Articles: postoperative.
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Pain following orthopedic surgery can be intense due to the nature of the surgical procedure. Pain is a multilevel phenomenon that includes physiological and psychosocial components. Interventions that address body, mind, and spirit are needed to provide holistic management of pain. Guided imagery is a mind-body intervention that can address all aspects of the patient's pain experience. ⋯ Based on the evidence reviewed, it is recommended that guided imagery be used as an adjunct for pain management in patients undergoing orthopedic surgery. However, additional research in this area is needed. Future research: Two topics for further research were identified. The first is a need to identify an optimal frequency of use of guided imagery. The second is to identify how to ensure patients are using the intervention as recommended.
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J. Cardiothorac. Vasc. Anesth. · Dec 2017
Randomized Controlled TrialIntravenous Acetaminophen Does Not Decrease Persistent Surgical Pain After Cardiac Surgery.
The authors investigated the hypothesis that perioperative acetaminophen reduces incisional pain at 30 and 90 days. ⋯ IV acetaminophen did not reduce the incidence or intensity of incisional pain at 30 days and 90 days after surgery.
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J. Thorac. Cardiovasc. Surg. · Dec 2017
Diaphragmatic fenestration for refractory chylothorax after congenital cardiac surgery in infants.
Medically refractory chylous pleural effusion after congenital heart surgery is associated with significant morbidity and mortality, especially in infants. We reviewed our experience with diaphragmatic fenestration procedure in this group of patients. ⋯ Diaphragmatic fenestration is an effective and safe strategy for management of persistent chylous effusions after congenital cardiac surgery.
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Comparative Study Clinical Trial
The effects of chemoradiotherapy on recurrence and survival in locally advanced rectal cancers with curative total mesorectal excision: a prospective, nonrandomized study.
There are only two prospective, randomized studies comparing preoperative long-term chemoradiotherapy and postoperative chemoradiotherapy in locally advanced rectal cancer (LARC); however, conflicting results in terms of locoregional recurrence (LR) and survival rates have been reported. This prospective study aims to compare the effects of preoperative versus postoperative chemoradiotherapy on recurrence and survival rates in LARC patients. ⋯ Preoperative chemoradiotherapy, as compared with postoperative chemoradiotherapy, significantly improved local control, patient compliance, CSS, and late toxicity and suggested a trend toward improved overall and disease-free survival.
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British journal of pain · Nov 2017
Does perioperative ketamine have a role in the prevention of chronic postsurgical pain: the ROCKet trial.
Identifying operations and individuals with an increased risk of chronic postsurgical pain (CPSP) has led to significant interest in interventions with the potential to achieve primary prevention of this condition. Pharmacological prevention remains controversial with a Cochrane review identifying perioperative ketamine administration as the only intervention with possible benefit although, with only small, heterogeneous studies, the authors called for a large randomised controlled trial (RCT) to confirm the validity of this result. In response to these data, a group of researchers from Australia and Hong Kong designed the ROCKet trial - Reduction Of Chronic Post-surgical Pain with Ketamine, endorsed by the Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network (CTN).