by HBOT News | Aug 3, 2017 | Concussion, Traumatic Brain Injury (TBI)
Baseline sleep characteristics were explored for 71 U.S. military service members with mild traumatic brain injury (mTBI) enrolled in a post-concussive syndrome clinical trial. The Pittsburgh Sleep Quality Index (PSQI), sleep diary, several disorder-specific questionnaires, actigraphy and polysomnographic nap were collected. Almost all (97%) reported ongoing sleep problems. The mean global PSQI score was 13.5 (SD=3.8) and 87% met insomnia criteria. Sleep maintenance efficiency was 79.1% for PSQI, 82.7% for sleep diary and 90.5% for actigraphy; total sleep time was 288, 302 and 400 minutes, respectively. There was no correlation between actigraphy and subjective questionnaires. Overall, 70% met hypersomnia conditions, 70% were at high risk for obstructive sleep apnea (OSA), 32% were symptomatic for restless legs syndrome, and 6% reported cataplexy. Nearly half (44%) reported coexisting insomnia, hypersomnia and high OSA risk. Participants with post-traumatic stress disorder (PTSD) had higher PSQI scores and increased OSA risk. Older participants and those with higher aggression, anxiety or depression also had increased OSA risk. The results confirm poor sleep quality in mTBI with insomnia, hypersomnia, and OSA risk higher than previously reported, and imply sleep disorders in mTBI may be underdiagnosed or exacerbated by comorbid PTSD.
by HBOT News | Jul 23, 2017 | Clinical Trials, HBOT Research, Post-Op Complication
I.V naloxone decreases incidence and severity of the common morphine side effects (pruritis,
nausea/emesis, constipation, urinary retention, respiratory depression and undesirable
sedation) so using it as additive to intrathecal morphine in patients undergoing anal
surgeries under spinal anesthesia may be beneficail
by HBOT News | Jul 15, 2017 | Key TBI Research, TBI (Traumatic Brain Injury), Traumatic Brain Injury (TBI) News
Abstract Studies of the association between traumatic brain injury (TBI) and suicide attempt have yielded conflicting results. Furthermore, no studies have examined the possible mediating role of common comorbid psychiatric conditions in this association. This study...
by HBOT News | Jun 22, 2017 | Caesarean Section, Clinical Trials, HBOT Research
Cesarean section commonly induces moderate to severe pain for 48 hours. These patients have
additional compelling reasons to provide adequate pain relief as early mobilization is a key
factor to prevent the risk of thromboembolic event which is increased during pregnancy.
Beside these, patients need to be pain free to takecare for their newborn and breastfeed
them. Poorly controlled pain after cesarean section also increases risk of chronic pain and
postpartum depression.
Intrathecal morphine is considered the "gold standard" for postoperative pain relief after
cesarean delivery. The duration of analgesic effect of morphine extend to 12-24 hours. Its
widespread use is due to its favorable pharmacokinetic profile, ease of administration and
low cost. Although intrathecal morphine is highly effective, its use is associated with
undesirable adverse effect particularly nausea, vomiting and pruritus which reduce overall
patients’ satisfaction. More serious complication is the risk of delayed maternal respiratory
depression.
The Quadratus Lumborum block was first described in 2007 which demonstrates a spread to the
paravertebral space, thus leads to a more extensive block to T5-L1 nerve branches and a long
lasting block with the potential to provide visceral pain relief. Therefore, this block has
an evolving role in postoperative analgesia for many lower abdominal surgeries. As the safety
is concerned, there has been one report of a patient with unilateral hip flexion and knee
extension weakness leading to unplanned overnight admission following lateral quadratus
lumborum block after laparoscopic gynaecological operation.
If the result favors effective, it will have the advantage of a combination with intrathecal
opioid to prolong the pain free period after cesarean section which has about 4,000 cases per
year.
by HBOT News | Apr 4, 2017 | Chronic Wounds
Abstract: After cesarean delivery, postoperative pain management allows early rehabilitation and helps prevent postpartum depression and chronic pain. Our present prospective, randomized controlled, double-blind study assessed the duration and effect of intrathecal...
