RESUMO
Periostitis is characterized by periosteal inflammation surrounding tubular bones. The pathophysiology is now considered to be multifactorial and a spectrum of disorders, recently being redefined as medial tibial stress syndrome (MTSS). Current treatment modalities include preventative and conservative measures, such as activity modification and footwear alterations. There is a paucity of literature for more invasive treatments, such as steroid injections. In conflict with the currently available limited literature, this study reports a case of recurrent tibial periostitis due to blunt trauma treated with steroid injections resulting in symptom resolution and no adverse events. While this case may suggest a therapeutic role for steroids in the treatment of MTSS from blunt trauma, it also highlights the need for additional studies to elucidate the safety profile and therapeutic efficacy of steroid injections.
Assuntos
Síndrome do Estresse Tibial Medial , Periostite , Ferimentos não Penetrantes , Humanos , TíbiaAssuntos
Implantes de Mama/efeitos adversos , Mama , Fístula/etiologia , Mamoplastia/efeitos adversos , Infecções por Mycobacterium/complicações , Infecções Relacionadas à Prótese/complicações , Adulto , Antibacterianos/uso terapêutico , Implantes de Mama/microbiologia , Doença Crônica , Remoção de Dispositivo , Drenagem , Contaminação de Equipamentos , Feminino , Fístula/terapia , Seguimentos , Humanos , Mycobacterium/isolamento & purificação , Infecções por Mycobacterium/microbiologia , Infecções por Mycobacterium/terapia , Infecções Relacionadas à Prótese/microbiologia , Infecções Relacionadas à Prótese/terapiaAssuntos
Dor/tratamento farmacológico , Receptores Opioides/biossíntese , beta-Endorfina/biossíntese , Analgésicos não Narcóticos/uso terapêutico , Analgésicos Opioides/efeitos adversos , Analgésicos Opioides/uso terapêutico , Humanos , Neurotransmissores/biossíntese , Neurotransmissores/sangue , Neurotransmissores/metabolismo , Dor/fisiopatologia , Sistema Nervoso Periférico/fisiologia , Hipófise/metabolismo , Receptores Opioides/sangue , Receptores Opioides/metabolismo , beta-Endorfina/metabolismoAssuntos
Genitália Feminina/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Adulto , Clitóris/cirurgia , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Procedimentos Cirúrgicos em Ginecologia/métodos , Humanos , Satisfação do Paciente , Complicações Pós-Operatórias/terapia , Procedimentos de Cirurgia Plástica/efeitos adversosAssuntos
Algoritmos , Mama/patologia , Mama/cirurgia , Mamoplastia/métodos , Índice de Gravidade de Doença , Elasticidade , Feminino , Humanos , Pele , Tela SubcutâneaAssuntos
Mama/efeitos da radiação , Mama/cirurgia , Mamoplastia/métodos , Implante Mamário , Feminino , HumanosRESUMO
BACKGROUND: In 2005 we reported a study on the efficacy of the preoperative use of the selective COX-2 inhibitor celecoxib (Celebrex) for reducing both postoperative pain and opioid requirements in patients undergoing bilateral subpectoral breast augmentation. Our findings showed that patients who received 400 mg of celecoxib 30 min before surgery required significantly less postoperative opioid analgesics compared with those given a placebo. Gabapentin (Neurontin) is an agent commonly used to control neuropathic pain. Here we describe a prospective study assessing the efficacy of preoperative gabapentin in combination with celecoxib for reducing postoperative pain and opioid requirements in elective subpectoral breast augmentation. METHODS: One hundred eighteen patients were given 1200 mg of gabapentin and 400 mg of celecoxib 30-60 min before surgery. From the day of surgery until postoperative day 5, patients documented any use of analgesics and recorded their degree of pain. Results were then compared with those of our previous study in which only celecoxib was used. RESULTS: The combination of gabapentin and celecoxib was found to be significantly superior (p < 0.001) in reducing postoperative pain and opioid requirements than celecoxib alone in the management of postoperative pain and opioid requirements. CONCLUSION: To decrease postoperative opioid requirements, we recommend 400 mg of celecoxib and 1200 mg of gabapentin taken 30-60 min before surgery by patients undergoing subpectoral breast augmentation or a comparable plastic surgery procedure.