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Local Infiltration Analgesia With Additional Intraarticular Catheter Provide Better Pain Relief Compared To Single Shot Local Infiltration Analgesia In Tka
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Book Synopsis Local Infiltration Analgesia with Additional Intraarticular Catheter Provide Better Pain Relief Compared to Single-shot Local Infiltration Analgesia in TKA by : Sarah Lisa Sommer
Download or read book Local Infiltration Analgesia with Additional Intraarticular Catheter Provide Better Pain Relief Compared to Single-shot Local Infiltration Analgesia in TKA written by Sarah Lisa Sommer and published by . This book was released on 2020 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt:
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.
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.
Book Synopsis Local Infiltration Analgesia by : Dennis R. Kerr
Download or read book Local Infiltration Analgesia written by Dennis R. Kerr and published by CRC Press. This book was released on 2016-04-19 with total page 130 pages. Available in PDF, EPUB and Kindle. Book excerpt: The concept of integrating pain management into the surgical process as a single entity is new and exciting. The use of local anaesthetic to block post-operative pain at the site of its generation is here refined into a management program allowing early mobilisation and dramatic pain control in the early post-operative period. This multimodal techn
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.
Book Synopsis Chronic Postsurgical Pain by : Gérard Mick
Download or read book Chronic Postsurgical Pain written by Gérard Mick and published by Springer Science & Business Media. This book was released on 2014-02-20 with total page 175 pages. Available in PDF, EPUB and Kindle. Book excerpt: Primum non nocere... The fact that a surgical procedure can leave any kind of pain casts a shadow over this tenet, which is seen as the basis of medical practice and anchor of its principle ethic... It is all the more surprising in that medicine has only paid attention to this paradoxical chronic pain situation for the past few years. Clarifying the knowledge acquired in this field has become all the more urgent for any care-giver today confronted by a legitimate request from patients: Why and how can a surgical procedure, which is supposed to bring relief, leave behind an unacceptable sequela? This is the approach which the contributors to this new subject of major clinical interest invite you to follow as you work your way through this book.
Book Synopsis The Analgesic Efficacy of Local Infiltration Analgesia Versus Peripheral Nerve Block After Anterior Cruciate Ligament Reconstruction: a Systematic Review and Meta-analysis by : Eric Albrecht
Download or read book The Analgesic Efficacy of Local Infiltration Analgesia Versus Peripheral Nerve Block After Anterior Cruciate Ligament Reconstruction: a Systematic Review and Meta-analysis written by Eric Albrecht 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 StudyMany authors consider blockade of the femoral nerve distribution the gold standard analgesic treatment after anterior cruciate ligament reconstruction. However, some argue an alternative approach of local infiltration analgesia, using local anesthetics injection into the surgical site, has similar efficacy. The objectives of this meta-analysis were to compare the analgesia and functional outcomes of both treatments following anterior ligament reconstruction.Materials and MethodsThe methodology followed the PRISMA statement guidelines. The primary outcomes were pain scores at rest (analogue scale, 0-10) in the early (0-2 postoperative hours), intermediate (3-12 postoperative hours), and late postoperative periods (13-24 postoperative hours). Secondary outcomes included range of motion, quadriceps muscle strength, and complication rates (neurologic events, cardiovascular events, falls, knee infections, or knee chondrolysis).Results and DiscussionTen trials, including 588 patients, were identified. Pain scores in the early (mean difference: 1.6; 95%CI: 0.2, 2.9mg; I2=97%; p=0.02), intermediate (mean difference: 1.2; 95%CI: 0.4, 1.5; I2=85%; p=0.002) and late (mean difference: 0.7; 95%CI: 0.1, 1.4; I2=82%; p=0.03) postoperative periods were significantly lower in patients who received a femoral nerve block (table 1). The quality of evidence for our primary outcomes were moderate to high according to the Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) Working Group System. Regarding the functional outcomes, only one trial reported range of motion at 48 postoperative hours, which was found to be similar between groups (mean difference: -5u00b0; 95%CI: -14, 4u00b0; p = 0.27). No trials sought to record side-effects such as neurologic events, cardiovascular events, falls, knee infections, or knee chondrolysis.ConclusionFemoral nerve block provides superior postoperative analgesia after anterior cruciate ligament reconstruction when compared to local infiltration analgesia. The impact of improved analgesia on function remains unanswered due to the lack of functional outcomes reported in existing literature.
