Epidural versus PCA Pain Management after Pectus Excavatum Repair: A Multi-Institutional Prospective Randomized Trial

Eur J Pediatr Surg DOI: 10.1055/s-0039-1697911 Introduction Postoperative pain control remains the primary reason for inpatient stay after minimally invasive repair of pectus excavatum. In a previous study, our group reported that early pain control was better in patients managed with a thoracic epidural, while late pain control was better in patients managed with patient-controlled analgesia (PCA). After revising our epidural transition and modifying the PCA protocol, we conducted a multi-institutional prospective randomized trial to evaluate these two pain control strategies. Materials and Methods Patients were randomized to epidural or PCA following minimally invasive repair of pectus excavatum with standard protocols for each arm. Primary outcome was length of stay with secondary variables including mean patient pain scores, complications, and parental satisfaction. Scores were pooled for the two groups and reported as means with standard deviation. Results were compared using t-tests and one-way analysis of variance with p-value 
Source: European Journal of Pediatric Surgery - Category: Surgery Authors: Tags: Original Article Source Type: research

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This study aimed to assess the potential efficacy of purified porcine atelocollagen (PAC) for the management of refractory chronic pain due to suspected connective tissue damage. Methods: Patients treated with PAC were retrospectively evaluated. Patients with chronic refractory pain, suspected to have originated from musculoskeletal damage or defects with the evidence of imaging studies were included. Pain intensity, using the 11-point numerical rating scale (NRS), was assessed before the procedure, and 1 month after the last procedure. Results: Eighty-eight patients were finally included for investigation. The mea...
Source: Korean Journal of Pain - Category: Anesthesiology Tags: Korean J Pain Source Type: research
This study aims to understand pain control outcomes with different analgesic regimens.
Source: Journal of the American College of Surgeons - Category: Surgery Authors: Tags: Pediatric surgery Source Type: research
Abstract A 71-year-old man presented to us with recurrent chest pain, which led to cardiac catheterization. He was a strong candidate for redo coronary artery bypass grafting (CABG). CT was performed to confirm whether the heart was adherent to the sternum and chest wall. For safety reasons, cardiopulmonary bypass (CPB) was first performed via right femoral cannulation before sternotomy. After the spontaneous right ventricular (RV) rupture, HTK was used to arrest the heart. Heart repair materials were applied to repair the fissure of RV to avoid further tearing and bleeding. A compromise scheme was adopted when it...
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
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Source: European Journal of Pain - Category: Anesthesiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Authors: Aiolfi A, Micheletto G, Guerrazzi G, Bonitta G, Campanelli G, Bona D Abstract Treatment of Boerhaave's syndrome is controversial. Formal thoracotomy and laparotomy were considered the gold standard treatment in the past. However, these approaches are associated with significant surgical trauma, stress, and postoperative pain. Recently published studies reported the application of minimally invasive surgery in the setting of such esophageal emergency. However, the application of minimally invasive surgery in the setting of Boerhaave's syndrome is debated and evidence is puzzled. The aim of this study was to...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
We report the first case of mesh migration into the sigmoid colon after TEP presenting 10 years after surgery. A 72-year-old male presented with left iliac fossa pain and diffuse lump. His computed tomogram scan showed sigmoid colon adherent to internal oblique at the site of hernia repair with a collection containing air specks and calcification. A colonoscopy revealed mesh within the sigmoid colon. He had to undergo a sigmoidectomy with Hartmann's surgery for the same. Here, we discuss the implicated pathophysiology, management and prevention of mesh migration after laparoscopic inguinal hernioplasty with literature review.
Source: Journal of Minimal Access Surgery - Category: Surgery Authors: Source Type: research
This study hypothesises that elite athletes have a superior advantage in both pre- and post-op rehabilitation and therefore will present and resume sporting activities quicker.MethodsA retrospective analysis on a secure database of athletes presenting with groin pain that underwent surgery for ‘inguinal disruption’. All data were explored via appropriate descriptive statistics and comparisons made between elite and amateur athletes.ResultsAll patients were male (n = 144). The median age 33 years (range 14–72). The median return to sporting activity was 4.5 weeks (range 2.0–16...
Source: Surgical Endoscopy - Category: Surgery Source Type: research
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Source: Current Reviews in Musculoskeletal Medicine - Category: Orthopaedics Source Type: research
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Source: Annali Italiani di Chirurgia - Category: Surgery Tags: Ann Ital Chir Source Type: research
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Source: Journal of Orthopaedics and Traumatology - Category: Orthopaedics Source Type: research
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