113,763 results match your criteria pain postoperative

Vulnerability to Postoperative Complications in Obstructive Sleep Apnea: Importance of Phenotypes.

Anesth Analg 2021 May;132(5):1328-1337

From the Adelaide Institute for Sleep Health, Flinders Health and Medical Research Institute, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.

Obstructive sleep apnea (OSA) is a common comorbidity in patients undergoing surgical procedures. Patients with OSA are at heightened risk of postoperative complications. Current treatments for OSA focus on alleviating upper airway collapse due to impaired upper airway anatomy. Read More

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Pharmacologically Induced Ventilatory Depression in the Postoperative Patient: A Sleep-Wake State-Dependent Perspective.

Anesth Analg 2021 May;132(5):1274-1286

Department of Anesthesiology and Perioperative Medicine, College of Medicine, Mayo Clinic, Rochester, Minnesota.

Pharmacologically induced ventilatory depression (PIVD) is a common postoperative complication with a spectrum of severity ranging from mild hypoventilation to severe ventilatory depression, potentially leading to anoxic brain injury and death. Recent studies, using continuous monitoring technologies, have revealed alarming rates of previously undetected severe episodes of postoperative ventilatory depression, rendering the recognition of such episodes by the standard intermittent assessment practice, quite problematic. This imprecise description of the epidemiologic landscape of PIVD has thus stymied efforts to understand better its pathophysiology and quantify relevant risk factors for this postoperative complication. Read More

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Obesity and Obesity Hypoventilation, Sleep Hypoventilation, and Postoperative Respiratory Failure.

Anesth Analg 2021 May;132(5):1265-1273

Department of Medicine, University of Chicago, Chicago, Illinois.

Obesity hypoventilation syndrome (OHS) is considered as a diagnosis in obese patients (body mass index [BMI] ≥30 kg/m2) who also have sleep-disordered breathing and awake diurnal hypercapnia in the absence of other causes of hypoventilation. Patients with OHS have a higher burden of medical comorbidities as compared to those with obstructive sleep apnea (OSA). This places patients with OHS at higher risk for adverse postoperative events. Read More

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Perioperative Management of the Patient With Obstructive Sleep Apnea: A Narrative Review.

Anesth Analg 2021 May;132(5):1231-1243

From the Department of Anesthesiology, Perioperative Medicine and Intensive Care Medicine, Paracelsus Medical University, Salzburg, Austria.

The prevalence of obstructive sleep apnea (OSA) has reached 1 billion people worldwide, implying significant risk for the perioperative setting as patients are vulnerable to cardiopulmonary complications, critical care requirement, and unexpected death. This review summarizes main aspects and considerations for the perioperative management of OSA, a condition of public health concern. Critical determinants of perioperative risk include OSA-related changes in upper airway anatomy with augmented collapsibility, diminished capability of upper airway dilator muscles to respond to airway obstruction, disparities in hypoxemia and hypercarbia arousal thresholds, and instability of ventilatory control. Read More

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Outcomes of Sleep Apnea Surgery in Outpatient and Inpatient Settings.

Anesth Analg 2021 May;132(5):1215-1222

From the Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas.

Background: Upper airway surgery is an alternative treatment for patients with severe obstructive sleep apnea (OSA). However, there is controversy regarding selection criteria for outpatient versus inpatient settings for these surgical procedures. The aim of this retrospective study was to compare postoperative outcomes of patients undergoing airway surgery in outpatient and inpatient settings based on length of stay at the facility. Read More

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Frequency and Temporal Distribution of Postoperative Respiratory Depressive Events.

Anesth Analg 2021 May;132(5):1206-1214

From the Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.

Background: The frequency and temporal distribution of postoperative respiratory depression (RD) events are not completely understood. This study determined the temporal distribution and frequency of RD episodes in postsurgical patients continuously monitored by bedside capnography and pulse oximetry.

Methods: This was a post hoc study of a subset of postsurgical patients enrolled in The PRediction of Opioid-induced respiratory Depression In patients monitored by capnoGraphY (PRODIGY) trial from 2 sites in the United States. Read More

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Prevention and treatment of postoperative pain in pediatric patients undergone craniotomy: Systematic review of clinical evidence.

