Comparison of Postoperative Pain and Application Effect of High Tibial Osteotomy and Total Knee Replacement in Patients with Knee Arthritis

2021 ◽  
Vol 7 (5) ◽  
pp. 4013-4020
Author(s):  
Bingtao Shi ◽  
Wentao Gao ◽  
Haifang Li
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Knee Joint ◽  
Total Knee Replacement ◽  
Operative Time ◽  
Tibial Osteotomy ◽  
Intraoperative Blood Loss ◽  
Knee Arthritis ◽  
Total Knee ◽  
Better Than

Objective: To investigate the effects of high tibial osteotomy (HTO) and total knee replacement (TKR) on postoperative pain of patients with knee arthritis. Methods: From February 2017 to March 2019, 72 patients with knee arthritis in our unit were collected for the experiment. Patients in the control group (CG, 35 cases) were treated with HTO, and research group (RG, 37 cases) were treated with TKR. Clinical efficacy. Visual Analogue Scale (VAS) score. Knee Society Score (KSS), and Hospital for Special Surgery (HSS) knee rating score of the two groups of patients were observed. Intraoperative blood loss, operative time and hospitalization expenses were observed, as well as the effect of knee joint recovery after operation. Results: In terms of overall effective rate, RG was superior to CG (p < 0.05). VAS score of RG was notably lower at 1 week and 2 weeks after operation than that in CG (p < 0.05). KSS of RG was evidently higher than that of CG (p < 0.05). HSS score of RG was notably higher than that of CG after operation (p < 0.05). The intraoperative blood loss and operative time in RG were notably better than those in CG (p < 0.05). The effects of knee joint recovery in RG was considerably better than that in CG (p < 0.05). Conclusion: TKR has a better clinical effect on elderly patients, which can reduce postoperative pain, intraoperative blood loss and operative time, and improve the recovery effect of knee joint.

scholarly journals Coblation Versus Diode Laser Tonsillectomy: A Comparative Study

2021 ◽  
Author(s):  
Ameer A. Alaqeedy ◽  
Rasheed Ali Rashid ◽  
Raid M. Al-Ani
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Comparative Study ◽  
Diode Laser ◽  
Operative Time ◽  
Postoperative Bleeding ◽  
P Value ◽  
Intraoperative Blood Loss ◽  
Laser Technique ◽  
Significant Difference

Abstract Introduction: The study aimed to compare the 2 procedures of tonsillectomy (coblation and diode laser) concerning the operative time, the amount of blood loss, postoperative pain, and other complications. Materials and Methods: A comparative study was conducted at many Private Hospitals, Baghdad, Iraq from February 2019- February 2020. Coblation and laser tonsillectomy were performed on the same patient (one for each side) which was blinded to the patients or their caregivers and the surgeon who did the tonsillectomy. Data concerning the age, gender, indications for tonsillectomy, operative time, the amount of the blood loss, post-tonsillectomy pain by VAS scores, and other complications were recorded for each patient. Results: Out of 62 participants, there were 34 (54.8%) females. The majority were from the age group ≤18 years (n=54, 87.1%). The operative time and amount of the intraoperative blood loss were significantly lower in the coblation than a diode laser tonsillectomy. However, the postoperative pain scores in the diode laser were a statistically significant difference less than the coblation group at the periods 3 hours, 8 hours, 24 hours, and 7 days (P-value<0.05). While there was no statistically significant difference between the two groups at 2 weeks postoperative period (P-value=0.392). No primary or secondary postoperative bleeding in all patients. Conclusion: coblation was better than diode laser because of shorter operative time and less intraoperative blood loss. However, the diode laser technique had lesser postoperative pain at the postoperative periods 3 hours, 8 hours, 24 hours, and 7 days than coblation.

scholarly journals Coblation vs. dissection tonsillectomy: a prospective randomized study comparing surgical and clinical outcomes

2019 ◽  
Vol 5 (2) ◽  
pp. 306
Author(s):  
Shifa Vyas ◽  
Pritosh Sharma ◽  
Nitin Sharma ◽  
Abhijit Makwana ◽  
V. P. Goyal
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Randomized Study ◽  
Postoperative Bleeding ◽  
Intraoperative Blood Loss ◽  
Surgical Time ◽  
Intraoperative Bleeding ◽  
Time Required ◽  
Pain Patients ◽  
Better Than

