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Preemptive Analgesia

Faramarz Mosaffa, Seyed Amir Mohajerani, Reza Aminnejad, Ali Solhpour, Shideh Dabir, Gholam Reza Mohseni
BACKGROUND: Preemptive analgesia is the blocking of pain perception afferent pathways before noxious painful stimuli. Clonidine is an alpha agonist drug that is partially selective for α-2 adrenoreceptors. Clonidine is used as anti-anxiety medication and an, analgesic, and it prolongs the duration of the block in the brachial plexus block. OBJECTIVES: To compare the effect of preemptive clonidine with midazolam on intraoperative sedation, duration of block, and postoperative pain scores...
June 2016: Anesthesiology and Pain Medicine
Keelara Shivalingaiah Savitha, Radhika Dhanpal, J Shilpa
BACKGROUND: Multimodal analgesia (MMA) by synergy with volatile anesthetics minimizes their use thus decreasing operation theater pollution and greenhouse gas emission. AIMS: To estimate minimum alveolar concentration (MAC) requirement of isoflurane (ISO) for skin incision with use of MMA in the study group versus conventional regime in the control group for a constant bispectral index (BIS). To observe the side effects of analgesic drugs administered in the study...
September 2016: Anesthesia, Essays and Researches
Amir Shlaifer, Zachary Tuvya Sharfman, Hal David Martin, Eyal Amar, Efi Kazum, Yaniv Warschawski, Matan Paret, Silviu Brill, Michael Drexler, Ehud Rath
PURPOSE: To evaluate and compare the efficacy of intra-articular and periacetabular blocks for postoperative pain control after hip arthroscopy. METHODS: Forty-two consecutive patients scheduled for hip arthroscopy were randomized into 2 postoperative pain control groups. One group received preemptive intra-articular 20 mL of bupivacaine 0.5% injection, and the second group received preemptive periacetabular 20 mL of bupivacaine 0.5% injection. Before closure all patients received an additional dose of 20 mL of bupivacaine 0...
October 8, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Yin Li
Enhanced recovery after surgery (ERAS) is a patient-centered, surgeon-led system combining anesthesia, nursing, nutrition and psychology. It aims to minimize surgical stress and maintain physiological function in perioperative care, thereby expediting recovery. ERAS theory has been clinically applied for nearly 20 years and it is firstly used in colorectal surgery, then widely used in other surgical fields. However, ERAS is not used commonly in esophagectomy because of its surgical complexity and high morbidity of postoperative complications, which limits the application of ERAS in the field of esophagectomy...
September 25, 2016: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
Bon Sebastian, Anand Tippanna Talikoti, Kiran Nelamangala, Dinesh Krishnamurthy
INTRODUCTION: Conquering postoperative pain which has significant impact on the surgery outcome can be challenging for the clinicians. Pregabalin is a GABA analogue used for various neuropathic pain syndromes. Very few studies are there with the use of pregabalin as a preemptive analgesic for orthopedic surgeries. AIM: To compare pregabalin 150 mg with placebo for postoperative pain control in patients undergoing elective lower limb orthopedic surgeries under spinal anaesthesia and to assess any side effects...
July 2016: Journal of Clinical and Diagnostic Research: JCDR
Xu Jianda, Qu Yuxing, Gao Yi, Zhao Hong, Peng Libo, Zhao Jianning
The aim of this study was to investigate the effects of preemptive analgesia on the inflammatory response and rehabilitation in TKA. 75 patients with unilateral primary knee osteoarthritis were conducted in this prospective study. All patients were randomly divided into two groups (MMA with/without preemptive analgesia group). The following parameters were used to evaluate analgesic efficacy: knee flexion, pain at rest and walking, functional walking capacity (2 MWT and 6 MWT), WOMAC score, and hs-CRP level...
2016: Scientific Reports
Marcelo Lourenço Silva, Josie Resende Torres Silva, Wiliam Alves Prado
Preemptive analgesia involves introducing an analgesic before noxious stimulation. Electroacupuncture (EA) activates descending mechanisms that modulate nociceptive inputs into the spinal dorsal horn. This study evaluated whether preoperative EA is more effective than postoperative EA in reducing incision pain in rats. The nociceptive threshold to mechanical stimulation was utilized to examine the effects of an intraperitoneal injection of saline (0.1 mL/kg) or naloxone (1 mg/kg) on antinociception induced by a 20-minute period of 2-Hz or 100-Hz EA applied to the Zusanli (ST36) and Sanyinjiao (SP6) acupoints before surgical incision, or 10 minutes after or 100 minutes after surgical incision of the hind paw...
