Articles: postoperative.
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Anasthesiol Intensivmed Notfallmed Schmerzther · Jun 2015
Review[The addicted patient in anaesthesia -screening, diagnosis and treatment of alcohol use disorders].
Patients consuming > 60g/d of alcohol (e.g. 1.5l of beer), are 2-5 times more likely to suffer post-operative complications such as infectious, bleeding or cardiac complications or an alcohol withdrawal syndrome. By screening and a systematic evaluation risk patients can be identified that may benefit from interventions such as counseling, brief interventions, abstinence, tailored anesthesia, prophylactic treatment of withdrawal symptoms, stress reduction, harm reduction, psychosocial therapy, addiction therapy, multidisciplinary treatment.
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Journal of anesthesia · Jun 2015
Feasibility, reliability, and validity of the Japanese version of the Postoperative Quality of Recovery Scale: a first pilot study.
The Postoperative Quality of Recovery Scale (PQRS) is a multi-domain tracking scale to assess recovery after surgery. The PQRS is used in seven countries and five languages; however, the Japanese version of the PQRS (PQRSj) has not been established. We therefore translated the PQRS into Japanese, and examined the feasibility, reliability and validity of the PQRSj. ⋯ A relationship was shown between cognitive domain and MMSE at baseline (r = 0.65, P < 0.01); however, no relationship was found between the other domains and the MMSE and QoR-40 J. Ceiling effects were observed in 78% of the questions. These results indicate that the PQRSj can be used to assess recovery after surgery, although it may be better to revise some of the questions to improve the validity of the PQRSj.
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One of the factors contributing to long-term outcome of posterior malleolar fractures is the development of osteoarthritis. Based on biomechanical, cadaveric, and small population studies, fixation of posterior malleolar fracture fragments (PMFFs) is usually performed when fragment size exceeds 25-33%. However, the influence of fragment size on long-term clinical and radiological outcome size remains unclear. ⋯ Level IV, retrospective case series.
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Randomized Controlled Trial
Evaluation of the preliminary effectiveness of hand massage therapy on postoperative pain of adults in the intensive care unit after cardiac surgery: a pilot randomized controlled trial.
Although many intensive care unit patients experience significant pain, very few studies explored massage to maximize their pain relief. This study aimed to evaluate the preliminary effects of hand massage on pain after cardiac surgery in the adult intensive care unit. A pilot randomized controlled trial was used for this study. ⋯ Although hand massage decreased muscle tension, fluctuations in vital signs were not significant. This study supports potential benefits of hand massage for intensive care unit postoperative pain management. Although larger randomized controlled trials are necessary, this low-cost nonpharmacologic intervention can be safely administered.
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Randomized Controlled Trial Comparative Study
Impact of epidural analgesia on quality of life and pain in advanced cancer patients.
Patients with advanced cancer often experience chronic postoperative pain and poor quality of life. The objective of this study was to determine if epidural self-controlled analgesia reduced the incidence of chronic pain and improved the quality of life when compared with intravenous self-controlled analgesia. A total of 50 patients diagnosed with advanced cancer who received analgesia treatment were randomly divided into two groups, epidural self-controlled analgesia group (EA group, n = 26) and intravenous self-controlled analgesia group (IA group, n = 24). ⋯ The VAS in the EA group was significantly lower than that in the IA group (p < .05), and the Karnofsky score in the EA group was significantly higher than that in the IA group (p < .05). Moreover, patients treated with EA felt more satisfied and experienced fewer complications than those with IA (p < .05). The epidural self-controlled analgesia may greatly improve the quality of life and relieve the pain in patients with advanced cancer.