Henrik Kehlet

..Application of this knowledge from pathophysiologic responses to uncomplicated surgical injury should be explored in patients with severe surgical illness...

..The effect of postoperative pain relief on morbidity and hospital stay is reviewed...

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..No serious side effects were observed for up to 6 mo after administration. In conclusion, bupivacaine incorporated in microcapsules provided analgesia for 96 h after subcutaneous infiltration...

..We propose a scheme for uniform assessment of chronic postherniorrhaphy pain in order to facilitate interpretation of future studies...

..In conclusion, paracetamol has a favourable efficacy-tolerability profile and is therefore recommended as a basic, first-line analgesic in acute pain states and as a valuable component in multimodal analgesia...

..Future studies, including those incorporating investigational agents, such as kappa-opioid agonists and peripheral mu-opioid antagonists, into a multimodal regimen, may offer new treatment options to further impact POI duration...

..Perioperative anemia leads to increased morbidity and mortality and potentially inhibits rehabilitation after hip fracture surgery. As such, the optimum transfusion threshold after hip fracture surgery is unknown...

..The goal of this study was to evaluate patient satisfaction with the hospital stay in relation to the length of stay for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA)...

..Optimization of postoperative outcome requires the application of evidence-based principles of care carefully integrated into a multimodal rehabilitation program...

..The objective of this study was to investigate the effects of 2 levels of intraoperative fluid administration on perioperative physiology and outcome after laparoscopic cholecystectomy...

..Further large-scale studies are required on potential differences in serious morbidity and mortality...

..In this prospective study of 150 consecutive patients undergoing laparoscopic cholecystectomy, the preoperative clinical data, cold pressor test, state of neuroticism and early postoperative pain intensity were assessed...

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..Earlier studies have identified patient characteristics predicting LOS, but little is known about specific reasons for being hospitalized following fast-track THA and TKA...

..To determine the effects of preoperative dexamethasone on surgical outcome after laparoscopic cholecystectomy (LC)...

..Persistent postherniotomy pain (PPP) affects everyday activities in 5-10% of patients. Identification of predisposing factors may help to identify the risk groups and guide anesthetic or surgical procedures in reducing risk for PPP...

..The goal of this study was to evaluate hospital stays for patients operated on with primary total hip- and knee-arthroplasty (THA and TKA) in order to identify important logistical and clinical areas for the duration of the hospital stay...

..Factors other than nerve damage may be involved in the development of chronic posthemiotomy pain...

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..CONCLUSIONS: Addition of small amounts of dexamethasone to bupivacaine incorporated in microcapsules prolonged local analgesia compared with microcapsules with plain bupivacaine after subcutaneous administration in humans...

..However, it has been speculated that a decrease in LOS may be associated with an increase in readmissions in general, including risk of dislocation after total hip arthroplasty (THA) or manipulation after total knee arthroplasty (TKA)...

..We therefore conducted a prospective study to establish whether anaemia affected functional mobility in the early post-operative phase after a hip fracture surgery...

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..The aim of the present article was to examine the validity of the preliminary prefracture New Mobility Score (NMS), age and fracture type as independent predictors of in-hospital outcome after hip fracture surgery...

..A simple multimodal approach using an intercostal catheter (ICC) may be of benefit since acute post-operative pain following VATS lobectomy primarily originates from the chest drain area...

..These guidelines will also be available at the website for the Danish Hernia Database (www.herniedatabasen.dk). The guidelines will be updated when new substantial evidence becomes available...

..To evaluate the applicability, effectiveness, immediate postoperative complaints and requirements for a postanaesthesia care unit stay after elective abdominal hysterectomy under a well defined, multimodal anaesthetic regime...

..There is an urgent need for better design of studies, especially in minimal invasive surgery to achieve maximal outcome effects when integrated into the fast-track methodology...

..High-volume local infiltration analgesia has been shown to be an effective pain treatment after knee replacement, but the role of bandaging to prolong analgesia has not been evaluated...

..This retrospective, nationwide, observational study was designed to compare treatment in tertiary referral centers vs. regional hospitals on overall survival for patients with stage IIIC and IV ovarian cancer...

..5% of patients. However, the specific psychosexological and neurophysiologic characteristics have not been described, thereby precluding assessment of pathogenic mechanisms and treatment strategies...

..The results are in line with animal findings on the role of GABA in pain processing and with studies in humans showing analgesic efficacy of GABA-related drugs in clinical pain conditions...

..0001). In conclusion, cooling with 8 degrees C for 30 min following a first degree burn injury in humans does not attenuate inflammatory or hyperalgesic responses compared with a placebo-treated control burn...

..In this study we investigated the effects of two levels of intravascular fluid administration ("liberal" versus "restrictive") in knee arthroplasty on physiological recovery as the primary outcome variable...

..05). CONCLUSIONS: Time to first defecation, hospital stay, and morbidity may be reduced after colonic resection with fast-track multimodal rehabilitation...

..High-volume infiltration analgesia may be effective in postoperative pain management after hip arthroplasty but methodological problems prevent exact interpretation of previous studies...

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..To explore the feasibility of progressive strength training commenced immediately after total knee arthroplasty (TKA)...

..In this controlled study, we investigated the analgesic and sensory effects of ultrasound-guided blocks of the ilioinguinal and iliohypogastric nerves with lidocaine...

..Treatment of hip fracture patients is controversial. We implemented a new operative and supervision algorithm (the Hvidovre algorithm) for surgical treatment of all hip fractures, primarily based on own previously published results...

..Therefore, we evaluated whether intraoperative high-volume LIA, in addition to a multimodal oral analgesic regimen, would further reduce acute postoperative pain after THA...

