The Experts below are selected from a list of 2517 Experts worldwide ranked by ideXlab platform

Henrik Kehlet - One of the best experts on this subject based on the ideXlab platform.

  • persistent sensory dysfunction in pain free Herniotomy
    Acta Anaesthesiologica Scandinavica, 2010
    Co-Authors: Eske Kvanner Aasvang, Henrik Kehlet
    Abstract:

    Background: Persistent post-Herniotomy pain may be a neuropathic pain state based on the finding of a persistent sensory dysfunction. However, detailed information on the normal distribution of sensory function in pain-free post-Herniotomy patients hinders identification of exact pathogenic mechanisms. Therefore, we aimed to establish normative data on sensory function in pain-free patients >1 year after a groin Herniotomy. Methods: Sensory thresholds were assessed in 40 pain-free patients by a standardized quantitative sensory testing (QST). Secondary endpoints included comparison of sensory function between the operated and the naive side, and correlation between sensory function modalities. Results: QST showed that on the operated side, thermal data were normally distributed, but mechanical pressure and pinch thresholds were normalized only after log-transformation, and cold pain and pressure tolerance could not be normalized. Comparison of QST results revealed significant (P<0.01) cutaneous hypoesthesia/hyperalgesia, but also significant pressure hyperalgesia (P<0.01) and decreased pressure tolerance (P=0.02) on the operated vs. the naive side. Wind-up was seen in 6 (15%) but with a low pain intensity. Conclusion: Persistent sensory dysfunction is common in pain-free post-Herniotomy patients. Future studies of sensory function in persistent post-Herniotomy pain should compare the findings to the present data in order to characterize individual patients and potentially identify subgroups, which may aid in allocation of patients to pharmacological or surgical treatment.

  • Persistent sensory dysfunction in pain‐free Herniotomy
    Acta Anaesthesiologica Scandinavica, 2009
    Co-Authors: Eske Kvanner Aasvang, Henrik Kehlet
    Abstract:

    Background: Persistent post-Herniotomy pain may be a neuropathic pain state based on the finding of a persistent sensory dysfunction. However, detailed information on the normal distribution of sensory function in pain-free post-Herniotomy patients hinders identification of exact pathogenic mechanisms. Therefore, we aimed to establish normative data on sensory function in pain-free patients >1 year after a groin Herniotomy. Methods: Sensory thresholds were assessed in 40 pain-free patients by a standardized quantitative sensory testing (QST). Secondary endpoints included comparison of sensory function between the operated and the naive side, and correlation between sensory function modalities. Results: QST showed that on the operated side, thermal data were normally distributed, but mechanical pressure and pinch thresholds were normalized only after log-transformation, and cold pain and pressure tolerance could not be normalized. Comparison of QST results revealed significant (P

  • Inguinal Herniotomy in outpatient clinics and in hospital departments
    Ugeskrift for laeger, 2003
    Co-Authors: Finn Heidemann Andersen, M. Bay-nielsen, Bak-christensen A, K. Nielsen, Struckmann, Henrik Kehlet
    Abstract:

    INTRODUCTION The purpose of the investigation was to examine the use of ambulatory surgery, anesthetic technique, reoperation rates, and reembursement fees after inguinal Herniotomy in private outpatients clinics compared to Herniotomy in hospital departments. MATERIAL AND METHODS Information on number of operations performed, choice of anesthetic and surgical technique in private outpatients clinics and hospital departments was extracted from the Danish Hernia Data Base. Information on reembursement fees was obtained from the relevant health authorities and the Danish Medical Association. RESULTS 7.4% of the inguinal herniotomies in Denmark were performed in private outpatients clinics. There was an extended use of local infiltration anesthesia (99%) and ambulatory procedures (99%) compared with 12% and 57% in the hospital departments. The reembursement fee for a Herniotomy is approximately 3700 DKK in private outpatients clinics vs. 11,000 DKK in hospital departments. DISCUSSION The results of the study showed that the quality of inguinal Herniotomy in private outpatients clinics is comparable to Herniotomy in hospital departments, but the reembursement fees are lower in private outpatients clinics.

  • Pain and convalescence after ambulatory inguinal Herniotomy during local anesthesia
    Ugeskrift for laeger, 1995
    Co-Authors: S. Møiniche, Hesselfeldt P, Bardram L, Henrik Kehlet
    Abstract:

    Postoperative pain and convalescence following ambulatory inguinal Herniotomy in local infiltration anesthesia was evaluated in this descriptive study. Sixty consecutive patients (median age 63 yr) were included. Per- and postoperative pain treatment were pre- and postoperative oral tenoxicam and methadone plus infiltration of the surgical field with up to 60 ml of 0.25% bupivacaine. Intraoperative pain intensity was slight and was treated with supplemental bupivacaine. Patients were totally relieved of pain at rest and during mobilisation in the first hours after surgery, but more than half of the patients had moderate pain from the first to the third postoperative day and still had light pain seven days after surgery. Normal daily activity was re-established five days postoperatively (median). Fifty-two patients were satisfied with the anesthesia and eight patients not satisfied due to fear of intraoperative pain. This study shows that inguinal Herniotomy can be performed routinely as an outpatient procedure under local infiltration anesthesia. However, late postoperative pain was significant and should be improved with multi-modal analgesia.

