Postoperative pain relief and functional outcome following total knee arthroplasty – a prospective comparative audit of three analgesic regimes / Aysha Rajeev in Acta Orthopaedica Belgica, Vol.82/2 (June 2016)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 265-270 Titre : Postoperative pain relief and functional outcome following total knee arthroplasty – a prospective comparative audit of three analgesic regimes Type de document : texte imprimé Auteurs : Aysha Rajeev ; Nezar Tumia ; Kaushlendra Karn ; [et al...] Année de publication : 2016 Article en page(s) : p. 265-270 Langues : Anglais (eng) Mots-clés : prothèse totale de genou  chirurgie  douleur Résumé : Pain control plays a key role in joint-replacement surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0.25% levobupivacaine + 10 ml 0.25%bupivacaine + adrenaline + 30 ml saline. Group 2 (n = 39) received a bolus injection as on group 1 with 240 ml 0.25% bupivacaine infusion and 5 ml/hour using a Pain Buster pump. Group 3 (n = 48) received 30 ml 0.125% levobupivacaine to femoral (3- in-1) block with 30 ml 0.25% levobupivacaine to sciatic nerve and introduction of a femoral nerve catheter. All patients were prescribed paracetamol 1 g QDS, Oxycontin 20 mg BD and Ibuprofen post operatively. Pain was assessed with a Visual Analog Scale (VAS). The incidence of PONV was measured by PONY intensity score. The mean post-op VAS score for Group 3 was 4. The demand of oxynorm and NSAID were minimal in Group 3. The mean in patient stay for Group 3 was 3.1 days. The PONV intensity score was > 50 for 9 (36%) in Group 1, 15 (40%) in Group 2 and 9 (20%) in Group 3. There was loss of 20-30 degrees of flexion movements in Group 3 in the first 4 to 6 days post-op. Our study demonstrated that Regime 3 with the use of nerve blocks and femoral nerve catheter has given the maximum pain relief and good functional outcome following total knee replacement. Permalink : ./index.php?lvl=notice_display&id=46092 [article] Postoperative pain relief and functional outcome following total knee arthroplasty – a prospective comparative audit of three analgesic regimes [texte imprimé] / Aysha Rajeev ; Nezar Tumia ; Kaushlendra Karn ; [et al...] . - 2016 . - p. 265-270. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol.82/2 (June 2016) . - p. 265-270 Mots-clés : prothèse totale de genou  chirurgie  douleur Résumé : Pain control plays a key role in joint-replacement surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0.25% levobupivacaine + 10 ml 0.25%bupivacaine + adrenaline + 30 ml saline. Group 2 (n = 39) received a bolus injection as on group 1 with 240 ml 0.25% bupivacaine infusion and 5 ml/hour using a Pain Buster pump. Group 3 (n = 48) received 30 ml 0.125% levobupivacaine to femoral (3- in-1) block with 30 ml 0.25% levobupivacaine to sciatic nerve and introduction of a femoral nerve catheter. All patients were prescribed paracetamol 1 g QDS, Oxycontin 20 mg BD and Ibuprofen post operatively. Pain was assessed with a Visual Analog Scale (VAS). The incidence of PONV was measured by PONY intensity score. The mean post-op VAS score for Group 3 was 4. The demand of oxynorm and NSAID were minimal in Group 3. The mean in patient stay for Group 3 was 3.1 days. The PONV intensity score was > 50 for 9 (36%) in Group 1, 15 (40%) in Group 2 and 9 (20%) in Group 3. There was loss of 20-30 degrees of flexion movements in Group 3 in the first 4 to 6 days post-op. Our study demonstrated that Regime 3 with the use of nerve blocks and femoral nerve catheter has given the maximum pain relief and good functional outcome following total knee replacement. Permalink : ./index.php?lvl=notice_display&id=46092

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The role of edmonton frailty scale and asa grade in the assessment of morbidity and mortality after fracture neck of femur in elderly / Aysha Rajeev in Acta Orthopaedica Belgica, Vol. 85/3 (Septembre 2019)

Public ISBD [article]  inActa Orthopaedica Belgica > Vol. 85/3 (Septembre 2019) . - p. 346-351 Titre : The role of edmonton frailty scale and asa grade in the assessment of morbidity and mortality after fracture neck of femur in elderly Type de document : texte imprimé Auteurs : Aysha Rajeev Année de publication : 2019 Article en page(s) : p. 346-351 Langues : Anglais (eng) Mots-clés : Indice de fragilité  Score ASA  Morbidité  Mortalité  Fractures du col fémoral  Sujet âgé Résumé : Frailty is a complex syndrome which affects the energy, physical ability, cognition and general health. Hip fractures are associated with causes and consequences of frailty such as osteoporosis, frequent falls, low body mass index, multiple medications and cognitive impairment. The aim of our study is to assess the value of ASA grade and Edmonton frailty score in the outcome of treatment of fracture neck of femurs in elderly patients. 192 patients admitted with fracture neck of femur were included in the study. The mean age was 79.23 years .120 patients had ASA grade 3, 56 patients had ASA grade 2 and 16 patients had ASA grade 1.The frailty index was calculated using Edmonton scoring index. Ninety four patients (49%) had low frailty score and 88 patients (51%) had a high frailty score of more than 10.All patients were followed up 4 weeks and one year after the surgery. In conclusion the patients with frailty scores and ASA grade have got more chance of developing wound infection. They also have got higher incidence of mortality and morbidity following fracture neck of femur. Permalink : ./index.php?lvl=notice_display&id=92213 [article] The role of edmonton frailty scale and asa grade in the assessment of morbidity and mortality after fracture neck of femur in elderly [texte imprimé] / Aysha Rajeev . - 2019 . - p. 346-351. Langues : Anglais (eng) in Acta Orthopaedica Belgica > Vol. 85/3 (Septembre 2019) . - p. 346-351 Mots-clés : Indice de fragilité  Score ASA  Morbidité  Mortalité  Fractures du col fémoral  Sujet âgé Résumé : Frailty is a complex syndrome which affects the energy, physical ability, cognition and general health. Hip fractures are associated with causes and consequences of frailty such as osteoporosis, frequent falls, low body mass index, multiple medications and cognitive impairment. The aim of our study is to assess the value of ASA grade and Edmonton frailty score in the outcome of treatment of fracture neck of femurs in elderly patients. 192 patients admitted with fracture neck of femur were included in the study. The mean age was 79.23 years .120 patients had ASA grade 3, 56 patients had ASA grade 2 and 16 patients had ASA grade 1.The frailty index was calculated using Edmonton scoring index. Ninety four patients (49%) had low frailty score and 88 patients (51%) had a high frailty score of more than 10.All patients were followed up 4 weeks and one year after the surgery. In conclusion the patients with frailty scores and ASA grade have got more chance of developing wound infection. They also have got higher incidence of mortality and morbidity following fracture neck of femur. Permalink : ./index.php?lvl=notice_display&id=92213

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