scholarly journals Rationale for preoperative (versus postoperative) administration of meloxicam for acute pain management and assessment of satisfaction in patients with femoroacetabular impingement who underwent hip arthroscopy

Pain medicine ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 19-29
Author(s):  
Yongqing Li ◽  
Guowei Li ◽  
Kai Zhang ◽  
Menglu Jiang ◽  
Xu Dai ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Adverse Events ◽  
Femoroacetabular Impingement ◽  
Acute Pain ◽  
Hip Arthroscopy ◽  
Satisfaction Score ◽  
Short Term ◽  
Patient Satisfaction Score ◽  
Vas Score ◽  
Postoperative Administration

Objective: This study is aimed to compare the analgesic effect and safety of preoperative (versus postoperative) meloxicam administration in femoroacetabular impingement (FAI) patients who underwent hip arthroscopy (HA). Methods: Totally, 136 FAI patients who scheduled for HA were recruited, then they were randomly assigned to preoperative administration (PREA) group (orally meloxicam 7.5 mg in 12h, 24h before operation, then orally 7.5 mg/d from 12h to Day 7 after operation; N=68) or postoperative administration (POSA) group (orally meloxicam 7.5 mg/d from 12h to Day 7 after operation; N=68) in 1:1 ratio. Furthermore, pain visual analog scale (VAS) score, patient satisfaction score, Harris hip score (HHS) and adverse events were assessed. Besides, the accumulated pethidine consumption for rescuing analgesia was calculated. Results: Acute pain VAS score at rest (Day1 – Day2) and pain VAS score at motion (Day1 – Day3) were decreased, meanwhile short-term patient satisfaction score (Day1–Day3) was increased in PREA group compared with POSA group; however, these scores in long-term period were of no difference between PREA group and POSA group (Day3–Month3). Furthermore, accumulated pethidine consumption on Day3 and Day7 were attenuated in PREA group compared with POSA group. Additionally, HHS at any assessed time points (Day7–Month3) did not differ between two groups. Besides, no difference in the incidence of adverse events was found between two groups. Conclusions: Preoperative meloxicam administration displays superior efficacy in short-term pain control, patient satisfaction improvement and attenuated consumption of rescue analgesia over postoperative meloxicam administration in FAI patients who underwent HA.

scholarly journals Fetomaternal outcome in high-risk parturients receiving epidural analgesia using fentanyl with ropivacaine versus iv tramadol: a comparative study

2017 ◽  
Vol 6 (7) ◽  
pp. 2836
Author(s):  
Ashima Taneja ◽  
Kamaldeep Arora ◽  
Isha Chopra ◽  
Anju Grewal ◽  
Sushree Samiksha Naik ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
High Risk ◽  
Epidural Analgesia ◽  
Comparative Study ◽  
Satisfaction Score ◽  
Epidural Group ◽  
Patient Satisfaction Score ◽  
Vaginal Deliveries ◽  
Group A ◽  
Group B

Background: Labour analgesia has been recommended but sufficient data on use of labour epidural analgesia with ropivacaine and fentanyl combination during labour is not available.Methods: A comparative study was conducted on 40 high risk labouring partuirents, randomly allocated to group A (iv tramadol) and group B (epidural analgesia with ropivacaine plus fentanyl). Assessments were done for fetal heart rate abnormality, mode of delivery, duration of labour, and Apgar score. The VAS score, patient satisfaction score, and complications were recorded.Results: Group A had more number of instrumental deliveries compared to group B, the later had higher number of caesarean sections. No difference was observed in vaginal deliveries in both the groups. Pain relief was significant in patients of epidural group. The neonatal outcome was same in both the groups. Significant number of patients had a higher degree of satisfaction score in group B compared to group A.Conclusions: Tramadol and epidural analgesia in labour are safe and effective. Patient satisfaction is significantly higher in epidural group as compared to the tramadol group.

scholarly journals Results of hip arthroscopy in elite level water polo players with femoroacetabular impingement: return to play and patient satisfaction

2020 ◽  
Vol 7 (1) ◽  
pp. 116-121
Author(s):  
Nicholas Ramos ◽  
Keon Youssefzadeh ◽  
Michael Gerhardt ◽  
Michael Banffy
Keyword(s):  
Patient Satisfaction ◽  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Return To Sport ◽  
The Body ◽  
Return To Play ◽  
Water Polo ◽  
Study Results ◽  
Division 1 ◽  
Elite Level

