Abstract：
BACKGROUND:It has been generally recommended that platelet function may recover after the recommended 5-day discontinuation period prior to operation. The technique of thromboelastography has been demonstrated to monitor intraoperative platelet function in liver transplantation and coronary bypass surgery. However, there is a dearth of literature that addresses the utility of thromboelastography in aspirin-treated patients undergoing fusion. OBJECTIVES:To introduce a functional method of monitoring coagulation and validate the effectiveness of thromboelastography perioperatively in assessing aspirin-treated patients undergoing posterior lumbar fusion. STUDY DESIGN:This research used a retrospective study design. SETTING:Orthopedic Department of Changhai Hospital,Shanghai, China and Orthopedic and Anesthesia Department of Changzheng Hospital. METHODS:Eighty patients were divided into aspirin-naive and aspirin-treated groups in this study. They had equally undergone lumbar fusion surgery for at least one or more segments between January and June 2018. They matched for age, gender, number of fused segments, and surgical procedures. The coagulation profile, including the reaction time (R), kinetics (K), maximal amplitude (MA), alpha-angle, and coagulation index (CI), platelet inhibition ratio (PIR) was analyzed by thromboelastogram (TEG) prior to operation and on preoperative days 1, 3, and 5. Correlation analysis included parameters such as waiting time, intraoperative blood loss, and postoperative drainage. RESULTS:Perioperatively, the TEG values including R, K, MA, alpha-angle, and CI, PIR, and correlation analysis showed no significant difference between the 2 groups, respectively (P > 0.05). LIMITATIONS:First, the relatively small number of patients recruited limits control over other factors; larger studies may need to confirm our findings. Second, the patients were objectively less healthy with more medication treatment, which may result in a variance in the amount of blood loss. Randomized controlled studies are needed to further confirm these results. CONCLUSIONS:TEG may be a helpful method to monitor perioperative platelet function in aspirin-treated patients undergoing fusion. It may be comparatively safe to relax the restriction of the aspirin-discontinued therapeutic window to approximately 2 to 3 days prior to surgery.
journal_name
Pain Physicianjournal_title
Pain physicianauthors
Li X,Wu J,Zhang S,Liu S,Yuan J,Wang C,Miao X,Lin X,Li J,Shi Zsubject
Has Abstractpub_date
2020-11-01 00:00:00pages
E619-E628issue
6eissn
1533-3159issn
2150-1149journal_volume
23pub_type
杂志文章相关文献
Pain Physician文献大全abstract：BACKGROUND:Epidural injection is performed for treatment of back and radicular pain in patients with lumbosacral disc herniation (LDH). Steroids are usually administered to effectively remove inflammatory mediators, and local anesthetics or saline also contribute to pain reduction by washing out chemical mediators or b...
journal_title：Pain physician
pub_type： 杂志文章,meta分析
doi：
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Epidural injection of corticosteroids is one of the most commonly used interventions in managing chronic spinal pain. However, there has been a lack of well-designed randomized, controlled studies to determine the effectiveness of epidural injections. Consequently, debate continues as to the value of epidura...
journal_title：Pain physician
pub_type： 杂志文章,评审
doi：
更新日期：2007-01-01 00:00:00
abstract：BACKGROUND:Gonadal hormones are critical factors in modulating the experience of pain, as suggested by the several sex differences observed: women have a greater risk of many clinical pain conditions, and postoperative and procedural pain may be more severe in them than in men. A growing body of literature demonstrates...
journal_title：Pain physician
pub_type： 杂志文章,评审
doi：
更新日期：2012-07-01 00:00:00
abstract：BACKGROUND:Thoracic epidural analgesia (TEA) has a well-known effect on neurohormonal response. Attenuation of stress response by post-operative epidural analgesia has shown beneficial effects such as lower pain scores and less immunological alterations. OBJECTIVES:Investigation of the combined effects of TEA and prot...
