The Effect of a New Multimodal Perioperative Anesthetic Regimen on Postoperative Pain, Side Effects, Rehabilitation, and Length of Hospital Stay After Total Joint Arthroplasty

2006 ◽  
Vol 21 (6) ◽  
pp. 132-138 ◽  
Author(s):  
Christopher L. Peters ◽  
Brayton Shirley ◽  
Jill Erickson
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Total Joint Arthroplasty ◽  
Length Of Hospital Stay ◽  
Joint Arthroplasty

Multi-Modal, Pre-Emptive Analgesia Decreases the Length of Hospital Stay Following Total Joint Arthroplasty

Orthopedics ◽  
2009 ◽  
Vol 32 (3) ◽  
pp. 1-5 ◽  
Author(s):  
Todd J. Duellman ◽  
Catherine Gaffigan ◽  
Joseph C. Milbrandt ◽  
D. Gordon Allan
Keyword(s):  
Hospital Stay ◽  
Total Joint Arthroplasty ◽  
Length Of Hospital Stay ◽  
Joint Arthroplasty

Electrolyte imbalance after total joint arthroplasty: risk factors and impact on length of hospital stay

2019 ◽  
Vol 29 (7) ◽  
pp. 1467-1472 ◽  
Author(s):  
Ravikumar Mukartihal ◽  
Harish G. Puranik ◽  
Sharan Shivaraj Patil ◽  
Soundar Rajan Dhanasekaran ◽  
Venugopal K. Menon
Keyword(s):  
Risk Factors ◽  
Hospital Stay ◽  
Total Joint Arthroplasty ◽  
Length Of Hospital Stay ◽  
Joint Arthroplasty ◽  
Electrolyte Imbalance

scholarly journals Tranexamic acid lowers transfusion requirements and hospital length of stay following revision total hip or knee arthroplasty

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Bishoy N. Saad ◽  
Luke G. Menken ◽  
Sherif Elkattaway ◽  
Frank A. Liporace ◽  
Richard S. Yoon
Keyword(s):  
Blood Loss ◽  
Tranexamic Acid ◽  
Hospital Stay ◽  
Knee Arthroplasty ◽  
Total Joint Arthroplasty ◽  
Length Of Hospital Stay ◽  
Joint Arthroplasty ◽  
Thromboembolic Complications ◽  
Revision Tha ◽  
Revision Tka

Abstract Backgroud Intravenous tranexamic acid (TXA) has been shown to reduce blood loss in patients undergoing total joint arthroplasty without systemic complications. There is limited evidence of its effectiveness in revision procedures. This study evaluated intravenous TXA effect on blood loss, transfusion rates, and length of hospital stay in revision joint replacement. Methods One-hundred revision total joint arthroplasty patients were retrospectively reviewed [44 revision total hip arthroplasty (THA) and 54 revision total knee arthroplasty (TKA)] who underwent surgery from 2013 to 2016. Fifty-four revision joint patients (23 THA and 31 TKA) received intravenous TXA intra-operatively, while 46 revision joint patients (23 THA/TKA) did not. Primary outcome measures were blood loss, transfusion rates, and length of hospital stay. Results The mean blood loss difference between revision THA patients who received TXA vs. not receiving TXA was 180ml in revision THA patients (p < .005). Mean length of hospital stay was 6 days in non-TXA vs. 3 days in TXA patients (p < .001). Eighteen patients received transfusions in the non-TXA revision TKA group compared to nine patients in the TXA revision TKA group (p < .001). Average length of hospital stay was 5 days in the non-TXA revision TKA group compared to 3 days in the TXA revision TKA group (p < .003). There was no increased risk of thromboembolic complications in TXA groups for either procedure. Conclusions Intravenous TXA reduced length of hospital stay in both revision cohorts, decreased blood loss in revision THA and decreased the rate of transfusion in revision TKA without an increase in thromboembolic complications. Level of Evidence Level III (Case-control study)

scholarly journals Is tranexamic acid effective and safe for patients undergoing revision total hip and knee arthroplasty: a meta-analysisIs

2019 ◽  
Author(s):  
Qian Wu ◽  
Jiang nan Xu ◽  
Lu jie Zong ◽  
Sheng hao Wang ◽  
Wu Xu ◽  
...  
Keyword(s):  
Tranexamic Acid ◽  
Hospital Stay ◽  
Total Joint Arthroplasty ◽  
Meta Analysis ◽  
Length Of Hospital Stay ◽  
Revision Total Knee Arthroplasty ◽  
Joint Arthroplasty ◽  
Secondary Outcome ◽  
Thromboembolic Complications ◽  
Total Knee

