Background: High-volume local infiltration analgesia (LIA) is widely used in total hip arthroplas... more Background: High-volume local infiltration analgesia (LIA) is widely used in total hip arthroplasty (THA) to reduce postoperative pain and opioid requirements. The efficacy of LIA in THA with different approaches to the joint remains unclear. Therefore, we examined whether intraoperative highvolume LIA in addition to a multimodal oral analgesic regimen, with direct anterior approach (DAA) for total hip arthroplasty (THA) under general anaesthesia, would further reduce acute postoperative pain and early opioid requirements consumption. Methods: In total 106 patients were recruited. Patients scheduled for unilateral, primary DAA THA under general anaesthesia were included in this randomized, double-blind, placebo-controlled trial receiving high-volume (150ml) wound infiltration with ropivacaine 0.2%, epinephrine (10μg/ mL) and Ketorolac (30mg) or 150ml saline 0.9% to evaluate the effect on early postoperative opioid consumption and on acute postoperative pain. The primary endpoint was opioid consumption 24hrs after surgery. The secondary endpoints were visual analogue pain-scale scores mobilized at 4hrs with full weight bearing and at rest at 1hr, 2hrs, 3hrs, 12hrs, 24hrs after surgery. The chronic analgesic consumption and surgical result at 6 weeks and 1 year after surgery were investigated. Results: Wound infiltration with LIA did reduce postoperative opioid requirements. The average pain level 4hrs postoperatively mobilized was less in the LIA group. The rehabilitation progress or chronic pain after 6 weeks and 1 year showed no difference between both groups. Conclusion: LIA was effective reducing opioid consumption and diminishing postoperative pain during mobilization using DAA THA under general anaesthesia.
Background Both Sweet’s syndrome (SS), also known as acute febrile neutrophilic dermatosis, and P... more Background Both Sweet’s syndrome (SS), also known as acute febrile neutrophilic dermatosis, and Pyoderma Gangrenosum (PG) are rare syndromes that have been associated with malignancy, autoimmune disease and collagen vascular disease. Especially their more uncommon bullous presentations are strongly associated with haematologic malignancies. We report a case of a neutrophilic bullous dermatosis in the emergency department as the initial presentation of an acute myeloid leukaemia.
Various methods of artificial respiration using manual chest compressions with or without movemen... more Various methods of artificial respiration using manual chest compressions with or without movement of the arms were first proposed by Leroy d'Etiolles in 1827 and introduced in the late 19th and early 20th centuries. External manual methods generating a forced expiration were preferred until Safar reintroduced mouth-to-mouth ventilation in 1958 [Baskett PJF. Resuscitation Great. Peter J Safar, The Early Years 1924-1961, The Birth of CPR. Resuscitation 2001;50:17-22]. This article focuses on one of the more elaborated mechanical devices: the 'pulmoventilateur' of Professor Charles Hederer [Hederer Ch. Dossier personnel CC7 4(e) MOD 2178 dossier 3 au CEHD, chateau de Vincennes, BP 153; Hederer Ch. La respiration artificielle. Bruxelles-Médical 1934:1362-9].
The early diagnosis of hollow viscous injury after blunt abdominal trauma remains a challenge for... more The early diagnosis of hollow viscous injury after blunt abdominal trauma remains a challenge for physicians in the Emergency Department, although the early diagnosis of hollow viscous injury decreases morbidity and mortality. After a description of two cases of hollow viscous injury after blunt abdominal trauma, a literature review is performed concerning the indications and limitations of diagnostic imaging modalities. Focused abdominal sonography for trauma, computed tomography scan and diagnostic peritoneal lavage are described. On the basis of the review a proposal for maximal diagnostic accuracy is made.
for reassurance about proceeding with an operation, and if it is forthcoming they are quite willi... more for reassurance about proceeding with an operation, and if it is forthcoming they are quite willing to carry out the planned surgery. Again, we want to thank Dr. Stemp for his interest in our study. We hope that he and other anesthesiologists are reassured by these data that adverse events after local anesthetic-induced seizures are infrequent.
