No abstract

Increasing pain levels after the first week postoperatively, for 3 days, are most likely to be caused by the change to more extensive mobilization and physiotherapy in the rehabilitation unit. No significant influence or correlation on the intensity of postoperative pain could be found while evaluating potential predictors except preoperative pain levels. Pain management has to take these findings into account in the future to further increase patients' satisfaction in the postoperative course after total hip arthroplasty and to adapt pain management programs.

Automode ventilator weaning trended toward more rapid extubation than did conventional protocol-driven ventilation in conjunction with a standardized weaning protocol. Physiologic and hemodynamic factors were better in patients using automode ventilation compared to patients using conventional ventilation. Automode ventilation was well tolerated and did not induce significant adverse effects.

To evaluate the potential of centrifugal blood pumps for saving blood, 120 patients scheduled for elective coronary artery bypass grafting were entered into a prospective randomized trial. A standard roller pump (group I) was compared with a centrifugal blood pump (group II) and roller pump plus aprotinin (group III). There was no significant difference between groups I and II with respect to free haemoglobin, lactic dehydrogenase, serum bilirubin, platelet surface glycoprotein IIb-IIIa and granule membrane protein 140, chest-tube drainage, use of blood products, length of stay in intensive care, time on ventilator and postoperative mortality. Aprotinin reduced chest-tube drainage and use of blood products significantly. Three cases of graft occlusions were noted in group III. Centrifugal blood pumps offer no advantage in routine heart surgery over conventional roller pumps. Aprotinin reduces blood loss, but does not influence GP IIb-IIIa and GMP 140 expression on blood platelets.

Equalization of biomechanical differences is a major goal in total hip arthroplasty (THA). In the current study we compared the accuracy of restoring leg length and offset using imageless navigation with an osseous fixed pin to a femoral pinless device in 97 minimally invasive THAs through an anterolateral approach in the lateral decubitus position. Leg length and offset differences were evaluated on magnification-corrected radiographs by a blinded observer. A postoperative mean difference of -0.9 mm (95% CI -2.8 mm to 1.1 mm, p = 0.38) between pinless navigation and navigation with a fixed pin was observed for leg length and that of -2.4 mm (95% CI -3.9 mm to -0.9 mm, p = 0.002) was observed for offset, respectively. The number of patients with a residual difference below 5 mm after THA was higher if using a fixed pin than in pinless navigation for both leg length (98.2%, 54/55 to 50.0%, 21/42, p < 0.001) and offset (100.0%, 55/55 to 71.4%, 30/42, p < 0.001). Imageless navigation is a feasible method in intraoperative control of leg length and offset in minimally invasive THA. The use of pins fixed to the bone has a higher precision than pinless devices. This trial is registered with DRKS00000739.