Articles: postoperative.
-
Paediatric anaesthesia · Feb 2023
Benefit of epidural analgesia for postoperative pain control after a Kasai Portoenterostomy: A ten-year retrospective cohort study.
Biliary atresia is a rare obstructive cholangiopathy that presents in infants. The Kasai portoenterostomy procedure, which reestablishes biliary drainage into the intestine, is a surgical procedure that has been found to improve survival with the native liver. The options for postoperative analgesia include systemic opioids and epidural analgesia. The primary objective of this study was to compare the postoperative systemic opioids used in morphine equivalents (mg/kg) on postoperative days 0 through 3 between patients who underwent a Kasai portoenterostomy and received a thoracic epidural infusion to those without thoracic epidural analgesia. ⋯ In our cohort study, continuous thoracic epidural analgesia in patients undergoing a Kasai portoenterostomy was associated with lower postoperative opioid use. We also observed that the epidural group had a lower ICU admission rate and a lower rate of postoperative supplemental oxygen requirement over the first three postoperative days.
-
To determine if spine surgery patients with greater improvement in patient-reported outcomes measures (PROMs) at early postoperative follow-up are more likely to be lost to follow-up at the 1-year and 2-year postoperative visits. ⋯ Overall patient outcomes were not found to affect loss to long-term follow-up after spine surgery. The general lack of association between postoperative follow-up status and clinical outcome may limit bias introduced in retrospective PROM studies.
-
We present the case of a 65-year-old man undergoing open-heart surgery through a full sternotomy with the use of bilateral intercostal cryo nerve block (cryoNB) as adjunctive therapy for postoperative analgesia. CryoNB has been previously demonstrated as safe and effective for pain control in thoracotomy procedures as well as bilaterally in adolescent patients with pectus excavatum undergoing Nuss procedure. Herein, we describe for the first time, the cryoNB procedure for postoperative pain management in a patient undergoing full sternotomy.