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Author: Ion Chesov Publisher: ISBN: Category : Languages : en Pages :
Book Description
Background and Goals of the StudyTransversus abdominis plane (TAP) block has been described as effective technique for pain management after abdominal surgery. So far, it is little known about quantitative sensory changes induces by TAP block.The goal of this study was to assess the quantitative sensory changes induced by TAP block in ventral hernia repair.Materials and MethodsThe Research Ethics Committee, Nicolae Tetsemitanu State University of Medicine and Pharmacy reviewed and approved the study protocol. Seventy (23 male, 47 female) consecutive adult (>18 years) patients, without cognitive impairment were enrolled in this study. Subjects (ASA 1-3) were scheduled for elective ventral hernia repair with general anesthesia (induction thiopental or propofol and opioids, maintained with endotracheal tube fentanyl and a mixture of air/O2/sevoflurane, NMBA u2013atracurium).Patients were randomly allocated to receive TAP block (case group u2013 35 subjects) or systemic analgesic drugs (control group - subjects) for postoperative pain treatment. Case group subjects received bilateral USG-guided TAP block with bupivacaine (1 mg/kg per each site). TAP block was performed after the induction of anesthesia before surgery. Control group subjects received morphine and AINS according to institutional pain management protocol.The end points:- preoperative qualitative sensory testing: pain threshold and tolerance; intensity of pain at 48u00b0 C at site of future incision;- postoperative (day 0, day 1) quantitative sensory testing: area and width of hyper- and hypoalgesia; presence of allodynia, hyperpathia, pain intensity at 48u00b0 C, abnormal sensitive sensations around the wound.- postoperative visual analogue scale (VAS) pain score (0, 3, 6, 12, 24 hours) during rest and movement.For comparison of parametric variable T-student test was used and for categorial variables X2 was was applied.ResultsData sets from all 70 subjects were included in final analysis. There was no differences in demographic characteristics and results of preoperative qualitative sensory testing.VAS score was lower in case vs control group:at rest 0h, 3h, 6h, 12h, 24h u2013 10.7 (95%CI, 5.6 - 15.8), 12.82 (95%CI, 8.8 - 16.8), 12.3 (95%CI, 8.3 - 16.3), 12.3 (95%CI, 8.45 - 16.2), 12.5 (95%CI, 8.5 u2013 16.5) vs 44.0 (95%CI, 35 -53), 41 (95%CI, 32 -50), 35 (95%CI, 28 - 42), 35.7 (95%CI, 29 u2013 42.5), 31 (95%CI, 23.7 u2013 39), p
Author: Ion Chesov Publisher: ISBN: Category : Languages : en Pages :
Book Description
Background and Goals of the StudyTransversus abdominis plane (TAP) block has been described as effective technique for pain management after abdominal surgery. So far, it is little known about quantitative sensory changes induces by TAP block.The goal of this study was to assess the quantitative sensory changes induced by TAP block in ventral hernia repair.Materials and MethodsThe Research Ethics Committee, Nicolae Tetsemitanu State University of Medicine and Pharmacy reviewed and approved the study protocol. Seventy (23 male, 47 female) consecutive adult (>18 years) patients, without cognitive impairment were enrolled in this study. Subjects (ASA 1-3) were scheduled for elective ventral hernia repair with general anesthesia (induction thiopental or propofol and opioids, maintained with endotracheal tube fentanyl and a mixture of air/O2/sevoflurane, NMBA u2013atracurium).Patients were randomly allocated to receive TAP block (case group u2013 35 subjects) or systemic analgesic drugs (control group - subjects) for postoperative pain treatment. Case group subjects received bilateral USG-guided TAP block with bupivacaine (1 mg/kg per each site). TAP block was performed after the induction of anesthesia before surgery. Control group subjects received morphine and AINS according to institutional pain management protocol.The end points:- preoperative qualitative sensory testing: pain threshold and tolerance; intensity of pain at 48u00b0 C at site of future incision;- postoperative (day 0, day 1) quantitative sensory testing: area and width of hyper- and hypoalgesia; presence of allodynia, hyperpathia, pain intensity at 48u00b0 C, abnormal sensitive sensations around the wound.