Articles: postoperative-pain.
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J Coll Physicians Surg Pak · Feb 2021
Randomized Controlled Trial Observational StudyImpact of Intraoperative Dexmedetomidine versus Remifentanil on Recovery Characteristics following Laparoscopic Sleeve Gastrectomy.
To evaluate the impact of intraoperative dexmedetomidine versus remifentanil on postoperative pain; and enhanced recovery profile in patients scheduled for laparoscopic sleeve gastrectomy (LSG). ⋯ Better enhanced recovery profile after LSG supports the use of intraoperative infusion of dexmedetomidine as an anaesthetic adjuvant versus remifentanil. Key Words: Dexmedetomidine, Remifentanil, Enhanced recovery after surgery (ERAS); Bariatric surgery.
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Neurosurgical review · Feb 2021
Observational StudySafety aspects of opioid-naïve patients with high-grade glioma treated with D,L-Methadone: an observational case series.
It was suggested that D, L-Methadone might improve the clinical course of glioma patients. Owing to massive press coverage, patients demand the prescription of D, L-Methadone, but regarding its adjunctive use in glioma therapy there is no standard medication plan. Furthermore, it is not known which side effects the administration of D, L-Methadone might harbor, especially if the patients are opioid-naïve and if D, L-Methadone therapy was managed by the patients themselves or their general practitioners. ⋯ In all cases, symptoms resolved after cessation or dose reduction. Our results show that D/L M intake lead to frequent occurrence of side effects in opioid-naïve patients especially when not handled with caution and close supervision. Patients, their relatives, their GPs and neuro-oncologists need to be informed about the broad spectrum of side effects in order to thoroughly counsel glioma patients.
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Orthopaedic surgery · Feb 2021
Mid-term Results of Subtalar Arthroereisis with Talar-Fit Implant in Pediatric Flexible Flatfoot and Identifying the Effects of Adjunctive Procedures and Risk Factors for Sinus Tarsi Pain.
To (i) report the mid-term outcomes of subtalar arthroereisis using Talar-Fit implant for the treatment of flexible flatfoot patients; (ii) compare clinical and radiographic outcomes between arthroereisis with and without adjunctive operative procedures to investigate the effects of adjuncts on the outcomes; and (iii) analyze the risk factors associated with sinus tarsi pain, which is the most common postoperative complication of arthroereisis. ⋯ The mid-term clinical and radiographic results were satisfactory in patients who underwent the subtalar arthroereisis procedure using Talar-Fit implant, alone or in combination with other adjuncts, for the treatment of flexible flatfoot.
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Comparative Study
Comparison of multimodal analgesia with thoracic epidural after transthoracic oesophagectomy.
Thoracic epidural analgesia (TEA) has been regarded as the standard of care after oesophagectomy for pain control, but has several side-effects. Multimodal (intrathecal diamorphine, paravertebral and rectus sheath catheters) analgesia (MA) may facilitate postoperative mobilization by reducing hypotensive episodes and the need for vasopressors, but uncertainty exists about whether it provides comparable analgesia. This study aimed to determine whether MA provides comparable analgesia to TEA following transthoracic oesophagectomy. ⋯ MA is less effective than TEA at controlling pain, but this difference may not be clinically significant. However, fewer patients experienced hypotension or required vasopressor support with MA; this may be beneficial within an enhanced recovery programme.