Chronic Pain After Cardiac Surgery

2019 ◽  
pp. 166-171
Author(s):  
Jennette D. Hansen ◽  
Mark A. Chaney
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Cardiac Surgery ◽  
Acute Pain ◽  
Multimodal Analgesia ◽  
Minimally Invasive Techniques ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks ◽  
Invasive Techniques

Chronic pain after cardiac surgery can impair quality of life and rehabilitation. Chronic pain is difficult to study, and depending on how patients are questioned, the incidence of chronic pain after sternotomy is between 17% and 56%, and chronic pain after thoracotomy is between 15% and 80%. Several risk factors are independent predictors for the development of chronic pain. In recent years, minimally invasive techniques have been utilized in cardiac surgery patients to potentially minimize pain and to decrease length of stay in the hospital. At this point in time, no single regimen has been proven superior at preventing chronic pain. An aim to treat acute pain without delaying extubation has been the recent focus of pain management, with research in neuraxial and peripheral nerve blocks. In addition, multimodal analgesia is key for treatment of acute pain to allow patients to deep breathe, cough, and ambulate comfortably without respiratory depression. Some believe treatment of acute pain leads to less development of chronic pain; however, this has not yet been definitively proven.

Minimally Invasive Separation Surgery for Metastases in the Vertebral Column: A Technical Report

2019 ◽  
Vol 18 (6) ◽  
pp. 606-613
Author(s):  
Rafael A Vega ◽  
Jeffrey I Traylor ◽  
Ahmed Habib ◽  
Laurence D Rhines ◽  
Claudio E Tatsui ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Spinal Cord ◽  
Minimally Invasive ◽  
Definitive Treatment ◽  
Invasive Technique ◽  
Thoracic Vertebrae ◽  
Minimally Invasive Techniques ◽  
Invasive Approach ◽  
Invasive Techniques

Abstract BACKGROUND Epidural spinal cord compression (ESCC) is a common and severe cause of morbidity in cancer patients. Minimally invasive surgical techniques may be utilized to preserve neurological function and permit the use of radiation to maximize local control. Minimally invasive techniques are associated with lower morbidity. OBJECTIVE To describe a novel, minimally invasive operative technique for the management of metastatic ESCC. METHODS A minimally invasive approach was used to cannulate the pedicles of the thoracic vertebrae, which were then held in place by Kirschner wires (K-wires). Following open decompression of the spinal cord, cannulated screws were placed percutaneously with stereotactic guidance through the pedicles followed by cement induction. Stereotactic radiosurgery is performed in the postoperative period for residual metastatic disease in the vertebral body. RESULTS The minimally invasive technique used in this case reduced tissue damage and optimized subsequent recovery without compromising the quality of decompression or the extent of metastatic tumor resection. Development of more minimally invasive techniques for the management of metastatic ESCC has the potential to facilitate healing and preserve quality of life in patients with systemic malignancy. CONCLUSION ESCC from vertebral metastases poses a challenge to treat in the context of minimizing potential risks to preserve quality of life. Percutaneous pedicle screw fixation with cement augmentation provides a minimally invasive alternative for definitive treatment of these patients.

Thoracoscopic diaphragm plication

2020 ◽  
Keyword(s):  
Quality Of Life ◽  
Surgical Approaches ◽  
Minimally Invasive Techniques ◽  
Respiratory Compromise ◽  
Video Tutorial ◽  
The Past ◽  
Huge Impact ◽  
Invasive Techniques ◽  
Thoracoscopic Technique

Diaphragmatic paralysis with subsequent eventration and respiratory compromise has a huge impact on the quality of life of affected patients. Many different surgical approaches for correcting this problem have been described in the past, using both transabdominal and transthoracic pathways. Either way, since the procedure in general requires suturing of the diaphragm, minimally invasive techniques have only been adopted very slowly and most thoracic surgeons nowadays still use a minithoracotomy, even when adopting a video-assisted approach. We have developed a safe and simple completely thoracoscopic technique for diaphragmatic plication, and in this video tutorial we demonstrate our technique.

scholarly journals Tackling pain after cardiac surgery: It takes a village!

