Objective: Postoperative pain after total hip arthroplasty (THA) is not well tolerated. We assessed postoperative pain relief and the need for opioid use after using a cocktail of local and intraarticular analgesic injection (LIA) after THA.
Methods: Eighty patients undergoing THA under spinal anesthesia were randomly assigned to receive either LIA or placebo. The LIA was composed of 5 mg morphine, 30 mg bupivacaine (15 mg/1.5 mL), 1 mL betamethasone, and 0.5 mL epinephrine (1:1,000) intraoperatively. We compared three outcomes total morphine consumption, visual analog scale (VAS) at rest and during activity, and hip flexion angle while standing.
Results: When compared with placebo, opioid consumption was significantly reduced in the trial group, as well as VAS at rest and during mobilization. Earlier rehabilitation and better range of motion (ROM) were achieved in the trial group. There were no significant differences in side effects or postoperative wound healing between groups.
Conclusion: In patients undergoing THA, LIA may reduce postoperative systemic opioid use and offer better pain control and earlier rehabilitation, without observable risks.
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http://dx.doi.org/10.1111/j.1526-4637.2010.01043.x | DOI Listing |
Clin Nutr ESPEN
January 2025
Department of Nutrition and Dietetics, University of Thessaly, Trikala, Argonafton 1, 42132 Trikala, Greece. Electronic address:
Background & Aims: Buprenorphine and methadone are drugs used as medication for addiction treatment for patients with opioid use disorders (OUDs). However, scarce evidence indicates that they induce oxidative stress, which contributes to the deterioration of psychosocial parameters, thus complicating successful rehab. Therefore, a dietary antioxidant intervention such as pomegranate could be beneficial for that group of patients.
View Article and Find Full Text PDFEur J Orthop Surg Traumatol
January 2025
Department of Trauma Surgery, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
Purpose: A prospective longitudinal cohort study was performed to gain insight into the course of recovery in terms of pain, opioid consumption, and mobility in patients with a lateral compression (LC) pelvic injury.
Methods: Adult patients with an LC injury, without any cognitive disorders or limited mobility and who could communicate in Dutch were asked to participate. Pain in terms of NRS (numeric rating scale, range 0-10), opioid use and mobility were recorded at eight time points: at hospital admission, and three days, one week, six weeks, three months, six months, one year and two years after the injury.
BMC Anesthesiol
January 2025
Department of Paediatric Anaesthesiology and Intensive Care, Medical University of Warsaw University Clinical Centre, ul. Żwirki i Wigury 63A, Warsaw, 02-091, Poland.
Background: Lidocaine, a widely used local anaesthetic, also serves as an adjuvant in pain management. However, its use in children is off-label. This study aimed to determine if intravenous lidocaine alleviates the haemodynamic, metabolic, and hormonal responses to intubation and laparoscopic surgery in children.
View Article and Find Full Text PDFJAMA Health Forum
January 2025
Department of Population Health Sciences, Weill Cornell Medical College, New York, New York.
Importance: The prevalence of pharmacies owned by integrated insurers and pharmacy benefit managers (PBMs), or insurer-PBMs, is of growing regulatory concern. However, little is known about the role of these pharmacies in Medicare, in which pharmacy network protections may influence market dynamics.
Objective: To evaluate the prevalence of insurer-PBM-owned pharmacies and the extent to which insurer-PBMs steer patients to pharmacies they own in Medicare.
Ann Thorac Surg Short Rep
June 2024
Thoracic Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy.
Background: Paravertebral block (PVB) is effective in controlling postoperative pain after video-assisted thoracoscopic surgery (VATS) lobectomy but is subject to a high rate of failure because of incorrect site of injection. We compared methylene blue PVB with thoracic epidural anesthesia (TEA) for postoperative pain after VATS lobectomy.
Methods: We conducted a prospective randomized trial of patients undergoing VATS lobectomy; 120 patients were randomly assigned to the PVB or TEA group.
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