KNEE ARTHROPLASTY

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Author : Germaine Cuff
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis DELAYED ATTAINMENT OF PHYSICAL THERAPY MILESTONES WITH THE ADDITION OF AN ADDUCTOR CANAL BLOCK TO LOCAL INFILTRATION ANALGESIA FOLLOWING TOTAL KNEE ARTHROPLASTY by : Germaine Cuff

Download or read book DELAYED ATTAINMENT OF PHYSICAL THERAPY MILESTONES WITH THE ADDITION OF AN ADDUCTOR CANAL BLOCK TO LOCAL INFILTRATION ANALGESIA FOLLOWING TOTAL KNEE ARTHROPLASTY written by Germaine Cuff and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Background and Goal of Study: Retrospective data, prior studies and a recent meta-analysis suggest a synergistic analgesic effect of an Adductor Canal Blockade (ACB) added to Local Infiltration Analgesia (LIA) compared to LIA alone following Total Knee Arthroplasty (TKA). Our hypothesis was therefore that Physical Therapy (PT) milestones would be reached faster with ACB + LIA than LIA alone.Materials and Methods: After IRB approval, patients scheduled for unilateral primary TKA were randomized to receive either ACB or a sham block (saline) in addition to the LIA administered by the surgeon. Exclusion criteria included significant systemic disease, substance abuse and chronic pain. Spinal anesthetic and postoperative pain management were standardized. ACB was performed at the mid-thigh level with 30 mL of 0.25% bupivacaine with 1:200,000 adrenaline. LIA was performed by the surgeon using bupivacaine, ketorolac, adrenaline and morphine, as well as liposomal bupivacaine.Data collected included passive and active ROM of the knee in flexion and extension; quadriceps strength; bed mobility skill: transfer skill; 2-minute walk test; total distance ambulated on the day of surgery and the first and second post-operative days; ability to climb stairs; readiness for discharge; and pain complaints by NVS before, during and after physical therapy sessions.Results: Preliminary results of 63 patients out of 150 planned are reported. Pain scores, measured as an AUC for the initial 48 hours, were not different between groups (186 u00b1 71 vs. 187 u00b1 80). However, total distances ambulated and 2-minute walk tests suggested that the group that received the ACB in addition to LIA achieved less on PT at each of the time points than the group that received LIA alone (total distances ambulated: DOS: 104 u00b1 90 vs. 137 u00b1 89 ft; POD1 am: 150 u00b1 106 vs. 249 u00b1 152 ft; POD1 pm: 142 u00b1 110 vs. 183 u00b1 92 ft; POD2 am: 135 u00b1 124 vs. 210 u00b1 36 ft; 2-minute walk test: DOS: 56 u00b1 50 vs. 76 u00b1 60 ft; POD1 am: 80 u00b1 71 vs. 129 u00b1 121 ft; POD1 pm: 78 u00b1 66 vs. 118 u00b1 65 ft; POD2 am: 80 u00b1 65 vs. 152 u00b1 75 ft).Discussion: While these interim results remain to be confirmed, the data suggest that LIA alone is preferable to LIA + ACB, providing similar pain control with earlier achievement of physical therapy milestones.

AN OLD APPROACH TO A NEW BLOCKADE - THE EFFECT OF POPLITEAL PLEXUS BLOCKADE AFTER TOTAL KNEE ARTHROPLASTY

Author : charlotte Runge
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis AN OLD APPROACH TO A NEW BLOCKADE - THE EFFECT OF POPLITEAL PLEXUS BLOCKADE AFTER TOTAL KNEE ARTHROPLASTY by : charlotte Runge