  • Wound infiltration with ropivacaine and bupivacaine for pain after inguinal Herniotomy.
    Acta anaesthesiologica Scandinavica, 1995
    Co-Authors: C. J. Erichsen, H. Vibits, Joergen B. Dahl, Henrik Kehlet
    Abstract:

    In a double-blind, randomized study, 32 patients scheduled for elective inguinal Herniotomy under general anaesthesia received subcutaneous infiltration with 40 ml ropivacaine 2.5 mg/ml or bupivacaine. Postoperative pain intensity was assessed repeatedly for 24 hours at rest, during cough and movement on a visual analogue scale (VAS) and by means of pressure algometry. No differences between pain intensities or wound tenderness were found between the groups. The demand for analgesics was similar in the two groups. We conclude that incisional ropivacaine is as effective as bupivacaine in the management of post-Herniotomy pain.

Eske Kvanner Aasvang - One of the best experts on this subject based on the ideXlab platform.

  • persistent sensory dysfunction in pain free Herniotomy
    Acta Anaesthesiologica Scandinavica, 2010
    Co-Authors: Eske Kvanner Aasvang, Henrik Kehlet
    Abstract:

    Background: Persistent post-Herniotomy pain may be a neuropathic pain state based on the finding of a persistent sensory dysfunction. However, detailed information on the normal distribution of sensory function in pain-free post-Herniotomy patients hinders identification of exact pathogenic mechanisms. Therefore, we aimed to establish normative data on sensory function in pain-free patients >1 year after a groin Herniotomy. Methods: Sensory thresholds were assessed in 40 pain-free patients by a standardized quantitative sensory testing (QST). Secondary endpoints included comparison of sensory function between the operated and the naive side, and correlation between sensory function modalities. Results: QST showed that on the operated side, thermal data were normally distributed, but mechanical pressure and pinch thresholds were normalized only after log-transformation, and cold pain and pressure tolerance could not be normalized. Comparison of QST results revealed significant (P<0.01) cutaneous hypoesthesia/hyperalgesia, but also significant pressure hyperalgesia (P<0.01) and decreased pressure tolerance (P=0.02) on the operated vs. the naive side. Wind-up was seen in 6 (15%) but with a low pain intensity. Conclusion: Persistent sensory dysfunction is common in pain-free post-Herniotomy patients. Future studies of sensory function in persistent post-Herniotomy pain should compare the findings to the present data in order to characterize individual patients and potentially identify subgroups, which may aid in allocation of patients to pharmacological or surgical treatment.

  • Persistent sensory dysfunction in pain‐free Herniotomy
    Acta Anaesthesiologica Scandinavica, 2009
    Co-Authors: Eske Kvanner Aasvang, Henrik Kehlet
    Abstract:

    Background: Persistent post-Herniotomy pain may be a neuropathic pain state based on the finding of a persistent sensory dysfunction. However, detailed information on the normal distribution of sensory function in pain-free post-Herniotomy patients hinders identification of exact pathogenic mechanisms. Therefore, we aimed to establish normative data on sensory function in pain-free patients >1 year after a groin Herniotomy. Methods: Sensory thresholds were assessed in 40 pain-free patients by a standardized quantitative sensory testing (QST). Secondary endpoints included comparison of sensory function between the operated and the naive side, and correlation between sensory function modalities. Results: QST showed that on the operated side, thermal data were normally distributed, but mechanical pressure and pinch thresholds were normalized only after log-transformation, and cold pain and pressure tolerance could not be normalized. Comparison of QST results revealed significant (P

A. M. Hassan - One of the best experts on this subject based on the ideXlab platform.

Sherif Shehata - One of the best experts on this subject based on the ideXlab platform.

C. J. Erichsen - One of the best experts on this subject based on the ideXlab platform.

  • Wound infiltration with ropivacaine and bupivacaine for pain after inguinal Herniotomy.
    Acta anaesthesiologica Scandinavica, 1995
    Co-Authors: C. J. Erichsen, H. Vibits, Joergen B. Dahl, Henrik Kehlet
    Abstract:

    In a double-blind, randomized study, 32 patients scheduled for elective inguinal Herniotomy under general anaesthesia received subcutaneous infiltration with 40 ml ropivacaine 2.5 mg/ml or bupivacaine. Postoperative pain intensity was assessed repeatedly for 24 hours at rest, during cough and movement on a visual analogue scale (VAS) and by means of pressure algometry. No differences between pain intensities or wound tenderness were found between the groups. The demand for analgesics was similar in the two groups. We conclude that incisional ropivacaine is as effective as bupivacaine in the management of post-Herniotomy pain.