Ketamina / Ketamine

Abril 8 2017. No. 2653

Ketamina perioperatoria para dolor post toracotomía Perioperative Ketamine Administration for Thoracotomy Pain. Moyse DW1, Kaye AD, Diaz JH2, Qadri MY1, Lindsay D1, Pyati S3. Pain Physician. 2017 Mar;20(3):173-184. Abstract BACKGROUND: Of all the postsurgical pain conditions, thoracotomy pain poses a particular therapeutic challenge in terms of its prevalence, severity, and ensuing postoperative morbidity. Multiple pain generators contribute to the severity of post-thoracotomy pain, and therefore a multimodal analgesic therapy is considered to be a necessary strategy. Along with opioids, thoracic epidural analgesia, and paravertebral blocks, N-Methyl-D-Aspartate (NMDA) receptor antagonists such as ketamine have been used as adjuvants to improve analgesia. OBJECTIVE: We reviewed the evidence for the efficacy of intravenous and epidural administration of ketamine in acute post-thoracotomy pain management, and its effectiveness in reducing chronic post-thoracotomy pain. STUDY DESIGN: Systematic literature review and an analytic study of a data subset were performed. METHODS: We searched PubMed, Embase, and Cochrane reviews using the key terms "ketamine," "neuropathic pain," "postoperative," and "post-thoracotomy pain syndrome." The search was limited to human trials and included all studies published before January 2015. Data from animal studies, abstracts, and letters were excluded. All studies not available in the English language were excluded. The manuscript bibliographies were reviewed for additional related articles. We included randomized controlled trials and retrospective studies, while excluding individual case reports. RESULTS: This systematic literature search yielded 15 randomized control trials evaluating the efficacy of ketamine in the treatment of acute post-thoracotomy pain; fewer studies assessed its effect on attenuating chronic post-thoracotomy pain. The majority of reviewed studies demonstrated that ketamine has efficacy in reduction of acute pain, but the evidence is limited on the long-term benefits of ketamine to prevent post-thoracotomy pain syndrome, regardless of the route of administration. A nested analytical study found there is a statistically significant reduction in acute post-thoracotomy pain with IV or epidural ketamine. However currently, the evidence for a role of ketamine as a preventative agent for chronic post-thoracotomy pain is insufficient due to the heterogeneity of the studies reviewed with regard to the route of administration, dosage, and outcome measures. LIMITATIONS: The evidence for a role of ketamine as a preventative agent for chronic post-thoracotomy pain is insufficient due to the heterogeneity of the studies reviewed. CONCLUSION: The majority of randomized controlled trials reviewed show no role for ketamine in attenuating or preventing post-thoracotomy pain syndrome at variable follow-up lengths. Therefore, additional research is warranted with consideration of risk factors and long-term follow-up for chronic post-thoracotomy pain though the evidence for benefit appears clear for acute post-thoracotomy pain.Key words: Ketamine, postoperative, thoracotomy pain, post thoracotomy pain syndrome, neuropathic pain. PDF Curso sobre Anestesia en Trasplantes, Cirugía abdominal, Plástica, Oftalmología y Otorrinolaringología. Committee for European Education in Anaesthesiology (CEEA)  y el Colegio de Anestesiólogos de León A.C. Abril 7-9, 2017, León Guanajuato, México Informes  (477) 716 06 16, kikinhedz@gmail.com Vacante para Anestesiología Pediátrica El Hospital de Especialidades Pediátricas de León, Guanajuato México  ofrece un contrato laboral en el departamento de anestesiología  Informes con la Dra Angélica García Álvarez  angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Anestésicos y anti-inflamación / Anti-inflammatory properties of anesthetic

Abril 9, 2017. No. 2654

Propiedades anti-inflamatorias de los anestésicos Anti-inflammatory properties of anesthetic agents Fernanda Ferreira Cruz1 , Patricia Rieken Macedo Rocco1 and Paolo Pelosi Cruz et al. Critical Care (2017) 21:67 For more than a century, experimental and clinical studies have reported that anesthetic agents have diverse effects on the immune system. Despite rapid development in the fields of immunology and anesthesiology in recent decades, the specific mechanisms by which each anesthetic drug affects the immune system remain unclear. Here, we will define innate and adaptive immunity, present factors that can lead to immune dysregulation during the perioperative period, describe the effects of some of the most common anesthetic drugs on immune cells and cytokines, and discuss the possible clinical implications of the use of these drugs  PDF Vacante para Anestesiología Pediátrica El Hospital de Especialidades Pediátricas de León, Guanajuato México  ofrece un contrato laboral en el departamento de anestesiología  Informes con la Dra Angélica García Álvarez  angy.coachanestped@gmail.com o al teléfono 477 101 8700 Ext 1028

Anestesiología y Medicina del Dolor 52 664 6848905 vwhizar@anestesia-dolor.org anestesia-dolor.org

Imagen postoperatoria en cirugía artroscópica de cadera

http://www.clinicadeartroscopia.com.mx/academia/imagen-postoperatoria-en-cirugia-artroscopica-de-cadera/

Postoperative imaging in arthroscopic hip surgery

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28210944

https://link.springer.com/article/10.1007%2Fs12306-017-0459-y

De:

Di Pietto F1,2,Chianca V3,de Ritis R4,Cesarano E5,Reginelli A6,Barile A7,

Zappia M8,Ginolfi L3.

Musculoskelet Surg.