Clin Neurol Neurosurg 2021 Apr 1;205:106627. Epub 2021 Apr 1.

Department of Anesthesiology, Critical Care and Pain Medicine, Sapienza University of Rome, Italy.

Background: Prevention and treatment of postoperative pain after craniotomy in pediatric patients is an open and challenging clinical problem due to limited epidemiological data and significant concerns on safety of the most common analgesics in neurosurgical patients. We reviewed the literature to evaluate the possible available strategies in pain management in pediatric patients.

Methods: The systematic review was performed in accordance with PRISMA statement recommendations. Read More

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Repeated intermittent hypoxic stimuli to operative lung reduce hypoxemia during subsequent one-lung ventilation for thoracoscopic surgery: A randomized controlled trial.

PLoS One 2021 15;16(4):e0249880. Epub 2021 Apr 15.

Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: An intervention to potentiate hypoxic pulmonary vasoconstriction may reduce intrapulmonary shunt and hypoxemia during one-lung ventilation. Previous animal studies reported that repeated intermittent hypoxic stimuli potentiated hypoxic pulmonary vasoconstriction, but no clinical study has examined the effects of this intervention on hypoxemia during one-lung ventilation. We thus performed a single-center, parallel-group, double-blind, randomized controlled trial to investigate whether repeated intermittent hypoxic stimuli to the operative lung reduce hypoxemia during the subsequent one-lung ventilation for thoracoscopic surgery. Read More

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Successful treatment of adult cecorectal intussusception caused by cecum cancer with mobile cecum: a case report.

Surg Case Rep 2021 Apr 15;7(1):96. Epub 2021 Apr 15.

Department of Surgery, Kobe Rosai Hospital, 4-2-23 Kagoikedori, Chuouku, Kobe, Hyogo, 651-0053, Japan.

Background: Intussusception occurs when a segment of the bowel (the intussusceptum) telescopes into an adjacent segment (the intussuscipiens). Adult intussusception occurs rarely and often requires surgical resection for its treatment. We describe the case of an adult patient with extremely rare cecorectal intussusception treated using a novel combined transabdominal and trans-anal approach, which has not yet been reported in the literature. Read More

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Percutaneous Peripheral Nerve Stimulation (Neuromodulation) for Postoperative Pain: A Randomized, Sham-controlled Pilot Study.

Anesthesiology 2021 Apr 15. Epub 2021 Apr 15.

Background: Percutaneous peripheral nerve stimulation is an analgesic technique involving the percutaneous implantation of a lead followed by the delivery of electric current using an external pulse generator. Percutaneous peripheral nerve stimulation has been used extensively for chronic pain, but only uncontrolled series have been published for acute postoperative pain. The current multicenter study was undertaken to (1) determine the feasibility and optimize the protocol for a subsequent clinical trial and (2) estimate the treatment effect of percutaneous peripheral nerve stimulation on postoperative pain and opioid consumption. Read More

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Effect of Intravenous Acetaminophen on Mean Arterial Blood Pressure: A Post Hoc Analysis of the EFfect of Intravenous ACetaminophen on PosToperative HypOxemia After Abdominal SurgeRy Trial.

Anesth Analg 2021 Apr 12. Epub 2021 Apr 12.

From the Department of Outcomes Research, Cleveland Clinic, Cleveland, Ohio.

Background: Acetaminophen is commonly used as part of multimodal analgesia for acute pain. The intravenous formulation offers a more predictable bioavailability compared to oral and rectal acetaminophen. There have been reports of hypotension with intravenous acetaminophen attributable to centrally mediated and vasodilatory effects. Read More

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Cervicogenic dizziness alleviation after coblation discoplasty: a retrospective study.

Ann Med 2021 Dec;53(1):639-646

Department of Pain Management, Xuanwu Hospital, Capital Medical University, Beijing, China.

