European journal of anaesthesiology
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Multicenter Study Observational Study
Chronic postsurgical pain in Europe: An observational study.
Chronic postsurgical pain (CPSP) is an important clinical problem. Prospective studies of the incidence, characteristics and risk factors of CPSP are needed. ⋯ The collection of data on CPSP was feasible within the European registry PAIN OUT. The incidence of moderate to severe CPSP at 12 months was 11.8%. Functional impairment was associated with CPSP severity and neuropathic characteristics. Risk factors for CPSP in the present study were chronic preoperative pain, orthopaedic surgery and percentage of time in severe pain on D1.
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Several previous studies using univariate analysis have suggested that the pre-anaesthetic train-of-four (TOF) ratio, concentration of anti-acetylcholine receptor (AChR) antibodies and the presence of preoperative generalised muscular involvement are determinants of an increased response to neuromuscular blocking agents (NMBAs) in patients with myasthenia gravis. However, the determinants of the response of patients with myasthenia gravis to rocuronium, which is expected to be used more frequently since the advent of sugammadex, have not been studied. ⋯ Multivariate analysis identified baseline TOF ratio and age of disease onset as determinants of the increased response to rocuronium in patients with myasthenia gravis.
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Comparative Study Observational Study
Persistent posthysterectomy pain: A prospective, observational study.
There is a large variation in the prevalence of persistent postsurgical pain depending on the type of surgery. It is unclear how common persistent postsurgical pain is after vaginal or laparoscopic hysterectomy. ⋯ Persistent posthysterectomy pain is common, but pain is mild and does not interfere with daily activities for most of the patients 6 months after surgery. Smoking is the strongest predictor for persistent pain.
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Observational Study
Preoperative glycosylated haemoglobin as a predictor of postoperative analgesic requirements in diabetic patients: A prospective observational study.
In diabetic individuals undergoing surgery, the analgesic effect of opioids on postoperative pain may be different from normal. Although the ability of glycosylated haemoglobin (HbA1c) to predict adverse events and outcomes after major surgery has recently been assessed, the ability of HbA1c to predict the need for postoperative analgesia has not been determined. ⋯ This study demonstrated that in diabetic patients, the preoperative level of HbA1c was associated with the postoperative fentanyl consumption. In diabetic patients, the HbA1c level prior to surgery may be useful in anticipating postoperative analgesic requirements and help to improve patient counselling regarding postoperative pain.