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

Proximal row carpectomy as a treatment of disorders of the radiocarpal joint remains controversial despite numerous reports documenting clinically successful outcomes. Criticism includes postoperative loss of grip strength, unsatisfactory range of motion, prolonged rehabilitation time, and the potential for progressive painful arthritis. Twenty-seven patients were studied to address these concerns. The average length of follow-up was 4 years. Postoperative pain relief was achieved in 26 patients, allowing 24 of the 27 patients to return to their previous activity status within an average of 4.5 months after surgery. In all cases, range of motion matched or surpassed preoperative values. Grip strength improved to an average of 80% of the contralateral side. A detailed radiographic analysis of the radii of curvature of the lunate fossa and the capitate showed that the radius of curvature of the capitate is approximately two thirds of the corresponding value of the lunate. Motion between the capitate and the radius is translational with a moving center of motion, which may dissipate load on the radius and explain the relative success of the procedure.
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PMID:Proximal row carpectomy: clinical evaluation. 234 60

Wide resection in 12 cases of malignant or potentially malignant lesions of the chest wall resulted in full-thickness loss of skeleton and frequently of overlying soft tissues (defect greater than or equal to 15 cm in its smallest diameter or at least 90% of the sternum resected). In reconstruction of the defect, steel bars were used to replace lost ribs and a double layer of Marlex mesh for intercostal spaces. Soft-tissue coverage and primary closure were accomplished with current plastic surgical procedures and good stability of the chest wall was achieved. Protracted respiratory support was required in only one case. Postoperative pain was managed with epidural anesthesia and routine analgesics. Functionally and cosmetically satisfactory long-term results were obtained, with no infection and no need for removal of prosthetic material. The overall 5-year and 10-year actuarial survival rates were 60% and 37.5%. If lesions are radically resectable, the extent of thoracic wall resection need not be restricted because of inability to close the defects.
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PMID:A method for reconstruction of large full-thickness defects of the bony thorax. 235 79

Postoperative pain, activity level, medication use, and psychological variables after laparoscopic tubal ligation with Falope rings in 1-day surgery in 50 women was investigated. The women completed the McGill Pain Questionnaire, the Modified Functional Assessment Instrument, the Brief Symptom Inventory, the Krantz Health Opinion Survey, and the state scale of the State-Trait Anxiety Inventory. The McGill Pain Questionnaire generated the pain rating index total score (PRIT) and the present pain intensity (PPI). The women repeated pain and activity scales after surgery, before discharge, and daily before bed for 7 days. Pain scores declined over the week. Mean PRIT scores were lower than expected because some women objected to a single word descriptor of pain. 38 women took codeine-containing medication. 42 women took 4-7 days to return to normal activity because of pain and fatigue. Psychological test scores did not correlate with pain or activity scores. The sum of PRIT and PPI scores was a good predictor of return to activity.
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PMID:Pain after day-care tubal ligation. 237 53

Seventeen patients with symmetrically embedded lower wisdom teeth were selected for this study, intended to evaluate the local effect of soft laser therapy on postoperative pain. Both lower third molars were removed in the same operation. The test side, chosen by lot, was treated using a helium-neon laser (632,8 nm, 8 mW, 50 Hz) for 2 minutes. The other side served as the untreated control side. Facial swelling was measured using a modification of the face-bow technique. Postoperative pain was estimated using a visual analogue scale (VAS). When it became apparent that conventional statistical analysis was revealing no difference in postoperative swelling and pain between the test and the control groups, the study was discontinued for ethical reasons.
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PMID:Helium-neon laser therapy in the prevention of postoperative swelling and pain after wisdom tooth extraction. 238 79

This study examines the incidence and severity of postoperative pain after gingivectomy using one non-eugenol-containing periodontal dressing, Coe-pak (n = 76) and 2 eugenol-containing periodontal dressings, Wondrpak (n = 64) and Nobetec (n = 86). All patients were subjected to gingivectomy using 1 type of local anaesthesia (lidocaine + adrenalin) only and covering the surgical areas with either of the 3 different dressings in a randomized study. Postoperative pain was assessed on 100 mm visual analogue scales over 5 days starting immediately after surgery. No pain was reported by 22.0% of the patients after Coe-pak, 23.4% after Wondrpak and 30.2% after Nobetec. 13.2% of the patients took analgesics after Coe-pak treatment, 3.1% after Wondrpak and 1.2% after Nobetec. Mean pain score after Coe-pak was higher (P less than 0.05) than after Nobetec 2 h after operation until the morning on the 3rd postoperative day. Mean pain score after Coe-pak was higher (P less than 0.05) than after Wondrpak 3 h to 9 h after operation. No statistically significant difference was found between Wondrpak and Nobetec regarding mean pain score.
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PMID:Effect of non-eugenol- and eugenol-containing periodontal dressings on the incidence and severity of pain after periodontal soft tissue surgery. 239 30