Objective: Little is known about the therapeutic relationship between coblation discoplasty and cervicogenic dizziness (CGD). CGD can be caused by abnormal proprioceptive inputs from compressed nerve roots, intradiscal mechanoreceptors and nociceptors to the vestibulospinal nucleus in the degenerative cervical disc. The aim was to analyze the efficacy of coblation discoplasty in CGD through intradiscal nerve ablation and disc decompression in a 12-month follow-up retrospective study. Read More

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December 2021

Lunate Revascularization With Temporary Internal Radiocarpal Spanning Fixation for Kienböck Disease.

Hand (N Y) 2021 Apr 15:15589447211006858. Epub 2021 Apr 15.

Duke University School of Medicine, Durham, NC, USA.

Background: The goal in the treatment of stages II and III Kienböck disease is to restore lunate vascularity and halt the progression of avascular necrosis.

Methods: We report the outcomes for patients with stages II and III Kienböck disease treated with fourth extensor compartment artery vascularized bone grafting and temporary radiocarpal spanning internal fixation. Nine patients with a mean age of 28. Read More

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Inguinal hernia repair with or without mesh in late adolescent males.

Ann Surg Treat Res 2021 Apr 30;100(4):246-251. Epub 2021 Mar 30.

Department of Surgery, Armed Forces Capital Hospital, Seongnam, Korea.

Purpose: Inguinal hernia repair is one of the most common treatments worldwide, but there are few studies about the use of mesh in late adolescent patients because hernias are rare in this group. This study aimed to evaluate the postoperative outcomes of hernia repair with and without mesh in late adolescent patients.

Methods: We retrospectively reviewed the data of 243 male patients aged between 18 and 21 years who underwent inguinal hernia repair at a single institution from January 2013 to December 2017. Read More

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Postoperative outcomes of purely laparoscopic donor hepatectomy compared to open living donor hepatectomy: a preliminary observational study.

Ann Surg Treat Res 2021 Apr 30;100(4):235-245. Epub 2021 Mar 30.

Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Purpose: To lessen the physical, cosmetic, and psychological burden of donors, purely laparoscopic donor hepatectomy (PLDH) has been proposed as an ideal method for living donors. Our study aimed to prospectively compare the effect of PLDH and 2 other types of open living donor hepatectomy (OLDH) on postoperative pain and recovery.

Methods: Sixty donors scheduled to undergo donor hepatectomy between March 2015 and November 2017 were included. Read More

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Effect of evening primrose oil on postoperative pain after appendectomy: A double-blind, randomized, clinical trial.

Biomedicine (Taipei) 2020 28;10(1):28-32. Epub 2020 Mar 28.

Deputy of Health, Sabzevar University of Medical Sciences Sabzevar, Iran.

Background And Objective: Despite advances in surgical techniques and pharmacology, postoperative pain remains a common problem after appendectomy, and its management continues to be suboptimal. The aim of this study was to evaluate the effect of evening primrose oil on the reduction of postoperative pain after appendectomy.

Materials And Methods: In a double-blind, randomized, clinical trial, a total of 80 adults patients with acute appendicitis who were undergoing appendectomy at the Shahid Beheshti Emdad Hospital in Sabzevar, were included. Read More

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Sudden, Transient Intraoperative Hypotension During the Use of the Cantilever Technique for Correction of Adult Spine Deformity.

Cureus 2021 Mar 11;13(3):e13835. Epub 2021 Mar 11.

Department of Orthopaedic Surgery, University of Tsukuba, Faculty of Medicine, Tsukuba, JPN.

Intraoperative hypotension is a common but critical complication of spinal surgery. However, it is uncommon to experience sudden transient intraoperative hypotension in patients undergoing surgery for adult spine deformity (ASD) without the presence of major vascular injury, spinal cord injury, or cardiac events. We report a patient who experienced sudden transient intraoperative hypotension during the use of the cantilever technique for correction of an ASD. Read More

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Modified envelope flap, a novel incision design, can relieve complications after extraction of fully horizontal impacted mandibular third molar.

J Dent Sci 2021 Mar 18;16(2):718-722. Epub 2020 Sep 18.

Department of Oral and Maxillofacial Surgery, Guangxi Medical University College of Stomatology, Nanning, China.

