Acta anaesthesiologica Scandinavica
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Acta Anaesthesiol Scand · Mar 2012
Randomized Controlled TrialEffects of adductor-canal-blockade on pain and ambulation after total knee arthroplasty: a randomized study.
Total knee arthroplasty (TKA) is associated with intense post-operative pain. Besides providing optimal analgesia, reduction in side effects and enhanced mobilization are important in this elderly population. The adductor-canal-blockade is theoretically an almost pure sensory blockade. We hypothesized that the adductor-canal-blockade may reduce morphine consumption (primary endpoint), improve pain relief, enhance early ambulation ability, and reduce side effects (secondary endpoints) after TKA compared with placebo. ⋯ The adductor-canal-blockade significantly reduced morphine consumption and pain during 45 degrees flexion of the knee compared with placebo. In addition, the adductor-canal-blockade significantly enhanced ambulation ability assessed by the TUG test.
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Acta Anaesthesiol Scand · Mar 2012
The saphenous nerve and its relationship to the nerve to the vastus medialis in and around the adductor canal: an anatomical study.
Recently, ultrasound-guided saphenous nerve blocks within and distal to the adductor canal have shown success. However, a potential side effect is an unintentional block of branches of the nerve to the vastus medialis resulting in undesired motor weakness. ⋯ Knowledge of this anatomy may help establish a safe region in preventing motor blockade when performing saphenous nerve blocks.
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Acta Anaesthesiol Scand · Mar 2012
Multicenter StudyIs day surgery safe? A Danish multicentre study of morbidity after 57,709 day surgery procedures.
Day surgery is expanding in several countries, and it is important to collect information about quality. The aim of this study was to assess morbidity and unanticipated hospital visits 0-30 days post-operatively in a large cohort. ⋯ This large-scale Danish national study confirmed that day surgery is associated with a very low rate of return hospital visits. Despite the rapid expansion of day surgery, safety has been maintained, major morbidity being very rare, and no deaths being definitely related to day surgery.
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Acta Anaesthesiol Scand · Mar 2012
Review Meta AnalysisWound infiltration with local anesthetics for post-operative pain relief in lumbar spine surgery: a systematic review.
In this systematic review, we evaluated double-blind, randomized and controlled trials on the effect of wound infiltration with local anesthetics compared with the effect of placebo on post-operative pain after lumbar spine surgery. ⋯ Interpretation of the results was difficult because of diversity of the studies. However, clinical significance was in general questionable, with only a few trials showing a small or a modest reduction in pain intensity, which was observed mainly immediately after the operation. Similarly, although more frequently observed, only a minor and probably not clinically relevant reduction in opioid consumption was shown.