Pain medicine : the official journal of the American Academy of Pain Medicine
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Postoperative pain is associated with delayed discharged and recovery, reduced patient satisfaction, and increased costs. The aim of this study was to investigate the short-term association between preoperative psychological variables (pain catastrophizing, anxiety, and depression) and postoperative pain in a sample of cardiac surgery patients. ⋯ Pain catastrophizing can predict postoperative pain intensity in cardiac surgery patients, independently of the presence of anxiety, depression, or preoperative level of pain. Future studies should aim to establish the role of pain catastrophizing in longer-term outcomes in cardiac surgery.
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To determine the impact of regional anesthesia on hospital stay for selected orthopedic procedures compared with traditional pain control modalities. ⋯ When compared with traditional pain control modalities, single PNB and CPNB were associated with decreased length of hospital stay, though results for specific surgeries varied. The hazard ratios for hospital discharge from a Current Procedural Terminology code-stratified, covariate (age, gender, and ASA status) adjusted Cox proportional hazards model for single PNB vs no PNB and for CPNB vs no PNB were 1.35 (95% confidence interval: 1.02-1.79) and 1.91 (95% confidence interval: 1.42-2.57), respectively, pointing toward earlier hospital discharge when PNBs were used. CONCLUSIONS Our retrospective case review showed that, overall, hospital lengths of stay tended to be shorter for orthopedic surgery patients receiving single PNB and CPNB than for those receiving no block and traditional pain management.
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Although retrospective studies show the risk of neurological complications after spinal anesthesia with local anesthetics is small in diabetic patients, there is still concern about the safety of different local anesthetics in diabetics undergoing neuroaxial anesthesia. We examined block duration and histology of spinal cord and roots with intrathecal local anesthetics in diabetic rats. ⋯ Duration of local anesthetic spinal block is longer in diabetic animals than in nondiabetics. However, there was no increased pathology of spinal cord, roots, or dorsal root ganglia.