Efficacy of Abductor Pollicis Longus Suspensionplasty Compared to Ligament Reconstruction and Tendon Interposition

Hand ◽  
2020 ◽  
pp. 155894472090656
Author(s):  
Ellen S. Satteson ◽  
Cassie Driscoll ◽  
Mija Khan ◽  
Nicholas J. Walker ◽  
David Person ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Ligament Reconstruction ◽  
Surgical Techniques ◽  
Wound Dehiscence ◽  
Postoperative Pain Relief ◽  
Pinch Strength ◽  
Exact Test ◽  
Abductor Pollicis Longus ◽  
Tendon Interposition

Background: Multiple surgical techniques are described for basal joint osteoarthritis. This study compares clinical outcomes and patient satisfaction with trapeziectomy and abductor pollicis longus (APL) suspensionplasty compared to trapeziectomy with ligament reconstruction and tendon interposition (LRTI) when performed by 2 fellowship-trained hand surgeons. Methods: A retrospective review of 51 consecutive patients undergoing APL suspensionplasty (53 hands) was performed. With this technique, a distally based APL slip is brought through and sewn to the flexor carpi radialis (FCR). The remaining APL is placed in the trapeziectomy void. This technique was compared to 151 patients (166 hands) who underwent LRTI using the FCR tendon. Outcomes assessed included postoperative pain relief, grip and pinch strength, complications, and need for reoperation. Two-tailed, Fisher’s exact test was used for data analysis. Results: APL suspensionplasty resulted in postoperative pain relief in 92.5% (n = 49) compared to 94.0% (n = 156) with LRTI ( P = .758). Mean postoperative grip and pinch strengths with APL suspensionplasty were 41.2 and 10.4 kg, respectively. With LRTI, average grip strength was 42.0 kg, and pinch was 10.1 kg. Both techniques were well tolerated with minimal complications. In the APL group, 1 patient had a postoperative infection requiring drainage. Among the LRTI cases, 1 wound dehiscence required closure, and 2 minor postoperative wound infections resolved with oral antibiotics. Mean follow-up time among APL suspensionplasty patients was 3.3 months compared to 8.4 months following LRTI. Conclusions: APL suspensionplasty is a safe, effective procedure which provides similar pain relief and functional outcomes compared to LRTI.

scholarly journals THE STRUCTURE OF ODONTOGENIC INFLAMMATORY DISEASES AT THE OUTPATIENT SURGICAL DENTISTRY

2018 ◽  
Vol 14 (2) ◽  
pp. 78-85 ◽  
Author(s):  
Ирина Костина ◽  
Irina Kostina ◽  
Александр Чернавский ◽  
Aleksandr Chernavskiy ◽  
Михаил Огнев ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Period ◽  
Analgesic Effect ◽  
Inflammatory Diseases ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Symptomatic Treatment ◽  
Postoperative Pain Relief ◽  
Dental Procedures

Importance. NSAIDs take one of the leading places in drug therapy for postoperative pain relief. They are among the most common medicines used in clinical practice of a dentist. The article presents a comparative clinical evaluation of NSAID analgesic effect in postoperative period of dental surgical techniques. Objective. is to compare the etoricoxib analgesic effect of oral administration in a dosage of 90 mg and nimesulide in dosage of 100 mg in the postoperative period of dental surgical techniques. Methods. Randomized prospective study included 46 patients aged from 20 to 59 years. Two groups of 23 patients (10 men, 13 women in each group) were formed. They were prescribed medications for the pain relief after surgery. Etoricoxib in tablets of 90 mg 1 time a day was prescribed to the patients of the first group. In the second group nimesulide tablets of 100 mg were taken 2 times a day. The patients had taken the pills for three days. Results. Reduction of pain syndrome took place in the first and third day after tooth extraction. The comparison is performed by using visual analogue scale (VAS). Conclusions. Using of etoricoxib as symptomatic treatment of pain syndrome relief after application of surgical dental procedures provides fast, pronounced and long lasting analgesic effect. The drug is effective for preemptive analgesia and also for prevention of inflammatory complications in ambulatory surgical dentistry. It has a favorable safety profile that allows using it extensively in postoperative pain relief.