Book Synopsis Acute Pain Management by : Raymond S. Sinatra
Download or read book Acute Pain Management written by Raymond S. Sinatra and published by Cambridge University Press. This book was released on 2009-04-27 with total page 729 pages. Available in PDF, EPUB and Kindle. Book excerpt: This textbook provides an overview of pain management useful to specialists as well as non-specialists, surgeons, and nursing staff.
Book Synopsis Total Knee Arthroplasty by : James Alan Rand
Download or read book Total Knee Arthroplasty written by James Alan Rand and published by Lippincott Williams & Wilkins. This book was released on 1993 with total page 488 pages. Available in PDF, EPUB and Kindle. Book excerpt: This comprehensive reference on total knee arthroplasty describes all surgical techniques and prosthetic designs for primary and revision arthroplasty, discusses every aspect of patient selection, preoperative planning, and intraoperative and postoperative care.
Book Synopsis Perioperative Pain Management, An Issue of Orthopedic Clinics, E-Book by : Frederick M. Azar
Download or read book Perioperative Pain Management, An Issue of Orthopedic Clinics, E-Book written by Frederick M. Azar and published by Elsevier Health Sciences. This book was released on 2023-09-22 with total page 283 pages. Available in PDF, EPUB and Kindle. Book excerpt: In this issue, guest editors bring their considerable expertise to this important topic. Contains 14 relevant, practice-oriented topics including cannabis and pain control after total hip and knee surgery; postoperative pain control following shoulder arthroplasty: rethinking the need for opioids; perioperative pain management for distal radius fractures; wide awake anesthesia for foot and ankle surgery; perioperative pain management for the spine; and more. Provides in-depth clinical reviews on perioperative pain management, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.
Book Synopsis Ultrasound-Guided Regional Anesthesia by : Fernando L. Arbona
Download or read book Ultrasound-Guided Regional Anesthesia written by Fernando L. Arbona and published by Cambridge University Press. This book was released on 2011-03-03 with total page 207 pages. Available in PDF, EPUB and Kindle. Book excerpt: Regional anesthesia is a fast-growing field, fuelled by the application of ultrasound technology over the last decade. This book is a technique-oriented guide, which introduces the use of ultrasound technology with practical instruction in the placement of peripheral nerve blocks and continuous perineural catheters. Each procedure is summarized for quick, easy reference, and supplemented by ultrasound images, color photos, and detailed illustrations. Helpful hints and instructions are provided to further optimize block success. Chapters are organized into four sections, focusing on introductory concepts, upper extremity peripheral nerve blocks, lower extremity peripheral nerve blocks and continuous perineural catheters. Written by instructors from a major academic medical center who work in a fast-paced ambulatory setting, this is a key text for residents, fellows and staff physicians who wish to incorporate the use of ultrasound into the scope of their anesthetic practice.
Book Synopsis World Health Organization Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses by : World Health Organization
Download or read book World Health Organization Guidelines on the Pharmacological Treatment of Persisting Pain in Children with Medical Illnesses written by World Health Organization and published by . This book was released on 2012 with total page 166 pages. Available in PDF, EPUB and Kindle. Book excerpt: These guidelines have been developed to support countries to relieve pain in their paediatric populations. These guidelines address persisting pain in children caused by conditions such as cancer, HIV/AIDS, sickle-cell disease, burns, trauma, and phantom limb pain. Recommendations -- developed following a careful and transparent appraisal of available evidence -- are presented for the pharmacological treatment of mild, moderate and severe pain. The guidelines include chapters on the various systems used to classify pain and on the evaluation of pain, which reviews the available tools for routine pain measurement in children. Provision of sustainable pain relief within health care systems is covered in a separate chapter. Since morphine and other opioid analgesics -- required for the relief of moderate-to-severe pain in children -- are listed under the 1961 UN Single Convention on Narcotic Drugs, the new guidelines include an annex explaining the Convention's requirements for the handling and procurement of opioid analgesics for the relief of pain.
Book Synopsis Acute Pain Management by : Pamela E. Macintyre
Download or read book Acute Pain Management written by Pamela E. Macintyre and published by CRC Press. This book was released on 2021-06-20 with total page 262 pages. Available in PDF, EPUB and Kindle. Book excerpt: With a focus on practical acute pain management in adults in the hospital setting, this book provides health professionals with simple and practical information to help them manage patients with acute pain safely and effectively. • Combines evidence-based information with practical guidelines and protocols • Covers the pharmacology of opioids, local anesthetics, and nonopioid and adjuvant analgesic agents • Discusses management of acute pain in both surgical and nonsurgical acute pain settings including in patients with spinal cord or burns injuries and selected medical illnesses • Includes evidence-based information about management of acute pain in some specific patient groups , including the older patient, opioid-tolerant patients, and those with addiction disorders, pregnant or lactating patients and patients with obstructive sleep apnea or who have renal or hepatic impairment • Considers the role of acute pain management in the context of the current opioid epidemic and identifies possible strategies to minimise the risks. This resource will be helpful to a variety of professionals in assessing and managing acute pain.