Background/purpose: Patients always suffer from dental extraction complications of fully horizontal impacted mandibular third molar, such as pain, swelling and limited mouth opening. A novel incision, modified envelope flap (MEF), was designed to alleviate the complications through minimizing the tissue injury during this surgery procedure.

Materials And Methods: With indications of removing bilateral fully horizontal impacted mandibular the third molars, 40 patients were recruited and received dental extraction under incision with modified envelope flap (MEF) in one lateral and modified triangular flap (MTF) in the other lateral respectively. Read More

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Perineal endometriosis: a rare case of a unique sizeable nodule.

Pan Afr Med J 2021 18;38:47. Epub 2021 Jan 18.

University of Medicine of Sfax, Department of Gynecology and Obstetrics, Hedi Chaker Hospital, 3029, Sfax, Tunisia.

Endometriosis is the presence of endometrial tissue in abnormal locations outside the uterine cavity. These locations are usually the ovaries, the peritoneum, and the uterine ligaments. Less frequently, the endometrial tissue can affect the perineum especially after surgical procedures or obstetric lesions. Read More

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January 2021

The Effect of Lidocaine on Postoperative Quality of Recovery and Lung Protection of Patients Undergoing Thoracoscopic Radical Resection of Lung Cancer.

Drug Des Devel Ther 2021 7;15:1485-1493. Epub 2021 Apr 7.

Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, People's Republic of China.

Purpose: To evaluate the effectiveness and safety of lidocaine on postoperative quality of recovery and lung protection of patients undergoing thoracoscopic radical resection of lung cancer.

Patients And Methods: Seventy ASA II-III patients undergoing thoracoscopic radical resection of lung cancer were randomly assigned into either the lidocaine group (Group L) or control group (Group C). Patients in Group L received lidocaine with a 1. Read More

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Diabetes is associated with greater leg pain and worse patient-reported outcomes at 1 year after lumbar spine surgery.

Sci Rep 2021 Apr 14;11(1):8142. Epub 2021 Apr 14.

Department of Orthopaedic Surgery and Spinal Surgery, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.

Although patients with diabetes reportedly have more back pain and worse patient-reported outcomes than those without diabetes after lumbar spine surgery, the impact of diabetes on postoperative recovery in pain or numbness in other regions is not well characterized. In this study, the authors aimed to elucidate the impact of diabetes on postoperative recovery in pain/numbness in four areas (back, buttock, leg, and sole) after lumbar spine surgery. The authors retrospectively reviewed 993 patients (152 with diabetes and 841 without) who underwent decompression and/or fixation within three levels of the lumbar spine at eight hospitals during April 2017-June 2018. Read More

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Postoperative opioid consumption after spine surgery: 24 hours or midnight to midnight? An infographic.

Reg Anesth Pain Med 2021 Apr 14. Epub 2021 Apr 14.

Anesthesiology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA

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Intercostal cryoablation during Nuss procedure: A large volume single surgeon's experience and outcomes.

J Pediatr Surg 2021 Mar 17. Epub 2021 Mar 17.

Department of Surgery, Division of Pediatric Surgery, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, United States; Department of Surgery, Baylor College of Medicine, Houston, TX, United States.

Background: Recent studies have shown intercostal cryoablation(IC) during the Nuss procedure decreases hospital length of stay(LOS) and opioid administration. However, few studies have also evaluated the risk of postoperative complications related to IC.

Methods: We performed a single center retrospective analysis of all patients who underwent Nuss procedure by one surgeon from 2/2016 to 2/2020, comparing intraoperative IC to other pain management modalities(non-IC). Read More

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Adherence to participant flow diagrams in trials on postoperative pain management after total hip and knee arthroplasty: a methodological review.

Trials 2021 Apr 14;22(1):280. Epub 2021 Apr 14.

Department of Anaesthesiology, Centre for Anaesthesiological Research, Zealand University Hospital, Lykkebækvej 1, 4600, Køge, Denmark.

Background: The Consolidated Standards of Reporting Trials (CONSORT) statement aims to improve transparent reporting of randomised clinical trials. It comprises a participant flow diagram with the reporting of essential numbers for enrolment, allocation and analyses. We aimed to quantify the use of participant flow diagrams in randomised clinical trials on postoperative pain management after total hip and knee arthroplasty. Read More

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Efficacy of Adductor Canal Blocks in Total Knee Arthroplasty.

