Articles: postoperative.
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Randomized Controlled Trial
Advantages of Transmuscular Quadratus Lumborum Block via Subfascial Approach versus Extrafascial Approach for Postoperative Analgesia after Laparoscopic Cholecystectomy: A Randomized Controlled Study.
We aimed to compare the analgesic effect and incidence of lower limb weakness of transmuscular quadratus lumborum (TQL) block via subfascial approach with that via extrafascial after laparoscopic cholecystectomy (LC). ⋯ TQL block via subfascial had the advantages of better analgesic effect and less lower limbs weakness after LC over that via extrafascial.
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Liver transplantation remains the only definitive treatment for advanced liver disease and liver failure. Current allocation schemes utilized for liver transplantation mandate a 'sickest first' approach, thus most liver transplants occur in patients with severe systemic illness. For intensive care providers who care for liver transplant recipients, a foundation of knowledge of technical considerations of orthotopic liver transplantation, basic management considerations, and common complications is essential. This review highlights the authors' approach to intensive care management of the postoperative liver transplant recipient with a review of common issues, which arise in this patient population. ⋯ Given a global increase in liver transplantation, an increasing number of intensive care professionals are likely to care for this patient population. For these providers, a foundational knowledge of the common complications and key management considerations is essential.
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Acupuncture and acupressure are not being systematically used in the management of postoperative nausea and vomiting and pain, despite being included in the guidelines. ⋯ Positive attitudes are reported by Australian doctors and nurses toward AA. This is despite of low levels of knowledge or personal exposure to AA. Further studies are required to explore the implementation of barriers and address respondent calls for further education.
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To identify risk factors for development of deep venous thrombosis (DVT) in patients undergoing spinal irrigation and débridement for an infection with subsequent peripherally inserted central catheter placement and to determine if chemoprophylaxis mitigates the risk of developing DVT. ⋯ Patients undergoing spinal débridement with subsequent peripherally inserted central catheter placement are at high risk for postoperative DVT. Multiple spine débridement procedures, a history of diabetes, and previous DVT are risk factors for postoperative DVT. Chemoprophylaxis does not mitigate patients' risk for postoperative DVT.
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Chronic postsurgical pain (CPSP) is defined by pain intensity and pain-related functional interference. This study included measures of function in a composite score of patient-reported outcomes (PROs) to investigate the incidence of CPSP. Registry data were analyzed for PROs 1 day and 12 months postoperatively. ⋯ Opioid doses and PROs 24 hours postoperatively improved the fit of the regression model. A more comprehensive assessment of pain and interference resulted in lower CPSP rates than previously reported. Although inclusion of CPSP in the ICD-11 is a welcome step, evaluation of pain characteristics would be helpful in differentiation between CPSPF and continuation of pre-existing chronic pain.