Postoperative pain control can be a major problem after selective dorsal rhizotomy for the treatment of spasticity. We report the use of epidural morphine delivered via a catheter placed at surgery for postoperative analgesia in 28 consecutive patients undergoing this procedure. Pain was well controlled using this technique, and no patients required concomitant parenteral analgesia. There were no instances of respiratory depression, wound infection, or central nervous system depression, and the patients were easily mobilized in the early postoperative period. Epidural morphine is concluded to be a safe and very efficacious method of analgesia after selective dorsal rhizotomy.
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PMID:Use of epidural morphine for control of postoperative pain in selective dorsal rhizotomy for spasticity. 248 50

Postoperative pain management for major abdominal or thoracoabdominal procedures requires bilateral multisegmental intercostal nerve blocks or epidural analgesia. This study was undertaken to examine the possible role of bilateral intrapleural regional analgesia (BIRA) and to select the proper dose for this new technique. Bilateral intrapleural catheters were inserted after surgery, using a Mancao dual-cannula system. Bupivacaine with epinephrine 1/200,000 (BE) was administered in each side as 20 mL of 0.5% in three patients. When this dose was found to be ineffective, 30 mL of 0.75% BE was administered in five patients; however, two patients complained of tinnitus and visual disturbances. Subsequently, 20 mL of 0.75% BE was used in five patients and was found to be satisfactory. Thirteen additional patients received the latter dose. Arterial blood levels of bupivacaine were determined at 15, 30, 60, and 120 minutes. The group of 18 patients (group I) who received 20 mL of 0.75% BE bilaterally were compared with a second group (group II) of 16 patients undergoing similar surgery who received only parenteral narcotics for pain management. BIRA was considered effective when patients denied pain or discomfort and when narcotics were not required in the postanesthesia recovery unit. Patients in groups I and II received narcotic medication whenever they felt pain or discomfort. The duration of BIRA was considered to be from the injection of the drug until the time a narcotic was administered to the patient. Demographic variables, changes in BP and heart rate after surgery, frequency of narcotic administration during the first four postoperative days, and postoperative hospital stay were compared in groups I and II.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Bilateral intrapleural regional analgesia for postoperative pain control: a dose-finding study. 252 Sep 36

One hundred twenty-six primary total hip arthroplasties composed of a hybrid cemented femoral component and a cementless acetabular component were followed for a minimum of two years (mean, 42 months). The average patient age was 63 years. The most common diagnosis was osteoarthritis (85 hips), although 13 of the cases were severe or total congenital dislocations. Overall, the results were excellent. The mean Harris hip score was 93. Postoperative pain was rated as none or slight in 94% of the cases. No patient had moderate or severe pain. No femoral or acetabular components were revised. Roentgenographically no femoral component was definitely or probably loose. One acetabular reconstruction component had migrated. The authors conclude that the selective use of cemented and cementless fixation by anatomic site in this hybrid form of hip arthroplasty provided excellent results for five and one-half years.
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PMID:Hybrid total hip arthroplasty. 258 70

Postoperative pain is a distressing and disabling feature of scoliosis surgery. Epidural morphine has recently been advocated to reduce the frequency and severity of postoperative pain in adults. A retrospective study of 35 patients was conducted to determine whether epidural administration of morphine is useful in the management of postoperative pain in children and adolescents following posterior spinal fusion. The derived data included dose and frequency of narcotic administration on the day of surgery and during the subsequent three days. On the first postoperative day, the total morphine given averaged only 16.4 mg in patients receiving epidural morphine compared to 27 mg in those receiving only conventional parenteral morphine. Similar significant differences persisted through the second postoperative day. Intermittent epidural injection of small doses of morphine can give satisfactory and prolonged analgesia for early postoperative pain management.
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PMID:Efficacy of intermittent epidural morphine following posterior spinal fusion in children and adolescents. 258 72

We administered general anesthesia for an emergency abdominal surgery due to duodenal ulcer hemorrhage. The patient was in postoperative state after femoral supracondylar fracture, in pre-shock state, of old age (97 y-o), with severe anemia, and hypoproteinemia, and complicated with a giant abdominal aneurysm and mild aortic regurgitation. Before the operation, the patient was transferred to ICU and had intravascular volume replaced (infused with blood 600 ml, crystalloid fluid 2000 ml, colloid fluid 500 ml) and received stomach lavage. Under monitoring of direct arterial pressure, after fully pre-oxygenation, fentanyl 0.1mg was administered slowly, and crush induction was performed by a small dose of thiopental and SCC. After induction of anesthesia systolic blood pressure decreased to 60 mmHg temporarily and it was maintained between 80 and 120 mmHg during the surgery, but tachycardia continued (90-110.min-1). In order to treat oliguria owing to pre-shock state, we administered dopamine and urinastatin continuously. The patient was transferred to ICU postoperatively and close attention was paid. Postoperative pain controlled was well by epidural morphine and bupivacaine. The postoperative course was uneventful without any complications. Twenty three days later, abdominal aortic aneurysm resection was performed uneventfully. In this paper, problems of preanesthetic and anesthetic management of emergency abdominal surgery for an aged patient were discussed.
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PMID:[Anesthetic experience in emergency abdominal surgery in a 97-year-old patient complicated with a giant abdominal aneurysm]. 258 3


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