J Knee Surg 2021 Apr 14. Epub 2021 Apr 14.

Department of Orthopaedics, Toowoomba Hospital, Toowoomba, Queensland, Australia.

Total knee arthroplasty (TKA) is associated with significant postoperative pain. The population receiving TKA is generally elderly and often have multiple comorbidities that can present a challenge to postoperative management. Safe and effective multimodal pain management has led to improved outcomes while minimizing complications and side effects. Read More

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Enhanced Recovery after Surgery: Benefits for the Fetal Surgery Patient.

Fetal Diagn Ther 2021 Apr 14:1-8. Epub 2021 Apr 14.

Department of Anesthesiology, Perioperative and Pain Medicine,Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, USA.

Background: The fetoscopic approach to the prenatal closure of a neural tube defect (NTD) may offer similar advantages to the newborn compared to prenatal open closure of a NTD, with a reduction in maternal risks. Enhanced recovery after surgery (ERAS) protocols have been applied to different surgical procedures with documented advantages. We modified the perioperative care of patients undergoing in utero repair of myelomeningocele with the goal of enhancing the recovery. Read More

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Prospective Randomized Study Evaluating the Effects of Preoperative Opioid Counseling on Postoperative Opioid Use after Outpatient Lower Extremity Orthopaedic Surgery.

J Surg Orthop Adv 2021 ;30(1):2-6

From Rothman Institute at Thomas Jefferson University, Philadelphia, Pennsylvania.

The objective of this study was to investigate the effect of standardized preoperative opioid counseling on postoperative opioid consumption for patients undergoing outpatient lower extremity orthopaedic surgery. Participating patients undergoing elective outpatient lower extremity orthopaedic surgery were randomized to either receive preoperative opioid counseling or not receive counseling (control group). Counseling was delivered via a five-minute pre-recorded standardized video preoperatively. Read More

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January 2021

Vaginal NOTES surgery in patients with prior hysterectomy: A first case series.

Asian J Endosc Surg 2021 Apr 14. Epub 2021 Apr 14.

Department of Gynecology and Obstetrics, IMELDA Hospital, Bonheiden, Belgium.

This is a first feasibility on vaginal natural orifice transluminal endoscopic surgery (vNOTES) in patients with prior hysterectomy. Our aim was to gain initial experience on performing vNOTES surgery on prior hysterectomy cases, whereby the main concern is that pelvic adhesions may impede safe transvaginal access. Between January 2017 and February 2020, a single surgeon (J. Read More

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Demographic, clinical, and anthropometric profiles and postoperative outcomes in patients with chronic limb threatening ischemia: A prospective descriptive study.

Niger J Clin Pract 2021 Apr;24(4):511-516

Department of Surgery, University of Cape Town, Groote Schuur Hospital, Vascular Surgery Unit, Cape Town, South Africa.

Background: Chronic limb-threatening ischemia (CLTI) is a complex disease caused by peripheral artery disease. It is associated with ischemic foot pain (rest pain) and tissue loss in the form of chronic nonhealing foot ulcers or gangrene. CLTI has a high short-term risk of limb amputations, postoperative sepsis, and cardiovascular-related events. Read More

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Successful laparoscopic treatment for sustained abdominal pain due to fish bone migrating into the neck of the pancreas: a case report and thinking about surgical approach through the literature review.

Surg Case Rep 2021 Apr 13;7(1):91. Epub 2021 Apr 13.

Hepatic Biliary and Pancreatic Cancer Center, Chongqing University Cancer Hospital, No. 181 Hanyu Road, Shapingba, Chongqing, 400030, People's Republic of China.

Background: The majority of ingested foreign bodies pass through the gastrointestinal tract smoothly, with less than 1% requiring surgery. Fish bone could perforate through the wall of stomach or duodenum and then migrate to other surrounding organs, like the pancreas and liver.

Case Presentation: We report herein the case of a 67-year-old male who presented with sustained mild epigastric pain. Read More

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