- postoperative visual analogue scale (VAS) pain score (0, 3, 6, 12, 24 hours) during rest and movement.For comparison of parametric variable T-student test was used and for categorial variables X2 was was applied.ResultsData sets from all 70 subjects were included in final analysis. There was no differences in demographic characteristics and results of preoperative qualitative sensory testing.VAS score was lower in case vs control group:at rest 0h, 3h, 6h, 12h, 24h u2013 10.7 (95%CI, 5.6 - 15.8), 12.82 (95%CI, 8.8 - 16.8), 12.3 (95%CI, 8.3 - 16.3), 12.3 (95%CI, 8.45 - 16.2), 12.5 (95%CI, 8.5 u2013 16.5) vs 44.0 (95%CI, 35 -53), 41 (95%CI, 32 -50), 35 (95%CI, 28 - 42), 35.7 (95%CI, 29 u2013 42.5), 31 (95%CI, 23.7 u2013 39), p
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
Background: Transversus abdominis plane (TAP) block is a safe and effective analgesia technique for paediatric patients (1). This study is designed to compare the analgesic efficacy of different bupivacaine concentrations in paediatric patients undergoing ultrasound-guided TAP blocks for unilateral inguinal hernia repair surgery.Materials and Methods: Seventy-four patients aging between 1 and 8 years, undergoing unilateral inguinal hernia surgery, were enrolled for this study after obtaining Institutional Ethics Committee approval and written informed consents from parents or legal guardians (2016/1281). Group 1 (n:37) received 1 mg/kg bupivakain 0.25% and Group 2 (n: 37) received 1 mg/kg bupivakain 0.125% for ultrasound-guided TAP block following standard general anaesthesia induction (Figure 1). All patients received remifentanil 0,1 u03bcg/kg/h infusion and paracetamol 15 mg/kg intraoperatively, andparacetamol 4x15 mg/kg per day postoperatively. FLACC (Face, Legs, Activity, Cry, Consolability) behavioral pain assessment scale was used for evaluating patientsu2019 postoperative pain levels at 15-, 30-, 45-minute and 1-, 2-, 6-, 24-hour. Tramadol 1 mg/kg was administered intravenously as rescue analgesic when FLACC score was u22654. Total analgesic requirement, length of hospital stay and side effects were recorded.Results: Sixty-four patients, Group 1 (n:30) and Group 2 (n:34), completed the study. Demographic data were similar in both groups (p>0.05). FLACC pain scores at all time points (Figure 2), total analgesic requirement and length of hospital stay were all comparable in both groups (p>0.05). None of the patients reported FLACC score u22654 orasked for rescue analgesic after postoperative 6th hour. No perioperative and/or postoperative complication was observed.Conclusion: This study demonstrated that higher and lower concentrations of bupivacaine do not have any superiority over each other when the doses are kept equal in TAP blocks. TAP blocks are effective regional analgesic techniques for pediatric patients undergoing inguinal hernia repair surgery.References: Sahin L, Sahin M, Gul R et al. Ultrasoundguided transversus abdominis plane block in children: a randomised comparison with wound infiltration. Eur J Anaesthesiol 2013;30:409-14.
Author: Yuri W. Novitsky Publisher: Springer ISBN: 3319274708 Category : Medical Languages : en Pages : 527
Book Description
This textbook provides a state-of-the-art reference in the rapidly changing field of hernia surgery. With contributions by key opinion leaders in the field, this book describes the latest trends and detailed technical modifications for both routine and complex hernias. The reader will gain unique insights into robotic and laparoscopic repairs, anterior and posterior component separations, reconstructions in the setting of contamination, enterocutaneous fistulas and loss of abdominal domain. Important contributions from key reconstructive plastic surgeons detail modern trends on how to deal with complex skin and soft tissue challenges. The textbook provides unparalleled step-by-step instructions to perform both routine and complex repairs by incredible illustrations, intra-operative color photographs and a unique video collection of procedures performed by today’s top hernia surgeons. As a comprehensive and most up-to-date reference to modern treatment algorithms, trends in prosthetic science and technique selections, Hernia Surgery: Current Principles will be an invaluable resource to all residents and practicing general, plastic, and trauma surgeons to help them succeed in the field of Hernia surgery.