August 2016: Journal of Acupuncture and Meridian Studies
Gloria S Cheng, Brian M Ilfeld
OBJECTIVE: To review the published evidence regarding perioperative analgesic techniques for breast cancer-related surgery. DESIGN: Topical review. METHODS: Randomized, controlled trials (RCTs) were selected for inclusion in the review. Also included were large prospective series providing estimates of potential risks and technical reports and small case series demonstrating a new technique or approaches of interest to clinicians. RESULTS: A total of 514 abstracts were reviewed, with 284 studies meeting criteria for full review...
August 22, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Eleftheria Kalogera, Sean C Dowdy
A paucity of data exists regarding traditional perioperative practices (bowel preparation, NPO at midnight, liberal narcotics, PCA use, liberal fluids, prolonged bowel and bed rest). Enhanced Recovery after Surgery (ERAS) is an evidence-based approach to peri-operative care associated with improved outcomes including earlier return of gastrointestinal function, reduced opioid use, shorter hospital stay, and substantial cost reductions with stable complication and readmission rates. Basic principles include patient education, minimizing preoperative fasting, avoiding bowel preparation, preemptive analgesia, nausea/vomiting prophylaxis, perioperative euvolemia, no routine use of drain and nasogastric tubes, early mobilization, oral intake, and catheter removal, non-opioid analgesics, and preemptive laxatives...
September 2016: Obstetrics and Gynecology Clinics of North America
Deepthi Mony, Deepak Kulkarni, Lakshmi Shetty
INTRODUCTION: Analgesia pre-emptively administered effect-ively aid in management of pain. Pre-emptive analgesia is anti-nociceptive treatment which prevents altered central sensitization of afferent inputs. AIM: To compare and evaluate the pre-emptive analgesic efficacy of preoperatively administered ketorolac and diclofenac for controlling postoperative pain after third molar surgery. MATERIALS AND METHODS: A total of 50 patients with symmetrically impacted third molars were divided into two groups, 30mg intramuscular injection of ketorolac and 75 mg diclofenac sodium were used in the respective groups...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
M-A Isiordia-Espinoza, A Pozos-Guillen, R Martinez-Rider, J Perez-Urizar
BACKGROUND: Preemptive analgesia is considered an alternative for treating the postsurgical pain of third molar removal. The aim of this study was to evaluate the preemptive analgesic efficacy of oral ketorolac versus intramuscular tramadol after a mandibular third molar surgery. MATERIAL AND METHODS: A parallel, double-blind, randomized, placebo-controlled clinical trial was carried out. Thirty patients were randomized into two treatment groups using a series of random numbers: Group A, oral ketorolac 10 mg plus intramuscular placebo (1 mL saline solution); or Group B, oral placebo (similar tablet to oral ketorolac) plus intramuscular tramadol 50 mg diluted in 1 mL saline solution...
2016: Medicina Oral, Patología Oral y Cirugía Bucal
Hong-Qi Lin, Dong-Lin Jia
The pain following gynecological laparoscopic surgery is less intense than that following open surgery; however, patients often experience visceral pain after the former surgery. The aim of this study was to determine the effects of preemptive ketamine on visceral pain in patients undergoing gynecological laparoscopic surgery. Ninety patients undergoing gynecological laparoscopic surgery were randomly assigned to one of three groups. Group 1 received placebo. Group 2 was intravenously injected with preincisional saline and local infiltration with 20 mL ropivacaine (4 mg/mL) at the end of surgery...
August 2016: Journal of Huazhong University of Science and Technology. Medical Sciences
Ana Maria Munteanu, Simona Cionac Florescu, Denisa Madalina Anastase, Cristian Ioan Stoica
BACKGROUND: Optimal postoperative analgesia is a challenge for the anaesthesiologist, with the ideal combination of methods, drugs, doses and timing of administration still the subject of research. The COX-2 inhibitors are a class of NSAIDs that may provide useful perioperative analgesia but the optimal timing of administration has not been elucidated. OBJECTIVE: We hypothesised that etoricoxib given 1 h before total knee arthroplasty under spinal anaesthesia will decrease the cumulative dose of intravenous and subcutaneous morphine required to maintain pain intensity of 3 or less on a 10-point numerical rating scale (NRS) during the first postoperative 48 h compared with the same dose of etoricoxib given after surgery...
