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

Anterior cruciate ligament reconstruction by free patellar tendon graft was performed using 2 different surgical approaches to the intercondylar notch in 67 consecutive patients with chronic anterior cruciate ligament insufficiency. In the first 30 patients (Group A), the traditional medial parapatellar arthrotomy with lateral luxation of the patella was done, whereas in the last 37 patients (Group B) a transpatellar tendon approach was used. Postoperative pain was managed by analgesics and, in patients who had epidural anesthesia, by administration of bupivacaine in indwelling catheters. Generally, the analgesics and bupivacaine were given immediately on request to establish comfort at rest and to permit range of motion exercises without severe pain. Compared with those in Group A, the patients of Group B had a significantly longer period from the first dose of analgesic or bupivacaine to the second, and the total number of doses of analgesic or bupivacaine was significantly lower. In the subgroup of patients with epidural anesthesia (21 in Group A and 32 in Group B), the Group B patients required significantly less analgesics, as doses equivalent to 10 mg of morphine, compared with that of Group A.
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PMID:Postoperative pain after anterior cruciate ligament reconstruction using a transligamentous approach. 836 9

A prospective study was undertaken during the past 3 years to investigate the effectiveness of thoracoscopic corpectomy--endoscopic removal of the vertebral body in 15 cases (8 for pathologic fractures for tumors, 5 for traumatic fractures and 2 for infections). The average age of the patients was 53.2 years (range 28-85 years). The vertebral levels of corpectomy ranged from T3 to L1. The mean operating time was 211 min (range 83-450 min) and the mean estimated blood loss was 890 ml (range 150-2,800 ml). The postoperative morbidity appeared to be more favorable than with open thoracotomy [Alband OW, Corkill G. Thoracic disk herniation: treatment and prognosis. Spine 1979; 4:41-6; Landreneau RJ, Hazelrigg SR, Mack NJ. Postoperative pain-related morbidity: video-assisted thoracic surgery versus thoracotomy. Ann Thorac Surg (in press); McAfee PC. Complications of anterior approaches to the thoracolumbar spine: emphasis on Kaneda instrumentation. Clin Orthop 1994;306:110-9; McAfee PC, Bohlman HH, Yuan HA. Anterior decompression of traumatic thoracolumbar fractures with incomplete neurological deficit using a retroperitoneal approach. J Bone Joint Surg [Am] 1985;67: 89-104; Regan JJ, Mack MJ, Picetti GD, Guyer RD, Hochschuler SH, Rashbaum RF. A comparison of video-assisted thoracoscopic surgery (VATS) with open thoracotomy in thoracic spinal surgery. Today's Ther Trends 1994;11: 203-18.] because the mean chest tube duration was 1.22 days (range 1-3 days), the mean length of time in the intensive care unit was 2 days (range 1-4 days), and the mean length of total hospitalization was 6.5 days (range 2-12 days). Overall, the ability to visualize the anterior surface of the dura during corpectomy was better endoscopically than with open thoracotomy techniques--improved magnification, the ability of the operative assistant to see and therefore suction more efficiently, and the perspective of visualization was improved. It was possible to place the 30 degrees angled endoscope within the defect left by the resected vertebral body and look directly posteriorly at the dura, visualizing the epidural vessels and dural pulsations at close range. The limiting factor in wide application of the technique is the absence of a commercially available internal fixation system that can be applied endoscopically.
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PMID:Anterior thoracic corpectomy for spinal cord decompression performed endoscopically. 884 76

Anterior tension-free and laparoscopic inguinal herniorrhaphies represent one of the most common surgical procedure. Postherniorrhaphy persistent pain due to injures of inguinal regional nerves is rare, difficult to cure, often disabling and involving malpractice litigation. In a prospective study, we evaluated the effectiveness of neurectomy of the iliohypogastric nerve in prevention of postoperative persistent pain after anterior tension free herniorrhaphy. Between 1992-1995, we performed 180 anterior herniorraphies in 151 male patients. Iliohypogastric nerve was removed in all the herniorrhaphies. Polypropylene plug and sutured mesh were employed. Postoperative pain and clinical relevance of hypo-anesthesia and paresthesia were assessed. No patient complained of postoperative persistent pain. Hypo-anesthesia, never considered incapacitating, was present in 1% of patients after 2 years. We consider neurectomy of the iliohypogastric nerve a potentially useful surgical step in preventing postoperative persistent pain after anterior tension-free herniorrhaphy.
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PMID:Prevention of postherniorrhaphy persistent pain: results of a prospective study. 1066 16

Anterior iliac crest bone grafting is a well-established modality in the treatment of alveolar bone deficiencies. However, this procedure may also have considerable postoperative morbidity which is mostly related to general anesthesia. Postoperative pain-related complications can be managed by neuroaxial blockade techniques which provide adequate surgical analgesia and reduce postoperative pain. This clinical report describes the reconstruction of a severely atrophic maxilla with anterior iliac crest bone grafting using combined spinal epidural anesthesia. Neuroaxial blockade techniques may be a useful alternative to eliminate general anesthesia related challenges of anterior iliac crest bone grafting procedures.
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PMID:Reconstruction of atrophic maxilla by anterior iliac crest bone grafting via neuroaxial blockade technique: a case report. 2895 86