Author: Andrew N Kingsnorth Publisher: Springer Science & Business Media ISBN: 1848828772 Category : Medical Languages : en Pages : 412
Book Description
Hernia repair is one of the commonest operations in general surgery. Open or laparoscopic repair of a primary inguinal hernia is a relatively straightforward operation, but more complex abdominal wall hernias demand greater surgical skill and knowledge. The editors have assembled the world's top herniologists to describe and illustrate numerous surgical techniques in detail. The field of herniology has developed rapidly over the last few years. Since the previous edition of this book, published in 2003, new surgical techniques have been developed and many new prosthetic and biologic materials have been introduced. Management of Abdominal Hernias 4e presents an authoritative, comprehensive and fully updated account of the surgical techniques and the available prosthetic materials for performing repair of abdominal wall hernias. Both open and laparoscopic methods are included. It is aimed at general and specialist surgeons in the practice of clinical surgery, as well as trainee surgeons.
Author: Feliciano Crovella Publisher: Springer Science & Business Media ISBN: 8847007224 Category : Medical Languages : en Pages : 269
Book Description
Incisional hernia surgery has witnessed important advances over recent years, not only as far as the pathophysiological and etiopathogenetic aspects are concerned, but also from a technical point of view. This book provides an update on incisional hernia surgical techniques. It includes chapters on synthetic prostheses, biomaterials and robotics. Surgeons, surgical residents, and medical students will find the information in this volume very useful in their daily practice.
Author: Michael R. Anderson Publisher: Cambridge University Press ISBN: 1107093546 Category : Medical Languages : en Pages : 209
Book Description
In light of evolving techniques and strategies for increasingly complex orthopedic procedures, this accessible guide to patient management outlines the considerations involved in selecting the most suitable anesthetic for both common and complex clinical scenarios. Chapters cover a multitude of clinical presentations and procedures, ranging from orthopedic trauma to total joint replacement, outpatient hand procedures and regional anesthetic placement in patients with pre-existing conditions. Each chapter discusses and evaluates multiple approaches, accompanied by a review of the current literature. Abundant case scenarios of patients undergoing orthopedic surgical or regional anesthesia provide a handy framework for specialists and consultants, as well as an invaluable guide for trainees in anesthesia, regional anesthesia and emergency medicine.
Author: Ehab Farag Publisher: Cambridge University Press ISBN: 1107005310 Category : Medical Languages : en Pages : 477
Book Description
A comprehensive guide to anesthesia specifically for spine surgery, explaining procedures from the point of view of both anesthesiologists and surgeons.
Author: Honorio MD Benzon Publisher: Elsevier Health Sciences ISBN: 0323083404 Category : Medical Languages : en Pages : 1379
Book Description
Obtain all the core knowledge in pain management you need from one of the most trusted resources in the field. The new edition of Practical Management of Pain gives you completely updated, multidisciplinary overview of every aspect of pain medicine, including evaluation, diagnosis of pain syndromes, rationales for management, treatment modalities, and much more. In print and online, it is all the expert guidance necessary to offer your patients the best possible relief. "In summary, this is the best explanation of what lies behind MRI that I have read, taking what can be a dry subject and making it readily understandable and really interesting. I would recommend it to anyone starting their MRI training and anyone trying to teach MRI to others." Reviewed by RAD Magazine, June 2015 Understand and apply the latest developments in pain medicine with brand-new chapters covering disability assessment, central post-stroke pain, chronic widespread pain, and burn pain. Effectively ease your patients' pain with today's best management techniques, including joint injections, ultrasound-guided therapies, and new pharmacologic agents (such as topical analgesics). Access up-to-the-minute knowledge on all aspects of pain management, from general principles to specific management techniques, with contributions from renowned experts in the field. Read the full text and view all the images online at expertconsult.com. Understand and apply the latest developments in pain management with brand-new chapters covering disability assessment, central post-stroke pain, widespread chronic pain, and burn pain. Effectively ease your patients' pain with today's best management techniques, including joint injections, ultrasound-guided therapies, and new pharmacologic agents (such as topical analgesics).
Author: Ion Chesov
Author: Ion Chesov
Author: 
Author: Yuri W. Novitsky
Author: Mary Ellen McCann
Author: Raymond S. Sinatra
Author: Andrew N Kingsnorth
Author: Feliciano Crovella
Author: Michael R. Anderson
Author: Ehab Farag
Author: Honorio MD Benzon