Is peri-articular multimodal drug infiltration in knee arthroplasty safe when used in conjunction with autologous retransfusion drains?

Abstract:

INTRODUCTION:Adequate peri-operative analgesia following total knee arthroplasty (TKA) promotes earlier rehabilitation but remains problematic because of the drug side-effects. Peri-articular multimodal drug infiltration (PMDI) has been developed as an alternative strategy to avoid such complications. Autologous retransfusion drains reduce the need for peri-operative allogenic blood transfusions and the consequent risk. There is a theoretical risk of local anaesthesia toxicity when these systems are used concurrently. We performed a review of current practice to quantify this risk. PATIENTS AND METHODS:A series of 10 patients undergoing TKA by the senior author (CAB) had drain fluid analysed for the concentration of ropivacaine. At the same time, the patients completed a questionnaire to establish the presence of ropivacaine-induced side-effects. RESULTS:The ropivacaine level in the retransfusion blood was less than 10 mg in all patients. This concentration was a factor of 6 below the published safe level. Three patients had minor neurological disturbances which recovered spontaneously and quickly. There were no cases of significant cardiovascular compromise. CONCLUSIONS:The theoretical risk of local anaesthesia toxicity when these systems are used together is negligible and we conclude that peri-articular multimodal drug infiltration is safe in conjunction with the use of autotransfusion drains.

journal_name

Ann R Coll Surg Engl

authors

Gill I,Gallagher K,Busch CA

doi

10.1308/003588410X12628812459733

subject

Has Abstract

pub_date

2010-05-01 00:00:00

pages

335-7

issue

4

eissn

0035-8843

issn

1478-7083

journal_volume

92

pub_type

杂志文章
  • Necrotising fasciitis after laparoscopic rectal cancer surgery.

    abstract::Necrotising fasciitis is a rare, serious infection of the deep fascia leading to subcutaneous tissue necrosis. It is extremely important for this condition to be identified and treated promptly as it bears significant mortality. We describe a case of necrotising fasciitis after laparoscopic rectal cancer surgery. To o...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2017.0045

    authors: Yiasemidou M,Majumder S,Basheer M

    更新日期:2017-04-01 00:00:00

  • Vascular surgery: the European perspective.

    abstract::Isaac Newton, among others, observed that 'we see so far because we are standing upon the shoulders of giants'. In vascular surgery most of the giants have been European, and this is a heritage which we as Europeans can take pride in and build upon if we chose to do so. As in other areas of life, commitment is essenti...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 历史文章,杂志文章

    doi:

    authors: Harris P

    更新日期:1999-09-01 00:00:00

  • The Falklands war: Army field surgical experience.

    abstract::In the recent Falklands campaign four Army Field Surgical Teams were deployed in the two phases of the war. They functioned as Advanced Surgical Centres and operated on 233 casualties. There were 3 deaths. The patterns of wounding and the methods of casualty management are discussed and compared with other recent camp...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Jackson DS,Batty CG,Ryan JM,McGregor WS

    更新日期:1983-09-01 00:00:00

  • One-stage tubeless antegrade ureteric stenting: a safe and cost-effective option?

    abstract:INTRODUCTION:Antegrade insertion of ureteric stent has become an established mode of management of upper tract obstruction secondary to ureteric pathology. It is conventionally performed as a two-stage procedure for various reasons but, more recently, a one-stage approach has been adopted. PATIENTS AND METHODS:We disc...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,多中心研究

    doi:10.1308/003588410X12518836439128

    authors: Chitale S,Raja V,Hussain N,Saada J,Girling S,Irving S,Cockburn JF

    更新日期:2010-04-01 00:00:00

  • Hip fractures: public perceptions.

    abstract:INTRODUCTION:Hip fractures are common injuries in elderly patients presenting to the trauma surgeon. Mortality following such injuries approaches 10% at one month, rising to 30% at one year. Of those who survive, most experience a decrease in mobility and independence. The authors believe that the general public are no...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588411X12851639107034

    authors: McBride TJ,Panrucker S,Clothier JC

    更新日期:2011-01-01 00:00:00

  • Validation of the acute cholecystectomy rate as a quality indicator for emergency general surgery using the SWORD database.

