Scand J Plast Recons
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To investigate the safety and efficacy of interpleural analgesia for postoperative pain control in patients having breast reconstruction we did a retrospective audit of 114 women who had had their breasts reconstructed by the same team. A group of 22 women given morphine postoperatively acted as a historical control. Ninety-two women were given continuous postoperative interpleural bupivacaine with free access to morphine. ⋯ Pain scores were similar in all groups (p=0.11). Nausea and vomiting scores were significantly lower in the interpleural group (p=0.04) and hospital stay was shorter in the interpleural group but not significantly so (p<0.9). We conclude that interpleural analgesia improves the quality of postoperative care in breast reconstruction with latissimus dorsi flaps.
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Scand J Plast Recons · Jan 2008
Intra-articular bupivacaine as treatment for postoperative pain after arthroscopy of the wrist.
Intra-articular injection of local anaesthetic is a confirmed method of treatment of postoperative pain, particularly after arthroscopy of the knee. The wrist however, has a limited capacity for intra-articular instillation of local anaesthetic, and the aim of this study was to investigate the effect of intra-articular bupivacaine on postoperative pain after arthroscopy of the wrist. ⋯ The bupivacaine group reported less pain and less use of analgesics in the first postoperative hours, but for the remaining five postoperative day's pain and the use of analgesics were similar in the two groups. We conclude that intra-articular injection of 0.5% bupivacaine 5 ml after wrist joint arthroscopy reduces pain and use of analgesics during the first postoperative hours, but has no effect during the following five days.
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Scand J Plast Recons · Jan 2008
Comparative StudyComparison of carpal tunnel injection techniques: a cadaver study.
The purpose of the study was to evaluate the accuracy of injections into the carpal tunnel using three different portals in cadavers, and to define safe guidelines. In this study, 150 wrists of 75 cadavers (54 male, 21 female) were included. To compare three injection sites, 50 wrists of 25 cadavers were used for each technique; we used 23 gauge needles, and acrylic dye. ⋯ Median nerve injuries caused by injection was seen mostly with the second technique. Although a steroid injection may provide symptomatic relief in patients with carpal tunnel syndrome, the median nerve and other structures in the carpal tunnel are at risk of injury. Because of that, the injection should be given using the correct technique by physicians skilled in carpal tunnel surgery.
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Scand J Plast Recons · Jan 2008
Application of infrared thermography for the analysis of rewarming in patients with cold intolerance.
Cold intolerance is a serious long-term problem after injury to the ulnar and median nerves, and its pathophysiology is unclear. We investigated the use of infrared thermography for the analysis of thermoregulation after injury to peripheral nerves. ⋯ At baseline temperature distribution of the hand was symmetrical, but after testing the injured side warmed up much slower. We concluded that the infrared profile of the temperature of the hand after immersion in cold water is helpful to assess thermoregulation after injury to peripheral nerves.
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Scand J Plast Recons · Jan 2008
Case ReportsTranszygomatic coronoidectomy as a treatment for pseudoankylosis of the mandible after transtemporal surgery.
Pseudoankylosis of the mandible after a transtemporal operation is rare. In patients with severely limited mouth opening, a transzygomatic approach is the approach of choice. We report a case of pseudoankylosis of the mandible that was successfully treated by transzygomatic coronoidectomy.