Articles: postoperative-pain.
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Both children and adults with cognitive impairment (CI) have historically been excluded from research examining pain. This is unfortunate since patients with CI may be at higher risk for experiencing pain or having their pain undertreated due to the difficulty of pain assessment and communication. There are now several published reports about the general pain experience of both adult and pediatric patients with cognitive impairment. ⋯ Analgesic administration data include type and amount of opioid, type of non-opioid medication, and prescribed discharge medications. Results of this study show that children with CI undergoing surgery received less opioid in the perioperative period than children without CI. However, children with CI received comparable amounts and types of analgesics in the postoperative period as children without CI.
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Case Reports
Can peripheral nerve blocks contribute to heel ulcers following total knee replacement?
Peripheral nerve blocks are widely used for postoperative analgesia following total knee replacement. We would like to present three cases of heel ulcers encountered following a peripheral nerve block for knee replacement surgery. ⋯ Attention needs to be given to the pressure points in the foot after the nerve blocks. Awareness of this uncommon complication is necessary to prevent its occurrence.
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Case Reports
Ultrasound guidance for a lateral approach to the sciatic nerve in the popliteal fossa.
Descriptions of the use of ultrasound for nerve location have focused on upper limb blocks. We present a case in which ultrasound imaging was used for a lateral approach to the sciatic nerve in the popliteal fossa. ⋯ Under direct ultrasound guidance, we placed a block needle close to the tibial nerve and confirmed its position with nerve stimulation. Injected local anaesthetic was seen on ultrasound as it spread around both tibial and common peroneal nerves.
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Anesthesia and analgesia · Oct 2004
Bradykinin antagonists have no analgesic effect on incisional pain.
Bradykinin, an endogenous nonapeptide and an important mediator of inflammation, is also implicated in the initiation and maintenance of pain. Both des-Arg(8), Leu(8)-bradykinin (dALBK) and HOE-140, the prototypic bradykinin B1 and B2 receptor antagonists, respectively, have been shown to reduce pain behaviors and inflammation in animal models of persistent nociception. We studied them for activity against incision-induced pain behaviors in a rat model for postoperative pain. ⋯ None of the doses of either dALBK or HOE-140 affected the responses to punctate or blunt mechanical stimulation or heat, either as a pretreatment or as a posttreatment. These data support the unique mechanisms for incision-induced pain relative to inflammation-related pain. Although inflammation may represent a component of incisional pain, the etiology of inflammation and its role seem different than in other models.