EP.FRI.623 Outcome of Rectus Sheath Catheters for Post Operative Analgesia in Patients Undergoing Laparotomies and Elective Colorectal Resections

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Nourelhuda Darwish ◽  
AdeelAbbas Dhahri ◽  
Adam Anad ◽  
David Sanwu ◽  
Bogdan Ivanov
Keyword(s):  
Retrospective Study ◽  
Pain Relief ◽  
Rectus Sheath ◽  
Multimodal Analgesia ◽  
The Other ◽  
Local Analgesia ◽  
Midline Laparotomy ◽  
Chest Infection ◽  
Good Pain Relief ◽  
Colorectal Resections

Abstract Aims Multimodal analgesia combining regional and local analgesia and avoiding opioids are part of most ERAS protocols aiming to achieve good pain relief. We aim to examine the effectiveness of using rectus sheath catheters (RCSs) for pain relief in patients undergoing laparotomy surgery and wither this have affected the postoperative (30-day) outcome and the need of opioids. Methods This was a retrospective study involving patients who underwent midline laparotomy surgery, including elective colorectal resections in the period between 01/07/2020 and 23/12/2020. Results A total of 71 patients were included in the study, of which 40(56.33%) had RSCs while 31(43.66%) did not. Morphine was required for 24(60%) of those with RSCs and for 18 patients (58.06%) with no RSCs. PCA was used in 5 (12.5%) of those with RSCs and in 10 (32.25%) of those without RSCs. Of patients requiring non-PCA morphine, mean total morphine doses were 6.4 in patients with RSCs and 4.89 in patients with no RSCs. Of patients with RSCs, (22.5%, 9/40) developed chest infection within 30 days (average onset at day-11) compared to (25.8%,8/31) of the other group (average onset at day-5). 20% (8/40) of the patients with RSCs had atelectasis postoperatively compared to 29.03% (9/31) of those who did not. The Average postoperative stay was 13.65 days and 21 days for those with and without RSCs, respectively. Conclusions Using RSCs did not reduce morphine usage, However, it is associated with lower incidence of chest infection and atelectasis in addition to shorter hospital stay.

OUTCOMES OF SILASTIC TRAPEZIUM REPLACEMENTS

Hand Surgery ◽  
2011 ◽  
Vol 16 (03) ◽  
pp. 301-305 ◽  
Author(s):  
D. P. A. Jewell ◽  
M. B. S. Brewster ◽  
M. A. Arafa
Keyword(s):  
Patient Satisfaction ◽  
Pain Relief ◽  
Complication Rate ◽  
Surgical Techniques ◽  
The Other ◽  
Dash Score ◽  
Power Grip ◽  
Effective Operation ◽  
Good Pain Relief ◽  
Joint Arthritis

Trapezio-metacarpal joint arthritis is common, affecting 7% of men and 15% of women. Numerous surgical techniques are described for this condition but it is not clear which is best. Eighty-six silicone trapezium replacements were assessed at an average of 46 months (six to 156 months) postoperatively for patient satisfaction, pain, key and power grip strength, range of motion, complications and disability with DASH score. Patient satisfaction was 92%. There was excellent pain reduction from 4.2 to 0.6 on a scale of 0 to 5. Strength was 72% and 84% of age-sex-matched normal data for key and power grips, respectively. The complication rate was low, with two cases of persistent pain. One resolved spontaneously, the other resolved following revision of the silicone implant. The average DASH score was 30. Silicone trapezium replacement is an effective operation that offers the patient good pain relief, strength and good function with few complications.

Replacement of the Trapezium with a Silicone Elastomer Universal Small Joint Spacer

1989 ◽  
Vol 14 (4) ◽  
pp. 456-459
Author(s):  
B. HELAL ◽  
I. McPHERSON
Keyword(s):  
Pain Relief ◽  
Radial Nerve ◽  
The Other ◽  
Silicone Elastomer ◽  
Other Hand ◽  
Good Pain Relief ◽  
Small Joint

31 patients have been received between one and five years (average 2¾ years) after replacement of the trapezium with a silicone elastomer universal small joint spacer for carpo-metacarpal arthritis. Good pain relief was achieved in 84% and most patients retained 80% of power and movement compared to the other hand. Two prostheses fractured and two more subluxed painfully; another two were too big, causing pain, and had to be removed. Minor damage to the radial nerve occurred in four patients.

