Articles: function.
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Anesthesia and analgesia · Jul 2023
Practice Advisory for Preoperative and Intraoperative Pain Management of Thoracic Surgical Patients: Part 1.
Pain after thoracic surgery is of moderate-to-severe intensity and can cause increased postoperative distress and affect functional recovery. Opioids have been central agents in treating pain after thoracic surgery for decades. The use of multimodal analgesic strategies can promote effective postoperative pain control and help mitigate opioid exposure, thus preventing the risk of developing persistent postoperative pain. ⋯ It is a systematic review of existing literature for various interventions related to the preoperative and intraoperative pain management of thoracic surgical patients and provides recommendations for providers caring for patients undergoing thoracic surgery. This entails developing customized pain management strategies for patients, which include preoperative patient evaluation, pain management, and opioid use-focused education as well as perioperative use of multimodal analgesics and regional techniques for various thoracic surgical procedures. The literature related to this field is emerging and will hopefully provide more information on ways to improve clinically relevant patient outcomes and promote recovery in the future.
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Comment Randomized Controlled Trial Multicenter Study
In ischemic stroke, adding EVT to usual care at 6 to 24 h improved functional status at 90 d.
Olthuis SGH, Pirson FAV, Pinckaers FME, et al; MR CLEAN-LATE investigators. Endovascular treatment versus no endovascular treatment after 6-24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial. Lancet. 2023;401:1371-1380. 37003289.
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Pain in the orofacial region is often reported after whiplash trauma. However, prospective studies evaluating clinical signs related to orofacial pain and disability in whiplash populations are rare. The aim of the present study was to evaluate clinical signs related to pain and dysfunction in orofacial and neck regions after whiplash trauma, in a short- and long-term perspective. ⋯ Orofacial pain is often reported after whiplash trauma but most previous studies concerning orofacial pain in whiplash populations have been questionnaire studies. Cases with a previous whiplash trauma and women, in general, had higher risk for pain on palpation in the jaw and neck region. Investigating pain on palpation after a whiplash trauma can help to identify individuals at risk of developing long-lasting pain in the orofacial region.
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Multicenter Study
Risk for Chronic Kidney Disease Progression After Acute Kidney Injury: Findings From the Chronic Renal Insufficiency Cohort Study.
Prior studies associating acute kidney injury (AKI) with more rapid subsequent loss of kidney function had methodological limitations, including inadequate control for differences between patients who had AKI and those who did not. ⋯ National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health.
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Arch Orthop Trauma Surg · Jul 2023
Multicenter StudyReverse total shoulder arthroplasty pain and function: new perspectives from a 10-year multicenter study at the 7-year follow-up.
Reverse total shoulder arthroplasty (RTSA) can decrease shoulder pain and improve function. However, results reportedly deteriorate as patients approach mid-term follow-up and little is known about how this impacts physical health-related quality of life (PHRQOL) and mental health-related quality of life (MHRQOL). The study hypothesis was that shoulder function, pain, and medication use for pain would influence PHRQOL and MHRQOL. ⋯ Excellent device survival and good-to-excellent perceived shoulder function, and PHRQOL improvements were observed. Secondary objectives of improved shoulder mobility, strength, pain and instability were also achieved. In contrast to previous reports, subjects did not display shoulder mobility or perceived function deterioration by the 7-year follow-up. Following chronic pain relief at 6 weeks post-RTSA, subjects appear to balance PHRQOL and shoulder pain relationships at the 6-month and 1-year post-RTSA follow-ups. Careful evaluation at this time may help patients with higher pain levels and lower function expectations reverse these trends, or patients with lower pain levels and higher function expectations to optimize RTSA use and longevity.