journal_title：Pain physician
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2014-07-01 00:00:00
abstract：:Spinal fusion for degenerative disc disease has been associated with a variety of side effects, including increased morbidity, infection, failed back syndrome, pseudoarthrosis, and acceleration of degenerative changes in adjacent intervertebral discs and facet joints. Based on the experience of arthroplasty of hip and...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2003-04-01 00:00:00
abstract：:Management of pain from skeletal metastases is notoriously difficult. Case reports and case series have described radiofrequency ablation of the obturator nerve branches to the femoral head for treatment of intractable hip pain. Ablation of the obturator branches to the femoral head is technically difficult because of...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2014-01-01 00:00:00
abstract：BACKGROUND:The growth of interventional pain medicine in recent years has resulted in more procedures being carried out under fluoroscopic guidance. The proximity of the pain physician (PP) to ionization radiation (IR) potentially increases the risk of radiation exposure to the ocular region. A European directive has r...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2018-09-01 00:00:00
abstract：BACKGROUND:Bone cement leakage in patients with vertebral fracture limits the use of percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP). Finding a method to reduce bone cement leakage is clinically rather important. OBJECTIVE:To compare the efficacy and safety of bone-filling mesh containers (BFMCS) ...
journal_title：Pain physician
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2018-05-01 00:00:00
abstract：BACKGROUND:Evidence of a paradigm shift towards epicranial neurostimulation treatment techniques aimed at the site of headache pain is beginning to populate the literature. This is most apparent by 2 recently published reports describing alternative approaches to peripheral nerve stimulation techniques for refractory m...
journal_title：Pain physician
pub_type： 杂志文章,评审
doi：
更新日期：2011-01-01 00:00:00
abstract：BACKGROUND:Osteonecrosis, also known as avascular necrosis, of the femoral head is a debilitating disorder that commonly affects 30- to 50-year-old individuals. Currently, definitive treatment is limited to total hip replacement. However, recent studies have demonstrated bone regeneration in the femoral head after the ...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2012-01-01 00:00:00
abstract：BACKGROUND:The BenchMarket Medical (BMM) Vertebral Compression Fracture (VCF) Registry, now known as Talosix, is a collaborative effort between Talosix (the authorized registry vendor), Noridian Healthcare Solutions, and clinicians to gather outcomes evidence for cement augmentation treatments in patients with acute pa...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2020-07-01 00:00:00
abstract：BACKGROUND:The symptom severity of back pain/leg pain is not correlated with the severity of degenerative changes and canal stenosis in lumbar stenosis. Considering the individual pain sensitivity might play an important role in pain perception, this discordance between the radiologic findings and clinical symptoms in ...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2013-03-01 00:00:00
abstract：BACKGROUND:Epidural and intrathecal injections of methylprednisolone acetate (MPA) have become the most commonly performed interventional procedures in the United States and worldwide in the last 2 decades. However neuraxial MPA injection has been dogged by controversy regarding the presence of different additives used...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2014-09-01 00:00:00
abstract：:Although percutaneous endoscopic lumbar discectomy (PELD) is an effective treatment for herniated discs, its application in a disc with extensive migration is still challenging. As such, epiduroscopic laser neural decompression (ELND) provides a new view of the epidural space as well as an alternative treatment for a ...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2017-05-01 00:00:00
abstract：:Discogenic low back pain resulting from internal disc disruption can be severely disabling, clinically challenging, and expensive to treat. Previously, when conservative care had been exhausted, open surgical intervention such as spinal fusion or artificial disc replacement was the only treatment option for these pati...
journal_title：Pain physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-09-01 00:00:00
abstract：OBJECTIVE:To describe management challenges and follow-up data for three years in a case with spontaneous carotid artery dissection (SCAD). CASE REPORT:We present a case of SCAD that presented with Horner's syndrome and headache. The patient developed the SCAD, Horner's syndrome and headache one month after a lumbar e...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2004-10-01 00:00:00
abstract：BACKGROUND:Lumbar provocation discography is a controversial diagnostic test. Currently, there is a concern that the test has an unacceptably high false-positive rate. STUDY DESIGN:Systematic review and meta-analysis. OBJECTIVE:To perform a systematic review of lumbar discography studies in asymptomatic subjects and ...