Download or read book AN OLD APPROACH TO A NEW BLOCKADE - THE EFFECT OF POPLITEAL PLEXUS BLOCKADE AFTER TOTAL KNEE ARTHROPLASTY written by charlotte Runge and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: A subinguinal obturator nerve block and a femoral triangle block (FTB) provide effective analgesia after total knee arthroplasty (TKA).1, 2 The popliteal plexus (PP) in the popliteal fossa is formed by contribution from the tibial nerve and the posterior obturator nerve, innervating the posterior aspect of the knee.3 An injection of dye in the distal adductor canal spreads to the popliteal fossa and stains the PP in cadavers.4 We hypothesized, that this popliteal plexus block (PPB) as a supplement to an FTB would reduce pain after TKA without anaesthetising motor branches from the sciatic nerve in the popliteal fossa.Aim: To assess the analgesic effect of adding a PPB to an FTB in 10 subjects with significant pain after TKA in a feasibility study.Methods: All subjects underwent unilateral TKA with spinal anaesthesia and received an FTB. Primary outcome was the proportion of subjects with pain above numeric rating scale (NRS) 3 followed by a reduction to NRS u2264 3, after conducting a PPB. Other outcomes were the PPB onset time, the ankle muscle strength.Results: Ten subjects with a median pain of NRS 5.5 (IQR 4-8) after TKA received a PPB. All subjects experienced a reduction in pain to NRS u2264 3 (NRS 1.5 (IQR 0-3)) within 8.5 [95%CI 6.8-10.2] minutes. Three subjects were completely pain-free after the PPB. The ankle muscle strength was not compromised.Conclusions: The PPB provided effective pain relief without compromising the ankle muscle strength in all subjects with significant pain after TKA and an FTB. 1. Runge C, Borglum J, Jensen JM, et al. The Analgesic Effect of Obturator Nerve Block Added to a Femoral Triangle Block After Total Knee Arthroplasty: A Randomized Controlled Trial. Reg Anesth Pain Med 2016;41:445-451. 2. Runge C, Jensen JM, Clemmesen L, et al. Analgesia of Combined Femoral Triangle and Obturator Nerve Blockade Is Superior to Local Infiltration Analgesia After Total Knee Arthroplasty With High-Dose Intravenous Dexamethasone. Reg Anesth Pain Med 2018;43:352-356. 3. GARDNER E. The innervation of the knee joint. Anat Rec 1948;101:109-130. 4. Runge C, Moriggl B, Borglum J, Bendtsen TF. The Spread of Ultrasound-Guided Injectate From the Adductor Canal to the Genicular Branch of the Posterior Obturator Nerve and the Popliteal Plexus: A Cadaveric Study. Reg Anesth Pain Med 2017;42:725-730.

Peripheral Nerve Blocks Provide Better Post Operative Pain Relief Without Affecting Mobilisation Than Local Infiltration Analgesia In Enhanced Recovery Knee Arthroplasty

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Author : M. Kashif
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (125 download)

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Book Synopsis Peripheral Nerve Blocks Provide Better Post Operative Pain Relief Without Affecting Mobilisation Than Local Infiltration Analgesia In Enhanced Recovery Knee Arthroplasty by : M. Kashif

Download or read book Peripheral Nerve Blocks Provide Better Post Operative Pain Relief Without Affecting Mobilisation Than Local Infiltration Analgesia In Enhanced Recovery Knee Arthroplasty written by M. Kashif and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Aims: Total knee arthroplasty (TKA) results in moderate to severe post-operativepain. Peripheral nerve blocks (PNB), though ver effective have potentialdisadvantage of lower limb weakness which affects post op mobilisation afterTKA. The present study was carried out to evaluate the analgesic effect of PNB ascompared to local infiltration analgesia (LIA) and its impact on post-operativemobilisation after TKA.Methods: In this non-randomised comparative study, 25 patients undergoingERAS knee arthroplasty received PNB as part of multimodal analgesia for post opanalgesia. The results were compared to previously conducted study in which LIAinstead of PNB was used as post op analgesia. Rest of the care pathway wassimilar in both groups. After spinal anaesthesia, patients received ultrasoundguided femoral nerve (FNB), adductor canal (ACB) and IPACK nerve blocks using20 mls Levobupivacaine 0125% for FNB & ACB and 20 mls of Levobupivacainefor IPACK block. Post-operative pain score (0-3), 24 hours opiate consumptionand time to mobilisation was recorded and compared with the patients whoreceived LIA only.Results: Average pain score in PNB group was 1 as compared to 2 in LIA group. 3out of 25 patients (12%) required opioids in first 24 hours after surgery in PNB and40% in LIA group. There was no difference in post-operative mobilisation in bothgroups.Conclusions: PNB results in superior post op analgesia than LIA after TKA.Appropriate selection of nerve blocks and local anaesthesia concentration does notdelay post-operative mobilisation in patients undergoing total knee arthroplasty.

