Use of Intraoperative Analgesic and Anesthetic Substances by Intramuscular Infiltrations during Hip Surgery for Postoperative Pain Monitoring

Abstract

The authors present their intraoperative and postoperative experience in using intramuscular infiltrations with analgesic and anesthetic substances as pain control methods in patients that undergo hip surgery: arthroplasty or hemiarthroplasty. A total of 30 patients that have undergone either an elective total hip arthroplasty surgery or hemiarthroplasty of the hip following a hip fracture, since May 2018 until August 2018. The patients were divided in two equal groups, one group that followed through the protocol and one control group. The intramuscular infiltrations were administered intraoperatively at the timeline of the muscle suture and contained: Bupivacaine 10 mL + Morphine 1 mL + Methylprednisolone 40mg. Postoperative protocol used the visual analogue scale (VAS) pain scores on days 1, 2, 3, 4, 5, 6 and 7 for measuring the postoperative pain control. Intraoperative intramuscular infiltrations, with an analgesic and anesthetic cocktail consisting of Bupivacaine, Morphine and Methylprednisolone, for patients that are going through hip surgery are safe to use with very good results in terms of postoperative pain control. We reduced the consumption of opioids and analgesic drugs, which indirectly leads to decreased direct cost per patient. Another important benefit was an early active mobilization of the patient, with shorter hospitalization time. All things considered, using regional anesthesia and multimodal pain management techniques may lead to a nearly painless hip surgery.

Mathematical Model for Reducing the Concentration of a Chemical Substance Applicable in the Procedures of Plasmatic Treatment

“…This calculation corresponds to the literature data [15][16][17], alleging that the use of a replacement volume equal to the plasma volume achieves a 63% purging (table 2).…”

“…Thus, in the central container we have 10% of 3000 mL, the equivalent of 300 g. Eliminating 100 mL of 10%, the equivalent of 10 g and adding 100 mL 0%, in the container we will have 290 g that represent a concentration of 9.66%. Continuing this pattern until the end of the procedure, we will have 30 steps that we import from an Excel table where we apply the following mathematical regression function [8][9][10][11][12][13][14].…”

The Utility of Different Types of Implants in Repairing Knee Joint Posttraumatic Lesions

“…The mesenchymal stem cells derived from bone marrow are flushed into the cartilage defect by the scaffold, while their differentiation into chondrocytic cells is supported by the hyaluronic acid. In the ovine model, the combination of an absorbable textile scaffold and hyaluronan has been shown to accelerate and improve repair with cartilage matrix rich in type II collagen, compared to microfracture alone [32][33][34][35][36].…”

New Evidence Supporting Joint Preservation Procedures of the Hip A confocal microscopy study of the femoral head

“…We encourage further research in the direction of joint preserving procedures for the hip in carefully selected patients, as confocal microscopy proves healthy contact surface on more than half of the femoral head [13][14][15].…”