Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA
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Knee Surg Sports Traumatol Arthrosc · Sep 2015
Randomized Controlled TrialEfficacy of intraarticular application of ketamine or ketamine-levobupivacaine combination on post-operative pain after arthroscopic meniscectomy.
To evaluate the efficacy of intraarticular injection of ketamine or ketamine plus levobupivacaine on post-operative analgesia in patients undergoing arthroscopic meniscectomy. ⋯ Intraarticular ketamine provides effective post-operative analgesia. Addition of intraarticular levobupivacaine to ketamine may provide better amelioration of pain after outpatient arthroscopic meniscectomy.
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Knee Surg Sports Traumatol Arthrosc · Sep 2015
Clinical TrialForeseeing the danger in the beach chair position: Are standard measurement methods reliable?
The aim of this study is to show whether peripheral perfusion monitoring methods reflect central perfusion during shoulder arthroscopy at beach chair position. We hypothesized that mean arterial pressure (MAP), central heart rate (CHR) and peripheral oxygenation (SaO2) measurements individually will not parallel cerebral oximetry measurements by near-infrared spectroscopy (NIRS). ⋯ Cerebral oximetry by NIRS may prove useful as a monitor for cerebral ischaemia. In the absence of NIRS, CHR can partially detect abnormalities but not trustable, and MAP is the most reliable method for monitoring.
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Knee Surg Sports Traumatol Arthrosc · Sep 2015
Anatomic observation of the running space of the suprascapular nerve at the suprascapular notch in the same direction as the nerve.
The configuration of suprascapular notch was previously analysed from the anteroposterior viewing. However, the approach direction of the suprascapular nerve (SSN) to the inlet of the suprascapular notch is consistently craniocaudal and mediolateral. We propose a new method to observe the suprascapular notch according to the running course of the SSN. We reviewed the anatomic characteristics of the suprascapular notch in relation to the nerve. ⋯ Based on the present study, the space between the STSL and deep fascia of the subscapularis formed the space for the nerve to run through. As a clinical implication, this new method to assess the suprascapular notch in the nerve approach direction might develop the imaging techniques for evaluation of SSN entrapment.
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Knee Surg Sports Traumatol Arthrosc · Sep 2015
Opioids as an alternative to amide-type local anaesthetics for intra-articular application.
Recently, the safety profile of local anaesthetics in intra-articular use became into focus of investigation. Opioid drugs have a different mode of action and may be a safe and potent alternative for intra-articular application. The purpose of this in vitro study is to provide evidence for significant chondrotoxicity of amide-type local anaesthetics even after short-term application on human chondrocytes and to demonstrate the absence of such negative effects for opioids [morphine, morphine-6-glucuronide (M6G)]. ⋯ The results confirm dose- and time-dependent cytotoxic effects on human chondrocytes for amide-type local anaesthetics. This study confirms the safety of morphine and M6G in terms of an absence of cytotoxic effects after intra-articular application, making them safe potential alternatives in clinical practice.
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Knee Surg Sports Traumatol Arthrosc · Sep 2015
Distribution of the axillary nerve to the subacromial bursa and the area around the long head of the biceps tendon.
Patients with a shoulder disorder often complain of pain on the anterior or lateral aspect of the shoulder. Such pain has been thought to originate from the suprascapular nerve. However, taking into consideration the distinctive course of the axillary nerve, the axillary nerve is likely to supply branches to the structure around the shoulder joint. This study was conducted to clarify the division, course, and distribution of the branches which originate from the axillary nerve and innervate structures around the shoulder joint. ⋯ These results would be useful to consider the cause of the shoulder pain or to prevent the residual pain after the biceps tenodesis.