    abstract:INTRODUCTION:Despite an increasing emphasis on data-driven quality improvement, few validated quality indicators for emergency surgical services have been published. The aims of this study therefore were: 1) to investigate whether the acute cholecystectomy rate is a valid process indicator; and 2) to use this rate to e...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2019.0042

    authors: Palser TR,Navarro AP,Swift S,Beckingham IJ

    更新日期:2019-07-01 00:00:00

  • Handwashing: simple, but effective.

    abstract::Using ward rounds in the department of surgery at a major teaching hospital, and with the help of the preregistration house officers (PRHO), we assessed whether the lesson taught to us by Semmelweis had been forgotten. We asked the PHROs to count the number of patients examined by their consultant or registrar on a wa...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Daniels IR,Rees BI

    更新日期:1999-03-01 00:00:00

  • Intraoperative diagnosis of mitral valve endocarditis secondary to Paenibacillus provencensis.

    abstract::We report the first case of infective endocarditis caused by Paenibacillus provencensis. A mitral valve vegetation was incidentally discovered by intraoperative transoesophageal echocardiography in a 70-year-old woman undergoing aortic valve replacement. The precise identification of the causative agent was by means o...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2016.0312

    authors: Pinho-Gomes AC,Nasir A,Mosca R,Mirza S,Kadir I

    更新日期:2017-02-01 00:00:00

  • Ecthyma gangraenosum--a trap for the unwary.

    abstract::Neutropaenic patients are at particular risk of developing a pseudomonal fasciitis known as ecthyma gangraenosum. Despite the similarities with necrotising fasciitis, Fournier's gangrene has a very different aetiology and management. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Arul GS,Spicer RD

    更新日期:2001-01-01 00:00:00

  • Regional anaesthesia in elective hand surgery.

    abstract::The technique of regional anaesthesia for hand surgery is described. This has been successfully carried out in a series of 179 patients treated as day cases. The advantages and disadvantages of the technique are discussed. Emphasis is placed on careful patient selection and attention to detail in applying the techniqu...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Slack CJ,Sylvester BS

    更新日期:1983-11-01 00:00:00

  • Primary mesenchymal chondrosarcoma of the pancreas.

    abstract::Extraskeletal chondrosarcomas are rare and there is only one reported case of primary pancreatic chondrosarcoma. We report the case of a 34-year-old woman with a 6-month history of abdominal pain and distention. Radiological studies indicated a mass in the pancreas, and exploratory laparotomy revealed a tumour of the ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870810X12659688851672

    authors: Bu X,Dai X

    更新日期:2010-04-01 00:00:00

  • Chronic groin sinus: an unusual complication of sterilisation clips.

    abstract::We report the case of a patient presenting with a chronic groin sinus secondary to a tubal ligation clip migration (Filshie clip) 21 years after the laparoscopic sterilisation took place. Our case report adds to the small number of cases describing tubal clip migration with resultant local sepsis. Although this is a r...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870810X476638

    authors: Kolias AG,Nikolaou S,Bilal KO,Abu-Own A

    更新日期:2010-01-01 00:00:00

  • Three-year audit and cost assessment of open abdominal aortic aneurysm repair in a district general hospital.

    abstract:INTRODUCTION:The aims of this study were to audit the outcome of elective open abdominal aortic aneurysm (AAA) repair in a district general hospital, as well as investigate the true costs for this procedure in relation to the national tariff. PATIENTS AND METHODS:A database is maintained on AAA surgery in the trust. D...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588409X12486167521037

    authors: El Kafsi J,Wake J,Lintott P,Northeast A,McLaren A

    更新日期:2009-11-01 00:00:00

  • Using therapeutic mammoplasty to extend the role of breast-conserving surgery in women with larger or ptotic breasts.

    abstract:INTRODUCTION:The equivalence of breast-conserving surgery followed by postoperative radiotherapy against mastectomy is now firmly established in patients with early breast cancer. The results of surgery in large-breasted women can be poor, with radiation-induced fibrosis, chronic pain and poor cosmesis contributing to ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588413X13511609958091

    authors: Currie A,Chong K,Davies GL

    更新日期:2013-04-01 00:00:00

  • Management of massive lower limb plexiform neurofibromatosis--when to intervene?

