Anesthesia and analgesia
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Anesthesia and analgesia · Sep 2009
Cytokine gene expression after total hip arthroplasty: surgical site versus circulating neutrophil response.
After surgery, cytokines and chemokines are released at the surgical wound site, which can contribute to postoperative pain, local inflammation, and tissue repair. Multiple cell types are present that can release cytokines/chemokines at the wound site and, thus, the exact cellular source of these molecules is unclear. We sought to better understand the contribution of neutrophils to cytokine/chemokine gene expression at the surgical wound site during the initial postsurgery phase of total hip arthroplasty (THA). ⋯ There is a distinct cytokine gene expression profile in neutrophils at the THA surgical wound site at 24 h postsurgery when compared with that found in presurgery circulating neutrophils. Understanding these changes may allow us to knowledgeably manipulate neutrophil activity to reduce postoperative pain and inflammation without impairing wound healing.
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Anesthesia and analgesia · Sep 2009
Sciatic nerve catheter placement: success with using the Raj approach.
Continuous regional analgesia has increased in popularity and is becoming standard of care for many painful surgical procedures. Various approaches of sciatic catheter insertion have been proposed, each with attributes and disadvantages. We investigated whether the Raj approach that uses a simple midpoint landmark between the ischial tuberosity and greater trochanter will facilitate sciatic catheter placement. ⋯ Use of a simple landmark between easily identifiable bony structures enhances the simplicity and placement of a sciatic nerve catheter and is recommended for use in clinical practice.
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Anesthesia and analgesia · Sep 2009
Editorial CommentSpend time on patients and families or on documentation?