2021 ◽  
Vol 1 (2) ◽  
pp. 308-314
Author(s):  
Geraldine Martorella
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Cardiac Surgery ◽  
Paradigm Shift ◽  
Self Management ◽  
Opioid Misuse ◽  
Management Skills ◽  
Hospital Stays ◽  
Multiple Levels

There is increasing concern regarding the risk to develop chronic pain after cardiac surgery with potential detrimental effects on recovery and quality of life. With shortened hospital stays after cardiac surgery, there needs to be more emphasis placed on self-management skills and the support provided to patients and their informal caregivers during the subacute phase. A paradigm shift needs to occur on multiple levels to prevent chronic pain and opioid misuse after surgery. Initiating this change means redefining the timing, recipients, and content and format of interventions. Several avenues can be examined and translated in practice to promote a successful transition after cardiac surgery.

scholarly journals Avaliação da eficácia da microabrasão no tratamento de manchas de fluorose: revisão de literatura

2020 ◽  
Vol 9 (3) ◽  
Author(s):  
Pedro Paulo Aguiar Santos Cavalcanti ◽  
Maria Eduarda Arruda de Lucena ◽  
Hian Carvalho Souza ◽  
Eloiza Leonardo de Melo ◽  
Jéssica Meirinhos Miranda ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Dental Fluorosis ◽  
Minimally Invasive Techniques ◽  
Health Related Quality ◽  
Porto Alegre ◽  
Related Quality ◽  
Health Related ◽  
Belo Horizonte ◽  
Invasive Techniques

Introdução: A fluorose dentária é uma patologia que afeta os elementos dentários sendo desencadeada pela presença em excesso de fluoreto, e manifestando-se ao nível do esmalte dentário na forma de manchas e/ou defeitos anatómicos. Objetivo: Avaliar a eficácia da microabrasão no tratamento da fluorose e verificar a aplicabilidade desta técnica nos dias atuais, ratificando a importância da microabrasão como um tratamento estético minimamente invasivo. Materiais e Métodos: Foram realizadas buscas nas bases de dados Google Acadêmico, Scielo e PubMed/MEDLINE através da inserção dos termos “Enamel Microabrasion AND Fluorosis Dental”. Os critérios de inclusão foram: Casos clínicos, publicados de 2015 à 2019, escritos na língua portuguesa, espanhola e inglesa. Os critérios de exclusão foram os artigos que não estavam nas bases de dados pré-definidas, artigos que não possuíam textos disponibilizados na íntegra e artigos em outras línguas das que foram definidas. Os dados foram extraídos e tabelados e posteriormente foi realizada a análise qualitativa dos dados. Resultados: Foram identificados 1.411 artigos nas bases de dados, sendo 1330 na base Google Acadêmico, 2 na base scielo, 79 na base PubMed/MEDLINE e foram excluídos 946 artigos de acordo com os critérios de inclusão e exclusão. Conclusão: Apesar de diminuir a espessura do esmalte, a microabrasão como técnica para o tratamento permite a resolução de problemas estéticos de maneira minimamente invasiva, com alto grau de satisfação pelos pacientes e pelos profissionais e ainda com baixo custo. Além disso, favorece os pacientes por trazer resultados imediatos e permanentes com mínima e imperceptível perda de esmalte.Descritores: Fluorose Dentária; Microabrasão do Esmalte; Esmalte Dentário.ReferênciasHermes SR. Microabrasão do esmalte dental para tratamento de fluorose. RGO Rev gaúch odontol. 2013; 61(supl 1):427-33.Prado Júnior RR, Ribeiro RC, Brito AC, Lopes TSP. Microabrasão como tratamento de esmalte fluorótico. RGO Porto Alegre. 2008;56(2):21-6.Chankanka O, Levy SM, Warren JJ, Chalmers JM. A literature review of aesthetic perceptions of dental fluorosis and relationships with psychosocial aspects/oral health-related quality of life. Community Dent Oral Epidemiol. 2010; 38(2):97-109.Calixto LR, Galafassi G, Alves MR, Mandarino F. Tratamento de manchas dentais: Clareamento e Microabrasão. Caderno Científico, Estética. 2007:20-2.Agostini M. Fluorose Dentária: uma revisão de literatura [monografia]. Belo Horizonte: Universidade Federal de Minas Gerais, Curso de Especialização em Atenção Básica em Saúde da Família; 2011.Bağlar S, Çolak H, Hamidi MM · Novel microabrasion paste. J Esthet Restor Dent. 2015; 27(5):258-66.Di Giovanni T, Eliades T, Papageorgiou SN. Interventions for dental fluorosis: A systematic review. J Esthet Restor Dent. 2018;30(6):502-8.Gupta A, Dhingra R, Chaudhuri P, Gupta A. A comparison of various minimally invasive techniques for the removal of dental fluorosis stains in children. J Indian Soc Pedod Prev Dent. 2017;35(3):260-68.Meireles SS, Goettems ML, Castro KS, Sampaio FC, Demarco FF. Dental fluorosis treatment can improve the individuals’ OHRQoL? Results from a randomized clinical trial. Braz Dent J. 2018;29(2):109-16.Oliveira LMX, Novaes Junior JB, Barreiros ID, Paiva SM, Martins CC. Tratamento de fluorose dentária moderada com a técnica de microabrasão de esmalte com ácido clorídrico 6% e carbeto de silício: relato de caso clínico. Arq Odontol. 2014;50(3):142-48.Pini NI, Sundfeld-Neto D, Aguiar FH, Sundfeld  RH, Martins LRM, Lovadino JR et al. Enamel microabrasion: An overview of clinical and scientific considerations. World J Clin Cases. 2015;3(1):34-41.Pinto MM, Guedes CC, Motta LJ, Bussadori SK. Alternativa estética para manchas de fluoroseempregando técnicas de microabrasão e clareamento em adolescents. Rev assoc paul cir dent. 2009;63(2):130-33.Mendonça AAM, Ponciano ACR, Fregonesi F, Porto CLA, Campos EA. Microabrasão como alternativa estética – relato de caso clínico. JBC j. bras. clin. odontol. Integr. 2006;10(54):200-3.Sundfeld RH, Komatsu J, Russo M, Holland Junior C, Castro MAM, Quintella LPAS et al. Remoção de manchas no esmalte dental: estudo clínico e microscópico. Rev bras odontol. 1990;47(3):29-34.