    abstract::Massive plexiform neurofibromatosis is an uncommon manifestation of Type 1 neurofibromatosis. These tumours result in functional disability and severe disfigurement. Due to the variable natural history od these lesions, the optimal management is not well defined and surgery is often delayed until significant disfigure...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870807X238230

    authors: Power KT,Giannas J,Babar Z,McGrouther DA

    更新日期:2007-11-01 00:00:00

  • Acute radiation enteritis causing small bowel obstruction.

    abstract::Although much is known about the late intestinal side effects of radiation, comparatively little has been published about its acute complications. We present a case of a small bowel obstruction due to acute radiation enteritis. As radiotherapy continues to expand its role in the management of oncological disease, cli...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/10.1308/147870811X602122

    authors: Curtis NJ,Bryant T,Raj S,Bateman AR,Mirnezami AH

    更新日期:2011-10-01 00:00:00

  • Trends in the delivery of elective general paediatric surgery.

    abstract:INTRODUCTION:There has been regular dialogue regarding the importance of developing clinical networks to compensate for the steady decline in general paediatric surgery performed by adult surgeons. Despite this dialogue, there are no contemporary published data to quantify the issue. This report documents patterns in d...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2019.0178

    authors: Tiboni SG,Stewart RJ

    更新日期:2020-04-01 00:00:00

  • The impact of Improving Outcomes Guidance on the management and outcomes of patients with carcinoma of the penis.

    abstract:INTRODUCTION:The Improving Outcomes Guidance (IOG) for patients with carcinoma of the penis states that treatment should be provided supraregionally to populations of 4 million or greater who treat over 25 cases of penis cancer each year. This study assesses the impact of this guidance on the management and outcomes of...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588410X12518836439047

    authors: Bayles AC,Sethia KK

    更新日期:2010-01-01 00:00:00

  • Carotid artery stenosis, an underestimated cause of stroke recurrence in patients with ischaemic monocular visual loss.

    abstract:INTRODUCTION:Isolated monocular ischaemic events are thought to be low risk for stroke recurrence. In the presence of carotid stenosis however, the risks should not be treated similarly and surgical intervention should be considered at an early stage. The aim of this study was to determine the vascular risk profile and...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2019.0071

    authors: Cheng SF,Zarkali A,Richards T,Simister R,Chandratheva A

    更新日期:2019-11-01 00:00:00

  • Combination of acellular dermal matrix with a de-epithelialised dermal flap during skin-reducing mastectomy and immediate breast reconstruction.

    abstract::Introduction Patients with large ptotic breasts undergoing immediate implant-based reconstruction often require skin-reducing mastectomy to optimise the aesthetic outcome. However, healing complications, especially at the resulting inverted T-junction, leading to wound dehiscence, infection, skin necrosis, implant exp...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/rcsann.2018.0127

    authors: Kankam H,Hourston G,Forouhi P,Di Candia M,Wishart GC,Malata CM

    更新日期:2018-08-16 00:00:00

  • Delayed aorto-right atrial fistula following percutaneous closure of atrial septal defect.

    abstract::We present the case of a 27-year-old man who underwent percutaneous atrial septal defect (ASD) repair using the Amplatzer(®) (St Jude Medical, St Paul, MN, US) septal occluder (ASO). Six weeks later, he presented with heart failure and was found to have an aorto-right atrial fistulation. He required urgent surgical de...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588414X13814021679591

    authors: Bashir M,Abudhaise H,Mustafa H,Fok M,Bashir A,Hammoud I,Mascaro J

    更新日期:2014-07-01 00:00:00

  • The avian egg and the retina.

    abstract::A mathematical model for study of blood flow has been derived from the avian egg, utilizing the theories of crystallography and photosynthesis. The model is employed to explain the form of the eye and the function of the cells of the human retina, with special reference to colour vision and the pathology of migraine. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Malcolm JE

