Articles: operative.
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Randomized Controlled Trial
Physiotherapeutic Reduction of Orofacial Pain Using Extremely Low-Frequency Electromagnetic Field and Light-Emitting Diode Therapy-A Pilot Study.
Pain is a natural response of the body to injury and one of the symptoms defining an inflammatory reaction. It is almost always present after orthognathic surgeries (OGS), but its severity is subjective in each patient. Postoperative care of the patient is aimed at minimizing of postoperative pain relief orofacial region. Options of physiotherapy include extremely low-frequency electromagnetic field (ELF EMF) and high-energy light-emitting diode (LED). Aim of the Study. The aim of this study was to evaluate the effects of physiotherapy combining ELF EMF and LED to reduce pain of the orofacial region in patients after OGS. Material and Methods. The study was conducted in thirty-two patients who underwent OGS to treat morphological defects. The participants were randomly divided into two groups: Physiotherapy group (PT) and Control group (CG). In both groups, patients were prescribed Paracetamol and nonsteroidal analgesics (NSAID-ibuprofen). Patients from the PT group additionally received postoperative physiotherapy immediately after leaving the surgical clinic in the form of ELF EMF and LED therapy. Physiotherapeutic treatments were performed for 10 days, three applications a day, at no cost to the patient. Pain intensity was assessed using the visual analogue scale (VAS), which is a reliable instrument for the measurement of pain intensity self-reported by the patient. ⋯ The conducted research revealed that the combined use of ELF EMF and LED is beneficial in the reduction of pain of patients after OGS. The analgesic effects of physiotherapy in the treatment after OGS are necessary to continue research in this area and analyze the possibility of extending the indications for its use in other surgically treated maxillofacial diseases.
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Due to the presence of multimorbidity and polypharmacy, patients aged 75 and older are at a higher risk for postoperative adverse events after lumbar fusion surgery. More effective enhanced recovery pathway is needed for these patients. Pain control is a crucial part of perioperative management. The objective of this study is to determine the impact of multimodal pain management on pain control, opioid consumption, and other outcomes. ⋯ This study demonstrates that the PMPM protocol is effective in pain control and reducing additional opioid consumption when compared with conventional analgesia, even for patients aged 75 and older. Moreover, these improvements occur with a lower incidence of postoperative complications within three months after PLF surgery.
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Pain following orthopedic surgery has always been a critical issue, which caused great distress to the patients. Analgesics in the treatment of postoperative pain following orthopedic surgery have aroused great attention from scholars, and numerous studies have been published in recent years. Bibliometrics could assist scholars in understanding the scope of research topics better, identifying research focuses and key literature, and analyzing the development and trend of analgesics in the treatment of postoperative pain following orthopedic surgery. ⋯ Analgesics in the treatment of postoperative pain following orthopedic surgery can be observed in this study by employing the online bibliometric tool and VOSviewer software, which established the relationship between the units of analysis. It can provide a meaningful resource with detailed information for orthopedic surgeons who would like to understand the trend in this field better. They can also benefit from the emphasis on citation count to carry out high-level research in the future.
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The development of pulmonary atelectasis is common in the surgical patient. Pulmonary atelectasis can cause various degrees of gas exchange and respiratory mechanics impairment during and after surgery. In its most serious presentations, lung collapse could contribute to postoperative respiratory insufficiency, pneumonia, and worse overall clinical outcomes. ⋯ Interventions such as noninvasive positive pressure ventilatory support may be beneficial in specific patients at high risk for pulmonary atelectasis (e.g., obese) or those with clinical presentations consistent with lung collapse (e.g., postoperative hypoxemia after abdominal and cardiothoracic surgeries). Preoperative interventions may open new opportunities to minimize perioperative lung collapse and prevent pulmonary complications. Knowledge of pathophysiologic mechanisms of atelectasis and their consequences in the healthy and diseased lung should provide the basis for current practice and help to stratify and match the intensity of selected interventions to clinical conditions.
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Randomized Controlled Trial
Analgesic Effect of Ropivacaine Combined with Hydromorphone following Surgery for Mixed Hemorrhoids: A Pilot Study.
Postoperative pain is a major adverse effect of surgery for mixed hemorrhoids. We evaluated whether spinal anesthesia with ropivacaine and hydromorphone provided safe and effective analgesia after surgery for mixed hemorrhoids. ⋯ In patients with mixed hemorrhoids, spinal anesthesia with ropivacaine/hydromorphone has a comparable analgesic effect and a lower incidence of pruritus during the first 24 hours after surgery than spinal anesthesia with ropivacaine/morphine.