<p class="abstract"><strong>Background:</strong> The objective of this study is to compare operative time, intraoperative bleeding, postoperative pain between coblation and dissection tonsillectomy.</p><p class="abstract"><strong>Methods:</strong> A total of 62 patients who met the inclusion criteria were divided into two groups according to the surgical procedure they went through. Surgical time intraoperative blood loss, postoperative pain, postoperative regaining of activity and any episode of postoperative bleeding were noted in both the groups and compared.  </p><p class="abstract"><strong>Results:</strong> Coblation tonsillectomy fared better than dissection tonsillectomy in terms of having less intraoperative blood loss, less postoperative pain. Patients who underwent coblation assisted tonsillectomy also had earlier return to normal activities. Though the time required for coblation tonsillectomy was more than dissection tonsillectomy there were no episodes of postoperative bleeding in subjects who underwent coblation tonsillectomy.</p><p class="abstract"><strong>Conclusions:</strong> Coblation assisted tonsillectomy is a promising new technique for tonsillectomy as patients had less postoperative morbidity mainly pain. The surgical time required could be reduced further with experience.</p>

scholarly journals OUTCOMES OF MULTIMODAL COCKTAIL VS TRANEXAMIC ACID ON POST OPERATIVE PAIN AND BLOOD LOSS IN TOTAL KNEE REPLACEMENT PATIENTS: A PROSPECTIVE RANDOMIZED STUDY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Suhail Malhotra ◽  
Parminder Kaur
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Total Knee Replacement ◽  
Tranexamic Acid ◽  
Pain Score ◽  
Knee Replacement ◽  
Control Group ◽  
Total Knee ◽  
The Mean ◽  
The Difference

Background: Osteoarthritis is the most common form of arthritis and a leading cause of disability. Total knee replacement (TKR) is one of the most effective surgical procedures, providing improvement in function and relief of pain for the majority of patients. Intra-articular tranexamic acid [TXA] and multimodal cocktail (mixture of ketorolac, tramadol and bupivacaine) are commonly used drugs which help to reduce postoperative bleeding and pain respectively, improving outcome of surgery. Objective: To compare the postoperative blood loss and pain with or without Intra-articular tranexamic acid and multimodal cocktail respectively in patients undergoing total knee replacement Material and Methods: A total of 96 patients of either gender presenting to Orthopaedics department of Government Medical College, Amritsar, with knee osteoarthritis and planned to undergo total knee replacement were enrolled. Patients were divided into 3 groups. Group A being the control group was not given tranexamic acid [TXA] but only standard drugs for anesthesia. Group B patients were given 3gm intra-articular injection of tranexamic acid. Group C patients were given a multimodal cocktail (mixture of ketorolac, tramadol and bupivacaine. TKR was done and patients were followed-up for 72 hours. Blood loss and pain score after every 24 hours for 72 hours were noted. Intra-articular injections were given just before wound closure. Results: The mean age of patients in control group was 48.92±13.22years, in TXA group was 52.31±14.69 years and in cocktail group was 50.22±9.63years. The male to female ratio was 11:21, 14:18 and 10:22 in three groups respectively. The total blood loss during first 72 hours was 1030.1±177.27ml in control group, 453.7±80.4ml in TXA group while 607.7±122.5ml in cocktail group. The difference was significant in all three groups and also between TXA and cocktail group (p<0.05). The mean postoperative pain score during first 72 hours was 4.4±2.3in control group, 2.4±1.5 in TXA group while 1.8±1.0in cocktail group. The difference was significant in all three groups (p<0.05) but insignificant between TXA and cocktail group (p>0.05). Conclusion: Results showed that intra-articular injection of TXA is beneficial in reducing blood loss and postoperative pain in comparison to control group. While pain was better controlled with the multimodal cocktail compared to TXA group and control group. Keywords: Post-operative blood loss, Intra-articular injection, tranexamic acid, cocktail, total knee replacement

scholarly journals Harmonic Scalpel versus Conventional Haemostasis in Neck Dissection: A Prospective Randomized Study

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Emanuele Ferri ◽  
Enrico Armato ◽  
Giacomo Spinato ◽  
Marcello Lunghi ◽  
Giancarlo Tirelli ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Hospital Stay ◽  
Neck Dissection ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Intraoperative Blood Loss ◽  
Bipolar Diathermy ◽  
Classic Technique

Purpose.The aim of this prospective randomized trial was to compare operative factors, postoperative outcomes, and surgical complications of neck dissection (ND) when using the harmonic scalpel (HS) versus conventional haemostasis (CH) (classic technique of tying and knots, resorbable ligature, and bipolar diathermy).Materials and methods.Sixty-one patients who underwent ND with primary head and neck cancer (HNSCC) resection were enrolled in this study and were randomized into two homogeneous groups: CH (conventional haemostasis with classic technique of tying and knots, resorbable ligature, and bipolar diathermy) and HS (haemostasis with harmonic scalpel). Outcomes of the study included operative time, intraoperative blood loss, drainage volume, postoperative pain, hospital stay, and incidence of intraoperative and postoperative complications.Results.The use of the HS reduced significantly the operating time, the intraoperative blood loss, the postoperative pain, and the volume of drainage. No significant difference was observed in mean hospital stay and perioperative, and postoperative complications.Conclusion.The HS is a reliable and safe tool for reducing intraoperative blood loss, operative time, volume of drainage and postoperative pain in patients undergoing ND for HNSCC. Multicenter randomized studies need to be done to confirm the advantages of this technique and to evaluate the cost-benefit ratio.

