Anesthesiology and pain medicine
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Post-operative nausea and vomiting (PONV) is one of the common problems after laparoscopic cholecystectomy. ⋯ Intravenous injection of 8 mg Dexamethasone or 3 mg Granisetron before anesthesia induction had similar effects in prophylaxis of nausea and vomiting after laparoscopic cholecystectomy.
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Blood loss in spine surgery is an important issue, even though it has been understudied compared with hip and knee arthroplasty. ⋯ As an oral premedication, clonidine can reduce surgical blood loss in lumbar spine posterior fusion surgery, even at the same levels of mean arterial pressure (MAP) with the control group. Its use can be studied in more complicated spine surgeries, such as scoliosis and spinal deformity surgeries.
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Chronic pain following lower-limb amputation is now a well-known neuropathic, chronic-pain syndrome that usually presents as a combination of phantom and stump pain. Controlling these types of neuropathic pain is always complicated and challenging. If pharmacotherapy does not control the patient's pain, interventional procedures have to be taken. ⋯ After a positive response to segmental nerve blockade at the L4 and L5 nerve roots, PRF was performed on the L4 and L5 dorsal root ganglia. Global clinical improvement was good in one patient, with a 40% decrease in pain on the visual analogue scale (VAS) in 6 months, and moderate in the second patient, with a 30% decrease in pain scores in 4 months. PRF of the dorsal root ganglia at the L4 and L5 nerve roots may be an effective therapeutic option for patients with refractory phantom pain.
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Intra-articular analgesia is a pain reliever that is frequently administered following arthroscopic knee surgery. ⋯ We have found a postoperative analgesic effect of intra-articularly administered morphine and tramadol following minor arthroscopic knee surgeries with a maximum effect 6 hours post injection.