Articles: postoperative-pain.
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Variability exists in opioid prescribing practices among surgeons, frequently resulting in the prescription of excessive opioids. This study evaluated the ability of a single educational intervention targeted toward general surgery residents to reduce the quantity of postoperative opioids prescribed. ⋯ Following this targeted intervention, patients were discharged with fewer OME and more nonopioid analgesics, even as refill requests decreased. Educating residents on opioid prescription guidelines and multimodal therapy is effective and should be part of the annual didactic curriculum.
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J Coll Physicians Surg Pak · Jan 2021
Combined use of Risdon Wiring and Lingual Splint in Pediatric Mandibular Fractures.
To implement and evaluate a simplified, rapid, single-day emergency management technique for pediatric mandibular fractures, the author applied the current technique of using combined lingual splint with Risdon wiring under sedation anesthesia as a cohort study in a group of pre-school mandibular fracture children aged 4 to 6 years. Clinical outcome variables were fixation length and reduction simplicity, post-reduction occlusion, recovery of mouth opening, and degree of postoperative edema and pain. Age, gender, fracture site and the cause of injury were other study variables. ⋯ The clinical results obtained from the combined technique were promising in terms of rapid surgical duration, simplicity of fracture reduction, decreased postoperative pain and edema, rapid recovery of mouth opening without a recorded complication. It could be concluded that combining Risdon wiring with lingual splint is a simple, fast, and reliable fixation technique for managing pre-school mandibular pediatric fractures. Key Words: Lingual splint, Pediatric, Mandibular, Fracture.
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Reg Anesth Pain Med · Jan 2021
Meta AnalysisDaring discourse: should the ESP block be renamed RIP II block?
During the time period 1984 to the turn of the millennium, interpleural nerve blockade was touted as a very useful regional anesthetic nerve blockade for most procedures or conditions that involved the trunk and was widely practiced despite the lack of proper evidence-based support. However, as an adequate evidence base developed, the interest for this type of nerve block dwindled and very few centers currently use it-thereby to us representing the rest in peace (RIP) I block. ⋯ Emerging meta-analysis data also raise concern and give cause to healthy skepticism regarding the use of ESPB for major thoracic or abdominal surgery. Against this background, we foresee that ESPB (and variations on this theme) will end up in a similar fashion as interpleural nerve blockade, thereby soon to be renamed the RIP II block.