: Postoperative analgesia is important for reducing biologically invasive reactions to surgery. In Japan, postoperative analgesia, including indices of analgesia, has not been adequately addressed. This study aimed to determine the relationship between postoperative pain and postoperative course and the importance of analgesia for early recovery. : Patients who underwent any of seven surgical procedures in gastrointestinal, thoracic, and cardiac surgery were enrolled. The primary endpoint was a median Prince Henry Pain Scale score from postoperative days 1 to 3. Secondary endpoints were the quality of recovery on postoperative day 7 (Quality of Recovery-15 [QoR-15]) and the length of postoperative hospital stay. : Median postoperative pain levels among surgeries were 3 on day 1, 2 on days 2 and 3, 1 on day 7, and 1 at discharge. In both univariate and multivariate analyses, the use of postoperative epidural analgesia and intravenous patient-controlled analgesia (IV-PCA) were significant predictors of early postoperative pain. Only early postoperative pain was a significant predictor of QoR-15 score. Regular use of acetaminophen, early postoperative pain, no appetite, and postoperative complications were significant in affecting the length of postoperative hospital stay. In the comparison of early postoperative pain according to whether epidural analgesia and IV-PCA were used, the group that used both methods had the least pain. : In Japan, early postoperative pain persists after major surgical procedures and affects postoperative quality of recovery and length of hospital stay. The use of epidural analgesia, IV-PCA, or both appeared to be effective in overcoming early postoperative pain, thereby enhancing early postoperative recovery.
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http://dx.doi.org/10.3390/jcm14041130 | DOI Listing |
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.
Sci Transl Med
March 2025
Hagey Laboratory for Pediatric Regenerative Medicine, Division of Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, CA 94305, USA.
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 PDFJ Am Acad Orthop Surg
March 2025
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.
View Article and Find Full Text PDFMusculoskelet Surg
March 2025
IRCCS Istituto Ortopedico Rizzoli, Via Cesare Pupilli 1, 40136, Bologna, BO, Italy.
Background: Chronic periprosthetic knee infection is a highly debilitating complication. In case of failed R-TKA, with significant bone loss and extensor mechanism failure, re-revision procedures could not even be feasible. The most appropriate therapeutic strategy in these cases remains unclear.
View Article and Find Full Text PDFCurr Pain Headache Rep
March 2025
Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA.
Purpose Of Review: Herein we review recent trends in opioid prescribing, the rise in office-based surgeries, and propose a framework to minimize opioid consumption following such procedures.
Recent Findings: Outpatient surgical procedures are increasing year over year in the United States. This observed increase is expected to continue due to the financial incentives to perform outpatient procedures.
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