Pub Date : 2019-10-25DOI: 10.1136/rapm-2019-100804
Promil Kukreja, Lisa MacBeth, Adam Sturdivant, Charity J Morgan, Elie Ghanem, Hari Kalagara, Vincent W S Chan
Background and objectives: Quadratus lumborum (QL) block is a new regional analgesic technique for upper and lower abdominal surgeries as part of a multimodal analgesic regime. It has also been reported to relieve pain after total hip arthroplasty (THA). In this prospective, randomized, double-blind study, we compared QL block with control (no block) in patients undergoing primary THA.
Methods: Eighty patients undergoing primary THA surgery under spinal anesthesia were randomized into two groups, one with and one without QL block. The patients in both groups were randomized after sedation, positioning and ultrasound scanning. Both the patient and the researcher collecting data were blinded to the patient's group assignment. Opioid consumption and visual analog scores (VAS) pain scores were measured at 12, 24, and 48 hours after surgery. Also, the ambulation distance, patient satisfaction, and length of stay were recorded.
Results: The study analysis included 36 patients in the QL group and 35 patients in the control group. Both VAS pain score at 24 hours (difference -1.76, 95% CI -2.87 to -0.64) and cumulative opioid consumption were significantly lower in the QL group at 12, 12-24, 24, 24-48, and 48 hours after surgery as compared with the control group (difference at 48 hours -36.13, 95% CI -62.89 to -9.37) (p<0.05). However, there was no difference in pain score at 12 and 48 hours, nor in the ambulation distance and duration of hospital stay between the two groups. The patient satisfaction score was significantly higher in the QL group.
Conclusions: Our preliminary data show that the QL block provided effective analgesia and decreased opioid requirements up to 48 hours after primary THA.
{"title":"Anterior quadratus lumborum block analgesia for total hip arthroplasty: a randomized, controlled study.","authors":"Promil Kukreja, Lisa MacBeth, Adam Sturdivant, Charity J Morgan, Elie Ghanem, Hari Kalagara, Vincent W S Chan","doi":"10.1136/rapm-2019-100804","DOIUrl":"10.1136/rapm-2019-100804","url":null,"abstract":"<p><strong>Background and objectives: </strong>Quadratus lumborum (QL) block is a new regional analgesic technique for upper and lower abdominal surgeries as part of a multimodal analgesic regime. It has also been reported to relieve pain after total hip arthroplasty (THA). In this prospective, randomized, double-blind study, we compared QL block with control (no block) in patients undergoing primary THA.</p><p><strong>Methods: </strong>Eighty patients undergoing primary THA surgery under spinal anesthesia were randomized into two groups, one with and one without QL block. The patients in both groups were randomized after sedation, positioning and ultrasound scanning. Both the patient and the researcher collecting data were blinded to the patient's group assignment. Opioid consumption and visual analog scores (VAS) pain scores were measured at 12, 24, and 48 hours after surgery. Also, the ambulation distance, patient satisfaction, and length of stay were recorded.</p><p><strong>Results: </strong>The study analysis included 36 patients in the QL group and 35 patients in the control group. Both VAS pain score at 24 hours (difference -1.76, 95% CI -2.87 to -0.64) and cumulative opioid consumption were significantly lower in the QL group at 12, 12-24, 24, 24-48, and 48 hours after surgery as compared with the control group (difference at 48 hours -36.13, 95% CI -62.89 to -9.37) (p<0.05). However, there was no difference in pain score at 12 and 48 hours, nor in the ambulation distance and duration of hospital stay between the two groups. The patient satisfaction score was significantly higher in the QL group.</p><p><strong>Conclusions: </strong>Our preliminary data show that the QL block provided effective analgesia and decreased opioid requirements up to 48 hours after primary THA.</p><p><strong>Trial registration number: </strong>NCT03408483.</p>","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"61 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90373525","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cen tral ve nous pres sure is a very com mon clin i cal mea sure ment, but it is fre quently mis un der stood and mis used. As with all hemodynamic mea sure ments, it is im por tant to un der stand its ba sic prin ci ples. Use of CVP for the es ti mat ing of car diac preload and vol ume sta tus re quires an un der stand ing of its de ter mi nants. Ac tu ally, CVP and car diac out put are de ter mined by the in ter ac tion of two func tion curves: the car diac func tion curve and the re turn curve. There are no data to sup port the wide spread prac tice of us ing cen tral ve nous pres sure (CVP) to guide fluid ther apy. But, CVP is readily avail able in many pa tients. The fact that an iso lated mea sure ment of CVP does not pre dict the re sponse to a fluid bolus does not re duce its im por tance as a hemodynamic vari able. CVP may be usefull taken in the con text of the whole clin i cal pic ture and over time.
