Ugeskrift for laeger
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Ugeskrift for laeger · May 2006
Comparative Study[Accelerated versus conventional hospital stay in total hip and knee arthroplasty III: patient satisfaction].
The goal of this study was to evaluate patient satisfaction with the hospital stay in relation to the length of stay for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA). ⋯ Patients in accelerated stays are not less satisfied with their hospital stay (or any part of it) compared to patients with longer and more conventional hospital stays. These results support the implementation of fast-track total hip- and knee arthroplasty.
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Ugeskrift for laeger · May 2006
Comparative Study[Accelerated versus conventional hospital stay in total hip and knee arthroplasty II: organizational and clinical differences].
The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in order to identify important logistical and clinical areas for the duration of the hospital stay. ⋯ Implementation of logistical and clinical features, as shown in this study in all departments, are expected to increase rehabilitation and reduce the length of hospital stay.
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Ugeskrift for laeger · May 2006
Comparative Study[Length of stay in total hip and knee arthroplasty in Danmark I: volume, morbidity, mortality and resource utilization. A national survey in orthopaedic departments in Denmark].
The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in Denmark in order to focus on the relationship between duration of hospital stay, surgical volume, morbidity and mortality and resources. ⋯ Nation-wide implementation of fast-track THA and TKA would result in a significant decrease in the needed number of hospital beds and generate economic savings with similar or better outcome.
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Genetic factors can explain a significant amount of the variance in the perception of pain, sensitivity to painful stimuli and development of chronic pain. Twin studies, association studies and linkage analysis have located DNA sequences and SNPs that may be involved in the regulation of pain. Individual genes have an influence on the reaction to experimental painful stimuli, and certain genes are probably involved in painful clinical conditions. Optimal pain control and counselling of patients may be achievable through research into the genetic mechanisms involved in pain.
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Total knee arthroplasty (TKA) is associated with considerable postoperative pain which may be difficult to manage. This article describes advantages and disadvantages of the different analgesic techniques used for pain treatment after TKA, for example i.v. patient-controlled analgesia, epidural pain treatment, and peripheral nerve blocks (especially femoral and sciatic blocks). Randomised studies suggest that peripheral nerve blocks have the best effect and have fewest side effects. Intra-articular administration of analgesics is the most recently introduced technique.