Differential expression of cerebrospinal fluid neuroinflammatory mediators depending on osteoarthritis pain phenotype.

Neuroinflammation is implicated in the development and maintenance of persistent pain states, but there are limited data linking cerebrospinal fluid (CSF) inflammatory mediators with neurophysiological pain processes in humans. In a prospective observational study, CSF inflammatory mediators were compared between patients with osteoarthritis (OA) who were undergoing total hip arthroplasty due to disabling pain symptoms (n = 52) and pain-free comparison controls (n = 30). In OA patients only, detailed clinical examination and quantitative sensory testing were completed.

Acute reduction of cerebrospinal fluid volume prior to spinal anesthesia: implications for sensory block extent.

Background: Multiple patient and clinical characteristics contribute to the variable outcome of spinal anesthesia (SPA). Acute reduction of cerebrospinal fluid (CSF) volume may alter the effect of SPA. The objective of the present study was to test if aspiration of 10 mL CSF immediately prior to SPA is associated with higher extent of sensory block.

Tourniquet versus no tourniquet on knee-extension strength early after fast-track total knee arthroplasty; a randomized controlled trial.

Background: Thigh tourniquet is commonly used in total knee arthroplasty (TKA) but may contribute to pain and muscle damage. Consequently, the reduction in knee-extension strength after TKA may be caused by quadriceps muscle ischaemia underneath the cuff.

Aim: To examine if not using a thigh tourniquet during surgery was more effective than using a thigh tourniquet in preserving knee-extension strength 48 h after fast-track TKA.

Total intravenous general anaesthesia vs. spinal anaesthesia for total hip arthroplasty: a randomised, controlled trial.

Background: The choice of anaesthetic technique for patients undergoing joint arthroplasty is debatable. The hypothesis of this study was that general anaesthesia would generate a more favourable recovery profile than spinal anaesthesia.

Methods: We randomly allocated 120 patients to either intrathecal bupivacaine or general anaesthesia with target-controlled infusion of remifentanil and propofol.