Articles: postoperative-pain.
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J. Thorac. Cardiovasc. Surg. · May 2021
Significant reduction of postoperative pain and opioid analgesics requirement with an Enhanced Recovery After Thoracic Surgery protocol.
To evaluate differences in postoperative pain control and opioids requirement in thoracic surgical patients following implementation of an Enhanced Recovery after Thoracic Surgery protocol with a comprehensive postoperative pain management strategy. ⋯ Implementation of Enhanced Recovery after Thoracic Surgery allows safe elimination of epidural use, better pain control, and less postoperative opioids use, especially a drastic reduction of postdischarge opioid need, without adversely affecting outcomes.
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Patients undergoing spine surgery often inaccurately estimate their pain tolerance and postoperative analgesic requirement. We sought to identify an association between patients' self-perceived pain tolerance and postoperative opioid consumption (POC). ⋯ Self-perceived pain tolerance does not appear to predict POC, while younger age and higher preoperative VAS pain scores are related to increased POC. Younger patients who report high pain tolerance appear to consume higher levels of opioids compared with older patients.
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To analyze artificial intelligence image-assisted knee ligament injury repair and femoral nerve block analgesia after surgery. ⋯ The artificial intelligence image-assisted diagnosis system for analysis and processing of multiparametric magnetic resonance images is useful for clinical decision making, reducing physicians' labor intensity, improving efficiency, and lowering the rate of misdiagnosis.
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Randomized Controlled Trial
Posterior Quadratus Lumborum Block in Total Hip Arthroplasty.
Pain management is important for ensuring early mobilization after hip arthroplasty; however, the optimal components remain controversial. Recently, the quadratus lumborum block has been proposed as an analgesic option. The current study tested the hypothesis that the posterior quadratus lumborum block combined with multimodal analgesia decreases morphine consumption after hip arthroplasty. ⋯ After elective hip arthroplasty, neither morphine consumption nor pain scores were reduced by the addition of a posterior quadratus lumborum block to a multimodal analgesia regimen.
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Randomized Controlled Trial
Perioperative Methadone and Ketamine for Postoperative Pain Control in Spinal Surgical Patients.
Despite application of multimodal pain management strategies, patients undergoing spinal fusion surgery frequently report severe postoperative pain. Methadone and ketamine, which are N-methyl-d-aspartate receptor antagonists, have been documented to facilitate postoperative pain control. This study therefore tested the primary hypothesis that patients recovering from spinal fusion surgery who are given ketamine and methadone use less hydromorphone on the first postoperative day than those give methadone alone. ⋯ Postoperative analgesia was enhanced by the combination of methadone and ketamine, which act on both N-methyl-d-aspartate and μ-opioid receptors. The combination could be considered in patients having spine surgery.