    更新日期:1973-05-01 00:00:00

  • Blood patch treatment of chylothorax following transthoracic oesophagogastrectomy: a novel technique to aid surgical management.

    abstract::Chylothorax is a well-recognised complication of oesophagectomy, occurring in around 3% of cases. If managed conservatively, the mortality rate can be over 50%. We describe our experience of managing a patient with a chylothorax following oesophagectomy, and the use of a blood patch (a novel technique) to overcome per...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/147870810X12659688852392

    authors: Windhaber RA,Holbrook AG,Krysztopik RJ

    更新日期:2010-05-01 00:00:00

  • Profile of spine and joint tuberculosis on Pakistan's Afghan frontier.

    abstract::Two years individual experience of spine and joint tuberculosis in the North West Frontier of Pakistan is summarised. The problems of treating a population that presents late in the course of the disease, and of coping with an added influx of highly affected Afghans, feature prominently in surgical practice. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Currie MA

    更新日期:1984-03-01 00:00:00

  • Informed consent for total hip arthroplasty: does a written information sheet improve recall by patients?

    abstract:OBJECTIVE:To ascertain whether a written information sheet is acceptable to patients and improves recall of the consent interview. DESIGN:Prospective randomised controlled study using questionnaires, comparing a group of patients given information in a written sheet with appropriate explanation to a group given verbal...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1308/003588402760978201

    authors: Langdon IJ,Hardin R,Learmonth ID

    更新日期:2002-11-01 00:00:00

  • Tongue metastasis from a poorly differentiated urothelial carcinoma of the bladder.

    abstract::Chemotherapy may cause oral ulceration but a thorough investigation of symptoms and signs is important to determine the underlying diagnosis accurately. We describe a case of a patient with a poorly differentiated urothelial carcinoma of the bladder developing a tongue metastasis. This is a challenging diagnosis to ma...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588414X14055925060794

    authors: Kaleva AI,Hone RW,Szakacs SM,Streeter E,Nixon IJ

    更新日期:2015-03-01 00:00:00

  • When might an operative complication be regarded as acceptable? Part 2: Judicial factors that influence the finding of fault during surgical litigation.

    abstract::In cases where surgeons face litigation over operative misadventure, the result of a trial is uncertain. In order to identify factors in cases of surgical litigation that have influenced the final decision of the courts, we have previously reviewed reported cases where the outcome turned on actions taken by surgeons. ...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章,评审

    doi:10.1308/003588414X14055925060992

    authors: Wheeler R,Blackburn S,Biggs H

    更新日期:2015-04-01 00:00:00

  • Gastric cancer surgery--a balance of risk and radicality.

    abstract:INTRODUCTION:The aim of this study was to determine whether tailoring the extent of resection would allow radical gastric cancer surgery to be performed safely in a UK population. PATIENTS AND METHODS:A total of 180 consecutive patients (median age 70 years; male:female ratio 2:1) undergoing resection for gastric aden...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:10.1308/003588408X261546

    authors: Lamb P,Sivashanmugam T,White M,Irving M,Wayman J,Raimes S

    更新日期:2008-04-01 00:00:00

  • The importance of laparotomy in the diagnosis and management of intestinal bleeding of obscure origin.

    abstract::Thirty-seven patients who had had either a colonoscopy or a selective mesenteric angiogram while being investigated for severe or persistent gastrointestinal bleeding of obscure origin were reviewed. Failure to make a prompt diagnosis was partly responsible for the 16% hospital mortality in the series. Colonoscopy was...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Brearley S,Hawker PC,Dorricott NJ,Lee JR,Ambrose NS,Silverman SH,Dykes PW,Keighley MR

    更新日期:1986-09-01 00:00:00

  • Anatomical features of the origin and spread of tumours.

    abstract::All tumours have certain broad characteristics in common, though they vary widely in their origin, distribution, shape, and mode of spread. The part played by anatomical factors in determining these variations is discussed and the need for the surgeon to bear these factors in mind in diagnosis and treatment is emphasi...

    journal_title:Annals of the Royal College of Surgeons of England

    pub_type: 杂志文章

    doi:

    authors: Levene AL

    更新日期:1978-01-01 00:00:00