Asklepeion Voulas General Hospital

Athens, Greece

Asklepeion Voulas General Hospital

Athens, Greece

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Sarridou D.G.,Asklepeion Voulas General Hospital | Sarridou D.G.,Harefield Hospital | Sarridou D.G.,Imperial College London | Chalmouki G.,Asklepeion Voulas General Hospital | And 4 more authors.
Pain Physician | Year: 2015

Background: Up until now, the optimal strategy for postoperative pain management after total knee arthroplasty (TKA) remains to be elucidated. Objective: The current investigation aimed to examine the analgesic efficacy and the opioid sparing effects of intravenous parecoxib in combination with continuous femoral blockade. Study Design: Randomized, double-blind, prospective trial. Setting: University hospital in the United Kingdom. Methods: In total, 90 patients underwent TKA under subarachnoid anesthesia and received continuous femoral block initially as a bolus with 20 mL of ropivacaine 0.75%. Infusion of 0.2% on 10 mL/h followed. Patients were randomized into 2 groups. Group D and Group P received parecoxib and placebo, respectively at 12 hour time intervals. Visual analog scale (VAS) pain scores were obtained at different time intervals including 4, 8, 12, 24 and 36 hours. The pain scores were measured with patients in a resting position. Morphine could also be administered with a patient controlled analgesia (PCA) pump if the specified analgesia was deemed inadequate (VAS > 5). Results: None of the patients were withdrawn from the study. Parecoxib provided greater relief than placebo following TKA. The VAS pain scores measured at rest were statistically significantly lower in parecoxib-treated patients compared to the placebo group (P = 0.007) at 4 (P = 0.044), 12 (P = 0.001), and 24 hours (P = 0.012), postoperatively. Patients receiving parecoxib consumed less morphine at all time intervals than patients receiving placebo, with borderline statistical significance (P = 0.054). In each time period, all patients receiving continuous femoral block irrespectively of the treatment group, required low morphine doses. Limitations: Current protocol did not answer question as to functional recovery. Conclusion: According to our findings intravenous parecoxib in combination with continuous femoral block provided superior analgesic efficacy and opioid sparing effects in patients undergoing TKA. © 2015, American Society of Interventional Pain Physicians. All Rights Reserved.


Vlastarakos P.V.,MITERA Infirmary | Nazos K.,Asklepeion Voulas General Hospital | Tavoulari E.-F.,Penteli Childrens Hospital | Nikolopoulos T.P.,National and Kapodistrian University of Athens
European Archives of Oto-Rhino-Laryngology | Year: 2014

The aim of the present paper is to critically review the current evidence on the efficacy of cochlear implantation as a treatment modality for single-sided deafness (SSD), and/or unilateral tinnitus. Systematic literature review in Medline and other database sources was conducted along with critical analysis of pooled data. The study selection includes prospective and retrospective comparative studies, case series and case reports. The total number of analyzed studies was 17. A total of 108 patients with SSD have been implanted; 66 patients due to problems associated with SSD, and 42 primarily because of debilitating tinnitus. Cochlear implantation in SSD leads to improved sound localization performance and speech perception in noise from the ipsilateral side with an angle of coverage up to (but not including) 90° to the front, when noise is present in the contralateral quartile (Strength of recommendation B). Speech and spatial hearing also subjectively improve following the insertion of a cochlear implant (Strength of recommendation B); this was not the case regarding the quality of hearing. Tinnitus improvement was also reported following implant placement (Strength of recommendation B); however, patients need to be advised that the suppression is mainly successful when the implant is activated. The overall quality of the available evidence supports a wider use of cochlear implantation in SSD following appropriate selection and counseling (overall strength of recommendation B). It remains to be seen if the long-term follow-up of large number of patients in well conducted high quality studies will confirm the above mentioned results. © Springer-Verlag Berlin Heidelberg 2013.


PubMed | Asklepeion Voulas General Hospital and National and Kapodistrian University of Athens
Type: Journal Article | Journal: Pain and therapy | Year: 2016

Intravenous administration of parecoxib could provide significant pain relief in surgical operations that require additional forms of analgesia. However, very little is known about its effects on the anxiety levels of patients before a surgical procedure. The aim of this prospective study was to investigate whether intravenous parecoxib, pre-emptively administered, has an effect on anxiety levels experienced post-surgically after total knee arthroplasty (TKA) and if it influences the reported pain of the procedure itself.A total of 90 patients who underwent TKA under spinal anesthesia were included in the study. Prior to TKA, all patients received continuous femoral nerve block (CFNB) and were randomized into two groups: Group D consisted of 45 patients who received the drug parecoxib intravenously in addition to CFNB, whereas Group P consisted of 45 patients who received a placebo drug (N/S 0.9%) intravenously instead of parecoxib. All patients were asked to fill in the questionnaires STAI1 and STAI2 in order to evaluate anxiety levels pre- and post-surgically, respectively. One of the main aims was to distinguish personality-trait anxiety from state anxiety, i.e., anxiety experience due to the actual perioperative events and the actual pain endured.The group receiving parecoxib had statistically significant lower anxiety levels both for personality trait anxiety and state anxiety, as compared to the placebo group.Based on our findings, parecoxib had both analgesic and anxiolytic effects in patients undergoing TKA with CFNB.Current Controlled Trials: NCT02185924.


PubMed | Asklepeion Voulas General Hospital
Type: Journal Article | Journal: Pain physician | Year: 2015

Up until now, the optimal strategy for postoperative pain management after total knee arthroplasty (TKA) remains to be elucidated.The current investigation aimed to examine the analgesic efficacy and the opioid sparing effects of intravenous parecoxib in combination with continuous femoral blockade.Randomized, double-blind, prospective trial.University hospital in the United Kingdom.In total, 90 patients underwent TKA under subarachnoid anesthesia and received continuous femoral block initially as a bolus with 20 mL of ropivacaine 0.75%. Infusion of 0.2% on 10 mL/h followed. Patients were randomized into 2 groups. Group D and Group P received parecoxib and placebo, respectively at 12 hour time intervals. Visual analog scale (VAS) pain scores were obtained at different time intervals including 4, 8, 12, 24 and 36 hours. The pain scores were measured with patients in a resting position. Morphine could also be administered with a patient controlled analgesia (PCA) pump if the specified analgesia was deemed inadequate (VAS > 5).None of the patients were withdrawn from the study. Parecoxib provided greater relief than placebo following TKA. The VAS pain scores measured at rest were statistically significantly lower in parecoxib-treated patients compared to the placebo group (P = 0.007) at 4 (P = 0.044), 12 (P = 0.001), and 24 hours (P = 0.012), postoperatively. Patients receiving parecoxib consumed less morphine at all time intervals than patients receiving placebo, with borderline statistical significance (P = 0.054). In each time period, all patients receiving continuous femoral block irrespectively of the treatment group, required low morphine doses.Current protocol did not answer question as to functional recovery.According to our findings intravenous parecoxib in combination with continuous femoral block provided superior analgesic efficacy and opioid sparing effects in patients undergoing TKA.

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