scholarly journals Use of Alfentanil in Palliative Care

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 240
Author(s):  
José António Ferraz Gonçalves ◽  
Filipa Sousa ◽  
Lucy Alves ◽  
Patrícia Liu ◽  
Sara Coelho
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Retrospective Study ◽  
Pain Relief ◽  
Renal Impairment ◽  
Care Service ◽  
Palliative Care Service ◽  
Median Number ◽  
Second Line ◽  
Induction Of Tolerance

Alfentanil is used for chronic pain relief in palliative care. However, there is a dearth of data on its use. For this reason, a decision was made to review the use of alfentanil in palliative care. Retrospective study was carried out in a palliative care service. The files of patients who received alfentanil as an intravenous or subcutaneous continuous infusion for pain relief, between January 2018 and April 2019. In total, 111 patients received alfentanil out of 113 admissions. Of them, 56 were male, and the median age was 70 years. The median number of days on alfentanil was 6 (range 1 to 129). The most frequent primary reasons for switching to alfentanil was uncontrolled pain in 52 (46%) patients and renal impairment in 24 (21%) patients. The median 24-h initial dose of alfentanil was 4 mg (1–20), and the median final 24-h dose of alfentanil was 5 mg (1–60), (p < 0.001). The initial 24-h median number of rescue doses was 2 (0–8), and the final median number of rescue doses was 1 (0 to 8), (p = 0.025). In 56 patients who were on alfentanil for at least 7 days, the dose decreased in 3 (5%), remained stable in 10 (18%) and increased in 43 (77%). The patient on alfentanil for 129 days maintained the same dose throughout that period. Alfentanil can be a useful second-line opioid. The induction of tolerance does not seem to be particularly rapid with alfentanil.

Dorsal root entry zone lesions for the treatment of post-herpetic neuralgia

1984 ◽  
Vol 60 (6) ◽  
pp. 1258-1262 ◽  
Author(s):  
Allan H. Friedman ◽  
Blaine S. Nashold ◽  
Janice Ovelmen-Levitt
Keyword(s):  
Pain Relief ◽  
Dorsal Root ◽  
Post Herpetic Neuralgia ◽  
Entry Zone ◽  
Dorsal Root Entry Zone ◽  
Content Type ◽  
Root Entry Zone ◽  
Adequate Pain Relief ◽  
Good Pain Relief ◽  
Transcutaneous Nerve Stimulation

✓ Post-herpetic pain was treated in 12 patients using dorsal root entry zone (DREZ) lesions. All patients had failed to receive adequate pain relief from conservative therapy consisting of transcutaneous nerve stimulation, carbamazepine, and/or amitriptyline. Dorsal root entry zone lesions were made to include the involved dermatomes plus one-half of the dermatomes above and below the painful areas. Eight patients reported good pain relief with follow-up periods ranging from 6 to 21 months. A ninth patient obtained satisfactory pain relief, but the superior 1 cm of the original painful area was not included in the distribution of the DREZ lesions. Patients whose lesions were performed using a thermally controlled lesion probe suffered no significant postoperative neurological deficit. Dorsal root entry zone lesions appeared to be a satisfactory treatment for post-herpetic neuralgia in patients who have failed to respond to more conservative modes of therapy.

scholarly journals Clinical and Genetic Spectrum of Stargardt Disease in Argentinean Patients

2021 ◽  
Vol 12 ◽  
Author(s):  
Marcela D. Mena ◽  
Angélica A. Moresco ◽  
Sofía H. Vidal ◽  
Diana Aguilar-Cortes ◽  
María G. Obregon ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Next Generation Sequencing ◽  
Final Analysis ◽  
The Other ◽  
South American ◽  
Stargardt Disease ◽  
Targeted Next Generation Sequencing ◽  
Mutational Spectrum ◽  
Genetic Features ◽  
Generation Sequencing

