Spinal fusion surgery is a major surgery that results in severe postoperative pain, therefore pain reduction is a primary concern. New strategies for pain management are currently under investigation and include multimodal treatment. A 3-year retrospective analysis of patients with idiopathic scoliosis undergoing spinal fusion surgery was performed at our hospital, assessing patient pain scores, opioid use, and recovery. We evaluated the effect of adding continuous infusion of local anesthetics (CILA) to a postoperative pain management protocol that includes intraoperative intrathecal morphine, as well as postoperative patient-controlled analgesia and oral opioid/acetaminophen combination. The study compared 25 patients treated according to the standard protocol, with 62 patients treated with CILA in addition to the pain management protocol. Patients in the CILA group used nearly 0.5 mg/kg less opioid analgesics during the first 24 hours after surgery.
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http://dx.doi.org/10.1055/s-0033-1337119 | DOI Listing |
J Orthop Surg Res
December 2024
Department of Orthopedics, The First Medical Center, Chinese PLA General Hospital, Beijing, 050051, China.
Background: Total knee arthroplasty (TKA) is an effective treatment for end-stage knee osteoarthritis, and postoperative rehabilitation is crucial. However, a comprehensive bibliometric analysis of this area has yet to emerge. This study aims to visualize the research trends in postoperative rehabilitation after TKA through bibliometric analysis and explore current research frontiers and hotspots.
View Article and Find Full Text PDFReg Anesth Pain Med
December 2024
Department of Anaesthesiology, Intensive Care and Pain Therapy, Saarland University Hospital and Saarland University Faculty of Medicine, Homburg, Germany.
Introduction: Regional anesthesia is frequently used for upper limb surgeries and postoperative pain control. Different approaches to brachial plexus blocks are similarly effective but may differ in the frequency and severity of iatrogenesis. We, therefore, examined large-scale registry data to explore the risks of typical complications among different brachial plexus block sites for regional anesthesia.
View Article and Find Full Text PDFBMJ Open
December 2024
Health Services, University of Washington, Seattle, Washington, USA.
Introduction: Ineffective coordination during care transitions from hospitals to skilled nursing facilities (SNFs) costs Medicare US$2.8-US$3.4 billion annually and results in avoidable adverse events.
View Article and Find Full Text PDFBMJ Open
December 2024
Department of Anesthesiology, Henan Provincial Chest Hospital & Chest Hospital of Zhengzhou University, Zhengzhou, Henan, China.
Introduction: Chronic post-thoracotomy pain (CPTP) is a persistent and disabling condition affecting a significant proportion of patients after thoracotomy and posing a challenge for clinicians, despite advances in surgical and pain management strategies. Esketamine, the S-enantiomer of ketamine, has emerged as a promising therapeutic agent for various pain conditions, with evidence for its effectiveness in alleviating acute and chronic pain. This systematic review and meta-analysis will be conducted to assess the efficacy of esketamine in treating CPTP, and evaluate its effectiveness in reducing pain intensity, improving functional outcomes, and reducing opioid consumption, as well as its adverse effects.
View Article and Find Full Text PDFIn Vivo
December 2024
Department of Health and Care Professions, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K.;
Background: Coronary artery disease (CAD), primarily caused by atherosclerosis, is a leading cause of death, presenting as angina or myocardial infarction. Advances in cardiac imaging, angiography, and procedures like percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery have improved early detection and management of this condition. This report presents the case of a man who experienced worsening exertional chest pain and discomfort while at rest.
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