Abstract:
BACKGROUND:The multimodality addition of preoperative gabapentin, acetaminophen, and celecoxib (GAC) and postoperative TENS has been recommended to diminish narcotics. We predict that GAC-TENS implementation will reduce recovery room time, improve pain control, reduce narcotic refills, and demonstrate usefulness of TENS treatment. METHODS:A prospective study compared a control group of patients not utilizing the GAC-TENS protocol during 2015 to patients using the GAC-TENS protocol during 2016. RESULTS:There was less recovery room time in the control group compared to the protocol group. Postoperative day one pain control was similar between the groups. Less refills were noted. TENS unit satisfaction level was rated "very helpful" by 63% of patients. CONCLUSION:The results call into question the efficacy of the American Pain Society recommendations as they increase time in recovery room but do not decrease the quantity of narcotics used in the recovery room, nor do they improve pain satisfaction responses.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Wright R,Wright J,Perry K,Wright Ddoi
10.1016/j.amjsurg.2018.01.070subject
Has Abstractpub_date
2018-05-01 00:00:00pages
958-962issue
5eissn
0002-9610issn
1879-1883pii
S0002-9610(17)31673-2journal_volume
215pub_type
杂志文章abstract::This is the Presidential Address from the 104th meeting of the North Pacific Surgical Association held in Tacoma, Washington November 8-9, 2016. ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2017.01.041
更新日期:2017-05-01 00:00:00
abstract::Twenty-five patients were treated for retained, recurrent, or primary common duct stones by permanent drainage of the biliary tract with external choledochoduodenostomy. Twenty-one patients had common duct stones which became evident two to fifty years after the initial biliary tract procedure and which may represent ...
journal_title:American journal of surgery
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abstract:BACKGROUND:Clostridium difficile infection (CDI) is a common cause of healthcare associated infections contributing to morbidity and mortality. Our objective was to evaluate the impact of the implementation of a CDI bundle along with probiotic utilization. METHODS:A retrospective review of trauma admissions from 2008 ...
journal_title:American journal of surgery
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abstract::We report our experience with 65 patients with congenital duodenal obstruction, 36 with intrinsic and 29 with extrinsic lesions. Seventeen patients had trisomy 21 syndrome. Eight pregnancies were complicated by polyhydramnios. The diagnostic features encountered, the operative procedures used, and the postoperative ma...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(79)90305-2
更新日期:1979-12-01 00:00:00
abstract::Controversy continues about how often a negative laparotomy should be accepted in the management of patients with blunt and penetrating trauma. A key issue is the complications, especially small bowel obstruction. To define these complications, the charts of 248 patients who underwent negative laparotomy for trauma we...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(88)80549-x
更新日期:1988-12-01 00:00:00
abstract::With the aid of ultrasonography, representative percutaneous biopsy specimens were obtained from 20 of 21 patients (95 percent) with liver metastases of carcinoids and endocrine pancreatic tumors. The specimens were examined with silver stains and immunocytochemically after the application of monoclonal serotonin anti...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(84)90470-7
更新日期:1984-09-01 00:00:00
abstract::The technique of intraoperative autotransfusion utilizing the Haemonetics Cell Saver is described. This device separates and washes red blood cells removed from the surgical field. Advantages of this unit over others are (1) no systemic anticoagulation is required, (2) circulatory fibrin debris is removed, (3) plasma ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90390-1
更新日期:1981-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to assess how the practice patterns of breast surgeons affect their income and job satisfaction. METHODS:A 19-question survey regarding practice patterns and income and job satisfaction was mailed to all active US members of the American Society of Breast Surgeons. RESULTS:The...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.09.006
更新日期:2010-03-01 00:00:00
abstract:BACKGROUND:We previously identified serum creatinine values >2 mg/dL (176.8 micromol/L) and pathological chest radiographs due to the presence of pleural effusions or pulmonary densifications as two early prognostic factors of life-threatening acute pancreatitis (AP). The aim of the present study was to validate their ...
journal_title:American journal of surgery
pub_type: 杂志文章
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abstract:BACKGROUND:It is widely accepted that mastectomy and breast-conserving surgery (BCS) with irradiation yield similar results, yet many women continue to receive mastectomy. This study evaluates factors contributing to surgical decision-making in breast cancer. Registry data were obtained on all patients treated at the S...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2009.05.031
更新日期:2009-12-01 00:00:00
abstract:BACKGROUND:The treatment for a contralateral breast cancer (CBC) presents a growing dilemma given the expanding number of long-term survivors. We hypothesize that there will be specific surgical treatment trends with demographic differences between the treatment groups. METHODS:The Surveillance, Epidemiology, and End ...