Transdermal Buprenorphine- A novel Medication for Postoperative Pain Management Following Abdominal Hysterectomy for Benign Gynecological Conditions

2021 ◽  
Vol 17 ◽  
Author(s):  
Aarti Yevale ◽  
Jyothi Shetty ◽  
Vidyashree G Poojari ◽  
Vasudeva Guddattu
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Nausea And Vomiting ◽  
Postoperative Pain Management ◽  
Abdominal Hysterectomy ◽  
Postoperative Pain Relief ◽  
Safe Alternative ◽  
Intravenous Paracetamol ◽  
Semisynthetic Derivative ◽  
Time Frames

Background: Buprenorphine is a semisynthetic derivative of thebaine which is 75–100 times more potent than morphine and causes less respiratory depression. Efficacy and safety of transdermal buprenorphine have been well established in chronic pain, but data regarding acute postoperative pain relief are still limited. Aim: In this study we compared the efficacy of transdermal buprenorphine patch with injectable tramadol for the relief of postoperative pain (POP) following abdominal hysterectomy for benign gynecological conditions. Settings and design: three-year prospective observational study. Methods and material: One hundred patients undergoing abdominal hysterectomy were allocated to one of two groups. Buprenorphine group: we applied 10 mcg/hr transdermal buprenorphine patch on the lateral upper arm after surgery. The onset of relief from a patch is 8 to 16 hours. So, all patients were given diclofenac suppository 100mg before induction of anesthesia as preemptive analgesic to reduce postoperative pain. Injectable tramadol group : received intramuscular tramadol injections 50mg every 8 hours in the postoperative period. Patients were followed for two days to look for postoperative pain relief and adverse effects. If patients showed a visual analog pain (VAS) score >3, intravenous paracetamol was administered as rescue analgesic. Results: POP was assessed at different time frames: 12, 24, 36 and 48 hours after hysterectomy. Mean pain score at rest, in buprenorphine group was significantly lower than that of the tramadol group. Patients experienced less pain on mobility in the buprenorphine group compared with the tramadol group, which was statistically significant. Conclusion: We concluded that transdermal buprenorphine is an effective and safe alternative to injectable tramadol for providing postoperative analgesia. It provides a higher degree of pain relief, faster postoperative mobilization, lower incidence of postoperative nausea and vomiting and higher satisfaction scores starting 12 hours after surgery. However, for the first 12 post-operative hours, there is need for additional analgesia.

Thumb-Basal Joint Arthroplasty Outcomes and Metacarpal Subsidence: A Prospective Cohort Analysis of Trapeziectomy With Suture Button Suspensionplasty Versus Ligament Reconstruction With Tendon Interposition

Hand ◽  
2021 ◽  
pp. 155894472199422
Author(s):  
Owolabi Shonuga ◽  
Kristen Nicholson ◽  
Jack Abboudi ◽  
Gregory Gallant ◽  
Christopher Jones ◽  
...  
Keyword(s):  
Ligament Reconstruction ◽  
Demographic Data ◽  
Cohort Analysis ◽  
Joint Arthroplasty ◽  
Pinch Strength ◽  
Complication Rates ◽  
Suture Button ◽  
Basal Joint ◽  
Tendon Interposition ◽  
Cmc Joint

Background Thumb carpometacarpal (CMC) joint arthroplasty is a common procedure in the surgical management of symptomatic thumb basal joint arthritis. Following trapeziectomy, a number of suspensionplasty techniques are often used, but limited comparative evidence exists between these techniques. The central aim of this study was to prospectively compare the outcomes of 2 suspensionplasty techniques following trapeziectomy: suture button (TightRope) versus ligament reconstruction and tendon interposition (LRTI). Methods Prospective data were collected on 112 consecutive patients with Eaton stage III-IV thumb CMC arthritis who underwent open trapeziectomy and suspensionplasty. There were 53 LRTI and 59 TightRope suspensionplasty procedures. Outcomes were measured using the Quick Disabilities of the Arm, Shoulder, and Hand ( QuickDASH) questionnaire, Visual Analogue Scale (VAS) for pain, radiographic analysis, and lateral pinch strength. Patient demographic data and complications were also recorded. Results Patients undergoing TightRope suspensionplasty had significantly higher trapeziometacarpal index and thus less subsidence than the LRTI group at 2 weeks (0.22 vs 0.17 [ P < .0001]) and 3 months (0.17 vs 0.15 [ P < .05]) postoperatively. TightRope suspensionplasty also had a significantly lower QuickDASH score at 2 weeks (64.7 vs 74.6 [ P < .05]), 3 months (20.7 vs 32.5 [ P < .05]), and 1 year postoperatively (7.57 vs 21.5 [ P < .05]) compared with the LRTI group. However, there was no difference in VAS pain, lateral pinch strength, reoperation, or complications at any time point between groups. Conclusions Thumb CMC joint arthroplasty performed with a TightRope suspensionplasty versus LRTI yielded short-term improved resistance to subsidence, long-term greater improvement in clinical outcome by QuickDASH, and no difference in pain or complication rates.

scholarly journals Epidural tramadol for postoperative pain relief

Anaesthesia ◽  
1993 ◽  
Vol 48 (4) ◽  
pp. 328-331 ◽  
Author(s):  
A. E. Delilkan ◽  
R. Vijayan
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Pain Relief
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