Resultados de una artroplastia total anatómica de hombro con una artroplastia total reversa de hombro contralateral

http://www.lesionesdeportivas.com.mx/academia/resultados-de-una-artroplastia-total-anatomica-de-hombro-con-una-artroplastia-total-reversa-de-hombro-contralateral/

Outcomes of an anatomic total shoulder arthroplasty with a contralateral reverse total shoulder arthroplasty

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/29398394

http://www.jshoulderelbow.org/article/S1058-2746(17)30824-8/fulltext

De:

Cox RM1, Padegimas EM1, Abboud JA1, Getz CL1, Lazarus MD1, Ramsey ML1, Williams GR Jr1, Horneff JG 3rd2.

J Shoulder Elbow Surg. 2018 Feb 1. pii: S1058-2746(17)30824-8. doi: 10.1016/j.jse.2017.12.005. [Epub ahead of print]

Todos los derechos reservados para:

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

Abstract

BACKGROUND:

It is common for patients to require staged bilateral shoulder arthroplasties. There is a unique cohort of patients who require an anatomic total shoulder arthroplasty (TSA) and a contralateral reverse shoulder arthroplasty (RSA). This study compared the outcomes of patients with a TSA in 1 shoulder and an RSA in the contralateral shoulder.

CONCLUSION:

Despite known limitations and differences between TSA and RSA designs, patients who have received both implants are highly satisfied with both. The only parameter in which the TSA had superior outcomes was internal rotation.

KEYWORDS:

Total shoulder arthroplasty; bilateral shoulder arthroplasty; clinical outcomes; functional outcomes; reverse shoulder arthroplasty; shoulder arthroplasty

Resumen

ANTECEDENTES:

Es común que los pacientes requieran artroplastias bilaterales de hombro por etapas. Existe una cohorte única de pacientes que requieren una artroplastia total de hombro (TSA) anatómica y una artroplastia de hombro inversa contralateral (RSA). Este estudio comparó los resultados de los pacientes con una TSA en 1 hombro y un RSA en el hombro contralateral.

CONCLUSIÓN:

A pesar de las limitaciones y diferencias conocidas entre los diseños de TSA y RSA, los pacientes que han recibido ambos implantes están muy satisfechos con ambos. El único parámetro en el que la TSA tuvo mejores resultados fue la rotación interna.

PALABRAS CLAVE:

Artroplastia total del hombro; artroplastia bilateral de hombro; resultados clínicos; resultados funcionales; artroplastia reversa de hombro; artroplastia de hombro

Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

PMID:  29398394  DOI:  10.1016/j.jse.2017.12.005

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Dolor postoperatorio / Postoperative pain

Febrero 5, 2018. No. 2985

Nuevos enfoques en el tratamiento del dolor agudo postoperatorio N. Esteve Pérez , C. Sansaloni Perelló , M. Verd Rodríguez , H. Ribera Leclercy C. Mora Fernández Rev. Soc. Esp. del Dolor, Vol. 24, N.º 3, Mayo-Junio 2017 PDF Aspectos básicos del dolor postoperatorio y la analgesia multimodal preventiva Dr. Jorge Rosa-Díaz, Dr. Víctor Navarrete-Zuazo, Dra. Miosotis Díaz-Mendiondo Revista Mexicana de Anestesiología Volumen 37, No. 1, enero-marzo 2014 PDF Avances recientes en el manejo del dolor agudo: comprensión de los mecanismos del dolor agudo, la prescripción de opiáceos y el papel de la terapia del dolor multimodal. Recent advances in acute pain management: understanding the mechanisms of acute pain, the prescription of opioids, and the role of multimodal pain therapy. Wardhan R1, Chelly J2. Author information F1000Res. 2017 Nov 29;6:2065. doi: 10.12688/f1000research.12286.1. eCollection 2017. Abstract In this review, we discuss advances in acute pain management, including the recent report of the joint American Pain Society and American Academy of Pain Medicine task force on the classification of acute pain, the role of psychosocial factors, multimodal pain management, new non-opioid therapy, and the effect of the "opioid epidemic". In this regard, we propose that a fundamental principle in acute pain managementis identifying patients who are most at risk and providing an "opioid free anesthesia and postoperative analgesia". This can be achieved by using a multimodal approach that includes regional anesthesia and minimizing the dose and the duration of opioid prescription. This allows prescribing medications that work through different mechanisms. We shall also look at the recent pharmacologic and treatment advances made in acute pain and regional anesthesia. KEYWORDS: acute pain; multimodal therapy; pharmacogenetics; psychosocial factors PDF Safe Anaesthesia Worldwide Delivering safe anaesthesia to the world's poorest people Informes / Information World Congress on Regional Anesthesia & Pain Medicine April 19-21, 2018, New York City, USA Informes / Information

