Outpatient intravenous multimodal elastomeric pump with methadone in ambulatory surgery

DUCMA 2.0 project: Update on the current situation of the outpatient surgery units in Spain

INTRODUCTION

Ambulatory surgery is a safe and efficient management system to solve surgical problems, but its implementation and development has been variable. The aim of this study is to describe the characteristics, structure and functioning of ambulatory surgery units (ASU) in Spain.

METHODS

Multicenter, cross-sectional, observational study based on an electronic survey, with data collection between April and September 2022.

RESULTS

In total, 90 ASUs completed the survey. The mean overall ambulatory index is 63%. More than half of the ASUs (52%) are integrated units. Around half of the units provide training for physicians (51%) and for nurses (55%). The most frequently used quality indicators are suspension rate (87%) and the rate of unplanned admissions (80%).

CONCLUSIONS

Greater coordination between administrations is needed to obtain reliable data. It is also necessary to implement quality management systems in the different units, as well as to develop tools for the adequate training of the professionals involved.

Home-Based Intravenous Analgesia With an Elastomeric Pump After Medial Patellofemoral Ligament Repair: A Case Series

PURPOSE

The purpose of this study is to show our experience using elastomeric pumps for postoperative pain relief after outpatient medial patellofemoral ligament (MPFL) reconstruction.

DESIGN

Prospective case series.

METHODS

Patients (N = 78) with recurrent patella dislocation who underwent MPFL repair using an autogenous semitendinosus tendon graft were included. After discharge, pain was controlled using intravenous analgesia infused by an elastomeric pump for 48 hours. Outcomes regarding pain, complications, overall satisfaction, and knee functionality were assessed.

FINDINGS

Early postoperative pain was mild in 53.8% of patients, and 30.8% patients had no pain at all. Twenty-four hours after surgery, 38.5% patients presented no pain, which increased to 53.8% at 72 hours. Nausea was experienced by 2.6% patients as was vomiting (7.7%) and drowsiness (2.6%). The mean score for patient satisfaction regarding the treatment was 90.2 (60.0-100.0). Moreover, postoperative knee functionality 12 months after the procedure proved to be statistically significantly superior (P <0.05).

CONCLUSIONS

Postoperative analgesia using an intravenous elastomeric pump allows performance of MPFL reconstruction as an outpatient procedure with satisfactory pain control, complication rates and patient satisfaction.

The properties of MOF-Zn2(EBNB)2(BPY)2·2H2O and its basic study of loading methadone

The ligands of (E)-bis(p-3-nitrobenzoic acid) vinyl (C₁₆H₁₀N₂O₈) were synthesized in three steps, and then the MOF-Zn₂(EBNB)₂(BPY)₂·2H₂O was synthesized by solvothermal method. This structure was characterized by X-ray single crystal diffraction, SEM and TG. The drug loading and in vitro release of Zn₂(EBNB)₂(BPY)₂·2H₂O were also studied with Methadone as model drug. The results show that the highest loading amount of Zn₂(EBNB)₂(BPY)₂·2H₂O to Methadone was 0.256 g/g, and the drug delivery system was a two-phase mode. The results of in vitro cytotoxicity test show that Zn₂(EBNB)₂(BPY)₂·2H₂O has good biocompatibility.