Double-blind, randomized controlled trial of tranexamic acid in minor lumbar spine surgery: no effect on operative time, intraoperative blood loss, or complications

2019 ◽  
Vol 31 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Signe Elmose ◽  
Mikkel Ø. Andersen ◽  
Else Bay Andresen ◽  
Leah Yacat Carreon
Keyword(s):  
Placebo Group ◽  
Lumbar Spine ◽  
Blood Loss ◽  
Tranexamic Acid ◽  
Spine Surgery ◽  
Operative Time ◽  
Decompressive Surgery ◽  
Lumbar Spine Surgery ◽  
Intraoperative Blood Loss ◽  
Double Blind

OBJECTIVEThe purpose of this study was to investigate the effect of tranexamic acid (TXA) compared to placebo in low-risk adult patients undergoing elective minor lumbar spine surgery—specifically with respect to operative time, estimated blood loss, and complications. Studies have shown that TXA reduces blood loss during major spine surgery. There have been no previous studies on the effect of TXA in minor lumbar spine surgery in which these variables have been evaluated.METHODSThe authors enrolled patients with ASA grades 1 to 2 scheduled to undergo lumbar decompressive surgery at Middelfart Hospital into a double-blind, randomized, placebo-controlled, parallel-group study. Patients with thromboembolic disease, coagulopathy, hypersensitivity to TXA, or a history of convulsion were excluded. Patients were randomly assigned, in blocks of 10, to one of 2 groups, TXA or placebo. Anticoagulation therapy was discontinued 2–7 days preoperatively. Prior to the incision, patients received either a bolus of TXA (10 mg/kg) or an equivalent volume of saline solution (placebo). Independent t-tests were used to compare differences between the 2 groups, with statistical significance set at p < 0.05.RESULTSOf the 250 patients enrolled, 17 patients were excluded, leaving 233 cases for analysis (117 in the TXA group and 116 in the placebo group). The demographics of the 2 groups were similar, except for a higher proportion of women in the TXA group (TXA 50% vs placebo 32%, p = 0.017). There was no significant between-groups difference in operative time (49.53 ± 18.26 vs 54.74 ± 24.49 minutes for TXA and placebo, respectively; p = 0.108) or intraoperative blood loss (55.87 ± 48.48 vs 69.14 ± 83.47 ml for TXA and placebo, respectively; p = 0.702). Postoperative blood loss measured from drain output was 62% significantly lower in the TXA group (13.03 ± 21.82 ml) than in the placebo group (34.61 ± 44.38 ml) (p < 0.001). There was no significant difference in number of dural lesions or postoperative spinal epidural hematomas, and there were no thromboembolic events.CONCLUSIONSTranexamic acid did not have a statistically significant effect on operative time, intraoperative blood loss, or complications. This study gives no evidence to support the routine use of TXA during minor lumbar decompressive surgery.Clinical trial registration no.: NCT03714360 (clinicaltrials.gov)

scholarly journals Safety and effectiveness evaluation of a two-handed technique combining harmonic scalpel and laparoscopic Peng’s multifunction operative dissector in laparoscopic hemihepatectomy

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Jingwei Cai ◽  
Guixing Jiang ◽  
Yuelong Liang ◽  
Yangyang Xie ◽  
Junhao Zheng ◽  
...  
Keyword(s):  
Blood Loss ◽  
Operative Time ◽  
Harmonic Scalpel ◽  
Peak Level ◽  
Bile Leakage ◽  
Liver Parenchyma ◽  
Control Group ◽  
Case Group ◽  
Intraoperative Blood Loss ◽  
And Control

Abstract Objectives This study was designed to evaluate the safety and effectiveness of a two-hand technique combining harmonic scalpel (HS) and laparoscopic Peng’s multifunction operative dissector (LPMOD) in patients who underwent laparoscopic hemihepatectomy (LHH). Methods We designed and conducted a case-control study nested in a prospectively collected laparoscopic liver surgery database. Patients who underwent LHH for liver parenchyma transection using HS + LPMOD were defined as cases (n = 98) and LPMOD only as controls (n = 47) from January 2016 to May 2018. Propensity score matching (1:1) between the case and control groups was used in the analyses. Results The case group had significantly less intraoperative blood loss in milliliters (169.4 ± 133.5 vs. 221.5 ± 176.3, P = 0.03) and shorter operative time in minutes (210.5 ± 56.1 vs. 265.7 ± 67.1, P = 0.02) comparing to the control group. The conversion to laparotomy, postoperative hospital stay, resection margin, the mean peak level of postoperative liver function parameters, bile leakage rate, and others were comparable between the two groups. There was no perioperative mortality. Conclusions We demonstrated that the two-handed technique combing HS and LPMOD in LHH is safe and effective which is associated with shorter operative time and less intraoperative blood loss compared with LPMOD alone. The technique facilitates laparoscopic liver resection and is recommended for use.

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