Popliteal block with transfibular approach in ankle arthrodesis: a case series

<p>Abstract</p> <p>Introduction</p> <p>Ankle arthrodesis is primarily undertaken to control severe pain in the ankle joint. Immediate postoperative pain is usually treated using oral analgesics, intravenous opiates and regional anaesthesia. The outcomes of ankle fusion, including patient satisfaction studies, are well documented in the literature. However, the advantage of popliteal block in the management of early postoperative pain after ankle fusion for osteoarthritis has not been widely reported. This study aims to determine the role of popliteal block using ankle fusion in the management of ankle osteoarthritis.</p> <p>Case presentation</p> <p>Ankle arthrodeses were performed in 27 patients over a five-year period. Eighteen patients were males (one had bilateral arthrodesis) and eight were females. Their mean age was 56 years and they were all Caucasians. The notes and radiographs of the patients were reviewed in retrospect for the duration of their hospital admission, time to union and complications.</p> <p>Conclusion</p> <p>Popliteal block is a safe and effective technique for postoperative analgesia in ankle arthrodesis. By using this technique, we achieved a significant reduction in the duration of hospital stay for our patients after ankle arthrodesis. The resultant cost saving was GBP717 for each patient.</p

Nursing students motivation toward their studies – a survey study

<p>Abstract</p> <p>Background</p> <p>This study focuses on Swedish nursing students' motivation toward their studies during their three year academic studies. Earlier studies show the importance of motivation for study commitment and result. The aim was to analyze nursing students' estimation of their degree of motivation during different semester during their education and to identify reasons for the degree of motivation.</p> <p>Methods</p> <p>A questionnaire asking for scoring motivation and what influenced the degree of motivation was distributed to students enrolled in a nursing programme. 315 students who studied at different semesters participated. Analyzes were made by statistical calculation and content analysis.</p> <p>Results</p> <p>The mean motivation score over all semesters was 6.3 (ranked between 0–10) and differed significantly during the semesters with a tendency to lower score during the 5th semester. Students (73/315) with motivation score <4 reported explanations such as negative opinion about the organisation of the programme, attitude towards the studies, life situation and degree of difficulty/demand on studies. Students (234/315) with motivation score >6 reported positive opinions to becoming a nurse (125/234), organization of the programme and attitude to the studies. The mean score value for the motivation ranking differed significantly between male (5.8) and female (6.8) students.</p> <p>Conclusion</p> <p>Conclusions to be drawn are that nursing students mainly grade their motivation positive distributed different throughout their entire education. The main motivation factor was becoming a nurse. This study result highlights the need of understanding the students' situation and their need of tutorial support.</p

Efficient age determination: how freezing affects eye lens weight of the small rodent species Arvicola terrestris

Age determination of animals by measuring the weight of their eye lenses is a widely used method in wildlife biology. In general, it is recommended to prepare lenses immediately after trapping to avoid errors in the age estimation due to decomposition of lens tissue. However, in many field studies, large numbers of animals need to be trapped over long periods of time in huge areas and by many different field workers. Therefore, the immediate preparation of eye lenses imposes a considerable logistic constraint that could be avoided by prior freezing of trapped animals. To assess the impact of freezing, weights of lens of frozen and unfrozen eyes of 114 Arvicola terrestris were compared pair wise. The frozen lenses weighed at average 3.3% (95% CI: 2.4–4.1%) more than the unfrozen ones from the same animals. Freezing time, weight of lenses and mean temperature of the trapping day as an indicator of decomposition speed did not affect the freezing-induced weight increase. Age estimates based on weights of unfrozen lenses varied between 24 and 445 days. Estimates based on frozen lenses were systematically higher. Applying a constant correction factor of 1.033−1 for the weight of frozen lenses corrects this overestimation of age. We conclude that age determination with frozen lenses of small rodents can yield valid age estimates if a correction factor for freezing is applied. Thus, age determination can be organised much more efficiently in field studies, which is highly advantageous for many ecological, agricultural and epidemiological research projects

Similar Analgesic Effect After Popliteal Fossa Nerve Blockade with 0.375% and 0.75% Bupivacaine

This study tested the hypothesis that increasing the concentration of bupivacaine from 0.375 to 0.75% would increase the duration of postoperative analgesia by 3 h. Seventy patients scheduled for hospital admission after foot or ankle surgery gave consent to enter this prospective randomized trial. Patients were randomly assigned to receive a popliteal fossa block (posterior approach) using 30 cc of either 0.375% or 0.75% bupivacaine, with epinephrine. Patients also received a neuraxial anesthetic and postoperative intravenous patient-controlled analgesia. Patient characteristics, duration of analgesia, pain scores, use of analgesic medications, and side effects of analgesic therapy were determined. Duration of analgesia was similar with both concentrations of bupivacaine (0.375% 14 ± 8 h, 0.75% 13 ± 6 h; mean ± SD). Pain scores were the same for both groups on the first postoperative day (3 of 10 at rest, 5 with therapy). Analgesic use and side effects attributable to pain management did not differ between groups. In conclusion, postoperative analgesia was not affected by the concentration of bupivacaine used for the nerve block. There was no benefit to increasing the concentration of bupivacaine above 0.375% for single-injection popliteal fossa nerve blockade when performed for postoperative analgesia