Cryoneurolysis Prior To Total Knee Arthroplasty (TKA) Reduces Post-Operative Pain And Opioid Use

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ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (125 download)

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Book Synopsis Cryoneurolysis Prior To Total Knee Arthroplasty (TKA) Reduces Post-Operative Pain And Opioid Use by :

Download or read book Cryoneurolysis Prior To Total Knee Arthroplasty (TKA) Reduces Post-Operative Pain And Opioid Use written by and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: INTRODUCTION: Primary TKA surgeries continue to rise in number exponentially in the USA. This procedure is painful and poorer outcomes have been linked to prolonged narcotic use after surgery. If methods can be proven to decrease the morphine equivalents utilized after surgery then a benefit to the patient should be realized through less fatigue, better improvements and shorter time to achieving goals in physical therapy. Cryoneurolysis is an approved treatment around the knee that has been reported to decrease pain from OA and after TKA.(1,2) The procedure causes axonal degeneration in the nerves which then fully recover typically within a 3 month time frame. This prospective randomized trial compared standard primary TKA with use of an adductor canal block and periarticular injection to a group who underwent cryoneurolysis of the superficial femoral cutaneous (SFA) nerve and the infra patellar branch (IPB) of the saphenous nerve for pain control after primary TKA.METHODS: After IRB approval primary TKA patients were randomized into a control standard of care group or a treatment group with cryoneurolysis. Both groups received the same pre-emptive, intra-operative and post operative pain management treatments except the treatment group underwent cryoneurolysis of their SFA and IPB sensory branches between 3 and 7 days before surgery. Intra-operatively the only difference in treatment was that peri-articular injections were only performed in the posterior capsule in the treatment group and in the control group the perioperative injection was utilized about the circumference of the knee prior to closure. All patients were prescribed 40 narcotic pills at discharge and the pills were then counted at 72 hours and at weeks 2,6 and 12 after surgery. The morphine equivalents in the two groups were then compared at each time interval. In this prospective, randomized trial 120 subjects will be enrolled and to date 102 have been randomized. Exclusion criteria for the study included: chronic and ongoing narcotic use, peripheral neuropathy, and lower extremity deformity greater than 10 degrees. The primary endpoint was daily morphine equivalent (DME) based on opioid pill count and the secondary endpoints were changes in pain scores, Active Range of Motion (ROM), KOOS Jr. and Timed Get-Up and Go (TUG) Test.RESULTS: Preliminary results demonstrate that the DME for the treatment group was significantly lower than the control group at 72 hours (10.9mg vs. 17.6mg, p=0.0193, n=84) and at 6 weeks (3.9mg vs. 5.8mg, p=0.0265, n=68). This difference accounts for a 38% reduction in the amount of opioids taken over each of these periods. The treatment group also demonstrated a greater reduction in pain score from baseline with respect to the control group at 72 hours (0.8 vs. -0.8, p=0.0141, n=84) and at 6 weeks (4.1 vs. 2.9, p=0.0224, n=68). Patients in the treatment group also demonstrated significant improvements in active ROM from baseline relative the control group at 2 weeks (-17.9 vs. -11.9 degrees, p=0.0377, n=83). There have been no differences in the rate or severity of side effects or adverse events between the two groups. DISCUSSION: Preliminary results support that cryoneurolysis prior to a TKA can reduce pain and opioid consumption after primary TKA surgery. Now at the 80% point of enrollment the significant decrease in daily morphine equivalents during the first 72 hours and the following six weeks is significant along with a decrease in pain score which has also resulted in greater flexion at the two week visit. At 80% of enrollment this prospective randomized trial is seeing significant benefit in the treatment group with a nearly 40% reduction in DMEu2019s in the early postoperative window (72 hours post-op) and at the 6 week post-operative period as well. While the 2 week follow up has seen less difference this has been due to several patients not utilizing their tramadol prescriptions as directed in both groups. An almost 7 degree increase in flexion in the treatment group has also been realized at the two week postop physical therapy visit as well but it may not be at a clinically important difference at the 3 month follow up end of study. In a retrospective analysis Dasa et al reported on the same cryoneurolsis reatment comparing 50 treatment to standard of care and found 45% reduction in opioid use and a shorter length of stay. There have also been multicenter trials looking into cryoneurolysis for osteoarthritis pain comparing it to a sham procedure showing superiority for pain relief up to 3 months. (3) The current focus on the opioid crisis in the United States has made all orthopaedic surgeons become more aware of the narcotic use they prescribe for treatments and postoperative pain. Any treatment modalities that can be added to decrease the postoperative pain and improve the progress of physical therapy goals like range of motion after TKA is of very significant importance and surgeons should be made aware of this treatment option especially in those that may be on chronic opioid use for other pain control needs.SIGNIFICANCE/CLINICAL RELEVANCE: The number of TKA surgeries being performed is exponentially increasing year after year. The procedure is known to be painful and multimodal approaches have been developed to decrease narcotic use after surgery but dependence on opioids can occur within the 6 weeks after surgery. With a nationwide focus on the current opioid epidemic any treatment protocol that can significantly decrease narcotic use after TKA will be extremely beneficial to patients.REFERENCES: 1. Dasa V, Lensing G, Parsons M, Harris J, Volaufova J, Bliss R. Percutaneous freezing of sensory nerves prior to total knee arthroplasty. Knee. 2016 Jun;23(3):523-82. Lavie LG, Fox MP, Dasa V. Overview of Total Knee Arthroplasty and Modern Pain Control Strategies. Curr Pain Headache Rep. 2016 Nov;20(11):59.3. Radnovich R, Scott D, Patel AT, Olson R, Dasa V, Segal N, Lane NE, Shrock K, Naranjo J, Darr K, Surowitz R, Choo J, Valadie A, Harrell R, Wei N, Metyas S. Cryoneurolysis to treat the pain and symptoms of knee osteoarthritis: a multicenter, randomized, double-blind, sham-controlled trial. Osteoarthritis Cartilage. 2017 Aug;25(8):1247-1256.