Abstract Water polo places significant stress on the hip joint requiring repetitive hip flexion and rotation to elevate the body out of water for passing, shooting and blocking. Femoroacetabular impingement (FAI) is common in water polo athletes; however, no study to date has investigated the results of hip arthroscopy in this patient population. The purpose of this study was to determine return to play rates and satisfaction following hip arthroscopy for FAI in a cohort of elite level water polo players. A retrospective review of our surgical database was performed. Collegiate water polo players with clinical and radiographic FAI who underwent hip arthroscopy were identified. Pre- and post-operative modified Harris hip scores (mHHSs) were obtained. Patient surveys were administered to determine return to play rates, level of return to play, timing of return and patient satisfaction. A Wilcoxon ranked sum test was performed to compare pre- and post-operative outcome scores. Ten patients met inclusion criteria. Average age was 19.5 years old (SD  ±1.08). All patients were male Division 1 collegiate water polo players. Median mHHS improved from 66.0 (SD  ±7.9) pre-operatively to 89.5 (SD  ±3.2) at average 1.6 years (range: 0.4–3.6 years) post-operatively. Patient survey responses demonstrated a 100% return to water polo and 100% return to the same level of play (NCAA Division 1) at mean 5.75 months (SD  ±1.8). All patients (10/10) reported being satisfied with their surgical result. Our study results, suggest that return to sport rates and patient satisfaction are high in water polo players who undergo hip arthroscopy for FAI.

Hip arthroscopy with labral repair for femoroacetabular impingement: short-term outcomes

2014 ◽  
Vol 22 (4) ◽  
pp. 744-749 ◽  
Author(s):  
Christian Dippmann ◽  
Kristian Thorborg ◽  
Otto Kraemer ◽  
Søren Winge ◽  
Henrik Palm ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Labral Repair ◽  
Short Term

scholarly journals Patient Satisfaction Outcomes after Robotic Arm-Assisted Total Knee Arthroplasty: A Short-Term Evaluation

2017 ◽  
Vol 30 (09) ◽  
pp. 849-853 ◽  
Author(s):  
Robert Marchand ◽  
Nipun Sodhi ◽  
Anton Khlopas ◽  
Assem Sultan ◽  
Steven Harwin ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Patient Satisfaction ◽  
Physical Function ◽  
Knee Arthroplasty ◽  
Robotic Arm ◽  
Short Term ◽  
Patient Satisfaction Score ◽  
Total Patient ◽  
Total Knee ◽  
The Mean

AbstractRobotic arm-assisted total knee arthroplasty (RATKA) presents a potential, new added value for orthopedic surgeons. In today's health care system, a major determinant of value can be assessed by patient satisfaction scores. Therefore, the purpose of the study was to analyze patient satisfaction outcomes between RATKA and manual total knee arthroplasty (TKA). Specifically, we used the Western Ontario and McMaster Universities Arthritis Index (WOMAC) to compare (1) pain scores, (2) physical function scores, and (3) total patient satisfaction outcomes in manual and RATKA patients at 6 months postoperatively. In this study, 28 cemented RATKAs performed by a single orthopedic surgeon at a high-volume institution were analyzed. The first 7 days were considered as an adjustment period along the learning curve. Twenty consecutive cemented RATKAs were matched and compared with 20 consecutive cemented manual TKAs performed immediately. Patients were administered a WOMAC satisfaction survey at 6 months postoperatively. Satisfaction scores between the two cohorts were compared and the data were analyzed using Student's t-tests. A p-value < 0.05 was used to determine statistical significance. The mean pain score, standard deviation (SD), and range for the manual and robotic cohorts were 5 ± 3 (range: 0–10) and 3 ± 3 (range: 0–8, p < 0.05), respectively. The mean physical function score, SD, and range for the manual and robotic cohorts were 9 ± 5 (range: 0–17) and 4 ± 5 (range, 0–14, p = 0.055), respectively. The mean total patient satisfaction score, SD, and range for the manual and robotic cohorts were 14 points (range: 0–27 points, SD: ± 8) and 7 ± 8 points (range: 0–22 points, p < 0.05), respectively. The results from this study further highlight the potential of this new surgical tool to improve short-term pain, physical function, and total satisfaction scores. Therefore, it appears that patients who undergo RATKA can expect better short-term outcomes when compared with patients who undergo manual TKA.

scholarly journals Surgical hip dislocation versus hip arthroscopy for femoroacetabular impingement: clinical and morphological short-term results