journal_title：Pain physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-07-01 00:00:00
abstract：BACKGROUND:Percutaneous endoscopic cervical discectomy has evolved as an efficient, minimally invasive spine surgery for radiculopathy caused by soft and/or osseous foraminal stenosis. Although interlaminar access can be used to resect lateral herniated lesions or osteophytes located in the foramina, with limited opera...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:Compared to an abundance of data on surgical techniques for degenerative spine conditions and the outcomes thereof, little is available to guide optimal perioperative pain management after spinal surgery. The aim of this study was to survey patterns of perioperative pain management after spinal surgery and t...
journal_title：Pain physician
pub_type： 杂志文章,多中心研究
doi：
更新日期：2013-05-01 00:00:00
abstract：:Evidence-based medicine, systematic reviews, and guidelines are part of modern interventional pain management. As in other specialties in the United States, evidence-based medicine appears to motivate the search for answers to numerous questions related to costs and quality of health care as well as access to care. Sc...
journal_title：Pain physician
pub_type： 杂志文章,评审
doi：
更新日期：2008-03-01 00:00:00
abstract：:Pain following thoracotomy is of moderate to severe nature. Management of thoracotomy pain is a challenging task. Post thoracotomy pain has acute effects in the post operative period by affecting respiratory mechanics, which increases the morbidity. Poorly controlled thoracotomy pain in the acute phase may also lead t...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2015-05-01 00:00:00
abstract：BACKGROUND:Microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED) are 2 of the most popular minimally invasive spinal surgery techniques. We are investigating whether minimally invasive early annular closure can achieve a better clinical effect in the treatment of lumbar disc hern...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2020-11-01 00:00:00
abstract：BACKGROUND:Symptomatic Tarlov cysts are a common cause of chronic pain. Many methods have been reported to treat this disease, with variable results. Most previous reports concerning the treatment methods of symptomatic Tarlov cysts were either sporadic case reports or series of limited cases. OBJECTIVE:This study aim...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2017-07-01 00:00:00
abstract：BACKGROUND:The management of chronic pain is complex and often involves the integration of multiple clinical, humanistic, and economic factors. Primary care physicians (PCPs) are often at the forefront of managing chronic pain and often initiate pharmacological pain management therapy. To date little is known surroundi...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2018-11-01 00:00:00
abstract：BACKGROUND:Lumbar selective nerve root blocks have been performed to establish the origin of lumbar radiculopathy in clinically difficult cases. The diagnostic ability of selective nerve root blocks remains controversial because of concern over potential spread of an injectate onto adjacent structures. OBJECTIVE:To in...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2007-05-01 00:00:00
abstract：BACKGROUND:Extensive decompression with laminectomy, where appropriate, is often still described as the method of choice when operating on degenerative lumbar spinal stenosis. Nonetheless, tissue-sparing procedures are becoming more common. Endoscopic techniques have become the standard in many areas because of the sur...
journal_title：Pain physician
pub_type： 杂志文章,随机对照试验
doi：
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:While most trials of thoracic paravertebral nerve blocks (TPVB) for breast surgery show benefit, their effect on postoperative pain intensity, opioid consumption, and prevention of chronic postsurgical pain varies substantially across studies. Variability may result from use of different drugs and techniques...
journal_title：Pain physician
pub_type： 杂志文章,meta分析,评审
doi：
更新日期：2015-09-01 00:00:00
abstract：BACKGROUND:Corticosteroids have been used for the past 70 years in the treatment of various musculoskeletal conditions. This includes its use for joint pain such as rheumatoid arthritis and osteoarthritis. OBJECTIVES:A narrative review of the literature from its initial discovery to the present day to summarize the re...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2021-01-01 00:00:00
abstract：BACKGROUND:Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:Cervicogenic headache descriptors include its unilateral nature, "signs and symptoms linking it to the neck," and trauma of the neck. Since the pain often occurs over the C2 or C3 nerve root, we used a modification of the deep cervical block technique for treatment of this refractory type headache. OBJECTIV...
journal_title：Pain physician
pub_type： 杂志文章
doi：
更新日期：2008-11-01 00:00:00
