Results of Posterior Cruciate Retaining Total Knee Arthroplasty (3 to 8 years follow up) / 대한정형외과학회잡지

PURPOSE: To evaluate clinical results of posterior cruciate retaining TKA according to the preoperative range of motion (ROM), degree of deformity and obesity. MATERIALS AND METHODS: 81 cases were followed up more than 3 years. All cases were evaluated according to degree of preoperative ROM and varus deformity, presence of flexion contracture and BMI scale for obesity. Clinical and radiological evaluation systems were used with American knee society scale. RESULTS: Postoperative ROM according to the degree of preoperative ROM showed that the postoperative ROM in the good preoperative ROM group was better compared to the worse preoperative ROM groups and the results of knee scores showed the similar condition. Flex-ion contracture group revealed the better clinical results (p>0.05) compared to the group without contracture. The improvement of knee and functional scores was statistically significant in the more deformed varus groups and in the normal BMI group compared to the more obese groups. CONCLUSION: Good clinical results and satisfactory postoperative ROM are obtained by the good preoperative ROM, appropriate technique of maintaining adequate soft tissue balance in the deformed knee and preoperative weight control.

The Effects of Intraperitoneal Instillation of Lidocaine before Pneumoperitoneum on Postoperative Pain Score and Intraoperative Changes of Blood Pressure in Patients with a Laparoscopic Cholecystectomy / 대한마취과학회지

BACKGROUND: This study was performed to evaluate the effects of pre-emptive subdiaphragmatic instillation of lidocaine before pneumoperitoneum on postoperative pain following a laparoscopic cholecystectomy (LC) and also to evaluate it's effect on the changes of blood pressure during an operation. METHODS: Thirty-three relatively healthy patients for an LC were allocated into the two groups. after the induction of general anesthesia with sodium thiopental, vecuronium, nitrous oxide and enflurane (1-2 vol%), 0.2% lidocaine 200 ml was subdiaphragmatically instilled 10 min before pneumoperitoneum in the lidocaine group (n = 15), and normal saline in the control group (n = 18). The changes of the systolic and mean arterial pressure (SAP and MAP), postoperative pain score, and the number of analgesics used during the postoperative 24 h were compared between two groups. RESULTS: The pain scores at postoperative 1, 3, 6, 12, 18 and 24 h and the number of analgesics used were significantly low in the lidocaine group compared to the control group (P<0.01). The elevations of SAP and MAP during pneumoperitoneum were significantly attenuated in the lidocaine group (P<0.01). CONCLUSIONS: This data suggests that subdiaphragmatic instillation of lidocaine before pneumoperitoneum is effective in the control of postoperative pain following an LC and also effective to attenuate the elevation of blood pressure during pneumoperitoneum. However, further study is needed to evaluate the safety of these methods before recommendation of routine use.