2017 Mar;101(Suppl 1):43-49. doi: 10.1007/s12306-017-0459-y. Epub 2017 Feb 16.

Todos los derechos reservados para:

Copyright information

© Istituto Ortopedico Rizzoli 2017

Abstract

Arthroscopic surgery of the hip, compared to that of the knee or the shoulder, has only recently been developed in any significant way. Current indications for arthroscopic surgery of the hip include: diagnosis and treatment of lesions symptomatic of the acetabular labrum, femoroacetabular impingement (FAI), chondral lesions, joint infections, lesions of the teres ligament, impingement of the psoas tendon, pathology of the peritrochanteric space, external snapping hip (coxa saltans), and traumatic and atraumatic instability. Principal indications for imaging of the hip with arthroscopic techniques are represented by persistent groin pain which may be caused by inadequate recognition or treatment of bone alteration of FAI, fractures in the site of resectioned bones, intra-articular adhesion, development of cartilaginous lesions, iatrogenic chondral lesions, recurrent lesions of the fibrocartilaginous acetabular labrum and heterotopic ossification. Postoperative checkup examinations can be undertaken with conventional radiography. The appearance or persistence of groin pain may be investigated using MRI, arthro-MRI and even CT scans.

KEYWORDS:

Arthro-MRI; Femoroacetabular impingement; Hip arthroscopy; Osteochondroplasty

Resumen

La cirugía artroscópica de la cadera, comparada con la de la rodilla o el hombro, sólo se ha desarrollado recientemente de manera significativa. Las indicaciones actuales para la cirugía artroscópica de la cadera incluyen: diagnóstico y tratamiento de lesiones sintomáticas del labio acetabular, choque femoroacetabular (FAI), lesiones condrales, infecciones de las articulaciones, lesiones del ligamento del teres, incidencia del tendón del psoas, patología del espacio peritrocantérico , Cadera externa (coxa saltans) e inestabilidad traumática y atraumática. Las principales indicaciones para la imagen de la cadera con técnicas artroscópicas están representadas por dolor persistente de la ingle que puede ser causado por un inadecuado reconocimiento o tratamiento de la alteración ósea de FAI, fracturas en el sitio de huesos resecados, adhesión intraarticular, desarrollo de lesiones cartilaginosas, Lesiones condrales, lesiones recurrentes del labrum acetabular fibrocartilaginoso y osificación heterotópica. Los exámenes de control postoperatorio se pueden realizar con radiografía convencional. La aparición o la persistencia del dolor en la ingle pueden ser investigadas mediante resonancia magnética, artro-MRI e incluso tomografías computarizadas.

PALABRAS CLAVE:
Arthro-MRI; Impacto femoroacetabular; Artroscopia de cadera; Osteocondroplastia

PMID:   28210944   DOI:  

10.1007/s12306-017-0459-y

#cadera#pinzamiento femoroacetabular#artroscopia de cadera#Osteocondroplastia#coxa saltans

Pinzamiento del Iliopsoas después de Artroplastia Total de Cadera Primaria: Resultados del Tratamiento Operativo y No Operativo.

Pinzamiento del Iliopsoas después de Artroplastia Total de Cadera Primaria: Resultados del Tratamiento Operativo y No Operativo.

http://www.reemplazoprotesico.com.mx/academia/pinzamiento-ded-iliopsoas-despues-de-artroplastia-total-de-cadera-primaria-resultados-del-tratamiento-operativo-y-no-operativo/

 Iliopsoas Impingement After Primary Total Hip Arthroplasty: Operative and Nonoperative Treatment Outcomes.

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28375888

http://insights.ovid.com/crossref?an=00004623-201704050-00003

De:

Chalmers BP1,Sculco PK,Sierra RJ,Trousdale RT,Berry DJ

J Bone Joint Surg Am.

2017 Apr 5;99(7):557-564. doi: 10.2106/JBJS.16.00244.

Todos los derechos reservados para:

Copyright © 2016 Ovid Technologies, Inc., and its partners and affiliates. All Rights Reserved. Some content from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

Abstract

BACKGROUND:

A potential cause of persistent groin pain after total hip arthroplasty is impingement of the iliopsoas tendon. Treatment options include conservative management, tenotomy, and acetabular revision, but the literature, to our knowledge, has been limited to small case series on each technique. We present a series of patients with iliopsoas impingement after total hip arthroplasty and evaluate efficacy and risk factors for success or failure of each treatment strategy.

CONCLUSIONS:

Nonoperative management of iliopsoas impingement led to groin pain resolution in 50% of patients. In patients with minimal acetabular component prominence, iliopsoas release provided a high rate of success. Acetabular revision was more predictable for groin pain resolution in patients with ≥8 mm of anterior component prominence.

Resumen

ANTECEDENTES:
Una posible causa de dolor persistente de la ingle después de la artroplastia total de cadera es el pinzamiento del tendón del iliopsoas. Las opciones de tratamiento incluyen tratamiento conservador, tenotomía y revisión acetabular, pero la literatura, hasta donde sabemos, se ha limitado a pequeñas series de casos en cada técnica. Presentamos una serie de pacientes con impaciencia del iliopsoas después de la artroplastia total de cadera y evaluamos la eficacia y los factores de riesgo para el éxito o el fracaso de cada estrategia de tratamiento.

CONCLUSIONES:
El manejo no operatorio del pinzamiento del iliopsoas llevó a la resolución del dolor en la ingle en el 50% de los pacientes. En pacientes con prominencia mínima del componente acetabular, la liberación de iliopsoas proporcionó un alto índice de éxito.La revisión acetabular fue más predecible para la resolución del dolor en la ingle en pacientes con ≥8 mm de prominencia del componente anterior.

PMID:   28375888   DOI:   10.2106/JBJS.16.00244

#artroplastia total de cadera#iliopsoas#pinzamiento