Scand J Plast Recons
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Scand J Plast Recons · Jan 2006
Local infiltration of anaesthesia with subpectoral indwelling catheters after immediate breast reconstruction with implants: a pilot study.
Our aim was to evaluate a supplementary method of pain relief following immediate breast reconstruction with submuscular tissue expanders in a descriptive, retrospective analysis. Between 2001 and 2003, 30 patients underwent 36 mastectomies with immediate breast reconstruction using submuscular tissue expanding prostheses. In 20/36 mastectomies an indwelling catheter was introduced behind pectoralis major for periodic injection of local ropivacaine as a supplement to standard postoperative analgesia. ⋯ The hospital stay was reduced in patients with subpectoral indwelling catheters. No patient had an adverse event during the postoperative period. Periodic infusion of local anaesthetics through an indwelling catheter during the early postoperative period reduces the consumption of oral opioids and reduces hospital stay.
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Scand J Plast Recons · Jan 2006
Risks for, and causes of, injuries to the hand and forearm: a study in children 0 to 6 years old.
Ninety-six children aged 0-6 years with unintentional hand injuries were referred to the Department of Hand Surgery between 2002 and 2003. Either parents, medical staff, or both, completed a questionnaire (response rate 79/96; 82%) about the circumstances of the injury. The incidence of injuries referred for treatment was 33.4/10,000 people/year. ⋯ Stuck in front doors (23/79; 29%) (closed by a child) was common. There was no increase in incidence in children with a foreign background (IRR 1.19, 95% CI 0.64 to 2.28). Advice about prevention will be distributed to parents to encourage safer environments in homes.
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Scand J Plast Recons · Jan 2006
Efficacy and safety of axillary brachial plexus block for operations on the hand.
An axillary brachial plexus nerve block by a transarterial approach is commonly used to achieve regional anaesthesia for hand surgery. We designed a retrospective study to evaluate efficacy and safety of the technique for acute and elective operations. Anaesthetic records of 189 of all 5520 patients (1996-2000) who had axillary brachial plexus blocks for hand surgery were reviewed, and results compared with complications recorded in the anaesthetic register and in the hand surgery records. ⋯ Four patients had a toxic drug reaction or axillary haematoma with a transient neurological deficit. Medical complications were recorded in the anaesthetic register in less than 0.7% of axillary brachial plexus procedures. Axillary brachial plexus block by a transarterial approach is effective and safe in hand surgery.
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Scand J Plast Recons · Jan 2005
Randomized Controlled TrialIntermittent injection of bupivacaine into the margin or the cavity after reduction mammaplasty.
Twenty-seven operated women had postoperative intermittent injections of bupivacaine or saline for 24 hours after reduction mammaplasty. The injections were given five-hourly either subcutaneously along the submammary incision or deep into the wound. The patients were randomised into three groups of nine each: 5 ml bupivacaine 0.25% into the margin; 5 ml bupivacaine 0.25% into the cavity; and 5 ml physiological saline into the cavity. ⋯ Total morphine consumption was significantly (p<0.03) lower in patients given bupivacaine into the margin (2.0 (0.9) mg) or into the cavity (2.4 (0.8) mg) compared with controls (6.9 (1.5) mg). VAS pain scores and vomiting did not differ among the three groups. Postoperative intermittent infusion of bupivacaine lowered morphine consumption after reduction mammaplasty, and the analgesic effect seemed to be independent of where the infusion was given.