Regional anesthesia for anterior cruciate ligament reconstruction in adolescents

Source: Pediatric Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research

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Infiltration between popliteal artery and capsule of the knee (IPACK) is a novel technique that can provide additional analgesic relief, although there are no studies to date in the adolescent population. In 3 adolescent patients undergoing anterior cruciate ligament surgery, IPACK block augmented continuous femoral nerve block by providing posterior knee analgesia with no or only minimal opioid needs in the post-anesthesia care unit and did not produce sciatic motor weakness.
Source: A&A Case Reports - Category: Anesthesiology Tags: Case Reports Source Type: research
Authors: Kavak Akelma F, Baran AkkuĊŸ I, Altinsoy S, Özkan D, Ergil J Abstract Background and Objectives To determine the effectiveness of pregabalin and adductor canal block on opioid consumption, postoperative pain and fast-tracking. Methods A total of 51 ASA I-II patients aged 18-70 years who were scheduled to undergo elective anterior cruciate ligament reconstruction were included in the study. Patients were randomized into groups P, A and C. Patients in group P (n=16), received preoperative 150 mg oral pregabalin, patients in Group A (n=17) received postoperative adductor canal blockade, and patients in g...
Source: Turkish Journal of Medical Sciences - Category: General Medicine Tags: Turk J Med Sci Source Type: research
CONCLUSIONS: Implementation of standard PONV guidelines for adolescents undergoing outpatient ACL reconstruction was associated with lower emesis rates. This reduction in emesis rate may have been due to the concurrent reduction in opioids we observed following guideline implementation. PMID: 31894609 [PubMed - as supplied by publisher]
Source: Paediatric Anaesthesia - Category: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research
AbstractPurposeThe pivot shift (PS) test is commonly used to diagnose and evaluate the dynamic instability of the knee joint in cases of anterior cruciate ligament (ACL) tear. There is a need of a reliable and inexpensive tool which is easily available to measure PS objectively in a clinical setting. The purpose of this study was to evaluate the use of a smartphone, which is readily available, to assess the PS phenomenon.MethodsSeventeen patients with unilateral ACL-injured knees, undergoing ACL reconstruction, were enrolled in the study. PS was initially graded according to the International Knee Documentation Committee c...
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
ConclusionsConcomitant ALC injury at the time of ACL injury had no effect on the rotational laxity of the knee in the postoperative course after ACL reconstruction. Therefore, additional treatment for ALC injury may not be warranted.Level of evidenceIV.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Editor ’s PerspectiveWhat We Already Know about This TopicAdductor canal nerve block is useful for a range of knee surgeries, although the optimal injection location has not been definedUnfortunately, analgesia achieved using adductor canal block is sometimes accompanied by unwanted motor blockWhat This Article Tells Us That Is NewProximal adductor canal injections were associated with lower first 24-h morphine consumption than when injections were more distalDecreases in quadriceps strength were similar whether the injection was made in a proximal, mid-, or distal adductor canal locationBackground The ideal location...
Source: Anesthesiology - Category: Anesthesiology Source Type: research
ConclusionPatients with an isolated ramp lesion of the medial meniscus in association with an ACL injury displayed a higher amount of dynamic rotational laxity as expressed by the pivot shift test in comparison to patients with isolated ACL injury and no ramp lesion. The association between ramp lesions of the medial meniscus and increased pivot shift grading suggests that it is important to diagnose and repair them during ACL reconstruction surgery.Level of evidenceIII.
Source: Knee Surgery, Sports Traumatology, Arthroscopy - Category: Orthopaedics Source Type: research
Abstract Anterior cruciate ligament (ACL) tears is a devastating injury and one of the most common knee injuries experienced by athletes in the United States. Although patients reach maximal subjective improvement by one-year following ACL reconstruction, many patients often experience moderate to severe post-operative pain. Opioids, intra-articular injections, and regional anesthesia have been previously implemented to mediate post-operative pain. However, chronic opioid usage has become an epidemic in the United States. Alternative analgesic modalities, such as nerve blocks, have been implemented in clinical pra...
Source: Annals of Anatomy - Category: Anatomy Authors: Tags: Ann Anat Source Type: research
The objectives of this cross-sectional analytical study were to (1) compare how the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PI) computer adaptive test (CT) performs against the Numeric Pain Scale (NPS) measure in evaluating pain, and (2) to determine demographic, clinical, and psychosocial correlates of PI in an urban population undergoing a variety of knee surgeries. We hypothesized that there would be a strong correlation between PI and NPS, with minimal floor and ceiling effects; and that a worse PI score would be associated with a worse general health profile. The sample con...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Given increasing health care costs and clinical equipoise on numerous topics, value calculations are critical. Cost-minimization analysis evaluates throughout a single episode of care. For anterior cruciate ligament reconstruction, this is a reasonable approach given that cost-effectiveness data have been published. Using Healthcare Cost and Utilization Project data, general anesthesia, anesthesia time, greater age, and medical comorbidities were correlated with higher costs. Among the surprising results were increased costs with male gender and Hispanic race.
Source: Arthroscopy - Journal of Arthroscopic and Related Surgery - Category: Surgery Authors: Tags: Editorial Commentary Source Type: research
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