scholarly journals Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Sharada Weir ◽  
Mihail Samnaliev ◽  
Tzu-Chun Kuo ◽  
Travis S. Tierney ◽  
Andrea Manca ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Spinal Surgery ◽  
Healthcare Costs ◽  
Case Control Study ◽  
Case Control ◽  
Persistent Postoperative Pain ◽  
Control Study

scholarly journals Glisson’s capsule cauterisation is associated with increased postoperative pain after laparoscopic cholecystectomy: a prospective case–control study

2017 ◽  
Vol 99 (6) ◽  
pp. 485-489 ◽  
Author(s):  
F Basak ◽  
M Hasbahceci ◽  
A Sisik ◽  
A Acar ◽  
Y Ozel ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Case Control Study ◽  
Gallbladder Disease ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Standard Laparoscopic Cholecystectomy ◽  
Control Study

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

Surgical-Site Infection Following Spinal Fusion: A Case-Control Study in a Children's Hospital

2003 ◽  
Vol 24 (8) ◽  
pp. 591-595 ◽  
Author(s):  
Annie-Claude Labbé ◽  
Anne-Marie Demers ◽  
Ramona Rodrigues ◽  
Vincent Arlet ◽  
Kim Tanguay ◽  
...  
Keyword(s):  
Risk Factors ◽  
Antibiotic Prophylaxis ◽  
Spinal Fusion ◽  
Spinal Surgery ◽  
Case Control Study ◽  
Tertiary Care ◽  
Surgical Site Infections ◽  
Case Control ◽  
Gram Negative Organisms ◽  
Control Study

AbstractObjectives:To determine the rates of surgical-site infections (SSIs) after spinal surgery and to identify the risk factors associated with infection.Design:SSIs had been identified by active prospective surveillance. A case-control study to identify risk factors was performed retrospectively.Setting:University-associated, tertiary-care pediatric hospital.Patients:All patients who underwent spinal surgery between 1994 and 1998. Cases were all patients who developed an SSI after spinal surgery. Controls were patients who did not develop an SSI, matched with the cases for the presence or absence of myelodysplasia and for the surgery date closest to that of the case.Results:There were 10 infections following 125 posterior spinal fusions, 4 infections after 50 combined anterior-posterior fusions, and none after 95 other operations. The infection rate was higher in patients with myelodysplasia (32 per 100 operations) than in other patients (3.4 per 100 operations; relative risk = 9.45; P < .001). Gram-negative organisms were more common in early infections and Staphylococcus aureus in later infections. Most infections occurred in fusion involving sacral vertebrae (odds ratio [OR] = 12.0; P = .019). Antibiotic prophylaxis was more frequently suboptimal in cases than in controls (OR = 5.5; P = .034). Five patients required removal of instrumentation and 4 others required surgical debridement.Conclusions:Patients with myelodysplasia are at a higher risk for SSIs after spinal fusion. Optimal antibiotic prophylaxis may reduce the risk of infection, especially in high-risk patients such as those with myelodysplasia or those undergoing fusion involving the sacral area.

scholarly journals USE OF INTRAOPERATORY VANCOMYCIN IN SPINAL SURGERIES

2019 ◽  
Vol 18 (2) ◽  
pp. 134-137
Author(s):  
Eduardo Teston Bondan ◽  
Xavier Soler I Graells ◽  
Álynson Larocca Kulcheski ◽  
Pedro Grein del Santoro ◽  
Marcel Luiz Benato
Keyword(s):  
Treatment Group ◽  
Antibiotic Prophylaxis ◽  
Spinal Surgery ◽  
Postoperative Infection ◽  
Case Control Study ◽  
Case Control ◽  
Control Group ◽  
Systemic Antibiotic ◽  
Control Study ◽  
Systemic Antibiotic Prophylaxis

ABSTRACT Objectives: Despite the use of systemic antibiotic prophylaxis, infection is still a challenge for spine surgeons, with high morbidity and mortality, long hospitalization, delayed rehabilitation, and a greater number of interventions. The purpose of this cross-sectional retrospective case-control study was to compare the incidence of postoperative infection in individuals who received a systemic antibiotic as the sole prophylactic method with those who received vancomycin in the operative wound in association with systemic antibiotic prophylaxis in spinal surgery. Methods: We evaluated 2694 medical records of individuals submitted to posterior spinal surgery in the thoracolumbar segment in the period from January 2012 to June 2017, 1360 in the treatment group and 1334 in the control group. Results: Nineteen (1.39%) of the treatment group progressed with surgical site infection, compared to 42 (3.14%) of the control group. Conclusions: There was a significant reduction in the postoperative infection rate with the use of vancomycin (p=0.0379). Level of Evidence III; Case-Control Study.

The scalp block for postoperative pain control in craniosynostosis surgery: a case control study

2020 ◽  
Vol 36 (12) ◽  
pp. 3063-3070
Author(s):  
Rossano Festa ◽  
Federica Tosi ◽  
Angela Pusateri ◽  
Sonia Mensi ◽  
Rossella Garra ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Case Control Study ◽  
Case Control ◽  
Postoperative Pain Control ◽  
Scalp Block ◽  
Control Study

scholarly journals Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study

2019 ◽  
Author(s):  
Sharada Weir ◽  
Mihail Samnaliev ◽  
Tzu-Chun Kuo ◽  
Travis S. Tierney ◽  
Andrea Manca ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Postoperative Pain ◽  
Spine Surgery ◽  
Spinal Surgery ◽  
Healthcare Costs ◽  
Lumbar Spine Surgery ◽  
Failed Back Surgery ◽  
Persistent Postoperative Pain ◽  
Lumbar Spinal

Abstract Purpose. To compare rates of persistent postoperative pain (PPP) after lumbar spine surgery—commonly known as Failed Back Surgery Syndrome—and healthcare costs for instrumented lumbar spinal fusion versus decompression/discectomy. Methods. UK population-based healthcare data from the Hospital Episode Statistics (HES) database from NHS Digital and the Clinical Practice Research Datalink (CPRD) were queried to identify patients with PPP following lumbar spinal surgery. Rates of PPP were calculated by type of surgery (instrumented and non-instrumented). Total healthcare costs associated with the surgery and covering the 24 month period after index hospital discharge were estimated using standard methods for classifying health care encounters into major categories of health care resource utilization (i.e., inpatient hospital stays, outpatient clinic visits, accident and emergency attendances, primary care encounters, and medications prescribed in primary care) and applying the appropriate unit costs (expressed in 2013 GBP). Results. Increasing the complexity of surgery with instrumentation was not associated with an increased rate of PPP. However, 2-year healthcare costs following discharge after surgery are significantly higher among patients who underwent instrumented surgery compared with decompression/discectomy. Conclusions. Although there is a not insubstantial risk of ongoing pain following spine surgery, with 1-in-5 patients experiencing PPP within two years of surgery, the choice of surgical procedure does not, by itself, appear to be a driving factor.

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