Articles: postoperative-pain.
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J Shoulder Elbow Surg · Sep 2020
Randomized Controlled TrialThe effect of preoperative education on opioid consumption in patients undergoing arthroscopic rotator cuff repair: a prospective, randomized clinical trial-2-year follow-up.
With the recent opioid epidemic in the United States, measures by both government and medical providers are being taken to decrease the opioid dependence rate. Different methods have been proposed, including patient education and multimodal pain therapies. The purpose of this study was to determine whether preoperative opioid education reduces the risk of opioid dependence at 2 years following arthroscopic rotator cuff repair (ARCR). ⋯ Our study found that patients who were preoperatively educated on opioid use were less likely to become opioid dependent at 2-year follow-up. Therefore, we demonstrated that opioid education does impart significant long-term benefits to patients undergoing ARCR.
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Titrating analgesic and sedative drugs in pediatric intensive care remains a challenge for caregivers due to the lack of pharmacodynamic knowledge in this population. The aim of the current study is to explore the concentration-effect relationship for morphine-associated oversedation after cardiac surgery in children aged 3 months to 3 years. Data on morphine dosing, as well as morphine plasma concentrations, were available from a previous study on the pharmacokinetics of morphine after cardiac surgery in children. ⋯ Additionally, the risk of oversedation was found to be increased during the first hours after surgery (P < .001) and was significantly lower during mechanical ventilation (P < .005). We conclude that morphine concentrations above approximately 45 ng/mL may increase the probability of oversedation in children after cardiac surgery. The clinician must evaluate, on a case-by-case basis, whether the analgesic benefits arising from dosing regimen associated with such concentrations outweigh the risks.
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Randomized Controlled Trial
The effect of kinesio taping with the web strip technique on pain, edema, and trismus after impacted mandibular third molar surgery.
There are many methods used to alleviate edema, trismus, and pain after impacted third molar (3M) removal, one of which is Kinesio Taping (KT). ⋯ KT with the web strip technique should be considered more economic and less traumatic than other approaches, as it is free from systemic side effects and is a simple method to carry out to decrease morbidity.
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Acta Anaesthesiol Scand · Sep 2020
Randomized Controlled TrialUltrasound-guided transmuscular quadratus lumborum catheters for elective caesarean section: A protocol for a single-center, double-blind randomised trial.
Management of moderate-to-severe post-operative pain after elective caesarean section (ECS) is internationally primarily based on either epidural catheters or opioids. However, both techniques are associated with some undesirable adverse events. Bilateral transmuscular quadratus lumborum (TQL) block has proven to reduce opioid consumption significantly in the first 24 post-operative hours following ECS and prolong time to first opioid (TFO) (Hansen CKD, Steingrimsdottir M, Laier GE, et al. Reg Anesth Pain Med. 2019; 10.1136/rapm-2019-100540). We present a randomised controlled trial aiming to investigate whether continuous analgesia via bilateral TQL catheters can prolong TFO after ECS. ⋯ Four patients were included from September 2018 to November 2018. Inclusion was resumed in June 2019 and will continue until 24 patients with useful data have been included in the trial. Expected inclusion period is 10-14 months.
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Acta Anaesthesiol Scand · Sep 2020
Randomized Controlled TrialTransmuscular quadratus lumborum block for percutaneous nephrolithotomy: study protocol for a dose-finding trial.
The objective of this trial is to optimize the transmuscular quadratus lumborum (TQL) block, by investigating the minimal effective volume (MEV90 ) of ropivacaine 0.75% for single-shot TQL block in percutaneous nephrolithotomy (PNL) patients. ⋯ Recruiting will begin June 2020 and is expected to finish November 2020. Data analysis will be performed at interims during and after the study. Results will be published in an international peer-reviewed medical journal.