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Query: UMLS:C0030201 (Postoperative pain)
 1,085 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

For pain relief after thoracotomy, intercostal nerve block with etidocaine 1% and bupivacaine 0.5%, both containing adrenaline 5 mug/ml, was used. Duration of skin analgesia for sharp pain was around 11 hours for both solutions. Post-operative pain was noted 6 and 5 hours after injection for etidocaine and bupivacaine respectively. No pathological changes in acid-base balance or ventilation were observed. Peak expiratory flow decreased to 35-40% of the pre-operative values and remained at this level for about 12 hours. Arterial and venous blood levels of the local anaesthetics were low and no signs of toxicity were noted. All patients experienced a certain pain relief from the blocks. Because of shoulder pain in some patients intercostal nerve block alone does not seem to be a perfect post-operative method for pain relief after thoracotomies.
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PMID:Etidocaine in intercostal nerve block for pain relief after thoracotomy; a comparison with bupivacaine. 24 Nov 97

To study the significance of normalization of ventilatory or thermal homeostasis during naloxone reversal, 95 patients were given naloxone after thiopental-N2O-O2-relaxant anaesthesia supplemented with fentanyl (6 microgram/kg/h). If naloxone 0.16 mg was given to combat postoperative apnoea during hypercapnia (end tidal carbon dioxide concentration (ETco2)8%), minute ventilation and respiratory rate were significantly higher during the first minutes as compared to the normocapnic patients. Shivering occurred in 44% in the hypercapnic group, as compared to about 30% if naloxone was given during normocapnia (ETco2 5%). Postoperative pain and restlessness were significantly increased in the hypercapnic group. During normocapnia, untoward reactions were less frequent (40%) if naloxone was given in smaller increments (0.08 + 0.08 mg) rather than in one dose (0.16 mg) (72%). This was mainly due to nausea (8% compared to 32%). The incidence and severity of shivering showed a positive correlation to the duration of anaesthesia (r = 0.42) and to the total amount of fentanyl (r = 0.32), but not to the actual postoperative oesophageal temperature (r = -0.13). The results indicate that though untoward reactions after naloxone reversal are aggravated by naloxone-induced normalization of deranged homeostatic mechanisms, their aetiology probably should be sought in an acute abstinence syndrome.
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PMID:Restlessness and shivering after naloxone reversal of fentanyl-supplemented anaesthesia. 42 15

Costs, morbidity, and recurrences have been reduced in the repair of inguinal hernias. In 18 months 135 repairs were done using local anesthetics, prompt ambulation, and minor variations in the Shouldice technic. Men and women aged 22 to 84 years were operated upon. No recurrences have been reported, and urinary catheterization has not been necessary. Significant savings are available by abbreviated hospital stay. The majority of patients require only 24 hours for repair of a unilateral inguinal hernia and the observation period following it. The same basic repair is used for direct and indirect sliding hernias. Rebuilding the floor of the inguinal canal is essential. Postoperative pain has been minimal. Use of long-acting local anesthetics has proven helpful.
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PMID:Inguinal herniorrhaphy: reduced morbidity, recurrences, and costs. 45 93

The metatarsal osteotomy, a relatively simple procedure, provides a great amount of correction and relief with a limited amount of bone resection. Postoperative pain and edema are minimal, and disability and loss of time from employment are eliminated as patients are able to walk immediately in a surgical shoe. If biomechanical management is not adequate in relieving discomfort, then a 10-year study of more than 1000 cases indicates that the osteotomy is the procedure of choice.
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PMID:The metatarsal osteotomy: a 10-year follow-up on the second, third and fourth metatarsal osteotomies and a new approach to the fifth metatarsal osteotomy. 59 60

The laser is a new tool which can be a precise and accurate instrument for tissue removal under colposcopic direction in the areas of the cervix, vagina and vulva. Healing is rapid since the laser inflicts minimal tissue destruction. Postoperative pain is minimal and healing is without scar formation. The expense of the equipment and training of the operating surgeon are its only drawbacks.
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PMID:Gynecologic surgery using the CO2 laser (light amplification by stimulated emission of radiation). 63 21

Postoperative pain is an important factor in the management of children undergoing thoracotomy. Intercostal nerve block has been used in adult patients, but its applicability in the pediatric age group has not been previously evaluated. Eighty-nine children (85 girls and 31 boys) aged 6 months to 16 years (mean age 4.7 years) underwent ligation of a patent ductus arteriosus (PDA) through a left thoracotomy. Twenty-nine children received intercostal blocks with bupivacaine from the level of the second to sixth thoracic vertebrae. Sixty cases constituted the control group. The patients with intercostal block had fewer doses of pain medication postoperatively, 2.7 mean (0 to 9), than did the control patients, 3.9 mean (0 to 21). The mean hospital stay was shortened in the patients with nerve block, 5.1 days versus 7.3 days for the control group. No ill effects of bupivacaine were noted. We conclude that intercostal nerve block is a valuable procedure reducing the need for postoperative analgesia and shortening hospital stay.
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PMID:Kindness pays dividends: the medical benefits of intercostal nerve block following thoracotomy. 88 80