2012 ◽  
Vol 133 (1) ◽  
pp. 69-79 ◽  
Author(s):  
Patrick O. Zingg ◽  
Erika J. Ulbrich ◽  
Tobias C. Buehler ◽  
Fabian Kalberer ◽  
Vaughan R. Poutawera ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Hip Dislocation ◽  
Surgical Hip Dislocation ◽  
Short Term

scholarly journals COMPARING THE EFFECTS OF BUPIVACAINE AND ROPIVACAINE INSTILLATION FOR POST OPERATIVE ANALGESIA IN PATIENTS UNDERGOING LUMBER SPINE SURGERY: A PROSPECTIVE RANDOMISED DOUBLE BLIND STUDY

2020 ◽  
Vol 4 (8) ◽  
Author(s):  
Shashikant Sharma ◽  
T. Prabhakar ◽  
Usha Shukla ◽  
Shagufta Naaz
Keyword(s):  
Heart Rate ◽  
Patient Satisfaction ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Respiratory Rate ◽  
Visual Analogue Score ◽  
Study Groups ◽  
Satisfaction Score ◽  
Patient Satisfaction Score ◽  
Surgeon Satisfaction

As it is a comparative study of Bupivacaine and Ropivacaine therefore Ropivacaine is a long-acting amide local anaesthetic with a potentially improved safety profile when compared to bupivacaine . Ropivacaine is less lipophilic than bupivacaine and is less likely to penetrate large myelinated motor fibres, resulting in a relatively reduced motor blockade. Subject and Methods:  90 patients, who belongs to American society of Anesthesiologist grade I & II of age 18-65 years randomized into three groups (n=30). All three groups received propofol bolus 0.75mg/kg IV followed by IV infusion at 0.025 mg/kg/min. group A received Nalbuphine 50 μg/kg IV bolus, group B fentanyl 1.5 μg/kg IV bolus and group C received Dexmedetomidine infusion 1 μg/kg given over 10 min as bolus followed by 0.1 mg/kg/hr IV infusion for maintenance. Ramsay sedation score and Visual analogue scale measured for sedation and analgesia respectively at 10 minute interval for 1st hour of surgery then every 30 minutes upto the end of surgery. Desired RSS was defined 3-5. Intraoperative hemodynamic variables viz. Heart Rate (HR), Respiratory Rate (RR), Mean Arterial Pressure (MAP) and SPO2 were recorded every 10 min till the end of surgery. Recovery was assessed using Modified Aldrete Score in the recovery room. Time to achieve Aldrete recovery score of 10 was recorded. Patient satisfaction score and Surgeon satisfaction score were noted using a 7-point Likert verbal rating scale. Results: The groups were comparable with respect to demographic parameters. Ramsay sedation was significantly higher in Dexmedetomidine group (P<0.05) than Nalbuphine and fentalyl group, while Visual analogue score was comparable in all three study groups (p>0.05). Heart rate and Mean arterial pressure both significantly decreased in Dexmedetomidine group from the baseline during study period (p<0.05). Respiratory rate and SPO2 were comparable in all three groups. In this study MAP was never <60 mmhg, SPO2 was never <94% and Respiratory rate was never <12 bpm. Time to achieve modified alderate score in Dexmedetomidine (0.93±2.33 min) was significantly least as compare to Nalbuphine (1.80±2.65) & Fentanyl group (3.50±4.76) (p=0.016). Patient satisfaction score in Dexmedetomidine was significantly higher (6.53±0.44) (p=0.005). Surgeon satisfaction score in Dexmedetomidine was also significantly higher (6.73±0.52) (p=0.000). Two patients in Dexmedetomidine group had episode of bradycardia which was managed with injection Atropine 0.6 mg effectively Conclusion: From these observations and analyses of the present study, it can be inferred that: ❖ Sedation in Dexmedetomidine was acceptable when used for MAC for middle ear surgeries. ❖ Visual analogue score was similar in all three study groups. ❖ Heart rate & Mean arterial pressure in Dexmedetomidine was lower than baseline value. ❖ Changes in Respiratory rate and SPO2 were similar in all three study groups. ❖ Time to achieve Modified alderate score of 10 in group Dexmedetomidine was least, suggesting quicker recovery from anesthesia. ❖ Patient and surgeon satisfaction score in Dexmedetomidine was significantly higher. Keywords: Dexmedetomidine, Nalbuphine, Bupivacaine, Ropivacaine

scholarly journals Lumbar canal stenosis: analyzing the role of stabilization and the futility of decompression as treatment