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

Opioides en dolor crónico / Opioids in chronic pain

Febrero 6, 2018. No. 2986

Prescripción responsable, segura y efectiva de opiáceos para el dolor crónico no relacionado con el cáncer: guías de la American Society of Interventional Pain Physicians (ASIPP). Responsible, Safe, and Effective Prescription of Opioids for Chronic Non-Cancer Pain: American Society of Interventional Pain Physicians (ASIPP) Guidelines. Manchikanti L, Kaye AM, Knezevic NN1, McAnally H2, Slavin K3, Trescot AM4, Blank S5, Pampati V, Abdi S6, Grider JS, Kaye AD, Manchikanti KN7, Cordner H, Gharibo CG, Harned ME, Albers SL, Atluri S, Aydin SM8, Bakshi S, Barkin RL, Benyamin RM, Boswell MV9, Buenaventura RM, Calodney AK, Cedeno DL10, Datta S, Deer TR, Fellows B, Galan V11, Grami V, Hansen H, Helm Ii S, Justiz R, Koyyalagunta D, Malla Y, Navani A12, Nouri KH, Pasupuleti R, Sehgal N, Silverman SM, Simopoulos TT13, Singh V14, Solanki DR15, Staats PS16, Vallejo R, Wargo BW, Watanabe A17, Hirsch JA1 Pain Physician. 2017 Feb;20(2S):S3-S92. CONCLUSIONS: These guidelines were developed based on comprehensive review of the literature, consensus among the panelists, in consonance with patient preferences, shared decision-making, and practice patterns with limited evidence, based on randomized controlled trials (RCTs) to improve pain and function in chronic non-cancer pain on a long-term basis. Consequently, chronic opioid therapy should be provided only to patients with proven medical necessity and stability with improvement in pain and function, independently or in conjunction with other modalities of treatments in low doses with appropriate adherence monitoring and understanding of adverse events.Key words: Chronic pain, persistent pain, non-cancer pain, controlled substances, substance abuse, prescription drug abuse, dependency, opioids, prescription monitoring, drug testing, adherence monitoring, diversionDisclaimer: The guidelines are based on the best available evidence and do not constitute inflexible treatment recommendations. Due to the changing body of evidence, this document is not intended to be a "standard of care." PDF Guías de los CDC para la prescripción de opiáceos para el dolor crónico - Estados Unidos, 2016. CDC Guideline for Prescribing Opioids for Chronic Pain--United States, 2016. Dowell D1, Haegerich TM1, Chou R1. Author information JAMA. 2016 Apr 19;315(15):1624-45. doi: 10.1001/jama.2016.1464. Abstract IMPORTANCE:Primary care clinicians find managing chronic pain challenging. Evidence of long-term efficacy of opioids for chronic pain is limited. Opioid use is associated with serious risks, including opioid use disorder and overdose. OBJECTIVE: To provide recommendations about opioid prescribing for primary care clinicians treating adult patients with chronic pain outside of active cancer treatment, palliative care, and end-of-life care. PROCESS: The Centers for Disease Control and Prevention (CDC) updated a 2014 systematic review on effectiveness and risks of opioidsand conducted a supplemental review on benefits and harms, values and preferences, and costs. CDC used the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework to assess evidence type and determine the recommendation category. EVIDENCE SYNTHESIS: Evidence consisted of observational studies or randomized clinical trials with notable limitations, characterized as low quality using GRADE methodology. Meta-analysis was not attempted due to the limited number of studies, variability in study designs and clinical heterogeneity, and methodological shortcomings of studies. No study evaluated long-term (≥1 year) benefit of opioids for chronic pain. Opioids were associated with increased risks, including opioid use disorder, overdose, and death, with dose-dependent effects. RECOMMENDATIONS: There are 12 recommendations. Of primary importance, nonopioid therapy is preferred for treatment of chronic pain. Opioids should be used only when benefits for pain and function are expected to outweigh risks. Before starting opioids, clinicians should establish treatment goals with patients and consider how opioids will be discontinued if benefits do not outweigh risks. When opioids are used, clinicians should prescribe the lowest effective dosage, carefully reassess benefits and risks when considering increasing dosage to 50 morphine milligram equivalents or more per day, and avoid concurrent opioids and benzodiazepines whenever possible. Clinicians should evaluate benefits and harms of continued opioid therapy with patients every 3 months or more frequently and review prescription drug monitoring program data, when available, for high-risk combinations or dosages. For patients with opioid use disorder, clinicians should offer or arrange evidence-based treatment, such as medication-assisted treatment with buprenorphine or methadone. CONCLUSIONS AND RELEVANCE: The guideline is intended to improve communication about benefits and risks of opioids for chronic pain, improve safety and effectiveness of pain treatment, and reduce risks associated with long-term opioid therapy. PDF Safe Anaesthesia Worldwide Delivering safe anaesthesia to the world's poorest people Informes / Information World Congress on Regional Anesthesia & Pain Medicine April 19-21, 2018, New York City, USA Informes / Information

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