{"title":"Central venous pressure up date: What is it good for?","authors":"D. Unić-Stojanović, M. Jovic","doi":"10.2298/ACI1701061U","DOIUrl":"https://doi.org/10.2298/ACI1701061U","url":null,"abstract":"Cen tral ve nous pres sure is a very com mon clin i cal mea sure ment, but it is fre quently mis un der stood and mis used. As with all hemodynamic mea sure ments, it is im por tant to un der stand its ba sic prin ci ples. Use of CVP for the es ti mat ing of car diac preload and vol ume sta tus re quires an un der stand ing of its de ter mi nants. Ac tu ally, CVP and car diac out put are de ter mined by the in ter ac tion of two func tion curves: the car diac func tion curve and the re turn curve. There are no data to sup port the wide spread prac tice of us ing cen tral ve nous pres sure (CVP) to guide fluid ther apy. But, CVP is readily avail able in many pa tients. The fact that an iso lated mea sure ment of CVP does not pre dict the re sponse to a fluid bolus does not re duce its im por tance as a hemodynamic vari able. CVP may be usefull taken in the con text of the whole clin i cal pic ture and over time.","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"64 1","pages":"61-68"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68394461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Izabella Fabri, G. Rakić, Danica Stanić, B. Draskovic
{"title":"Sepsis in children: Initial assessment and treatment","authors":"Izabella Fabri, G. Rakić, Danica Stanić, B. Draskovic","doi":"10.2298/ACI1701049F","DOIUrl":"https://doi.org/10.2298/ACI1701049F","url":null,"abstract":"","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"64 1","pages":"49-53"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68394439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Rakić, Izabella Fabri, J. Veličković, Danica Stanić, B. Draskovic
{"title":"Supportive therapy of sepsis in children","authors":"G. Rakić, Izabella Fabri, J. Veličković, Danica Stanić, B. Draskovic","doi":"10.2298/ACI1701055R","DOIUrl":"https://doi.org/10.2298/ACI1701055R","url":null,"abstract":"","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"1 1","pages":"55-59"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68394451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Stojakov, P. Sabljak, B. Špica, D. Velickovic, V. Šljukić, B. Nenadić, Ljubica Tomasević, Marija Ðukanovic, Aleksandra Ðuric-Stefanovic, P. Peško
{"title":"Perioperative complications of esophagectomy - prevention, diagnosis and management","authors":"D. Stojakov, P. Sabljak, B. Špica, D. Velickovic, V. Šljukić, B. Nenadić, Ljubica Tomasević, Marija Ðukanovic, Aleksandra Ðuric-Stefanovic, P. Peško","doi":"10.2298/ACI1701027S","DOIUrl":"https://doi.org/10.2298/ACI1701027S","url":null,"abstract":"","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"64 1","pages":"27-38"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68394375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T. Nastasovic, B. Milaković, M. Stosic, M. Kaludjerovic, O. Petrović, D. Kalimanovska‐Oštrić, D. Grujicic
{"title":"Stress-induced cardiomyopathy in aneurysmal subarachnoid hemorrhage","authors":"T. Nastasovic, B. Milaković, M. Stosic, M. Kaludjerovic, O. Petrović, D. Kalimanovska‐Oštrić, D. Grujicic","doi":"10.2298/ACI1701069N","DOIUrl":"https://doi.org/10.2298/ACI1701069N","url":null,"abstract":"","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"64 1","pages":"69-71"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68394480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Analgesia and sedation in surgery Intensive Care Unit (ICU)","authors":"S. Marić, D. Bošković","doi":"10.2298/ACI1701021M","DOIUrl":"https://doi.org/10.2298/ACI1701021M","url":null,"abstract":"","PeriodicalId":75377,"journal":{"name":"Acta chirurgica Iugoslavica","volume":"64 1","pages":"21-26"},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68394362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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