Local Infiltration Analgesia (LIA) Gives Superior Analgesia Compared to Epidural Analgesia After Total Knee Replacement

Author : Isabelle Scharlaeken
Publisher :
ISBN 13 :
Total Pages : pages
Book Rating : 4.:/5 (116 download)

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Book Synopsis Local Infiltration Analgesia (LIA) Gives Superior Analgesia Compared to Epidural Analgesia After Total Knee Replacement by : Isabelle Scharlaeken

Download or read book Local Infiltration Analgesia (LIA) Gives Superior Analgesia Compared to Epidural Analgesia After Total Knee Replacement written by Isabelle Scharlaeken and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Local infiltration analgesia (LIA) gives superior analgesia compared to epidural analgesia after total knee replacement.Scharlaeken I 1,2, Van Overschelde P 3, Byn P 3, Allaert S 1, Van de Velde M 2, Kalmar AF 11 Maria Middelares Hospital, Dept of Anesthesia & Intensive Care, Gent, Belgium2 University Hospitals Leuven, Katholieke Universiteit Leuven, Dept of Anesthesia, Leuven, Belgium3 Maria Middelares Hospital, Dept of Orthopaedics, Gent, Belgium,Background and GoalLocal infiltration analgesia (LIA) is an emerging alternative for patient controlled epidural analgesia (PCEA) for postoperative pain relief after total knee replacement. LIA allows faster mobilisation - with beneficial orthopaedic results-, obviates an urinary catheter, eliminates the risks of epidural catheters, and fastens patient turnover. Conversely, PCEA is considered the gold standardfor pain relief in the first days after this type of surgery. The aim of this observational study was toevaluate patient perception of the quality of analgesia, postoperative nausea & vomiting, and general comfort.Materials and Methods81 patients undergoing a total knee replacement between April and July 2015, were asked about pain scores at D0, D2, and D7, PONV, and general comfort. 40 patients received PCEA and 41 patients received LIA (70ml Ropivacaine 2%, ketorolac 30mg and adrenaline 0.4mg). All surgeries were performed using the same surgical technique by two orthopaedic surgeons, under a standardised general anaesthesia. Spinal anaesthesia with 2.5 ml levobupivacaine 0.25% was given prior to induction of general anesthesia, associated with either PCEA (levobupivacaine / sufentanil) for three days, or LIA during surgery, according to the preference of the surgeon. A strict protocol for other analgesic medication (paracetamol, NSAID and tramadol) was applied in all patients in both groups.Results and DiscussionThe figure summarizes the results in box-plots. The dots represent the average values. The asterisks represent a significant difference.At D0, no significant difference in pain scores was reported. Patients in the LIA group reported significantly better pain scores at D2 and D7 and PONV scores. General comfort was not significantly different (F-test : P=0.054). In addition to significantly better average scores in the LIA group, a remarkably favorable 75th percentile for most questions indicates a much lower incidence of the most extreme discomfort in this group.ConclusionIn addition to faster mobilisation of the patients and elimination of the risks and burden of an epidural catheter and PCEA, LIA delivers equal to better analgesia, and better PONV and general comfort scores.References1 Kerr DR, Kohan L. Local infiltration analgesia: a technique for the control of acute postoperative pain following knee and hip surgery: a case study of 325 patients. Acta Orthop. 2008 Apr;79(2):174-83.