PurposeTo describe the clinical and molecular spectrum of Stargardt disease (STGD) in a cohort of Argentinean patients.MethodsThis retrospective study included 132 subjects comprising 95 probands clinically diagnosed with STGD and relatives from 16 of them. Targeted next-generation sequencing of the coding and splicing regions of ABCA4 and other phenocopying genes (ELOVL4, PROM1, and CNGB3) was performed in 97 STGD patients.ResultsWe found two or more disease-causing variants in the ABCA4 gene in 69/95 (73%) probands, a single ABCA4 variant in 9/95 (9.5%) probands, and no ABCA4 variants in 17/95 (18%) probands. The final analysis identified 173 variants in ABCA4. Seventy-nine ABCA4 variants were unique, of which nine were novel. No significant findings were seen in the other evaluated genes.ConclusionThis study describes the phenotypic and genetic features of STGD1 in an Argentinean cohort. The mutations p.(Gly1961Glu) and p.(Arg1129Leu) were the most frequent, representing almost 20% of the mutated alleles. We also expanded the ABCA4 mutational spectrum with nine novel disease-causing variants, of which eight might be associated with South American natives.

scholarly journals Using tropicamide and phenylephrine without cyclopentolate for pupil dilation in cataract surgery reduces postoperative intraocular pressure rise

2020 ◽  
Vol 17 (3) ◽  
pp. 285-289
Author(s):  
Rachel Xuan ◽  
Keith Ong
Keyword(s):  
Intraocular Pressure ◽  
Retrospective Study ◽  
Cataract Surgery ◽  
Medical Records ◽  
Pressure Rise ◽  
Pupil Dilation ◽  
The Other ◽  
Sample Population ◽  
Iop Elevation ◽  
Larger Sample

The aim of this retrospective study was to evaluate whether intraocular (IOP) elevation post-cataract surgery can be reduced by using tropicamide and phenylephrine only, without cyclopentolate. Medical records across two surgical facilities were analyzed. One surgical facility (Cohort A) used a combination of tropicamide, cyclopentolate, and phenylephrine preoperatively, while the other (Cohort B) used tropicamide and phenylephrine only. Of patients in Cohort A, 63.6% (n = 7) had a higher IOP in the operated eye, while it was only 27.3% (n = 3) in Cohort B. Therefore, it is preferable to exclude the use of cyclopentolate in the preoperative dilation regimen of patients undergoing cataract surgery. However, a study with a larger sample population is required to further evaluate the significance of these results.

scholarly journals Erythroderma caused by vancomycin in children: concentration and speed of infusion

2013 ◽  
Vol 1 (2) ◽  
Author(s):  
José F. Luna Álvarez ◽  
Mónica Gómez Vázquez ◽  
Ana L. Moreno González ◽  
Aldo Melchor Hernández ◽  
Marco A. Escamilla-Acosta ◽  
...  
Keyword(s):  
Adverse Reaction ◽  
Clinical Practice ◽  
Retrospective Study ◽  
Clinical Characteristics ◽  
Male Gender ◽  
The Other ◽  
Paediatric Hospital ◽  
Other Hand ◽  
Red Man Syndrome ◽  
Main Factors

Vancomycin is an antibiotic glycopeptide that was isolated of the Streptomyces orientalis. It was introduced in the clinical practice for treatment of infections caused by staphylococcus in which other antibiotics were proving to be ineffective. In this retrospective study, we determine its prescription, clinical characteristics as well as the factors that favor the apparition of the erythroderma or red-man syndrome in a paediatric hospital. Forty patients to which physicians administer vancomycin and presented erythroderma were evaluated. Male gender was more predominated, with a total of 25 cases (62.5 %). The average age was of 12 ± 6 years. We identified two main factors that are directly related to the appearance of erythroderma. On one hand, the "concentration of the drug", which is related to the dilution that it is realized when a dose of vancomycin is going to be administered to the patient and on the other hand the “time or speed of infusion”. In the present study, it was found a low incident of this adverse reaction and few cases of complications.

scholarly journals Efficacy of additional periprostatic apex nerve block on pain in each of 12 transrectal prostate core biopsies: a retrospective study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeong Woo Yoo ◽  
Kyo Chul Koo ◽  
Byung Ha Chung ◽  
Kwang Suk Lee
Keyword(s):  
Retrospective Study ◽  
Pain Relief ◽  
Nerve Block ◽  
Prostate Biopsy ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Prostate Biopsies ◽  
Pain Scores ◽  
Average Pain ◽  
Probe Insertion