Twenty-nine upper dorsal sympathectomies have been carried out in 18 patients and a comparison made of the supraclavicular with the axillary approach to the upper thoracic sympathetic chain. Thirteen of these operations were carried out for essential hyperhidrosis, 15 for ischaemia in the hand and one for post-traumatic pain syndrome. Fourteen sympathectomies were carried out through the axilla and 15 through the supraclavicular approach. Post-operative pain was felt to be somewhat more severe when the axillary approach was used, but other complications were infrequent and hospital stay was slightly shorter in the axillary group. The axillary approach was felt to offer superior exposure, the capability for wider sympathetic excision, good cosmetic results, avoidance of Horner's syndrome and low morbidity. In the absence of lung disease or the need for a direct exploration of the root of the neck, the axillary approach is to be preferred for upper dorsal sympathectomy.
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PMID:A comparison of the supraclavicular and axillary approaches to upper thoracic sympathectomy. 105 96

The paper discusses peculiarities of breast cancer surgery using high-energy CO2 laser. Advantages of laser scalpel are discussed. CO2 laser was employed in 120 cases of breast surgery including 70 operations for cancer (radical mastectomy and radical resection--35 cases each). Operative blood loss was reduced by half (from 350 to 140 ml). The duration of surgery and wound healing did not increase. Postoperative pain was less severe. The study is in progress.
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PMID:[The use of the carbon dioxide laser in the surgical treatment of breast cancer]. 130 Jun 86

In view of the increasing development of laparoscopic surgery and hoping to minimize thoracotomy's risks, we had the idea to perform pleurectomy as a treatment of Spontaneous Pneumothorax (S.P.) through video thoracoscopy. The operation was performed under general endobronchial anesthesia, the patient placed in the posterolateral thoracotomy position. Three trocars inserted through the 5th, 7th and 9th intercostal space, allowed the introduction of non specific thoracoscopic instruments similar to those used in laparoscopic surgery. The apical pleurectomy was delimited by the 6th rib, the internal thoracic vessels, the costovertebral sulcus and the first rib. Blebs and small bullae are now transected with application of the "EndoGIA 30". Pleural cavity was drained by F28 ans F32 tubes through the lower orifices. This procedure was performed in 18 patients presenting 20.S.P.. Operative indications were: persistent air link (7 cases), recurrence (9 cases), bullae with bridle and or anterior thoracotomy for S.P. (4 cases). One bleeding of 200 ml from a wounded intercostal vessel ligated with a clip was the sole operative hitch. Operative duration decreased from two to one hour. Average drainage duration was 3.5 dys and hospital stay 4.5 days. There was no death nor immediate complications. Post-operative pain was judged in all cases less intensive than that experienced after pleurectomy with thoracotomy. This original procedure is the first described as entirely performed through thoracoscopy with non specific instruments and hence economic impact.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Upper parietal pleurectomy with resection of bullae by thoracoscopy in spontaneous pneumothorax. New perspectives from preliminary results in 20 cases]. 130 25

From 1974 to 1988, 868 open palm and/or finger operations were carried out by a surgeon at the SOS Main emergent hand surgery unit in Strasbourg. Out of these, 107 patients making up 140 fingers were seen again after a period of more than 5 years. The essential advantage of the method is the low rate of postoperative complications relative to the other methods involving skin closure. All patients had an ambulatory treatment with regional anesthesia. The palm was opened in 85% of cases, and both the palm and the base of the fingers in 14%. The average healing time was 26 days, with an average sick leave of 28 days. Postoperative pain was noted in 20% of cases, requiring medication in 10% for an average of 3 days. Postoperative bleeding requiring new dressing occurred in one case, after the patient had already been discharged (0.7%), while 3.5% of all patients had anticoagulants. No hematoma and no flap necrosis were noted, and temporary dysesthesia was noted in 4.6% of cases, nerve involvement in 3.1%, and neurovascular dystrophy in 7%, including 4 only with a functional deficit (2.8%). On the other hand, results after 5-6 years are similar to those of selective aponeurectomies published in the literature, with frequent recurrence (40.6%, including 23% severe enough to require second surgery). Extension was noted in 39% of all cases, and the total activity of the disease was present in 55% of all studied hands.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:["Open palm" technique in Dupuytren's disease. Postoperative complications and results after more than 5 years]. 133 28


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