Peripheral Nerve Blocks for Ambulatory Shoulder Surgery A Population-based Cohort Study of Outcomes and Resource Utilization

Conclusions In ambulatory shoulder surgery, nerve blocks were not associated with a significant difference in adverse postoperative outcomes. Costs were statistically higher with a block, but this increase is not likely clinically relevant.
Source: Anesthesiology - Category: Anesthesiology Source Type: research

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ConclusionWith this local –regional nerve-blocking protocol, opioid use after ARCR was unexpectedly low, and a large proportion of patients recovered without any post-surgical opioids. The correlation seen between opioid use and age may not be clinically significant, given the low use of post-operative opioids overall. The se results may be useful in guiding post-operative opioid prescribing after ARCR, as well as in lowering costs associated with ARCR.
Source: HSS Journal - Category: Orthopaedics Source Type: research
ConclusionsUnplanned admissions are more frequently related to general anaesthesia, lengthy surgeries and procedures such as arthroscopy, hallux valgus corrections or removal of osteosynthesis material. The major reasons for unplanned admissions were inadequate postoperative pain management for overnight admissions and wound infection for admissions after discharge.ResumenObjetivoLos procedimientos de Cirugía Ortopédica y Traumatología (COT) realizados en Unidades de Cirugía Mayor Ambulatoria (CMA) ofrecen importantes ventajas que desaparecen cuando la recuperación postoperatoria no es la...
Source: Revista Espanola de Cirugia Ortopedica y Traumatologia - Category: Orthopaedics Source Type: research
Authors: Kavak Akelma F, Baran Akkuş 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
Isolated posterior cruciate ligament (PCL) injuries are uncommon and can be easily missed with physical examination. The purpose of this article is to give an overview of the clinical, diagnostic and arthroscopic evaluation of a PCL injured knee. There are some specific injury mechanisms that can cause a PCL including the dashboard direct anterior blow and hyperflexion mechanisms. During the diagnostic process it is important to distinguish between an isolated or multiligament injury and whether the problem is acute or chronic. Physical examination can be difficult in an acutely injured knee because of pain and swelling, b...
Source: Sports Medicine and Arthroscopy Review - Category: Sports Medicine Tags: Review Articles Source Type: research
J Knee Surg DOI: 10.1055/s-0039-3400754The purpose of this study is to identify patterns of postoperative narcotic use and determine the impact of psychosocial and perioperative factors on postoperative opioid consumption following arthroscopic knee surgery. Fifty consecutive patients undergoing arthroscopic knee surgery were prospectively enrolled. Patients were contacted via telephone at 1 week postoperatively to report their pain level and opioid consumption. The patient was contacted again at 2 weeks, 4 weeks, and 90 days as necessary until opioid cessation, at which time the patient's plan for unused pills was inquire...
Source: Journal of Knee Surgery - Category: Orthopaedics Authors: Tags: Original Article Source Type: research
Authors: Plečko M, Bohaček I, Tripković B, Čimić M, Jelić M, Delimar D Abstract Anterior section of the hip joint capsule is innervated by femoral nerve and obturator nerve, and posterior section is innervated by the nerve to quadratus femoris muscle and occasionally by the superior gluteal (posterolateral region) and sciatic nerve (posterosuperior region). One of the regional anesthesia options for hip surgery is the fascia iliaca compartment block (FICB) that affects nerves important for hip innervation and sensory innervation of the thigh - femoral, obturator and lateral femoral cutaneous nerve. FICB can b...
Source: Acta Clinica Croatica - Category: General Medicine Tags: Acta Clin Croat Source Type: research
Conclusions The superior trunk block provided noninferior analgesia compared with interscalene brachial plexus block for up to 24 h after arthroscopic shoulder surgery and resulted in significantly less hemidiaphragmatic paresis.
Source: Anesthesiology - Category: Anesthesiology Source Type: research
ConclusionAlthough CISB significantly improved postoperative pain control and early (in the first 6  weeks) functional outcomes following arthroscopic rotator cuff repair, there was no significant difference between the CISB group and CISB + GA group at 6 months.Level of evidenceLevel II, Randomized Controlled Trial, Treatment Study.
Source: European Journal of Orthopaedic Surgery and Traumatology - Category: Orthopaedics Source Type: research
AbstractPurpose of ReviewHip arthroscopy is a rapidly growing field due to its significant diagnostic and therapeutic value in the management of numerous hip disorders. Adequate control of postoperative pain in patients undergoing hip arthroscopy continues to be a challenging and evolving area in orthopedics. In the absence of standardized protocols for pain management in these patients, a variety of different approaches have been utilized in an effort to find a regimen that is effective at reducing postoperative pain, narcotic consumption, and cost to the patient and healthcare system. The purpose of this article, therefo...
Source: Current Reviews in Musculoskeletal Medicine - Category: Orthopaedics Source Type: research
Abstract Idiopathic shoulder stiffness (i.e. frozen shoulder, FS) is a common pathology of the glenohumeral joint characterized by a sudden onset of pain syndrome and progressive restriction of the range of motion. While the histological changes of FS are accompanied by synovial inflammation and increasing capsular fibrosis, the underlying cause of FS is still unknown. The treatment options for FS are multifarious and include medication, local steroid injection, physiotherapy, hydrodistension, manipulation under anesthesia, arthroscopic and open capsular release. As the disease is usually self-limiting a...
Source: Der Unfallchirurg - Category: Orthopaedics Authors: Tags: Unfallchirurg Source Type: research
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