ABSTRACT Abstract: Anxiety is the commonest anticipated problem of patients during the perioperative period. Preoperative anxiety can produce poor postoperative outcome and make the management and control of postoperative pain more difficult. Studies have demonstrated a strong relationship between anxiety and pain. Anxiety leads to elevated pain, likewise pain results in an increased level of anxiety. Therefore, it can be postulated that reducing the amount of anxiety experienced preoperatively with an anxiolytic will reduce the burden of pain experienced by patients postoperatively. This study assessed the clinical effect of preoperative anxiolysis with Lorazepam on postoperative pain perception in patients undergoing elective lower limb major orthopaedic surgeries under combined spinal epidural (CSE) anaesthesia. This was a prospective study of 122 patients who presented for surgeries at the University of Abuja Teaching Hospital, Nigeria. Patients were randomly assigned to receive either Lorazepam 2mg (n=56) or placebo (n=56) the night before surgery and 2h before scheduled surgery. Postoperative pain scores, analgesic requirements and satisfaction with pain control were evaluated during the first 24h following surgery.We found that patients who received Lorazepam reported a significantly lower pain score than placebo group during the first12h (p= 0.031) while morphine requirement was significantly greater in the placebo group than Lorazepam group (8.20±1.91mg vs 14.8 ±2.10mg; p= 0.036) and patients treated with anxiolytics showed a greater satisfaction with pain relief (p=0.0185). In summary, preoperative Lorazepam produced significant anxiolysis that led to reduced pain, lower analgesic consumption, and better satisfaction but with modest side effects.
ABSTRACT Abstract: Osteochondroma is a developmental anomaly of the bone that results in the formation of an exophytic outgrowth on the surface of the bone. It is the most common benign bone tumor. Distal Femur and Proximal Tibia are the most common sites for this tumor. Osteochondroma is rare in the Pelvis. Osteochondroma is also known as Exostosis. We hereby report a case of solitary osteochondroma from the Anterior Superior Iliac Spine in a 22-year-old boy which was managed in our Centre.
ABSTRACT Abstract: Background: In era of increased air travel, airport security screening measures has been increased. A lot of anxiety to the patient that may trigger an alarm at airport securities post-surgery. The purpose of this study is to find out experiences of patients after total knee arthroplasty (TKA) passing through airport security. Methods: A retrospective case series of 250 TKA patients in a single high-volume center from January 2017 to January 2019, who had passed through airport security and met inclusion criteria. Patients were contacted during their regular follow ups or via phone. The patients were asked for alarm trigger, perceived inconvenience, whether security officials asked to show documentation regarding prosthesis, and any extra screening procedures check measures. Results: Out of 250 patients, 52 patients met inclusion criteria travelling by airplane. 27 patients reported alarm trigger. 7 patients had to undergo additional security check measures. 43% of the patients believed that having their TKA increased the inconvenience while traveling. Conclusions: This study provides information to surgeons regarding airport travel post TKA. Patients can be counselled regarding the inconvenience and to be prepared for delays in airport and to be prepared to present documentation of their prosthesis.
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Mst. Tanzina Islam
Nursing Instructor, Naogaon Nursing Institute, Naogaon, Rajshahi, Bangladesh
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