Articles: operative.
-
An infraclavicular catheter is a very efficient technique to provide excellent perioperative anesthesia/analgesia for upper limb surgery. However, complications can occur and are dependent on the technique used. We report the inadvertent placement of an infraclavicular catheter in the interscalene region when an ultrasound-guided infraclavicular catheter was threaded cranially. We proposed some strategies to avoid the occurrence of complications when performing this block.
-
Buprenorphine is a partial agonist at mu-opioid receptors and competes for these receptors with other opioids in vitro. Whether patients on buprenorphine maintenance require high doses of opioid analgesics to attain adequate postoperative pain control has not been determined. We evaluated differences in acute postoperative opioid consumption and pain burden between patients taking buprenorphine and those taking methadone preoperatively. ⋯ Preoperative buprenorphine use was associated with >50% reduction in postoperative opioid dose requirement and a statistically significant, though clinically unimportant, reduction in acute pain burden in comparison to methadone. The study is limited by several important factors such as the exclusion of patients requiring intravenous patient-controlled analgesia, small number of patients were on higher dose of buprenorphine, and a large percentage of methadone patients were not on a stable dose of methadone yet.
-
Randomized Controlled Trial
Effects of Gabapentin Enacarbil on Postoperative Pain After Hip and Knee Arthroplasty: A Placebo-controlled Randomized Trial.
Total joint arthroplasties are among the most common elective procedures performed in the United States, and they are associated with postoperative pain. Gabapentin enacarbil is a prodrug with an extended-release formulation that has been proposed for multimodal postoperative analgesia, but the drug's efficacy for major arthroplasties remains unclear. ⋯ We did not identify statistically significant or clinically meaningful differences in our primary and secondary outcomes related to perioperative use of gabapentin enacarbil in patients having primary hip or knee arthroplasties.
-
Randomized Controlled Trial
The Analgesic Effect of Ultrasound-guided Bilateral Pecto-intercostal Fascial Plane Block on Sternal Wound Pain after Open Heart Surgeries: A Randomized Controlled Study.
We aimed to evaluate the analgesic efficacy of ultrasound-guided bilateral pectointercostal fascial plane block after open heart surgeries. ⋯ pectointercostal fascial block is an effective technique in reducing morphine consumption and controlling poststernotomy pain after cardiac surgeries. Also, it may have a role in better postoperative respiratory outcomes.
-
Randomized Controlled Trial
Clinical Efficacy of Perioperative Intravenous Dexmedetomidine and Lidocaine Combined Infusion for Thyroidectomy: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trail.
The aim of this study was to evaluate the efficacy of perioperative dexmedetomidine (DEX) combined with lidocaine intravenous infusion on relieving postoperative pain and improving recovery for patients undergoing thyroidectomy. ⋯ DEX combined with lidocaine infusion can effectively attenuate the postoperative pain without any serious adverse events, which may improve postoperative recovery in patients undergoing thyroidectomy.