Abstract Background: The use of tranexamic acid (TXA) during primary total joint arthroplasty （pTJA） is well documented. However, whether TXA is safe for patients undergoing revision total joint arthroplasty (rTJA) remains to be resolved. Methods: This meta-analysis included 12 studies that involved 2195 cases. The primary outcomes were indicators of TXA effectiveness during perioperative perid, including blood loss, haemoglobin (Hb) level changes, allogeneic blood transfusion (ABT) rate, and number of red blood cell (RBC) units transfused per patient. The secondary outcomes included thromboembolic complications, non-thromboembolic complications, and length of hospital stay. Results: TXA administration was associated with statistically significant decreases in the primary outcomes, including ABT rate (odds ratio [OR], 0.24; 95% confidence interval [CI], 0.14–0.41; P < 0.00001), change in Hb level (mean difference [MD], −0.84; 95% CI, −1.28 to −0.41; P=0.002), and number of RBC units transfused per patient (MD, −0.49; 95% CI, −0.61 to −0.38; P < 0.00001) in the patients undergoing rTJA. Secondary outcome assessments showed no statistically significant differences in venous thromboembolism (OR, 0.99; 95% CI, 0.31–3.14; P=0.98) and non-thromboembolic complications (OR, 0.54; 95% CI, 0.18–1.68; P=0.29) between the patients who received and those who did not receive TXA in the revision total knee arthroplasty subgroup, while a significant decrease in length of hospital stay was found in those who received TXA (MD, −2.89; 95% CI, −4.85 to −0.93; P=0.004). Conclusion: In this meta-analysis, we found that the use of TXA acid can effectively reduce the number of blood transfusions in patients undergoing TJA without increasing the complication rate.

scholarly journals Combination Therapy with Continuous Three-in-One Femoral Nerve Block and Periarticular Multimodal Drug Infiltration after Total Hip Arthroplasty

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tomonori Tetsunaga ◽  
Tomoko Tetsunaga ◽  
Kazuo Fujiwara ◽  
Hirosuke Endo ◽  
Toshifumi Ozaki
Keyword(s):  
Side Effects ◽  
Pain Relief ◽  
Total Hip Arthroplasty ◽  
Combination Therapy ◽  
Hospital Stay ◽  
Nerve Block ◽  
Hip Arthroplasty ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
Length Of Hospital Stay

Background. Various postoperative pain relief modalities, including continuous femoral nerve block (CFNB), local infiltration analgesia (LIA), and combination therapy, have been reported for total knee arthroplasty. However, no studies have compared CFNB with LIA for total hip arthroplasty (THA). The aim of this study was to compare the efficacy of CFNB versus LIA after THA. Methods. We retrospectively reviewed the postoperative outcomes of 93 THA patients (20 men, 73 women; mean age 69.2 years). Patients were divided into three groups according to postoperative analgesic technique: CFNB, LIA, or combined CFNB+LIA. We measured the following postoperative outcome parameters: visual analog scale (VAS) for pain at rest, supplemental analgesia, side effects, mobilization, length of hospital stay, and Harris Hip Score (HHS). Results. The CFNB+LIA group had significantly lower VAS pain scores than the CFNB and LIA groups on postoperative day 1. There were no significant differences among the three groups in use of supplemental analgesia, side effects, mobilization, length of hospital stay, or HHS at 3 months after THA. Conclusions. Although there were no clinically significant differences in outcomes among the three groups, combination therapy with CFNB and LIA provided better pain relief after THA than CFNB or LIA alone, with few side effects.

scholarly journals Tolvaptan in the Management of Acute Euvolemic Hyponatremia After Transsphenoidal Surgery: A Retrospective Single-Center Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Rita Indirli ◽  
Júlia Ferreira de Carvalho ◽  
Arianna Cremaschi ◽  
Beatrice Mantovani ◽  
Elisa Sala ◽  
...  
Keyword(s):  
Side Effects ◽  
Hospital Stay ◽  
Hypertonic Saline ◽  
Transsphenoidal Surgery ◽  
Length Of Hospital Stay ◽  
Treatment Modalities ◽  
Fluid Restriction ◽  
Close Monitoring ◽  
Osmotic Demyelination ◽  
Sodium Correction