Role of Ethnicity on Pain Perception, Fatigue, and Quality of Life in a Pediatric Chronic Pain Population

2007 ◽  
Author(s):  
Jeffrey I. Gold ◽  
Trina Haselrig ◽  
D. Colette Nicolaou ◽  
Katharine A. Belmont
Keyword(s):  
Quality Of Life ◽  
Chronic Pain ◽  
Pain Perception ◽  
Pediatric Chronic Pain

Acute pain management in trauma: anatomy, ultrasound-guided peripheral nerve blocks and special considerations

2019 ◽  
Vol 85 (7) ◽  
Author(s):  
Theodosios Saranteas ◽  
Iosifina Koliantzaki ◽  
Olga Savvidou ◽  
Marina Tsoumpa ◽  
Georgia Eustathiou ◽  
...  
Keyword(s):  
Pain Management ◽  
Peripheral Nerve ◽  
Acute Pain ◽  
Ultrasound Guided ◽  
Acute Pain Management ◽  
Nerve Blocks ◽  
Peripheral Nerve Blocks

Key facts on moderate to severe acute pain combined treatment with tramadol and dexketoprofen at fixed doses

2020 ◽  
Vol 13 (3) ◽  
pp. 304-310
Author(s):  
Jarosław Woroń
Keyword(s):  
Quality Of Life ◽  
Treatment Adherence ◽  
Acute Pain ◽  
Pain Treatment ◽  
Combined Treatment ◽  
Physiological Changes ◽  
Physiological Mechanisms ◽  
Pain Mechanisms ◽  
Proven Efficacy

The development of pain is associated with numerous physiological mechanisms. Improper acute pain treatment significantly reduces the quality of life and leads to a number of physiological changes that adversely affect the general condition of the patient. In many cases, inadequate analgesic therapy results in the transition from acute to chronic pain. For this reason, it is extremely important to use drugs that synergistically affect various pain mechanisms. Combined preparations, including the combination of tramadol and dexketoprofen, are very effective. This combination has many advantages, including proven efficacy and tolerability, ensures better treatment adherence and is easy to administer.

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