Articles: postoperative-pain.
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Minerva anestesiologica · Nov 2024
The effect of sacral erector spinae plane block on the quality of recovery after total hip arthroplasty: a prospective, randomized, controlled, multicenter study.
Total hip arthroplasty, commonly performed to alleviate hip pain and enhance functionality in elderly patients, requires effective postoperative pain management to reduce opioid consumption and its associated side effects. A novel regional anaesthesia technique, the sacral erector spinae plane block, has the potential to enhance the quality of postoperative recovery significantly. ⋯ Sacral erector spinae plane block is a promising analgesic technique that enhances postoperative recovery and patient comfort in total hip arthroplasty.
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Different approaches to the obturator nerve have been described. However, few have focused on the injection point inferior the iliopubic ramus, specifically at the exit of the obturator canal. This study aims to anatomically evaluate the ultrasound-guided obturator nerve block at the exit of the obturator canal, detailing anatomical landmarks and solution distribution. ⋯ In conclusion, sagittal approaches using the iliopubic ramus as an anatomical reference achieve the most complete obturator nerve block. Our anatomical study details the structures of the obturator canal and access to the obturator nerve at its exit. Future studies are needed to confirm its safety and efficacy.
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Review Practice Guideline
Peri-operative pain management in adults: a multidisciplinary consensus statement from the Association of Anaesthetists and the British Pain Society.
Nearly half of adult patients undergoing surgery experience moderate or severe postoperative pain. Inadequate pain management hampers postoperative recovery and function and may be associated with adverse outcomes. This multidisciplinary consensus statement provides principles that might aid postoperative recovery, and which should be applied throughout the entire peri-operative pathway by healthcare professionals, institutions and patients. ⋯ We hope that with attention to these principles and their implementation, outcomes for adult patients having surgery might be improved.
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Arch Orthop Trauma Surg · Nov 2024
Randomized Controlled TrialDoes postoperative low-dose duloxetine provide analgesic effect and lower morphine consumption after primary total knee arthroplasty? A prospective, double-blind, randomized controlled trial.
Duloxetine as an adjunct analgesic has shown effective results in trials of patients undergoing total knee arthroplasty (TKA). However, the regimen has not been standardized. We, therefore, evaluated the analgesic efficacy of low-dose duloxetine after TKA. ⋯ Therapeutic Level I.