Enhanced recovery pathways in orthopedic surgery

Kaye, Alan D.; Urman, Richard D.; Cornett, Elyse M.; Hart, Brendon M.; Chami, Azem A.; Gayle, Julie; Fox, Charles J.

doi:10.4103/joacp.joacp_35_18

Cited by 97 publications

(88 citation statements)

References 24 publications

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“…In our study, we observed that female gender was a risk factor for nausea. Many previous studies have shown that female gender is a risk factor for PONV (Apfel et al, 2012; Gan et al, 2020; Kaye et al, 2019; Soffin & YaDeau, 2016; Son & Yoon, 2018). The aforementioned large study of orthopaedic surgical patients also demonstrated that women were at higher risk of PONV (Chinachot & Sritanadon, 2015).…”

Section: Discussionmentioning

confidence: 99%

Postoperative Nausea and Vomiting After Orthopaedic Surgery

Ursavaş,

Baksi,

Sarıca

2023

Orthopaedic Nursing

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Postoperative nausea and vomiting (PONV) is a common complication after surgery and can lead to additional complications and delayed discharge. This descriptive, cross-sectional study assessed the prevalence of PONV and its associated factors in patients undergoing orthopaedic surgery. The study was conducted between November 2020 and July 2021 with 149 patients in a public hospital in the Central Anatolia region of Turkey. In the first 48 hours after surgery, 40.9% of the patients had nausea and 17.4% had vomiting. Gender, age, medical diagnosis, surgical procedure, operative time, postoperative opioid use, and anxiety were identified as significant risk factors for PONV after orthopaedic surgery (p < .05). These factors should be considered during postoperative follow-up, and patients who are older, female, and have prolonged operative time or anxiety should be monitored more closely for PONV.

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Section: Discussionmentioning

confidence: 99%

Postoperative Nausea and Vomiting After Orthopaedic Surgery

Ursavaş,

Baksi,

Sarıca

2023

Orthopaedic Nursing

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“…Perioperative regional analgesia with ultrasound-guided peripheral nerve blocks has been reported to improve patients' satisfaction with post-operative pain management and facilitate early rehabilitation [32,33]. Therefore, perineural analgesia is currently favoured for UEFS and post-operative pain management as part of the MMA regimen [18,20,21]. Multiple randomised controlled trials have consistently demonstrated that peripheral nerve block provides superior analgesia compared with general anaesthesia in the setting of upper extremity surgery [34].…”

Section: Discussionmentioning

confidence: 99%

“…Currently, multimodal analgesia (MMA), which aims to reduce opioid use, has been shown to provide satisfactory perioperative pain relief with an opioid-sparing effect [16][17][18][19]. Epidural analgesia, either continuous or patient controlled; peripheral nerve blocks, either single injection or continuous; acetaminophen; nonsteroidal anti-inflammatory drugs (NSAIDs); gabapentin and ketamine have all been used for this purpose [20]. Many studies have applied MMA in upper extremity trauma surgery and reported good outcomes [21,22], but few have included DS.…”

Section: Introductionmentioning

confidence: 99%

Multimodal Analgesia with Extended-Release Dinalbuphine Sebacate for Perioperative Pain Management in Upper Extremity Trauma Surgery: A Retrospective Comparative Study

Zheng

Yeh

et al. 2022

Pain Ther

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Introduction:Patients undergoing upper extremity fracture surgery (UEFS) commonly suffer from unbearable acute pain. Opioids remain the mainstay of moderate to severe pain alleviation, although there is a growing concern regarding the increasing trend in misuse and abuse. This study aimed to observe the safety and efficacy of dinalbuphine sebacate (DS), a novel extended-release analgesic, along with multimodal analgesia (MMA) for post-UEFS pain control.Methods: We retrospectively reviewed the records of patients undergoing UEFS between August 2020 and January 2021. Eligible patients were included and divided into two groups, depending on the analgesic regimen. In the DS group, 150 mg DS was administered intramuscularly at least 12 h pre-operatively, while in the conventional analgesia (CA) group, 40 mg parecoxib was given within 3 h before surgery. Intraoperative fentanyl administration was guided by the Analgesia Nociception Index System in both groups. For breakthrough pain, fentanyl was used as rescue medicine in the

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“…Because of the widespread use of neuraxial opioids in the childbirth setting, opioid-induced pruritus is most frequently observed among obstetric patients 16,[24][25][26] (table 1), where it has an incidence of up to 85%, 20 and is primarily dose-dependent. 22,23 Pruritus is also frequently reported among orthopedic patients receiving neuraxial opioids (30 to 70%) 37,38 for Enhanced Recovery after Surgery. The incidence of pruritus in patients receiving neuraxial morphine is more common among female patients (60 to 85%), 16,[24][25][26] which mirrors the incidence and burden of chronic pain that also disproportionately affects women.…”

Section: Epidemiology and Burden Of Opioid-induced Pruritusmentioning

confidence: 99%

Evaluation of Therapies for Peripheral and Neuraxial Opioid-induced Pruritus based on Molecular and Cellular Discoveries

2021

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Opioids are a mainstay of treatment for pain worldwide. Pruritus, a common side effect of opioids, is a patient dissatisfier that limits their use in many clinical settings. Both parenteral and neuraxial administration of opioids frequently evoke pruritus. The ability of opioids to suppress pain while causing itch continues to perplex clinicians and researchers alike. Several mechanisms have been proposed to explain how opioids can give rise to pruritus, but specific knowledge gaps perpetuate debate. This review summarizes the clinical burden of opioid-induced pruritus and emphasizes recent discoveries of peripheral and central mechanisms for opioid-induced pruritus, particularly with respect to scientific and conceptual advances in spinal cord circuitry and mast cell biology. The mechanisms and effectiveness of existing medications used for clinical management of pruritus will be evaluated, and we will highlight the emerging preclinical utility of selective κ-opioid receptor agonists, such as nalfurafine, for the management of opioid-induced pruritus.

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Enhanced recovery pathways in orthopedic surgery

Cited by 97 publications

References 24 publications

Postoperative Nausea and Vomiting After Orthopaedic Surgery

Postoperative Nausea and Vomiting After Orthopaedic Surgery

Multimodal Analgesia with Extended-Release Dinalbuphine Sebacate for Perioperative Pain Management in Upper Extremity Trauma Surgery: A Retrospective Comparative Study

Evaluation of Therapies for Peripheral and Neuraxial Opioid-induced Pruritus based on Molecular and Cellular Discoveries

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