The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery

Author : Liane S. Feldman
Publisher : Springer
ISBN 13 : 3319203649
Total Pages : 367 pages
Book Rating : 4.3/5 (192 download)

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Book Synopsis The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery by : Liane S. Feldman

Download or read book The SAGES / ERAS® Society Manual of Enhanced Recovery Programs for Gastrointestinal Surgery written by Liane S. Feldman and published by Springer. This book was released on 2015-08-31 with total page 367 pages. Available in PDF, EPUB and Kindle. Book excerpt: This volume presents a comprehensive, up to date and practical approach to creating an ERAS program for GI surgery. The first sections review the evidence underlying individual elements of ERAS, including evidence from laparoscopic procedures when available or pointing to evidence gaps where more research is required. These are written by experts in the field, including surgeons, anesthesiologists, nurses, and physiotherapists. The format is in the style of a narrative review, with narrative evidence review, and concluding with a table with “take home messages” and 3-5 key references for readers interested in more depth in each topic. Each chapter also addresses management of common complications and patient selection or exceptions. Subsequent chapters address practical concerns, including creation of a pathway team, project management and engaging administration. Experts contribute real-world examples of their pathways for a variety of procedures, including colorectal surgery, bariatric surgery, upper GI and hepatobiliary surgery, enabling the user to have a starting point for creating their own programs. The SAGES Manual of Enhanced Recovery Programs for Gastrointestinal Surgery will be of great value to fully trained surgeons, anesthesiologists, nurses and administrators interested in initiating an ERAS program.

Burns

Author : Emily S. McLaughlin
Publisher :
ISBN 13 : 9781621004462
Total Pages : 0 pages
Book Rating : 4.0/5 (44 download)

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Book Synopsis Burns by : Emily S. McLaughlin

Download or read book Burns written by Emily S. McLaughlin and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book presents topical research in the study of the prevention, causes and treatment of burns. Topics discussed in this compilation include emergency burn care; nanotechnology and nanomedicine advancements in burn therapy; post-burn hand deformities; the role of apoptosis in burn injury; burns during arthroscopy due to the use of electrosurgical devices; the body's local and consecutive, systemic pathophysiological reaction to thermal lesions; the burn reconstructive units on the face and neck; use of modern day technology for pain management during burn injury rehabilitation; carbon monoxide intoxication in burns; the clinical application of Versajet Hydrosurgery System in burn debridement and escharotomy techniques in burn injuries.

Principles and Practice of Anesthesia for Thoracic Surgery

Author : Peter Slinger, MD, FRCPC
Publisher : Springer Science & Business Media
ISBN 13 : 1441901833
Total Pages : 718 pages
Book Rating : 4.4/5 (419 download)

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Book Synopsis Principles and Practice of Anesthesia for Thoracic Surgery by : Peter Slinger, MD, FRCPC

Download or read book Principles and Practice of Anesthesia for Thoracic Surgery written by Peter Slinger, MD, FRCPC and published by Springer Science & Business Media. This book was released on 2011-07-12 with total page 718 pages. Available in PDF, EPUB and Kindle. Book excerpt: Principles and Practice of Anesthesia for Thoracic Surgery will serve as an updated comprehensive review covering not only the recent advances, but also topics that haven't been covered in previously published texts: extracorporeal ventilatory support, new advances in chest imaging modalities, lung isolation with a difficult airway, pulmonary thrombo-endarterectomy, and chronic post-thoracotomy pain. Additionally, the book features clinical case discussions at the end of each clinical chapter as well as tables comprising detailed anesthetic management.

