scholarly journals Personalized rehabilitation therapy in obese and elderly patients undergoing hip replacement surgery

2019 ◽  
Vol 13 (3) ◽  
pp. 193-200
Author(s):  
Michał Skalski ◽  
Milena Socha-Kania ◽  
Maria Kozioł-Montewka ◽  
Anna Pańczuk
Keyword(s):  
Elderly Patients ◽  
Hip Replacement ◽  
Rehabilitation Therapy ◽  
Replacement Surgery ◽  
Hip Replacement Surgery

scholarly journals Different Concentrations of Ropivacaine under Ultrasound Guidance on Quadratus Lumbar Muscle Nerve Block in Elderly Patients with Hip Replacement

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Yi Han ◽  
Xiaoyuan Chen ◽  
Panpan Mi ◽  
Yunzhao Ji ◽  
Xiangan Meng ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Hip Replacement ◽  
Motor Block ◽  
Ultrasound Guidance ◽  
Control Group ◽  
Observation Group ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Lumbar Muscle ◽  
Muscle Nerve

Objective. To compare the effect of ropivacaine in different concentrations under ultrasound guidance on lumbar muscle nerve blocking in elderly patients undergoing hip replacement surgery. Methods. 60 elderly patients underwent hip replacement in our hospital over a period of April to December of 2019 were equally randomized into control and observation groups, with 30 each. Patients in the control group and observation group received 0.5% and 0.25% ropivacaine to block psoas muscle nerve, respectively. The anesthetic effect of ropivacaine at different concentrations was evaluated by time of sensory block onset and recovery and time of motor block onset and regression, blood pressure, heart rate, visual analogy scale, and postoperative nerve blocking degree. Results. The onset time of sensory and motor block in the observation group was dramatically higher than that in the control group ( P < 0.05 ), while the recovery time of sensory and motor was significantly shorter than that of the control group ( P < 0.05 ). The heart rate in the observation group was notably lower than that in the control group, while the average blood pressure was remarkably higher ( P < 0.05 ). After surgery, the degree of nerve block in the observation group was much lower compared with the control group ( P < 0.05 ), while no marked difference in the visual analogue scale in the control group before and after surgical intervention was observed ( P > 0.05 ). Conclusion. The 0.25% ropivacaine method has distinctive advantages over 0.50% ropivacaine psoas nerve anesthesia in hip replacement surgery in elderly patients.

scholarly journals The effects of competition and bundled payment on patient reported outcome measures after hip replacement surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fanny Goude ◽  
Sverre A. C. Kittelsen ◽  
Henrik Malchau ◽  
Maziar Mohaddes ◽  
Clas Rehnberg
Keyword(s):  
Hip Replacement ◽  
Health Gain ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Economic Incentives ◽  
Bundled Payment ◽  
Treatment Groups ◽  
Replacement Surgery ◽  
Hip Replacement Surgery ◽  
Patient Reported

Abstract Background Competition-promoting reforms and economic incentives are increasingly being introduced worldwide to improve the performance of healthcare delivery. This study considers such a reform which was initiated in 2009 for elective hip replacement surgery in Stockholm, Sweden. The reform involved patient choice of provider, free establishment of new providers and a bundled payment model. The study aimed to examine its effects on hip replacement surgery quality as captured by patient reported outcome measures (PROMs) of health gain (as indicated by the EQ-5D index and a visual analogue scale (VAS)), pain reduction (VAS) and patient satisfaction (VAS) one and six years after the surgery. Methods Using patient-level data collected from multiple national registers, we applied a quasi-experimental research design. Data were collected for elective primary total hip replacements that were carried out between 2008 and 2012, and contain information on patient demography, the surgery and PROMs at baseline and at one- and six-years follow-up. In total, 36,627 observations were included in the analysis. First, entropy balancing was applied in order to reduce differences in observable characteristics between treatment groups. Second, difference-in-difference analyses were conducted to eliminate unobserved time-invariant differences between treatment groups and to estimate the causal treatment effects. Results The entropy balancing was successful in creating balance in all covariates between treatment groups. No significant effects of the reform were found on any of the included PROMs at one- and six-years follow-up. The sensitivity analyses showed that the results were robust. Conclusions Competition and bundled payment had no effects on the quality of hip replacement surgery as captured by post-surgery PROMs of health gain, pain reduction and patient satisfaction. The study provides important insights to the limited knowledge on the effects of competition and economic incentives on PROMs.

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