..Therefore, the authors investigated the potential of a preoperatively induced heat injury to predict subsequent postoperative pain ratings in patients undergoing knee surgery...

..We tested this hypothesis using a postoperative pain model, in conjunction with serial functional magnetic resonance imaging (fMRI)...

..A multi-modal rehabilitation programme including continuous epidural analgesia with local anaesthetics, enforced nutrition and mobilisation may reduce PI to 1-2 days after colonic surgery...

..The purpose of this study was to determine whether TUG scores obtained upon discharge from an acute orthopedic hip fracture unit can predict falls in people with hip fracture during a 6-month follow-up period...

..A combination of bupivacaine and morphine reduced pain, duration of immobilization and of convalescence. The addition of methylprednisolone further reduced pain, use of more analgesics, joint swelling and convalescence...

..Here we report our results with short-duration pharmacological prophylaxis combined with early mobilization and reduced hospitalization...

..We analyze, on a nationwide basis, the risk of re-reoperation with reference to previous inguinal hernia repair technique...

..e. intraarticular or extraarticular) has not been evaluated...

..Purified capsaicin (ALGRX 4975 98% pure) has demonstrated prolong inhibition of C-fiber function in in vitro, preclinical, and clinical studies, and may be an effective adjunct to postoperative pain management...

..To describe the concept and early results from the Danish Hysterectomy Database (DHD)...

..These findings may serve as basis information for clinical studies of perioperative fluid management...

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..To investigate the relationship between early functional mobility and pain intensity in a fast track program after total knee arthroplasty (TKA)...

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..We assessed whether patients undergoing revision TKA for non-septic indications might also benefit from fast-track surgery...

..MRI can potentially be useful in the investigation of pathogenic mechanisms and guide surgeons in mesh removal and neurectomy. No study has investigated interobserver agreement or MRI-specific findings in persistent postherniotomy pain...

..To evaluate the analgesic effect of high-volume infiltration analgesia in urogenital prolapse surgery and provide a detailed description of the infiltration technique...

..There is, however, a paucity of data on their analgesic efficacy in acute pain. Therefore, the aim of the study was to examine the analgesic effects of dexamethasone in a validated burn model of acute inflammatory pain in humans...

..Pain treatment is traditionally based on systemic opioids. No study has examined the effect of fascia iliaca compartment blockade (FICB) in acute hip fracture pain management within a double-blind, randomized setup...

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..This article reviews some traditions that may influence outcome regarding pain, infection, blood loss, mobilisation, length of stay in hospital, thromboembolic prophylaxis, and costs...

..Data suggest that surgical complications requiring reoperation may lead to an excessively long in-patient stays. However, the overall impact of surgical complications has not been examined in detail...

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..No studies exist on the effect of postoperative epidural analgesia on pain and rehabilitation after hip fracture surgery...

..Studies of other childhood surgery before the age of 3 months suggest a risk of increased pain responsiveness later in life, but its potential relationship to chronic pain in adult life is unknown...

..The aim of this study was to investigate the effect of a similar fast track regimen in patients operated for ovarian cancer...

..The aim of this study was to evaluate the postoperative outcome after surgery for ovarian malignancy with conventional care compared to fast-track multimodal rehabilitation...

..Intraoperative nerve damage and disposition to other chronic pain conditions are among the most likely pathogenic factors...

..The frequent finding of a femoral hernia at reoperation suggests the need for the exploration of the femoral canal at the primary operation...

..We did a study to validate the Timed Up & Go (TUG) and New Mobility Score (NMS) as predictors of functional mobility, functional level, change of residence and home aid, six months after hip fracture...

..The aim of this study was to investigate the effect of an optimised admission protocol on the time spent in the A&E in an already established multimodal rehabilitation program...

..The primary aim of the present study was, therefore, to evaluate the organisation and quality of current primary surgical intervention for ovarian cancer in Denmark...

..Data from newer short-acting techniques of GA and RA are required to define the optimal anesthetic for inguinal herniorrhaphy...

..However, intercostal nerve injury seems to be the most important pathogenic factor. Since there is a general agreement on the clinical relevance of PTPS, a proposal for design of future trials is presented...

..No other complications occurred except three superficial wound infections. CONCLUSION: Postoperative hospital stay and morbidity may be reduced with multimodal rehabilitation after open colostomy closure after Hartmann's resection...

..Short-term success rate, satisfaction rates, and acceptability were all excellent. Follow up has been established to evaluate long-term success rates and recurrence...

..We also plead for a multimodal imaging approach in which classic brain-activation studies are supplemented with genetic, neurochemistry, brain morphometry, and transcranial magnetic stimulation studies...

..Constipation was noted in 43 percent before surgery vs. 28 percent at two months follow-up. CONCLUSION: Median hospital stay after abdominal rectopexy may be reduced to three days with postoperative multimodal rehabilitation...

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..We propose that in future, gastric resections for cancer should be performed in a maximum of five departments nationwide...

..Morbidity and mortality appears to be similar with either approach. Prospective evaluation of the potential benefits of the fast-track approach in different European centres is merited...

..Further data are needed from multi-national institutions on morbidity, safety, and costs...

..It is suggested that nephrectomy in the future is performed in fewer departments to fulfil these needs...

..However, data from large, nationwide studies are not available. Accordingly, the aim of the present study was to evaluate nationwide Danish data on RF in a nine-year period...

..The organization and results after cystectomy in Denmark are unknown...

..The aim of this study was to evaluate the implementation of laparoscopic colorectal surgery in Denmark...

..The aim of this study was to evaluate the availability and content of guidelines for perioperative care in all departments performing colonic resection, nephrectomy, ovarian cancer surgery, pulmonary resection and total knee replacement...