Articles: postoperative-pain.
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J Bone Joint Surg Am · May 2004
Low-back pain following surgery for lumbar disc herniation. A prospective study.
Lumbar disc herniation often causes sciatica. Although surgery may provide relief of sciatic pain, it is uncertain how surgery affects the relief of low-back pain. The purpose of the present prospective study was to assess the efficacy of discectomy in the treatment of low-back pain associated with lumbar disc herniation. ⋯ Excision of a herniated disc for relief of sciatica provided rapid relief of sciatica and low-back pain. The findings of the present small study suggest that lumbar disc herniation might be a possible cause of low-back pain.
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Comparative Study
Quality of care in postoperative pain management: what is realistic in clinical practice?
This paper presents a study describing nurses' assessment of whether it was realistic to carry out good quality of care in postoperative pain management. Further, the study compared their assessment with the quality of care actually performed in clinical practice as assessed by both patients and nurses. Three questionnaires were used; one for patients (n = 198) and two for nurses (n = 63). ⋯ The nurses also responded to questions concerning whether the different aspects of good quality of care were realistic to carry out in practice. The results show that in several important aspects of postoperative pain management, both patients and nurses assessed the quality of care to be lower than the nurses' assessment of what was actually possible to effectuate in clinical practice, e.g. pain assessment and information. This finding highlights the problem of applying evidence-based care in actual clinical practice.
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Ann Fr Anesth Reanim · May 2004
Case Reports[Increase in bispectral index induced by antihyperalgesic dose of ketamine].
We report two cases of sudden increase in Bispectral Index (BIS) after the injection of low-dose ketamine for the prevention of postoperative hyperalgesia. The two patients were anaesthetised with a continuous infusion of remifentanil associated with propofol for one and isoflurane for the other. ⋯ The BIS value returned progressively to 40-50 despite no increase in target concentration. None of the patients complained of intra-operative recall.
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Children with femur fractures can have severe pain after elastic nail fixation. The purpose of this paper is to test the effectiveness of an intraoperative hematoma block in controlling postoperative pain in children that underwent elastic nail fixation of isolated femur fractures. ⋯ The hematoma block did not significantly lengthen the time of surgery. This study demonstrates that an intra-operative hematoma block is a simple, quick and effective method of postoperative pain control after elastic femoral nailing in children.