IntroductionSyndrome of inappropriate antidiuresis (SIAD) can be a complication of hypothalamus-pituitary surgery. The use of tolvaptan in this setting is not well established, hence the primary aim of this study was to assess the sodium correction rates attained with tolvaptan compared with standard treatments (fluid restriction and/or hypertonic saline). Furthermore, we compared the length of hospital stay in the two treatment groups and investigated the occurrence of overcorrection and side effects including osmotic demyelination syndrome.MethodsWe retrospectively reviewed 308 transsphenoidal surgical procedures performed between 2011 and 2019 at our hospital. We selected adult patients who developed post-operative SIAD and recorded sodium monitoring, treatment modalities and outcomes. Correction rates were adjusted based on pre-treatment sodium levels.ResultsTwenty-nine patients (9.4%) developed post-operative SIAD. Tolvaptan was administered to 14 patients (median dose 15 mg). Standard treatments were employed in 14 subjects (fluid restriction n=11, hypertonic saline n=1, fluid restriction and hypertonic saline n=2). Tolvaptan yielded higher adjusted sodium correction rates (12.0 mmolL-1/24h and 13.4 mmolL-1/48h) than standard treatments (1.8 mmolL-1/24h, p&lt;0.001, and 4.5 mmolL-1/48h, p=0.004, vs. tolvaptan). The correction rate exceeded 10 mmolL-1/24h or 18 mmolL-1/48h in 9/14 and 2/14 patients treated with tolvaptan, respectively, and in no patient who received standard treatments. No side effects including osmotic demyelination occurred. Tolvaptan was associated with a shorter hospital stay (11vs.15 days, p=0.01).ConclusionsTolvaptan is more effective than fluid restriction (with or without hypertonic saline) and allows for a shortened hospital stay in patients with SIAD after transsphenoidal surgery. However, its dose and duration should be carefully tailored, and close monitoring is recommended to allow prompt detection of overcorrection.

Nalbuphine on postoperative gastrointestinal tract dysfunction after laparoscopic surgery for gynecological malignancies: a randomized controlled trial

2019 ◽  
Author(s):  
Jiawei Chen ◽  
Lin Tian ◽  
Le Zhang ◽  
Jianying Hu ◽  
Shaoqiang Huang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
Postoperative Nausea ◽  
Serum Gastrin ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
First Passage ◽  
Gynecological Malignancies ◽  
To Receive

Abstract Background The aim of this study was to compare the effects of nalbuphine and sufentanil on the gastrointestinal (GI) tract after laparoscopic surgery for gynecological malignancies. Methods A total of 100 patients aged between 18-70 years with American Society of Anesthesiologists (ASA) physical status I-II who scheduled for laparoscopic radical hysterectomy under general anaesthesia were enrolled. Patients were randomized to receive either sufentanil (Group S) or nalbuphine (Group N) to receive either sufentanil (Group S) or nalbuphine (Group N) in the intraoperative and postoperative periods. The time to the first passage of flatus, the time to the first defecation, the time to the toleration of diet, the serum gastrin and the length of hospital stay were compared between the groups. Postoperative pain by visual analogue scale (VAS), the number of PCA(patient-controlled analgesia)s, postoperative nausea and vomiting, and dizziness were compared between the groups. Results The time to the first passage of flatus(p =0.551), the time to the first defecation(p =0.310), the time to the toleration of diet(p =0.182), the serum gastrin(p =0.397), the number of postoperative nausea(p =0.920), vomit(p =0.334) and PCA events(p =0.167) and the length of hospital stay(p =0.482) were not significantly different between the two groups. VAS scores at postoperative 6 h(p=0.008), 12 h(p =0.002) and 24 h(p =0.013) were lower in Group N than in Group S. Conclusions Compared with sufentanil, nalbuphine was not associated with improved postoperative GI dysfunction after laparoscopic surgery for gynecological malignancies, but it was associated with reduced postoperative pain.

Pharmacogenomic Testing for Postoperative Pain Optimization Before Total Joint Arthroplasty

JBJS Reviews ◽  
2019 ◽  
Vol 7 (5) ◽  
pp. e2-e2
Author(s):  
Mohamed E. Awad ◽  
Muhammad Talha Padela ◽  
Zain Sayeed ◽  
Mouhanad M. El-Othmani ◽  
Mark Zekaj ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Total Joint Arthroplasty ◽  
Joint Arthroplasty
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