Improvement in Postoperative Pain Control and Length of Stay With Peripheral Nerve Block Prior to Distal Radius Repair.

Distal radius repair is a common orthopedic surgery often performed at outpatient surgical centers. To date, little is known regarding optimal pain control in this setting. In this study, the authors evaluated patients who underwent distal radius open reduction and internal fixation (ORIF) in an outpatient surgery center setting. Comparisons between 2 surgical groups, peripheral nerve block without general anesthesia vs general anesthesia only, were recorded in terms of postoperative length of stay (LOS) in phase I, total LOS, and patient-reported pain level at discharge. The authors identified 80 patients undergoing distal radius ORIF from March to August 2016. A total of 37 (46.3%) patients received general anesthesia only and 43 (53.8%) patients received peripheral nerve block without general anesthesia. Overall, patients in the nerve block only group showed a statistically significant decrease in pain at discharge, as well as decreased phase I and total LOS. Although the power of the data is low relative to the number of distal radius procedures performed every year, there is a trend of better pain control and decreased LOS when using nerve blocks instead of general anesthesia. [Orthopedics. 2020;43(6):e549-e552.].

Relationship between drain volume/fill volume ratio and clinical outcomes associated with overfill complaints in peritoneal dialysis patients.

BACKGROUND: To better understand the spectrum of overfill reports and their corresponding clinical severity and etiology, we conducted a review of overfill reports from the Manufacturer and User Facility Device Experience (MAUDE) database, which is within the Food and Drug Administration (FDA) Web site (www.fda.gov). METHOD: We searched the MAUDE database for events related to overfill reports between 1 January 1995 and 31 December 2008 and recorded drain volume (DV)/fill volume (FV), or DV/FV, and clinical symptoms and signs associated with the overfill report. RESULTS: Among 462 MAUDE reports with a possible overfill event, 440 reports (95.2%) with a confirmed overfill event contained sufficient information to ascertain the clinical severity of the event. The number of reports with a clinical severity rating of minor, moderate, major, or death was 331, 71, 28, and 10, respectively. The median (range) DV/FV for a subgroup of 292 reports with a clinical severity rating of minor, moderate, major, or death was 1.63 (1.06 - 4.29), 1.71 (1.08 - 5.87), 2.14(1.64 - 2.61), and 2.50 (2.28 - 3.33), respectively. Insufficient drain accounted for a majority of overfill reports. CONCLUSION: Our analysis of reports from the MAUDE database suggests an association between DV/FV and clinical severity of the reported overfill event, as well as significant patient-to-patient variability with respect to intraperitoneal volume tolerance.