November 2016: European Journal of Anaesthesiology
Jean-Noël A Argenson, Henrik Husted, Adolph Lombardi, Robert E Booth, Emmanuel Thienpont
Outpatient surgical procedures for adult hip and knee reconstruction are gaining interest on a worldwide basis and have been progressively increasing over the last few years. Preoperative screening needs to concentrate on both the patient's comorbidities and home environment to provide a proper alignment of expectations of the surgeon, the patient, and the patient's family. Preoperative multidisciplinary patient information covering all aspects of the upcoming treatment course is a mandatory step, focusing on pain management and early mobilization...
July 6, 2016: Journal of Bone and Joint Surgery. American Volume
Na Wang, Songling Zhang, Yaowen Fu, Jinguo Wang
BACKGROUND: Low-dose ropivacaine combined with intrathecal fentanyl can provide adequate anaesthesia with minimal haemodynamic variation. Preemptive analgesia can enhance analgesic effect of spinal anaesthesia without obvious side effects. AIMS: To assess the efficacy of preoperative intravenous oxycodone on transurethral resection of prostate (TURP) under 10 mg ropivacaine spinal anaesthesia combined with intrathecal 25 pg fentanyl. METHODS: Sixty patients undergoing TURP were randomly divided into two groups: Group o (n=30), in which the patients were administered 0...
February 2016: Middle East Journal of Anesthesiology
Weiyi Pan, Chenzhou Wu, Zheng Yang, Zexi Duan, Zhifei Su, Peiqi Wang, Qian Zheng, Chunjie Li
To assess the efficacy of present interventions optimizing the result of secondary alveolar bone grafting (SABG) and the interventions alleviating the donor site morbidity after iliac cancellous bone harvesting. Researches were identified by searching the electronic database of MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, Chinese BioMedical Literature Database, and the China National Knowledge Infrastructure. In addition, relevant journals and references of the included studies were searched manually...
June 2016: Journal of Craniofacial Surgery
Arvinder Pal Singh, Vaneet Kohli, Sukhminder Jit Singh Bajwa
BACKGROUND AND OBJECTIVE: Femoral fractures are extremely painful and pain invariably worsens on any movement. Anesthesia for fracture femur surgery is usually provided by spinal block. This study was undertaken to compare the analgesic effects of femoral nerve block (FNB) using nerve stimulator with 0.2% ropivacaine (15 ml) and intravenous (I.V.) fentanyl before patient positioning for fracture femur surgery under spinal anesthesia. MATERIALS AND METHODS: A prospective, randomized, double-blind, comparative study was conducted on 60 American Society of Anesthesiologists I and II patients (18-60 years) scheduled for femur surgery under combined spinal epidural anesthesia...
May 2016: Anesthesia, Essays and Researches
Srivishnu Vardhan Yallapragada, Thrivikram Shenoy
CONTEXT: Traditionally, pain in children is a topic that has received only minimal attention. However, in the recent times, considerable progress has been made in the field of neonatal and pediatric pharmacology. The concept of preemptive analgesia is important in combating postoperative pain in children. In this study, we sought to compare the effectiveness of preemptive analgesia provided by paracetamol alone and by its combination with diclofenac when administered per rectum. AIMS: To compare the efficacy of preoperative rectal paracetamol with paracetamol - diclofenac combination for postoperative analgesia in pediatric surgeries under general anesthesia...
May 2016: Anesthesia, Essays and Researches
David S Wang
No abstract text is available yet for this article.
May 2016: Journal of Urology
M Mardani-Kivi, M Karimi Mobarakeh, S Keyhani, M Haghighi, K Hashemi-Motlagh, K Saheb-Ekhtiari
BACKGROUND: The role of gabapentin as preemptive analgesia in managing acute pain following shoulder bankart arthroscopy is controversial and the studies addressing this issue are limited. HYPOTHESIS: The present study was undertaken to examine the effects of preemptive single dose of gabapentin on pain management and opioid consumption in patients undergoing arthroscopic bankart surgery. PATIENTS AND METHODS: In the current triple-blinded randomized clinical trial, 76 eligible patients were randomly divided into two groups either taking gabapentin 600mg (G group) or placebo (P group)...
September 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
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