Abstract Background We identified pain variation according to prostate biopsy sites and compared differences in pain relief according to the site of periprostatic nerve block (PNB). Methods This retrospective study collected data from 312 patients who underwent transrectal prostate biopsies between January 2019 and August 2020. Patients were stratified into two groups according to the site of local anesthesia (base vs. base and apex PNB), with each block achieved with 2.5 cm3 of 2% lidocaine. Pain scores were assessed using the visual analog scale at the following time points: probe insertion, PNB at base, PNB at apex, each of the 12 core biopsy sites, and 15 min after biopsy. The results were analyzed using a linear mixed model. Results The average pain scores were significantly higher in the base-only PNB group than were those in the base and apex PNB group (3.88 vs 2.82, p < 0.001). In the base-only PNB group, the pain scores increased from base to apex (p < 0.001), and the pain at each site also gradually increased as the biopsy proceeded (p < 0.001). In contrast, in the base and apex PNB group, there was minor change in pain scores throughout the procedure. Conclusions The pain scores varied at each site during the prostate biopsy. The provision of a base and apex PNB provided greater pain relief than does base-only PNB during prostate biopsy.

scholarly journals TAP-block as a component of multimodal analgesia for postoperative anesthesia in obstetrics and gynecology

Pain medicine ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. 67-74 ◽  
Author(s):  
Ye. V. Grigimalsky ◽  
A. Y. Garga
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Multimodal Analgesia ◽  
Postoperative Pain Relief ◽  
Obstetrics And Gynecology ◽  
Tap Block ◽  
Actual Problem ◽  
Advantages And Disadvantages ◽  
Obstetrics And Gynaecology

Postoperative pain relief is still quite actual problem in medicine, particularly in obstetrics and gynaecology. The most appropriate method of adequate post-operative anesthesia is multimodal analgesia. This article describes the features of multimodal analgesia using TAP-block combined with NSAIDs in obstetric and gynaecological patients, advantages and disadvantages of this combination and our own experience of applying this method in our clinic.

scholarly journals Surgical Outcome of Microvascular Decompression for Trigerminal Neuralgia in Terms of Pain Control Using Visual Analogue Scale

2020 ◽  
Vol 24 (3) ◽  
Author(s):  
RIAZ-UR- REHMAN ◽  
MUHAMMAD NAWAZ KHAN ◽  
ATTIYA NASIR SIDDIQUE ◽  
AKBAR JAMAL
Keyword(s):  
Pain Relief ◽  
Visual Analogue Scale ◽  
Trigeminal Neuralgia ◽  
Pain Control ◽  
Analogue Scale ◽  
Visual Analogue Score ◽  
Definitive Treatment ◽  
Inclusion Criteria ◽  
Good Pain Relief ◽  
Vascular Decompression

Objective:  The aim of conducting this study was to evaluate the outcome of a Micro vascular Decompression procedure for the definitive treatment of Trigeminal Neuralgia in our setup. Material and Methods:  This observational prospective study was carried out in Neurosurgery unit Hayatabad Medical Complex, Peshawar. A total of 50 patients operated for micro vascular decompression surgeries were enrolled in the study, both genders and any age were in inclusion criteria. Patients previously operated for trigeminal neuralgia were excluded from the study. Post operatively all patients were followed for 1year to calculate the outcome in terms of pain control using visual analogue score (VAS). Immediate pain relief during the first post-operative week and trigeminal neuralgia pain at 1 year post op were recorded and  graded into three categories based on Visual Analogue Scale (VAS) such as Excellent: 0-2 , Good: 3-6, Fail/Poor: 7 – 10. Results:  50 patients fulfilled the inclusion criteria. 22 were male & 28 were female with an age range from 42-78 years. Average duration of disease was 5 years. In 30 patients, clinically v2-v3 were predominantly involved, in remaining 14 patient v1-v2 were involved & only in 6 patients all three branches were involved. Among all operated 50 patients 18(36%) had excellent pain relief, 26 (52%) had good pain relief & 6 (12%) had fail/poor pain relief. Conclusion:  From this data it was concluded that micro vascular decompression is an effective surgical procedure in relieving pain of trigeminal neuralgia in patients who are refractive to medical treatment.

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