journal_title:American journal of surgery
pub_type: 杂志文章,多中心研究
doi:10.1016/j.amjsurg.2014.05.010
更新日期:2014-10-01 00:00:00
abstract::Ten patients with a discharging perineal sinus that developed after proctectomy were treated with a new fibrin adhesive system in order to close the sinus. Four of the patients also had a fistula that extended from the sinus to the vagina. Treatment was unsuccessful in two patients: one had retained foreign bodies in ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(83)90142-3
更新日期:1983-06-01 00:00:00
abstract::One hundred seventy-five patients underwent restorative proctocolectomy between November 1984 and December 1992. The pathologic results were reviewed by two pathologists, one being a gastrointestinal pathologist. One hundred fifty-eight patients had a confirmed diagnosis of ulcerative colitis, and 16 patients were dia...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(94)90248-8
更新日期:1994-05-01 00:00:00
abstract::Initial manifestations of AIDS in the head and neck area occur frequently. In fact, up to 40 percent of patients may have involvement of the head and neck. The most common malignancies are Kaposi's sarcoma and non-Hodgkin's lymphoma. Since AIDS-related malignancies are a relatively new problem for radiation oncologist...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90021-4
更新日期:1987-10-01 00:00:00
abstract::Other indicators of hormone sensitivity, besides estrogen receptor (ER) content, such as response to oophorectomy, antiestrogens, prolactin suppression, and correlation with progesterone receptors (PR), were evaluated in the hope of further improving selectivity and response of patients undergoing endocrine ablation f...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(80)90435-3
更新日期:1980-07-01 00:00:00
abstract:BACKGROUND:Acellular dermal matrix (ADM) represents a promising new fascial substitute for repairing abdominal wall defects. METHODS:We retrospectively studied 63 patients who underwent fascial reconstruction with ADM and analyzed risk factors for recurrence and infectious wound complications. RESULTS:Postoperative w...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.11.019
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND:Multimodality monitoring and goal-directed therapy may not prevent blood flow and brain oxygen (Flow/BrOx) crisis. We sought to determine the impact of these events on outcome in patients with severe traumatic brain injury (sTBI). METHODS:Twenty-four patients with sTBI were treated to maintain intracranial ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2014.08.003
更新日期:2014-12-01 00:00:00
abstract:PURPOSE:To describe the current practice and opinions held by surgeons performing colorectal surgery in Washington regarding laparoscopic colorectal surgery. METHODS:After attempting to identify all surgeons with hospital privileges in colorectal surgery in Washington, a survey was sent to 303 surgeons. The survey ask...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(03)00112-0
更新日期:2003-07-01 00:00:00
abstract::Vascular control of the injured retrohepatic vena cava is invariably a surgical challenge. Herein, we describe the technical aspects of inserting a vena cava balloon shunt through the saphenofemoral junction. The advantages of this approach include relative simplicity, maintenance of perihepatic tamponade, and avoidin...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(89)90288-2
更新日期:1989-11-01 00:00:00
abstract:BACKGROUND:To establish feasibility, reliability and validity of a newly designed basic surgical training (BST) assessment form. METHODS:The assessment form was evaluated among trainees on the South-east Scotland BST rotation over 18 months. Feasibility was indicated by response rate. Reliability was determined using ...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/s0002-9610(01)00647-x
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Data on the hemoglobin (Hb) after transfusion, or the "target," which reflects the "dose" of blood given are not well studied. We sought to examine the incidence and causes of "over transfusion" of red blood cells after surgery. METHODS:Data on blood utilization including Hb triggers and targets were obtain...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2015.12.020
更新日期:2016-07-01 00:00:00
abstract::The integrity of the normal mature intestinal mucosal barrier to unaltered proteins was evaluated with tritiated bovine albumin in rats. Intact H3-BSA placed into either colon or small intestinal lumen regularly reached the bloodstream in quantities sufficient to be antigenic or toxigenic, although the fraction of H3-...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(77)90193-3
更新日期:1977-01-01 00:00:00
abstract::Cytologic examination of peritoneal washings was performed in 40 patients with pancreatic ductal adenocarcinoma (35 head, 5 body) whose tumors had been selected as potentially resectable by computed tomographic (CT) findings. Saline (100 mL) was instilled and aspirated at laparoscopy in 27 patients and at laparotomy i...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(91)90356-i
更新日期:1991-01-01 00:00:00
abstract:BACKGROUND:In hepato-pancreato-biliary (HPB) surgery higher volumes are associated with improved outcomes; however, there are limitations to regionalization. Here we report our experience establishing multidisciplinary HPB program at a university-affiliated community hospital. METHODS:This is a retrospective review of...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.03.015
更新日期:2019-11-01 00:00:00
abstract:BACKGROUND:Glass tables can break and cause traumatic injury. This public health issue is avoidable by adequate regulatory measures. We describe the burden and characteristics of these injuries using the National Electronic Injury Surveillance System (NEISS) database and data from a level 1 trauma center. METHODS:NEIS...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.07.002
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:Although neoadjuvant chemotherapy is increasingly used for breast cancer, if a patient has a complete clinical response, it is often difficult for the surgeon to know exactly where and how much breast tissue to remove. METHODS:A method is described where the edges of the tumor are tattooed prior to chemothe...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2007.07.009
更新日期:2007-10-01 00:00:00
abstract::The relative roles of bacterial infection, fluid loss and myocardial failure were investigated in 24 patients in whom circulatory shock appeared as a complication of purulent peritonitis. The 13 acute survivors, including 6 hospital survivors, had strikingly lower initial plasma volumes and total blood volumes than th...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90290-7
更新日期:1981-08-01 00:00:00
abstract::One hundred seven patients with pseudocyst managed during the past decade were reviewed. The mortality rate of 11.2 percent compares favorably with the rates in other recent series. Twenty-two percent of the patients were managed conservatively, and 76 underwent exploration. None of the nonoperative patients died from...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/0002-9610(81)90052-0
更新日期:1981-05-01 00:00:00
abstract:BACKGROUND:The novel coronavirus (COVID-19) strain has resulted in restrictions potentially impacting patients presenting with acute appendicitis and their disease burden. METHODS:All acute appendicitis admissions (281 patients) between 1/1/2018-4/30/2020 were reviewed. Two groups were created: 6 weeks before (Group A...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2020.09.026
更新日期:2020-09-28 00:00:00
abstract:INTRODUCTION:Short-term outcomes after distal pancreatectomy (DP) for retroperitoneal (RP) tumors are unknown. We sought to identify rates of postoperative pancreatic fistula (POPF) and morbidity after en bloc DP with RP tumor resection. METHODS:A retrospective review of 43 patients who underwent DP with RP tumor rese...
journal_title:American journal of surgery
pub_type: 杂志文章
doi:10.1016/j.amjsurg.2019.11.026
更新日期:2020-07-01 00:00:00