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Query: UMLS:C0344307 (analgesia)
 28,200 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Peripheral nerve blocks have found increased popularity in providing prolonged post-operative analgesia following total knee replacement surgery. They generally provide effective analgesia with fewer complications than epidurals. This report describes an acute low-energy knee dislocation after a well balanced, fixed bearing, cruciate-retaining primary total knee replacement performed under a spinal anaesthetic with combined complimentary femoral and sciatic nerve blocks. The dislocation was not accompanied by neurovascular compromise. Due to the subsequent instability and injury to both collaterals, the posterior cruciate ligament and posterolateral corner structures, the knee was treated with a rotating-hinge revision total knee replacement. The dislocation occurred whilst the peripheral nerve blocks (PNB) were still working. We review our incidence of PNB related complications and conclude that PNB remain a safe and effective analgesia for total knee replacements. However, we advocate that ward staff and patients should be sufficiently educated to ensure that unaided post-operative mobilisation is prevented until such a time that patients have regained complete voluntary muscle control.
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PMID:Multi-ligament instability after early dislocation of a primary total knee replacement - case report. 2005 20

Digital amputations in children are usually caused by crush or avulsion injuries (door hinge, bicycle chain, etc.). The preponderance of this mechanism of injury means a survival rate generally lower than in adults. However, finger amputation in children is an absolute indication for replantation because the sensory and functional results are significantly higher. Technically, there is little difference, apart from the difficulty of the size of the structure and the presence of growth plates. Kirschner wires are the most suitable fixation method but two subcutaneous needles are ideally used in distal amputations. The dressing and postoperative immobilization in a circular plaster above the elbow is kept for 1 month. Secondary procedures are rare, later than in adults and give poorer results because of the difficulty of understanding the active mobilization exercises. The postoperative analgesia is fundamental following replantation to avoid the risk of arterial spasm, and after a secondary procedure to allow proper rehabilitation.
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PMID:[Digital replantation in children]. 2299 67