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Lidoderm effectiveness in reducing pain in post-operative unilateral knee replacements patients [Meeting Abstract]

Nafissi A.; Husain S.; Ahmed T.; Fedman D.; Bansal A.; Vitale K.; Jimenez A.; Gusmorino P.
Post-operative pain continues to be one of the most common complications in ambulatory surgery. Uncontrolled pain prolongs hospitalization, hinders recovery and contributes to patient dissatisfaction. Current pain therapies, such as opioids, have several debilitating side effects that include nausea, constipation, and drowsiness, which impact the patient's functional recovery. The objective was to assess Lidoderm (lidocaine 5%) patch effectiveness in reducing pain and opioid use in post-operative unilateral knee replacement patients. This was a randomized, double-blind, placebo-controlled trial. One Lidoderm or placebo patch was cut in half and placed on either side of the incision of the operated knee, for 12-hours on and 12-hours off each day. Both groups continued to receive their regular pain medication as needed, which included acetaminophen/codeine, acetaminophen/hydrocodone, acetaminophen 325mg/oxycodone5 mg (Percocet), hydromorphone, tramadol, and celecoxib. Pain levels were based on a 10-point numerical analog scale and were assessed daily for a total of 7-days. Data from 87 participants were included, 44 in Lidoderm and 43 in placebo group: the mean amount of Percocets used was 24.76 (SD=16.45) in the Lidoderm and 27.76 (SD=22.35) in the placebo group (p=0.64). The mean amount of Percocet use per day was 3.53 (SD=2.34) in the Lidoderm and 3.90 (SD=3.21) in the placebo group (p=0.71). The mean decrease in pain scale for the Lidoderm was 3.01 (SD=2.42) and 2.08 (SD=1.70) for the placebo group, and was significant (p=0.003). No side effects reported. Providing post-operative analgesia is difficult yet imperative to recovery. Patients with lidoderm patches had an overall lower pain level that was statistically significant over a 7-day post-operative period. The average total and daily Percocet use was also lower in the Lidoderm group. Based on our results, we found that placing a topical Lidoderm patch provides an effective adjunct treatment in post-operative pain management
ISSN: 1526-5900
CID: 131848

Inpatient admission for pain rehabilitation: re-examing an old idea

Feldman D; Vitale K; Jimenez A; Gusmorino P
ISSN: 1526-5900
CID: 91371

Functional recovery of a patient with complex regional pain syndrome in an inpatient pain rehabilitation program : a case report

Feldman DD; Vitale KC; Gusmorino P; Snow B; Shen H; Jimenez A; Moroz A; Knotkova H
ISSN: 1939-5914
CID: 90956

Bupivacaine for postoperative pain relief at the iliac crest bone graft harvest site

Puri R; Moskovich R; Gusmorino P; Shott S
An inevitable side effect of iliac crest bone graft harvesting is postoperative pain at the donor site. Bupivacaine hydrochloride is a long-acting local anesthetic that is clinically effective for approximately 8 hours. The present study was undertaken to assess postoperative pain relief with locally injected bupivacaine at the iliac crest bone graft harvest site. Pain relief with locally injected bupivacaine or saline at the iliac bone harvest site using an indwelling catheter was studied in 13 patients in a prospective, double-blind, crossover study. Twelve patients had cervical diskectomy and arthrodesis with autograft and one patient had a triple arthrodesis of the foot. There were no statistically significant differences between patients given bupivacaine and patients given saline with respect to pain relief ratings and hip-pain ratings at rest and motion during the first 24-hour postoperative period and the second 24-hour postoperative period (Mann-Whitney test). The single diabetic patient who had a triple arthrodesis developed a wound infection at the catheter placement site. The number of patients was too small to draw conclusions about the differences in pain-medication requirements between patients undergoing single versus multiple diskectomies and fusions. In view of the lack of improvement in pain relief and the risk of infection, local administration of bupivacaine at the iliac bone harvest site is not recommended in its present form for postoperative analgesia
PMID: 10890457
ISSN: 1078-4519
CID: 35843

Non-pharmacologic techniques for acute pain management

Chapter by: Snow BR; Gusmorino P
in: Pain management and regional anesthesia in trauma by Bernstein RL; Rosenberg AD; Grande CM [Eds]
London : WB Saunders, 2000
pp. 253-261
ISBN: 0702022853
CID: 3857

Hospitalization of the chronic pain patient

Chapter by: Snow BR; Gusmorino P; Pinter I
in: A practical approach to pain management by Lefkowitz M; Lebovits AH [Eds]
Boston : Little, Brown, 1996
pp. 165-170
ISBN: 0316519588
CID: 3856

Behavioral medicine and cancer: a clinician's guide

Chapter by: Snow BR; Gusmorino P; Pinter I
in: Musculoskeletal oncology by Lewis MM [Eds]
Philadelphia : WB Saunders, 1992
pp. 449-463
ISBN: 0721657710
CID: 3855

Multidisciplinary treatment for a chronic pain patient returning to work: a case report [Case Report]

Snow BR; Gusmorino P; Pinter I
PMID: 2175668
ISSN: 0883-9344
CID: 61875

Behavioral medicine and the geriatric orthopaedic inpatient: assessment and treatment

Chapter by: Gusmorino P; Snow BR; Pinter I
in: Comprehensive care of orthopaedic injuries in the elderly by Zuckerman JD [Eds]
Baltimore : Urban & Schwarzenberg, 1990
pp. 595-605
ISBN: 080672241x
CID: 3853

Chronic pain and the geriatric patient: assessment and treatment

Chapter by: Snow BR; Gusmorino P; Pinter I
in: Comprehensive care of orthopaedic injuries in the elderly by Zuckerman JD [Eds]
Baltimore : Urban & Schwarzenberg, 1990
pp. 607-618
ISBN: 080672241x
CID: 3854