In TKA, Lower Versus Higher Tourniquet Inflation Pressures Reduced Postoperative Pain at the Tourniquet Inflation Site and Surgical Site at 24 and 48 Hours and 2 Weeks

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
David Figueroa
Keyword(s):  
Postoperative Pain ◽  
Tourniquet Inflation

Preadministration of flurbiprofen suppresses prostaglandin production and postoperative pain in orthopedic patients undergoing tourniquet inflation

2007 ◽  
Vol 19 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Masafumi Takada ◽  
Makoto Fukusaki ◽  
Yoshiaki Terao ◽  
Kazunori Yamashita ◽  
Chiaki Inadomi ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Prostaglandin Production ◽  
Orthopedic Patients ◽  
Tourniquet Inflation

The Effects of Timing of Ankle Blocks in Forefoot, Midfoot, or Hindfoot Reconstruction With the Use of an Ankle Tourniquet

2018 ◽  
Vol 11 (6) ◽  
pp. 527-533
Author(s):  
James Gwosdz ◽  
Lattisha Bilbrew ◽  
Daniel Jupiter ◽  
Vinod Panchbhavi
Keyword(s):  
Postoperative Pain ◽  
Pain Control ◽  
Randomized Study ◽  
Comparative Trial ◽  
Vas Score ◽  
Level Ii ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Tourniquet Inflation

Background. Ankle blocks are used in the ambulatory surgery setting to control postoperative pain, which is often worst in the first 24 hours after surgery. We conducted a trial to determine whether the timing of ankle block administration in relation to ankle tourniquet inflation has an effect on perceived pain and narcotic consumption. Methods. A prospective randomized study was conducted between August 2015 and January 2016. Patients were assigned to three groups. In group A, an ankle block was performed before ankle tourniquet inflation; in group B, immediately after ankle tourniquet inflation; and in group C, immediately after ankle tourniquet inflation with additional local anesthetic placed around the incision at the end of the procedure. Pain was assessed by a visual analogue scale (VAS) score, which was recorded at discharge, 24 hours, 48 hours, and 2 weeks after surgery. Narcotic consumption was recorded at 24 and 48 hours after surgery. Results. The only statistically significant difference in mean VAS scores occurred at 24 hours, when patients who received an ankle block after tourniquet inflation with local incisional anesthetic at closure (group C) had a mean VAS score 2.8 points lower (3.5 vs 6.3; P = .025) than those who received only an ankle block after tourniquet inflation (group B). There was no difference in narcotic consumption between groups at 24 and 48 hours. Conclusions. The timing of ankle block in relation to tourniquet inflation did not have an effect on pain control in forefoot, midfoot, and hindfoot reconstruction. The synergistic effect of an ankle block with additional incisional anesthetic at closure, is more effective than ankle block alone and is the ideal combination for postoperative pain control in foot surgery. Levels of Evidence: Therapeutic, Level II: Prospective, comparative trial

Preemptive Analgesic Effects of Ketorolac in Ankle Fracture Surgery

2001 ◽  
Vol 94 (4) ◽  
pp. 599-603 ◽  
Author(s):  
Peter H. Norman ◽  
M. Denise Daley ◽  
Ronald W. Lindsey
Keyword(s):  
Postoperative Pain ◽  
Visual Analog Scale ◽  
Ankle Fracture ◽  
Postoperative Bleeding ◽  
Patient Controlled Analgesia ◽  
Analog Scale ◽  
Analgesic Effects ◽  
Intergroup Comparison ◽  
Fracture Surgery ◽  
Tourniquet Inflation

Background Preemptive analgesia has been difficult to show in human experiments. If ketorolac has preemptive effects, then there may be an advantage to administering it at the beginning of surgery despite the potential for increased blood loss. Methods The authors performed a randomized, double-blind, controlled trial of 48 patients scheduled for ankle fracture surgery in a county trauma hospital. Anesthesia management was standardized and included adequate opioid analgesia (5 microg/kg fentanyl and 0.1 mg/kg morphine). Intravenous 30 mg ketorolac was administered to 23 patients before tourniquet inflation and to 25 patients after tourniquet inflation. Visual analog scale pain scores, morphine patient-controlled analgesia consumption, nausea-vomiting, and postoperative bleeding were measured. Results The 23 patients given ketorolac before tourniquet inflation had no increase in pain postoperatively compared with their preoperative baseline (P = 0.280). The 25 patients who received ketorolac minutes later after tourniquet inflation had significant increases in their postoperative pain compared with their preoperative baseline (P = 0.00116). This effect was short-lived, and by 6 h the pain score in this group was not significantly more than it was preoperatively. Intergroup comparison showed a lower visual analog scale score at 2 (P = 0.0203) and 4 h (P = 0.00549) in the preemptive group and lower nausea scores at hour 6 (P = 0.00704). There was no difference in patient-controlled analgesia consumption between groups. Conclusions Intravenous 30 mg ketorolac appears to have preemptive analgesic effects in patients undergoing ankle fracture repair. Ketorolac administered before tourniquet inflation prevents postoperative pain being perceived as more intense than preoperative pain.

Concepts for the therapy of postoperative pain

1999 ◽  
Vol 56 (8) ◽  
pp. 460-464 ◽  
Author(s):  
Janson ◽  
Brunne
Keyword(s):  
Postoperative Pain

Eine adäquate Therapie postoperativ auftretender Schmerzen verbessert nicht nur das Wohlbefinden der Patienten, sondern beeinflußt auch die posttraumatische bzw. postoperative Pathophysiologie positiv. Dazu stehen neben der kontinuierlichen bzw. repetitiven Applikation von Antipyretika und Opioiden auch spezielle Methoden wie die intravenöse Patienten-kontrollierte Analgesie (PCA) und die Epiduralanalgesie zur Verfügung. Während bisher allein die Verbesserung der Analgesiequalität im Vordergrund der Bemühungen stand, werden zur Zeit neue Konzepte mit einem multimodalen Ansatz entwickelt. Dabei soll mit Hilfe der Analgesie eine gute Mobilisierbarkeit, ein früher enteraler Kostaufbau und eine insgesamt schnellere Konsolidierung des Patienten mit dem Ziel der Reduktion perioperativer Morbidität und Mortalität erreicht werden.

Sign in / Sign up

Export Citation Format

Share Document