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Background@#Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. @*Methods@#Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients’ sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. @*Results@#The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. @*Methods@#Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients’ sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. @*Results@#The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38;P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. @*Conclusions@#Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery. 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. @*Conclusions@#Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.
RESUMO
Background@#Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. @*Methods@#Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients’ sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. @*Results@#The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; Background: Local anesthetic infiltration at the site of a surgical wound is commonly used to control postoperative pain. In this study, we examined the effectiveness of continuous local infiltration at an abdominal surgical site in patients undergoing anterior lumbar interbody fusion (ALIF) surgery. @*Methods@#Sixty-one patients who underwent ALIF surgery were enrolled. For thirtyone of them, a continuous local anesthetics infiltration system was used at the abdominal site. We collected data regarding the patients’ sleep quality; satisfaction with pain control after surgery; abilities to perform physical tasks and the additional application of opioids in the postoperative 48 hours. @*Results@#The On-Q system group showed reduced visual analogue scale scores for pain at the surgical site during rest and movement at 0, 12, 24, and 48 hours; and more was satisfied with pain control management at the first postoperative day (7.0 ± 1.2 vs. 6.0 ± 1.4; P = 0.003) and week (8.1 ± 1.6 vs. 7.0 ± 1.8; P = 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38;P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. @*Conclusions@#Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery. 0.010) than the control group. The number of additional patient-controlled analgesia (PCA) bolus and pethidine injections was lower in the On-Q group (PCA: 3.67 ± 1.35 vs. 4.60 ± 1.88; P = 0.049 and pethidine: 2.09 ± 1.07 vs. 2.73 ± 1.38; P = 0.032). Patients who used the On-Q system performed more diverse activity and achieved earlier ambulation than those in the control group. @*Conclusions@#Continuous wound infiltration with ropivacaine using an On-Q system may be effective for controlling postoperative pain after ALIF surgery.
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OBJECTIVE: Sinus pericranii (SP) is a rare vascular malformation characterized by abnormal communication between the extracranial and intracranial venous systems, usually involving the superior sagittal sinus (SSS) and occasionally, the transverse sinus. CASE REPORT: A 28-year-old man was presented with a round, fluctuant, nonpulsatile scalp mass in the frontal area near the midline, the size of which changed, depending on his head position. Magnetic resonance imaging showed an extracranial vein extending through a bony defect in the vertex of the skull and draining into the superior portion of the sagittal sinus. RESULTS: The lesion was completely removed by surgery. The presence of vascular endothelium in the pathologic specimen suggests a congenital or spontaneous origin. CONCLUSION: SP is a rare vascular malformation that requires surgical or endovascular treatment for the prevention of life-threatening complications.
Assuntos
Adulto , Humanos , Endotélio Vascular , Cabeça , Imageamento por Ressonância Magnética , Couro Cabeludo , Seio Pericrânio , Crânio , Seio Sagital Superior , Malformações Vasculares , VeiasRESUMO
BACKGROUND: The prevalence of intracranial aneurysms in the elderly is increasing. However, most treatment strategies for the elderly is controversial and related research in the elderly has been insufficient. METHODS: Eighty-four patients > 65 years of age with intracranial aneurysms who received definitive treatment at our hospital between March 2007 and June 2010 were subjected to this study. Thirty-seven patients who had undergone endovascular treatment (EVT) were categorized into group I, while 47 patients who had undergone microsurgical treatment (MST) were categorized into group II. RESULTS: When the Glasgow Outcome Scale (GOS) score, which was independent to rupture, was evaluated at the time of discharge there was a trend of acquiring much better GOS scores (GOS> or =4) when the Hunt-Hess grade (HHG) is good (HHG< or =2) and the size of the aneurysm is small (<10 mm; p=0.001 [HHG] and p=0.000 [aneurysm size]). In the two groups in which EVT and MST were performed, the average values of the GOS scores by Student's t-test displayed a significant difference (4.54 [EVT] and 4.13 [MST], respectively, p=0.046). However, univariate and multivariate analyses were not statistically significant. CONCLUSION: If the clinical results are similar in the EVT and MST for intracranial aneurysms, then EVT is less invasive with less post-procedural complications would be considered with priority in elderly patients.