Core Topics in Paediatric Anaesthesia

Author : Ian James
Publisher : Cambridge University Press
ISBN 13 : 1107244188
Total Pages : 467 pages
Book Rating : 4.1/5 (72 download)

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Book Synopsis Core Topics in Paediatric Anaesthesia by : Ian James

Download or read book Core Topics in Paediatric Anaesthesia written by Ian James and published by Cambridge University Press. This book was released on 2013-07-04 with total page 467 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers all of the important elements of paediatric anaesthesia in a concise and structured manner. From the premature infant to the teenager, readers are guided through the complexities they may encounter, with key points at the end of each chapter to summarise the most important information. The common surgical conditions encountered in daily practice are covered along with comprehensive discussion of consent and the law, safeguarding children, and the complexity of drug dosing in the paediatric population. Other topics covered include trauma, burns, resuscitation, principles of intensive care, and transporting a sick child. Each chapter is written by an acknowledged expert in their field, sharing a wealth of relevant, practical experience. Covering the whole curriculum necessary for advanced training, this is essential reading for trainees, general anaesthetists managing children in non-specialist hospitals and anyone aspiring to become a paediatric anaesthetist, as well as those established in the field.

Pediatric Neurology

Author : Tena Rosser
Publisher : Lippincott Williams & Wilkins
ISBN 13 : 9780781778886
Total Pages : 360 pages
Book Rating : 4.7/5 (788 download)

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Book Synopsis Pediatric Neurology by : Tena Rosser

Download or read book Pediatric Neurology written by Tena Rosser and published by Lippincott Williams & Wilkins. This book was released on 2007 with total page 360 pages. Available in PDF, EPUB and Kindle. Book excerpt: Pediatric Neurology for the Oral Boards: A Case-Based Review is the first pediatric neurology review book written specifically for neurology residents preparing for the oral boards. The book presents sixty cases with discussions structured according to the neurology oral boards format: localization of neurologic findings; differential diagnosis and most likely diagnosis; diagnostic workup; and patient management. The cases will help readers lay a foundation of knowledge in pediatric neurology and develop an organized approach to clinical decision-making. An introduction explains in detail what to expect on the examination and gives helpful hints on preparing for and taking the exam.

Progressive Brain Disorders in Childhood

Author : Juan M. Pascual
Publisher : Cambridge University Press
ISBN 13 : 1107042054
Total Pages : 507 pages
Book Rating : 4.1/5 (7 download)

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Book Synopsis Progressive Brain Disorders in Childhood by : Juan M. Pascual

Download or read book Progressive Brain Disorders in Childhood written by Juan M. Pascual and published by Cambridge University Press. This book was released on 2017-04-20 with total page 507 pages. Available in PDF, EPUB and Kindle. Book excerpt: A review of childhood neurodegenerative and other progressive but non-degenerative disorders to guide their diagnosis and management.

Physical Assessment of the Newborn

Author : Ellen P. Tappero, DNP, RN, NNP-BC
Publisher : Springer Publishing Company
ISBN 13 : 0826121934
Total Pages : 392 pages
Book Rating : 4.8/5 (261 download)

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Book Synopsis Physical Assessment of the Newborn by : Ellen P. Tappero, DNP, RN, NNP-BC

Download or read book Physical Assessment of the Newborn written by Ellen P. Tappero, DNP, RN, NNP-BC and published by Springer Publishing Company. This book was released on 2014-09-01 with total page 392 pages. Available in PDF, EPUB and Kindle. Book excerpt: Physical Assessment of the Newborn, 5th Edition, is a comprehensive text with a wealth of detailed information on the assessment of the newborn. This valuable and essential resource illustrates the principles and skills needed to gather assessment data systematically and accurately, and also provides a knowledge base for interpretation of this data. Coverage addresses: gestational assessment, neurologic assessment, neonatal history, assessment of the dysmorphic infant, and systemic evaluation of individual body systems, as well as key information on behavioral and pain assessment, including the use of specific tools with various groups ranging from term to extremely preterm infants. Numerous tables, figures, illustrations, and photos, many of them in full color, are a major strength that enhances the book’s usefulness as a clinical resource. The text is an excellent teaching tool and resource for anyone who performs newborn examinations including nurses, neonatal and pediatric nurse practitioners, nurse-midwives, physicians and therapists. It can also serve as a core text for any program preparing individuals for advanced practice roles in neonatal care. KEY FEATURES: An authoritative and renowned text that comprehensively addresses all key aspects of newborn assessment Provides a well-ordered evaluation of individual body systems. Assists the practitioner in identifying infant state, behavioral clues, and signs of pain, facilitating individualized care. Comprehensively addresses the tremendous range of variation among newborns of different gestational ages. The content is amplified by numerous photos and illustrations, many in full color Includes Power Point slides and an Image Bank