2019 ◽  
Vol 46 (5) ◽  
pp. E7 ◽  
Author(s):  
Atul Goel ◽  
Shashi Ranjan ◽  
Abhidha Shah ◽  
Abhinandan Patil ◽  
Ravikiran Vutha
Keyword(s):  
Patient Satisfaction ◽  
Nodal Point ◽  
Satisfaction Score ◽  
Spinal Instability ◽  
Fixation Technique ◽  
Patient Satisfaction Score ◽  
Lumbar Canal Stenosis ◽  
Canal Stenosis ◽  
Spinal Segments

OBJECTIVEThe authors report their current experience with their previously published novel form of treatment in 70 cases of lumbar canal stenosis. The treatment consisted of only fixation of the spinal segments by the transarticular screw fixation technique. No bone, ligament, osteophyte, or disc resection was done for spinal canal and neural foraminal decompression. The proposed treatment is based on the concept that vertical instability that results in telescoping of the facets on physical activity forms the nodal point of pathogenesis of lumbar canal stenosis.METHODSDuring the period June 2014 to May 2018, 70 patients presenting with the classically described symptoms of lumbar canal stenosis were treated surgically by only fixation of involved spinal segments. Apart from clinical and radiological guides, instability was diagnosed on the basis of physical observation of the status of articulation by direct manipulation of bones of the region. The operation involved transarticular insertion of 2 or 3 screws for each articulation. The Oswestry Disability Index and visual analog scale were used to assess the patients before and after surgery and at follow-up. Additionally, a personalized patient satisfaction score was used to assess the outcome of surgery.RESULTSClinical symptomatic recovery was observed in all patients in the immediate postoperative period. During the average follow-up period, 100% of patients had varying degrees of symptomatic relief. The patient satisfaction score suggested that all patients were very satisfied with the surgical procedure. The transarticular fixation technique provided strong spinal segment fixation and a reliable ground for bone arthrodesis. No patient needed any additional modality of treatment or reoperation for recurrence of symptoms.CONCLUSIONSSpinal instability is the nodal point of pathogenesis of spinal degeneration–related lumbar canal stenosis. Only fixation of the involved spinal segments is necessary—decompression by bone or soft-tissue resection is not necessary.

Evaluation of Long-term Outcomes Following Plantar Fasciotomy

2018 ◽  
Vol 39 (11) ◽  
pp. 1312-1319 ◽  
Author(s):  
Rebekah Gibbons ◽  
Katherine E. Mackie ◽  
Todd Beveridge ◽  
Dana Hince ◽  
Peter Ammon
Keyword(s):  
Patient Satisfaction ◽  
Plantar Fasciitis ◽  
Satisfaction Score ◽  
Satisfaction Survey ◽  
Long Term Outcomes ◽  
Short Term ◽  
Patient Reported ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is a common condition prevalent in both athletic and nonathletic populations. Approximately 10% of patients do not respond to conservative treatment and suffer chronic recalcitrant plantar fasciitis. Outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and return to activity, and significant improvements in symptoms. Previous study limitations include small patient cohorts, short-term duration of follow-up or lack of validated outcome measures. We therefore aimed to investigate the long-term outcomes following complete plantar fasciotomy. Methods: Patients who underwent complete plantar fasciotomy surgery from a single surgeon within the past 10 years (minimum 7 months) were invited to participate in this retrospective survey study. To evaluate patient-reported function, participants were asked to complete the Foot and Ankle Outcome Score (FAOS). To assess subjective outcome, the participants were provided a satisfaction survey. The satisfaction survey was designed to include the 3 key factors for assessing postoperative patient satisfaction, which are preoperative expectations, symptom relief, and hospital experience. A total of 74 questionnaires were returned. Results: The median global satisfaction score was 85.4 (IQR=37.5) points out of 100. Significant correlations between the global patient satisfaction score and all FAOS subscale scores were identified. Only 3 participants (4%) reported a complication following surgery; however, 32 participants (44.4%) indicated that they still experienced swelling and/or tenderness in their foot at the time of the survey (mean follow-up time 4.8 ± 2.8 years) but for the majority of patients this was improved from before surgery. Conclusion: Long-term patient satisfaction was experienced by the majority of patients following plantar fasciotomy. Although 44% of patients continue to have postoperative complaints, 73% indicated that they were satisfied with their symptoms postoperatively, and 74% would undergo a similar procedure again. Level of Evidence: Level IV, case series.

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