Background: High-volume local infiltration analgesia (LIA) is widely used in total hip arthroplas... more Background: High-volume local infiltration analgesia (LIA) is widely used in total hip arthroplasty (THA) to reduce postoperative pain and opioid requirements. The efficacy of LIA in THA with different approaches to the joint remains unclear. Therefore, we examined whether intraoperative highvolume LIA in addition to a multimodal oral analgesic regimen, with direct anterior approach (DAA) for total hip arthroplasty (THA) under general anaesthesia, would further reduce acute postoperative pain and early opioid requirements consumption. Methods: In total 106 patients were recruited. Patients scheduled for unilateral, primary DAA THA under general anaesthesia were included in this randomized, double-blind, placebo-controlled trial receiving high-volume (150ml) wound infiltration with ropivacaine 0.2%, epinephrine (10μg/ mL) and Ketorolac (30mg) or 150ml saline 0.9% to evaluate the effect on early postoperative opioid consumption and on acute postoperative pain. The primary endpoint was opioid consumption 24hrs after surgery. The secondary endpoints were visual analogue pain-scale scores mobilized at 4hrs with full weight bearing and at rest at 1hr, 2hrs, 3hrs, 12hrs, 24hrs after surgery. The chronic analgesic consumption and surgical result at 6 weeks and 1 year after surgery were investigated. Results: Wound infiltration with LIA did reduce postoperative opioid requirements. The average pain level 4hrs postoperatively mobilized was less in the LIA group. The rehabilitation progress or chronic pain after 6 weeks and 1 year showed no difference between both groups. Conclusion: LIA was effective reducing opioid consumption and diminishing postoperative pain during mobilization using DAA THA under general anaesthesia.
Background Both Sweet’s syndrome (SS), also known as acute febrile neutrophilic dermatosis, and P... more Background Both Sweet’s syndrome (SS), also known as acute febrile neutrophilic dermatosis, and Pyoderma Gangrenosum (PG) are rare syndromes that have been associated with malignancy, autoimmune disease and collagen vascular disease. Especially their more uncommon bullous presentations are strongly associated with haematologic malignancies. We report a case of a neutrophilic bullous dermatosis in the emergency department as the initial presentation of an acute myeloid leukaemia.
Various methods of artificial respiration using manual chest compressions with or without movemen... more Various methods of artificial respiration using manual chest compressions with or without movement of the arms were first proposed by Leroy d'Etiolles in 1827 and introduced in the late 19th and early 20th centuries. External manual methods generating a forced expiration were preferred until Safar reintroduced mouth-to-mouth ventilation in 1958 [Baskett PJF. Resuscitation Great. Peter J Safar, The Early Years 1924-1961, The Birth of CPR. Resuscitation 2001;50:17-22]. This article focuses on one of the more elaborated mechanical devices: the 'pulmoventilateur' of Professor Charles Hederer [Hederer Ch. Dossier personnel CC7 4(e) MOD 2178 dossier 3 au CEHD, chateau de Vincennes, BP 153; Hederer Ch. La respiration artificielle. Bruxelles-Médical 1934:1362-9].
The early diagnosis of hollow viscous injury after blunt abdominal trauma remains a challenge for... more The early diagnosis of hollow viscous injury after blunt abdominal trauma remains a challenge for physicians in the Emergency Department, although the early diagnosis of hollow viscous injury decreases morbidity and mortality. After a description of two cases of hollow viscous injury after blunt abdominal trauma, a literature review is performed concerning the indications and limitations of diagnostic imaging modalities. Focused abdominal sonography for trauma, computed tomography scan and diagnostic peritoneal lavage are described. On the basis of the review a proposal for maximal diagnostic accuracy is made.
for reassurance about proceeding with an operation, and if it is forthcoming they are quite willi... more for reassurance about proceeding with an operation, and if it is forthcoming they are quite willing to carry out the planned surgery. Again, we want to thank Dr. Stemp for his interest in our study. We hope that he and other anesthesiologists are reassured by these data that adverse events after local anesthetic-induced seizures are infrequent.
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