Orthopedics
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Comparative Study
A comparison of epidural and non-epidural anesthesia and analgesia in total hip or knee arthroplasty patients.
This retrospective study explores a number of variables encountered with the use of either epidural or non-epidural anesthesia and analgesia. Postoperative mobility, amount of narcotic used, incidence of blood transfusion, length of stay, and presence of urinary retention, pruritus, nausea and vomiting, or respiratory depression were compared in a group of 101 consecutive patients scheduled for total hip or knee arthroplasty. ⋯ There were significantly fewer blood transfusions in the epidural group; however, epidural patients had significantly increased incidence of urinary retention and pruritus. The use of epidural anesthesia and analgesia for total hip and knee arthroplasty patients has definite merit, but is most safely administered in a monitored, skilled nursing unit.
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This report reviews the results of 36 children surgically treated for fractures of the head and neck of the radius. Indications for operation were: displacement over 2 mm and/or angulation over 45 degrees. ⋯ Eighteen children had a good result, 8 had a fair result, and 10 had a poor result. It appears that when radial head fractures are associated with severe displacement, a high rate of fair and poor results can be expected, despite treatment by open reduction and temporary internal fixation.
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In conclusion, intraspinal lumbar synovial cysts are uncommon causes of sciatic pain. Intraspinal synovial cysts are associated with degenerative arthritis of the lumbar spine. The radiographic findings on myelography are non-specific, but CT and MRI are helpful in establishing the diagnosis and in differentiating synovial cysts from other extradural lesions.