In patients undergoing spine surgery postoperative pain management can often be complicated with side effects associated with high dose narcotic such as respiratory depression and those associated with non-steroidal anti-inflammatory drugs such as interference with bone healing process. Local anesthetics can help in both decreasing postoperative pain and minimizing side effects associated with systematically administered analgesics. This report describes the use of preoperative ultrasound guided dorsal ramus nerve block to reduce postoperative pain in six patients undergoing lumbar spine surgery under general anesthesia.
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Objectives: To assess if implementing interventions to effectively manage preoperative chronic moderate to severe shoulder pain in patients undergoing rotator cuff repair (RCR) can improve shoulder surgery outcomes.
Methods: A systematic review was conducted following the PRISMA and SIGN guidelines. Randomized clinical trials (RCT), metanalysis, systematic revisions and cohort studies in Spanish/English, published within the last 10 years, evaluating interventions to control preoperative chronic moderate to severe shoulder pain in patients undergoing RCR and their impact in postoperative shoulder outcomes were included.
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Postoperative abdominal adhesions are the leading cause of bowel obstruction and a cause of chronic pain and infertility. Adhesion formation occurs after 50 to 90% of abdominal operations and has no proven preventative or treatment strategy. Abdominal adhesions derive primarily from the visceral peritoneum and are composed of polyclonally proliferating tissue-resident fibroblasts.
View Article and Find Full Text PDFCurrent Strategies in Regional Anesthesia for Shoulder Surgery.
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From the Department of Orthopaedic Surgery, MedStar Union Memorial Hospital, Baltimore, MD (Zhang and Murthi), and the Department of Anesthesiology, St. Francis Hospital and Medical Center, Hartford, CT (Sinha).
As arthroscopic and open shoulder surgery is increasingly performed on an outpatient basis, optimal and prolonged pain control is becoming more important while minimizing associated adverse effects. Traditional analgesic strategies relying on opioid and nonopioid medications provide inadequate pain control and are associated with undesirable adverse effects, such as opioid-related adverse effects (postoperative nausea and vomiting, respiratory depression, sedation), gastric lining irritation, and renal and hepatic adverse effects. Advances in ultrasonography-guided regional anesthesia have made placement of interscalene brachial plexus nerve blocks more reliable and precise and aided development of novel phrenic nerve-sparing peripheral nerve block techniques that decrease the risk of diaphragmatic paresis and dyspnea.
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IRCCS Istituto Ortopedico Rizzoli, Via Cesare Pupilli 1, 40136, Bologna, BO, Italy.
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