Analgesic efficacy of ultrasound-guided interscalene block vs. supraclavicular block for ambulatory arthroscopic rotator cuff repair: A randomised noninferiority study

BACKGROUND Ultrasound-guided interscalene block (ISB) is the reference technique for pain control after ambulatory upper limb surgery, but supraclavicular block (SCB) is an alternative. OBJECTIVES The aim of this study was to compare the efficacy of SCB vs. ISB in patients undergoing ambulatory arthroscopic rotator cuff repair (ARCR), with the hypothesis of noninferiority of SCB analgesia compared with ISB. DESIGN A randomised, single-blind, noninferiority study. SETTING Hôpital Privé Jean Mermoz, Centre Paul Santy, Lyon, France. PATIENTS Ambulatory ARCR patients. INTERVENTION Patients were randomly allocated (1 : 1) to receive a single injection SCB or ISB, as well as general anaesthesia. All patients received a postoperative analgesic prescription for home use before leaving hospital (including fast-acting oral morphine sulphate). Patients completed a telephone questionnaire on days 1 and 2 postsurgery. MAIN OUTCOME MEASURES Primary endpoint was oral morphine consumption (mg) during the first 2 days postsurgery. If the difference between mean morphine consumption in the SCB vs. ISB group was less than 30 mg, noninferiority of SCB compared with ISB would be demonstrated. Secondary evaluation criteria included pain scores (numerical rating scale), duration of motor and sensory blockade, and satisfaction with treatment. RESULTS The per-protocol cohort included 103 patients (SCB = 52, ISB = 51) (57% men, median age 58 years). Me...
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Loco-regional anaesthesia Source Type: research

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CONCLUSIONS This study contributed to the knowledge on the profile of confirmed cases of high severity yellow fever. The main factors associated with death were changes in renal excretion and elevated serum transaminases, especially ALT. High lethality emphasizes the need for early diagnosis and treatment, and the importance of increasing vaccination coverage.RESUMO OBJETIVO Descrever o perfil cl ínico-epidemiológico dos casos confirmados de febre amarela internados em hospital geral de referência para doenças infecciosas no estado do Rio de Janeiro, Brasil, de 11 de março de 2017 a 15 de ...
Source: Revista de Saude Publica - Category: International Medicine & Public Health Source Type: research
Locations - National Spine &Pain Centers treatingpain.com Hey all, anyone familiar with the National Spine and Pain practices operating out of the maryland and northern virginia area? A good practice to work for? Any idea what the compensation is for the pain docs working there?
Source: Student Doctor Network - Category: Universities & Medical Training Authors: Tags: Pain Medicine Source Type: forums
Source: Clinical Drug Investigation - Category: Drugs & Pharmacology Source Type: research
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Arizona will receive $2.8 million of a nearly $117 million settlement that Johnson&Johnson has reached over safety concerns and misleading marketing of a surgical mesh used to treat urinary incontinence and other pelvic floor disorders, Arizona Attorney General Mark Brnovich said. The nationwide settlement involved transvaginal surgical meshes implanted to treat a variety of pelvic floor issues. But state prosecutors in 41 states and the District of Columbia said it caused pain, incontinence,…
Source: bizjournals.com Health Care:Biotechnology headlines - Category: Biotechnology Authors: Source Type: news
Conclusions: Results suggest TCC may have a small positive effect on early outcomes, but use of the services was highly variable among sites. Level of Evidence: Therapeutic Level I. See Instructions for Authors for a complete description of levels of evidence.
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research
STOMACH bloating is usually remedied by making simple dietary changes. If quick fixes do not alleviate the tummy swelling, this may signal a more serious condition, including one that specifically affects women.
Source: Daily Express - Health - Category: Consumer Health News Source Type: news
Publication date: Available online 20 October 2019Source: The LancetAuthor(s): Daniel I Sessler, Lijian Pei, Yuguang Huang, Edith Fleischmann, Peter Marhofer, Andrea Kurz, Douglas B Mayers, Tanja A Meyer-Treschan, Martin Grady, Ern Yu Tan, Sabry Ayad, Edward J Mascha, Donal J Buggy, Gang Tan, Zhiyong Zhang, Helen Keane, Maurice Stokes, Oliver Zotti, Michael Gnant, Silvia Perez-ProttoSummaryBackgroundThree perioperative factors impair host defence against recurrence during cancer surgery: the surgical stress response, use of volatile anaesthetic, and opioids for analgesia. All factors are ameliorated by regional anaesthesia...
Source: The Lancet - Category: General Medicine Source Type: research
Conclusion: This qualitative study offers insight into the patient's perspective of dental hygienists administering LA. Participants supported dental hygienists administering LA and appreciated the aspects of patient-centered care that this practice provided. Patient participants were unclear on educational requirements and training, but supported legislation allowing dental hygienists to administer LA. PMID: 31628175 [PubMed - in process]
Source: Journal of Dental Hygiene - Category: Dentistry Tags: J Dent Hyg Source Type: research
Authors: Chimed-Ochir O, Mine Y, Fujino Y Abstract OBJECTIVES: The current research aimed to study the relationship between health-related quality of life (poor perceived health/unhealthy days) and workers' pain. METHODS: This cross-sectional study was conducted among 1360 Japanese workers of a Japanese company in Kyushu. Health-related quality of life was measured by HRQOL-4 tool developed by Centers for Disease Control and Prevention of the USA. Pain was assessed by numeric rating scale with 0-10 points. Regression analysis was conducted to identify the relationship between health-related quality of life and ...
Source: Journal of Occupational Health - Category: Occupational Health Tags: J Occup Health Source Type: research
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