European journal of anaesthesiology
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Myopathies are generally considered to increase the risk for succinylcholine-induced hyperkalaemia and may affect the duration of action of neuromuscular blockers. Centronuclear (myotubular) myopathy (CNM) is congenital and produces various degrees of muscular weakness and associated complications such as respiratory failure. The effects of succinylcholine and the potentially lethal consequences of hyperkalaemia on patients with CNM are unknown due to its rarity. One source of information is the dog, as CNM occurs naturally in dogs. Because of its remarkable similarity with the disease in man, canine CNM can serve as a model to further our knowledge of the effects of succinylcholine. ⋯ CNM did not exacerbate the increase in blood potassium that is ordinarily seen with succinylcholine. Recovery from succinylcholine was nearly 50% longer in dogs with CNM. Although our sample size is too small to evaluate the incidence of succinylcholine-induced hyperkalaemia, extrapolation of these findings suggests that increased duration of action should be expected if succinylcholine is given to a patient with autosomal-recessive CNM.
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The prevalence of chronic postsurgical pain (CPSP) is a critical medical problem with economic implications. Its prevalence after gastrointestinal surgery is not well documented, particularly when a laparoscopic approach is used. ⋯ The incidence of CPSP after laparoscopic colorectal surgery (17%) is similar to those reported in the literature after laparotomy. Risk factors are redo surgery for postoperative peritonitis, IBD and preoperative pain.
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Multicenter Study Observational Study
Chronic postsurgical pain in Europe: An observational study.
Chronic postsurgical pain (CPSP) is an important clinical problem. Prospective studies of the incidence, characteristics and risk factors of CPSP are needed. ⋯ The collection of data on CPSP was feasible within the European registry PAIN OUT. The incidence of moderate to severe CPSP at 12 months was 11.8%. Functional impairment was associated with CPSP severity and neuropathic characteristics. Risk factors for CPSP in the present study were chronic preoperative pain, orthopaedic surgery and percentage of time in severe pain on D1.
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Comparative Study Observational Study
Persistent posthysterectomy pain: A prospective, observational study.
There is a large variation in the prevalence of persistent postsurgical pain depending on the type of surgery. It is unclear how common persistent postsurgical pain is after vaginal or laparoscopic hysterectomy. ⋯ Persistent posthysterectomy pain is common, but pain is mild and does not interfere with daily activities for most of the patients 6 months after surgery. Smoking is the strongest predictor for persistent pain.
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Observational Study
Preoperative glycosylated haemoglobin as a predictor of postoperative analgesic requirements in diabetic patients: A prospective observational study.
In diabetic individuals undergoing surgery, the analgesic effect of opioids on postoperative pain may be different from normal. Although the ability of glycosylated haemoglobin (HbA1c) to predict adverse events and outcomes after major surgery has recently been assessed, the ability of HbA1c to predict the need for postoperative analgesia has not been determined. ⋯ This study demonstrated that in diabetic patients, the preoperative level of HbA1c was associated with the postoperative fentanyl consumption. In diabetic patients, the HbA1c level prior to surgery may be useful in anticipating postoperative analgesic requirements and help to improve patient counselling regarding postoperative pain.