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

One hundred patients (aged 22-86 years, mean 62.5), undergoing lower limb orthopaedic surgery, received continuous spinal anaesthesia using a 28 s.w.g. catheter inserted through a 22 s.w.g. Quincke needle. Post-operative pain relief was provided by bolus injections of 1-2.5 mL 4 h-1 of plain 0.25% bupivacaine. The mean dose of bupivacaine required for sufficient pain relief in 93% of patients was 1.6 +/- 0.2 (1.3-1.9) mL 4 h-1. The highest dose was needed between 4 and 8 h post-operatively. No dependence of dose on age or type of operation was found. Technical problems with the microcatheter occurred in 12%. The most frequent complaint was post-operative backache (12%). Only one patient suffered from post-dural puncture headache on the day after surgery. There was no microbiological contamination of the catheter tips after removal. In the post-operative interview, 89% of the patients were completely satisfied with CSA; 91% would prefer this technique to general anaesthesia.
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PMID:Microcatheter continuous spinal anaesthesia in the post-operative period: a prospective study of its effectiveness and complications. 764 17

The dorsal spine is the least affected region of the spine for intervertebral disc prolapse. The majority of cases of thoracic disc prolapse affect the lower dorsal spine, probably due to the increased mobility of that region. The dorsolumbar junction (DLJ) comprises D10 to L1 together with the intervening discs. Over a period of nine years, we have operated on thirty-two DLJ disc prolapses using a transpedicular approach in thirty patients. There were eight cases of D10/D11 disc prolapse, ten of D11/D12, and twelve of D12/L1 prolapse. Two patients had more than 1 level involvement. Back ache was the predominant symptom in patients with DLJ disc prolapse, seen in 92 % of cases. Presentation was in the form of conus/cauda equina syndrome with D11, D12 and L1 radiculopathy. All the patients were evaluated by MRI. Disc prolapse was eccentric in 10 and diffuse central in 22 levels. There was a distinct neurological improvement in all patients after surgery, pain relief being the most prominent feature. The dorsolumbar region differs from the dorsal spine in terms of mobility, anatomic and biomechanical features. It is a transition zone between the relatively fixed dorsal spine and the mobile lumbar region. These differences account for the higher incidence of disc prolapse in the region as compared to the dorsal spine cranial to D10. The transpedicular approach appears to be most suitable for discectomy for DLJ disc prolapse. The approach is minimally invasive considering the size of the incision, minimal bone removal and avoidance of vital structures. Postoperative pain is minimal and ambulation can be begun within 24 hours of surgery.
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PMID:Transpedicular surgery for dorsolumbar junction disc prolapse: anatomic and biomechanical considerations of a minimally invasive approach. 1632 Jan 89