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 Engljournal_title
Annals of the Royal College of Surgeons of Englandauthors
Gill I,Gallagher K,Busch CAdoi
10.1308/003588410X12628812459733subject
Has Abstractpub_date
2010-05-01 00:00:00pages
335-7issue
4eissn
0035-8843issn
1478-7083journal_volume
92pub_type
杂志文章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
更新日期:2017-04-01 00:00:00
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:
更新日期:1999-09-01 00:00:00
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:
更新日期:1983-09-01 00:00:00
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
更新日期:2010-04-01 00:00:00
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
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0042
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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:
更新日期:1999-03-01 00:00:00
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
更新日期:2017-02-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1983-11-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870810X12659688851672
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870810X476638
更新日期:2010-01-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588409X12486167521037
更新日期:2009-11-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588413X13511609958091
更新日期:2013-04-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/147870807X238230
更新日期:2007-11-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/10.1308/147870811X602122
更新日期:2011-10-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/rcsann.2019.0178
更新日期:2020-04-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:10.1308/003588410X12518836439047
更新日期:2010-01-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
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更新日期:2018-08-16 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
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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:
更新日期:1973-05-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2010-05-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1984-03-01 00:00:00
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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
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更新日期:2002-11-01 00:00:00
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
更新日期:2015-03-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2015-04-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
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更新日期:2008-04-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1986-09-01 00:00:00
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journal_title:Annals of the Royal College of Surgeons of England
pub_type: 杂志文章
doi:
更新日期:1978-01-01 00:00:00