Book Synopsis Joint Arthroplasty by : Shinichi Imura
Download or read book Joint Arthroplasty written by Shinichi Imura and published by Springer Science & Business Media. This book was released on 2012-12-06 with total page 428 pages. Available in PDF, EPUB and Kindle. Book excerpt: The introduction of total joint arthroplasty throughout the world has contributed manifold benefits to patients who suffer from joint diseases. Concurrently, however, there has been an increase in revision surgery. Many orthopedic surgeons agree that durability of prostheses is an eternal problem. In particular, periprosthetic osteolysis recently has been identified as one of the serious problems affecting prosthetic dura bility. To improve durability, osteolysis and many other problems must be investi gated and solved both experimentally and clinically with respect to such aspects as prosthetic material, design, and biological and biomechanical behavior. This book comprises 37 papers that were presented by orthopedic surgeons and biomedical engineers at the 28th Annual Meeting of the Japanese Society for Replace ment Arthroplasty, held in March 1998 in Kanazawa, Japan. The volume is thus a compilation of the latest knowledge about the pathogenesis and reduction of osteolysis and wear, newly developed total hip prostheses, and other current topics of total knee arthroplasty. We earnestly hope that this book will be of benefit to clinicians and researchers, and that it will contribute to the creation of more durable total joint prostheses in the future. SHINICHI IMURA v Contents Preface .................... '" .. .. .. ... . .. .. .. . ... .. . . .. . ... . . .. . V List of Contributors. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . XI . . . . . . . . . . . . Part 1 Wear and Pathogenesis of Osteolysis Friction and Wear of Artificial Joints: A Historical Review N. AKAMATSU ................................................ , 3 Matrix Degradation in Osteoclastic Bone Resorption Under Pathological Conditions .
Book Synopsis Surgery and Surgical Techniques—Advances in Research and Application: 2012 Edition by :
Download or read book Surgery and Surgical Techniques—Advances in Research and Application: 2012 Edition written by and published by ScholarlyEditions. This book was released on 2012-12-26 with total page 325 pages. Available in PDF, EPUB and Kindle. Book excerpt: Surgery and Surgical Techniques—Advances in Research and Application: 2012 Edition is a ScholarlyEditions™ eBook that delivers timely, authoritative, and comprehensive information about Surgery and Surgical Techniques. The editors have built Surgery and Surgical Techniques—Advances in Research and Application: 2012 Edition on the vast information databases of ScholarlyNews.™ You can expect the information about Surgery and Surgical Techniques in this eBook to be deeper than what you can access anywhere else, as well as consistently reliable, authoritative, informed, and relevant. The content of Surgery and Surgical Techniques—Advances in Research and Application: 2012 Edition has been produced by the world’s leading scientists, engineers, analysts, research institutions, and companies. All of the content is from peer-reviewed sources, and all of it is written, assembled, and edited by the editors at ScholarlyEditions™ and available exclusively from us. You now have a source you can cite with authority, confidence, and credibility. More information is available at http://www.ScholarlyEditions.com/.
Download or read book Pain and Treatment written by Gabor Racz and published by BoD – Books on Demand. This book was released on 2014-07-10 with total page 346 pages. Available in PDF, EPUB and Kindle. Book excerpt: This new edition reflects the evolution of the field including new topics for historical relevance regarding the changing attitudes towards opioid prescription and use. The book points out that the realization of liberalizing use is almost uncontrollably linked to unnecessary patient death. Similarly, the evidence is increasingly confirming that interventional pain procedures work. New evidence presents, for example, that Percutaneous Lysis of Adhesions is an effective therapeutic modality that has advantages over other options due to its cost effective nature and long term outcomes reducing the need for additional procedures including surgeries and more and more expensive medications. Awareness about the consequences of bad outcomes leads to medicolegal complications. The inevitable trigger is bad outcome which is often related to knowledge, training, experience, as well as equipment design. Some of the examples and lessons learned from the medicolegal arena may soon prevent such occurrences.
Book Synopsis Acute Pain Management by : Pamela E. Macintyre
Download or read book Acute Pain Management written by Pamela E. Macintyre and published by . This book was released on 2010-01-01 with total page 491 pages. Available in PDF, EPUB and Kindle. Book excerpt:
