Guest Recital: Ronald YaDeau, Piano

Kemp Recital Hall Thursday Evening October 6, 1994 8:00p.m

A clinical pathway for total shoulder arthroplasty-a pilot study

BACKGROUND: Appropriate pain management after total shoulder arthroplasty (TSA) facilitates rehabilitation and may improve clinical outcomes.; QUESTIONS/PURPOSES: This prospective, observational study evaluated a multimodal analgesia clinical pathway for TSA.; METHODS: Ten TSA patients received an interscalene nerve block (25cm(3) 0.375% ropivacaine) with intraoperative general anesthesia. Postoperative analgesia included regularly scheduled non-opioid analgesics (meloxicam, acetaminophen, and pregabalin) and opioids on demand (oral oxycodone and intravenous patient-controlled hydromorphone). Patients were evaluated twice daily to assess pain, anterior deltoid strength, handgrip strength, and sensory function.; RESULTS: The nerve block lasted an average of 18h. Patients had minimal pain after surgery; 0 (median score on a 0-10 scale) in the Post-Anesthesia Care Unit (PACU) but increased on postoperative day (POD) 1 to 2.3 (0.0, 3.8; median (25%, 75%)) at rest and 3.8 (2.1, 6.1) with movement. Half of the patients activated the patient-controlled analgesia four or fewer times in the first 24h after surgery. Operative anterior deltoid strength was 0 in the PACU but returned to 68% by POD 1. Operative hand strength was 0 (median) in the PACU, but the third quartile (75%) had normalized strength 49% of preoperative value.; CONCLUSIONS: Patients did well with this multimodal analgesic protocol. Pain scores were low, half of the patients used little or no intravenous opiate, and some patients had good handgrip strength. Future research can focus on increasing duration of analgesia from the nerve block, minimizing motor block, lowering pain scores, and avoiding intravenous opioids

Surgical predictors of acute postoperative pain after hip arthroscopy

BACKGROUND: Pain following hip arthroscopy is highly variable and can be severe. Little published data exists demonstrating reliable predictors of significant pain after hip arthroscopy. The aim of this study was to identify influence of intraoperative factors (arthroscopic fluid infusion pressure, operative type) on the severity of postoperative pain. METHODS: A retrospective review of 131 patients who had received a variety of arthroscopic hip interventions was performed. A standardized anaesthetic technique was used on all patients and postoperative pain was analysed using recovery pain severity outcomes and analgesic use. A multivariate logistic regression analysis was performed on intraoperative factors including patient age, sex and BMI, arthroscopic infusion pressures (40 vs 80 mm Hg), amount of fluid used, length of surgery and types of arthroscopic interventions performed. Thirty six patients were also prospectively examined to determine arthroscopic fluid infusion rates for 40 and 80 mm Hg infusion pressures. RESULTS: Use of a higher infusion pressure of 80 mm Hg was strongly associated with all pain severity endpoints (OR 2.8 – 8.2). Other significant factors included hip arthroscopy that involved femoral chondro-ostectomy (OR 5.8) and labral repair (OR 7.5). Length of surgery and total amount of infusion fluid used were not associated with increased pain. CONCLUSIONS: 80 mm Hg arthroscopic infusion pressures, femoral chondro-osteoectomy and labral repair are strongly associated with significant postoperative pain, whereas intraoperative infusion volumes or surgical duration are not. Identification of these predictors in individual patients may guide clinical practice regarding the choice of more invasive regional analgesia options. The use of 40 mm Hg arthroscopic infusion pressures will assist in reducing postoperative pain

Sciatic lateral popliteal block with clonidine alone or clonidine plus 0.2% ropivacaine: effect on the intra-and postoperative analgesia for lower extremity surgery in children: a randomized prospective controlled study

<p>Abstract</p> <p>Background</p> <p>The effect of adding clonidine to local anesthetics for nerve or plexus blocks remains unclear. Most of the studies in adults have demonstrated the positive effects of clonidine on intra- and postoperative analgesia when used as an adjunctive agent or in some cases as a single to regional techniques. In the pediatric population, there are only few trials involving clonidine as an adjunct to regional anesthesia, and the analgesic benefits are not definite in this group of patients. The evidence concerning perineural administration of clonidine is so far inconclusive in children, as different types and volume of local anesthetic agents have been used in these studies. Moreover, the efficacy of regional anesthesia is largely affected by the operator's technique, accuracy and severity of operation.</p> <p>Methods</p> <p>The use of clonidine alone or combined with 0.2% ropivacaine for effective analgesia after mild to moderate painful foot surgery was assessed in 66 children, after combined sciatic lateral popliteal block (SLPB) plus femoral block. The patients were randomly assigned into three groups to receive placebo, clonidine, and clonidine plus ropivacaine. Time to first analgesic request in the groups was analyzed by using Kaplan-Meier and the log-rank test (mean time, median time, 95% CI).</p> <p>Results</p> <p>In our study, clonidine administered alone in the SLPB seems promising, maintaining intraoperatively the hemodynamic parameters SAP, DAP, HR to the lower normal values so that no patient needed nalbuphine under 0.6 MAC sevoflurane anesthesia, and postoperatively without analgesic request for a median time of 6 hours. In addition, clonidine administered as adjuvant enhances ropivacaine's analgesic effect for the first postoperative day in the majority of children (p = 0.001). Clonidine and clonidine plus ropivacaine groups also didn’t demonstrate PONV, motor blockade, and moreover, the parents of children expressed their satisfaction with the excellent perioperative management of their children, with satisfaction score 9.74 ± 0.45 and 9.73 ± 0.70 respectively. On the contrary all the patients in the control group required rescue nalbuphine in the recovery room, and postoperatively, along with high incidence of PONV, and the parents of children reported a low satisfaction score (7.50 ± 0.70).</p> <p>Conclusions</p> <p>Clonidine appears promising more as an adjuvant in 0.2% ropivacaine and less than alone in the SLPB plus femoral block in children undergoing mild to moderate painful foot surgery, with no side effects.</p> <p>Trial registration</p> <p>ClinicalTrials.gov, <a href="http://www.controlled-trials.com/ISRCTN90832436">ISRCTN90832436</a>, (ref: CCT-NAPN-20886).</p

Graduate recital, piano. YaDeau, K., 1973

Recorded during a live performance at Oakland Recital Hall, Western Michigan University, Kalamazoo, Michigan, March 23, 1973, the 30th concert of the Department of Music's 1972-1973 season.Karen YaDeau, piano.In partial fulfillment of the requirements of the Master of Music degree in applied piano, Western Michigan University, 1973.Information from performance program.Reel 1: Toccata in C minor / Johann Sebastian Bach -- (10:44) Sonate, opus 1 / Alban Berg -- Sonata in A major, opus 101. (19:58) first movement ; (23:15) second movement ; (28:48) third movement ; (31:36) fourth movement / Ludwig van Beethoven.Reel 2: Iberia. first movement ; (7:30) second movement ; (15:38) third movement / Isaac Albéniz

Translingual Encounters: Freedom, Civic Virtue, and the Social Organism in Liang Qichao's Reading of Kant

From 1903 to 1904 while exiled in Japan, Liang Qichao (1873-1929), an intellectual and political theorist of late-Qing and early-Republican China,&nbsp; introduced Chinese readers for the first time to Immanuel Kant in a series of articles entitled “The Theory of Kant, the Greatest Modern Philosopher” (近世第一大哲康德之學說). Liang’s article serves as an example of what Lydia Liu terms translingual practices, its existence predicated upon complex international networks of institutional affiliations, the circulation of publications, the international movement of students, and the effects of political upheavals such as the failed 1898 Hundred Days reform that forced Liang to flee to Japan. These networks created the conditions of possibility for Liang’s article, the result of a chain of translations and interpretations traversing four languages: German, French, Japanese and Chinese. Possibly because Kant was neither a major figure in Liang’s subsequent writings nor a figure often cited as major source of inspiration by Chinese revolutionaries in the first half of the 20th century, the relationship between Kant and modern Chinese thought has been understudied. Rather than focusing on questions of accuracy in Kant’s transnational reception, this paper is instead interested in a different set of questions focusing on the productivity of Liang’s interpretation: how and towards what ends does Liang mobilize Kant rhetorically? How did Liang’s reading of Kant contribute to the articulation of ethical ideals or the creation of a new political imaginary? &nbsp;Drawing from Liang’s commentaries in his translations and his other articles published during this period, the paper argues that Liang’s interpretation of Kant places a particular emphasis on a conception of freedom founded upon the moral cultivation of the people that marks a fundamental break from the traditional Confucian concept of Tianxia 天下, or “all under heaven.”&nbsp; Liang argued that Kant’s concept of freedom, because it linked the individual to the group in an organismic whole, reconciled the needs of the individual vis-à-vis the collective state, which supported an account of ethics and politics that was committed to both universal humanist morality and nationalist politics.&nbsp; Liang’s interpretation of Kant therefore illuminates the historical and theoretical coarticulation of nationalism and liberalism that critiques the forms of ideological mystification which would hold these two terms in binary opposition

Translingual Encounters: Freedom, Civic Virtue, and the Social Organism in Liang Qichao's Reading of Kant

From 1903 to 1904 while exiled in Japan, Liang Qichao (1873-1929), an intellectual and political theorist of late-Qing and early-Republican China,&nbsp; introduced Chinese readers for the first time to Immanuel Kant in a series of articles entitled “The Theory of Kant, the Greatest Modern Philosopher” (近世第一大哲康德之學說). Liang’s article serves as an example of what Lydia Liu terms translingual practices, its existence predicated upon complex international networks of institutional affiliations, the circulation of publications, the international movement of students, and the effects of political upheavals such as the failed 1898 Hundred Days reform that forced Liang to flee to Japan. These networks created the conditions of possibility for Liang’s article, the result of a chain of translations and interpretations traversing four languages: German, French, Japanese and Chinese. Possibly because Kant was neither a major figure in Liang’s subsequent writings nor a figure often cited as major source of inspiration by Chinese revolutionaries in the first half of the 20th century, the relationship between Kant and modern Chinese thought has been understudied. Rather than focusing on questions of accuracy in Kant’s transnational reception, this paper is instead interested in a different set of questions focusing on the productivity of Liang’s interpretation: how and towards what ends does Liang mobilize Kant rhetorically? How did Liang’s reading of Kant contribute to the articulation of ethical ideals or the creation of a new political imaginary? &nbsp;Drawing from Liang’s commentaries in his translations and his other articles published during this period, the paper argues that Liang’s interpretation of Kant places a particular emphasis on a conception of freedom founded upon the moral cultivation of the people that marks a fundamental break from the traditional Confucian concept of Tianxia 天下, or “all under heaven.”&nbsp; Liang argued that Kant’s concept of freedom, because it linked the individual to the group in an organismic whole, reconciled the needs of the individual vis-à-vis the collective state, which supported an account of ethics and politics that was committed to both universal humanist morality and nationalist politics.&nbsp; Liang’s interpretation of Kant therefore illuminates the historical and theoretical coarticulation of nationalism and liberalism that critiques the forms of ideological mystification which would hold these two terms in binary opposition