Rapid Recovery in Total Joint Arthroplasty

Author : Giles R. Scuderi
Publisher : Springer Nature
ISBN 13 : 3030412237
Total Pages : 355 pages
Book Rating : 4.0/5 (34 download)

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Book Synopsis Rapid Recovery in Total Joint Arthroplasty by : Giles R. Scuderi

Download or read book Rapid Recovery in Total Joint Arthroplasty written by Giles R. Scuderi and published by Springer Nature. This book was released on 2020-04-02 with total page 355 pages. Available in PDF, EPUB and Kindle. Book excerpt: The approach to total hip and total knee arthroplasty is changing around the world. There is now a strong emphasis on a more rapid recovery and on more outpatient surgery. Each step of the process is now being modified with more thorough pre-operative evaluations, streamlined surgical approaches, rapid mobilization and faster return to normal activities. These changes place new pressures on all of the health care providers in the system. This unique text - the first of its kind - is a practical guide for each member of the clinical team with updates by the leading authorities from around the country. Each chapter addresses a specific issue and will outline the important new items that need to be addressed, very similar to a handbook. Topics covered include the implementation of new payment models and outcome measurements, recommendations to streamline the pre-, peri- and post-operative protocols, the utility and application of outpatient joint replacement programs, multimodal pain management and post-acute rehabilitation strategies. There is no publication at present that addresses all of these items together in one convenient place. Rapid Recovery in Total Joint Arthroplasty is written and edited by experienced clinicians and surgeons, sharing their years of experience to create a practical, up-to-date text useful for everyday work.

Postgraduate Orthopaedics

Author : Paul A. Banaszkiewicz
Publisher : Cambridge University Press
ISBN 13 : 1107627362
Total Pages : 301 pages
Book Rating : 4.1/5 (76 download)

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Book Synopsis Postgraduate Orthopaedics by : Paul A. Banaszkiewicz

Download or read book Postgraduate Orthopaedics written by Paul A. Banaszkiewicz and published by Cambridge University Press. This book was released on 2012-08-16 with total page 301 pages. Available in PDF, EPUB and Kindle. Book excerpt: The must-have book for candidates preparing for the oral component of the FRCS (Tr and Orth).

Postoperative Pain Management

Author : F. Michael Ferrante
Publisher :
ISBN 13 :
Total Pages : 720 pages
Book Rating : 4.3/5 (91 download)

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Book Synopsis Postoperative Pain Management by : F. Michael Ferrante

Download or read book Postoperative Pain Management written by F. Michael Ferrante and published by . This book was released on 1993 with total page 720 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Essentials of Regional Anesthesia

Author : Alan D. Kaye
Publisher : Springer Science & Business Media
ISBN 13 : 1461410134
Total Pages : 818 pages
Book Rating : 4.4/5 (614 download)

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Book Synopsis Essentials of Regional Anesthesia by : Alan D. Kaye

Download or read book Essentials of Regional Anesthesia written by Alan D. Kaye and published by Springer Science & Business Media. This book was released on 2011-12-21 with total page 818 pages. Available in PDF, EPUB and Kindle. Book excerpt: This is a compact, single-source guide to regional anesthesia. Chapters are authored by regional anesthesia fellowship directors and fellows to insure maximum practicality and up-to-date coverage. Essentials of Regional Anesthesia covers all anatomical regions as well as the unique considerations in patients with chronic pain, obstetric patients, pediatric patients, and patients treated in the outpatient setting. A common chapter format makes it easy to find information quickly, and extensive illustrations enhance the text. Stay current with Essentials of Regional Anesthesia, and stay ahead with these helpful features: • Ultrasound incorporated into each block • Extremely practical focus • More than 400 Q & As to test knowledge • Authored by regional anesthesia fellowship directors and fellows • Clinical pearls and guidance on complications • Concise, clinically oriented review of relevant basic science • Common chapter format for ease of use • Well illustrated with 350 figures, nearly 200 in color