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Postoperative analgesia

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https://www.readbyqxmd.com/read/29156875/sex-related-differences-in-the-efficacy-of-dexamethasone-pretreatment-for-postoperative-analgesia-in-patients-undergoing-laparoscopic-cholecystectomy-a-randomized-controlled-study
#1
Cheol Lee, Jae-Yoon Chung, Myeongjong Lee
Background/aim: Sex-related differences in response to pain have become a topic of increasing interest. However, sex-related differences in the efficacy of dexamethasone for postoperative analgesia have not been previously addressed. Materials and methods: The study included 196 men and 196 women, aged between 18 and 45 years, who were scheduled for laparoscopic cholecystectomy. The patients were randomly allocated into dexamethasone (M/F: 98/98) and control (normal saline; M/F: 98/98) groups. Patients in the study group received intravenous dexamethasone at 0...
August 23, 2017: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/29155958/effect-of-preoperative-opioid-dosage-on-postoperative-period-after-thoracic-spinal-cord-stimulator-surgery
#2
Ravichandra A Madineni, Colin M Smith, Shannon W Clark, David W Boorman, Chengyuan Wu, Dajie Wang, James S Harrop, Ashwini D Sharan
Objective: We aim to study the impact of preoperative opioid dosage on postoperative length of stay (LOS) in patients undergoing thoracic spinal cord stimulator (SCS) placement surgery as a primary objective. Secondary objectives of this study include investigating patient-controlled analgesia (PCA) usage and postoperative complications like fever in relation to patients' preoperative opioid dosage and postoperative LOS. Methods: A total of 47 patients who underwent thoracic SCS for first time were retrospectively studied through chart review...
November 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a-randomized-controlled-trial
#3
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment in premenopausal women, who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: To evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29154229/iliac-fascia-compartment-block-and-analgesic-consumption-in-patients-operated-on-for-hip-fracture
#4
Mateusz Klukowski, Rafał Kowalczyk, Grzegorz Górniewski, Paweł Łęgosz, Marek Janiak, Janusz Trzebicki
BACKGROUND: Fractures of the proximal femur in elderly patients are a challenge for orthopedics, anesthe-sio-logy and geriatrics. Early mobilization reduces postoperative mortality among these patients. Effective anal-gesia is necessary to achieve this goal. MATERIAL AND METHODS: A retrospective analysis of perioperative medical records of 78. patients undergoing surgical treatment of proximal femur fractures was performed. Group 1 (n=35)consisted of patients who were treated with pharmacologic analgesia only (systemic analgesics) and Group 2 (n=43) involved patients who re-ceived a preoperative fascia iliaca compartment block (FICB) and pharmacologic analgesia...
October 31, 2017: Ortopedia, Traumatologia, Rehabilitacja
https://www.readbyqxmd.com/read/29152938/a-case-of-ultrasound-guided-serratus-plane-block-for-postoperative-analgesia-in-video-assisted-thoracoscopic-lobectomy-in-a-patient-with-previous-axillary-dissection-surgery
#5
Paolo Scimia, Erika Basso Ricci, Emiliano Petrucci, Stefano DI Carlo, Franco Marinangeli, Pierfrancesco Fusco
No abstract text is available yet for this article.
November 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29150087/dexmedetomidine-methadone-ketamine-versus-dexmedetomidine-methadone-alfaxalone-for-cats-undergoing-ovariectomy
#6
Rocio Fernandez-Parra, Chiara Adami, Thomas Dresco, Thomas M Donnelly, Luca Zilberstein
OBJECTIVE: To compare the duration, quality of anaesthesia and analgesia, and quality of recovery of dexmedetomidine and methadone combined with either ketamine or alfaxalone. STUDY DESIGN: Randomized, prospective clinical trial. ANIMALS: A group of 44 healthy client-owned cats presenting for ovariectomy. METHODS: Cats were randomly assigned to one of the two treatment groups: DAM (n=22), which was administered intramuscularly (IM) dexmedetomidine (15 μg kg(-1)), methadone (0...
May 27, 2017: Veterinary Anaesthesia and Analgesia
https://www.readbyqxmd.com/read/29149146/dexamethasone-and-dexmedetomidine-as-an-adjuvant-to-intraarticular-bupivacaine-for-postoperative-pain-relief-in-knee-arthroscopic-surgery-a-randomized-trial
#7
Seham M Moeen, Islam K Ramadan, Hesham A Elkady
BACKGROUND: Knee arthroscopy causes minimal trauma, however, good analgesia is required for early rehabilitation and return to normal life in the patients. OBJECTIVE: We aimed to compare the analgesic effects of intraarticular dexamethasone and dexmedetomidine added to bupivacaine with those of bupivacaine alone. STUDY DESIGN: This study uses a double-blind, randomized, controlled design with allocation concealment in a 3-armed parallel group format among patients undergoing arthroscopic meniscal surgery...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149144/the-efficacy-of-preoperative-gabapentin-in-spinal-surgery-a-meta-analysis-of-randomized-controlled-trials
#8
Chao Han, Ming-Jie Kuang, Jian-Xiong Ma, Xin-Long Ma
BACKGROUND: Pain management after spinal surgery has been studied for years. Gabapentin is a third-generation antiepileptic drug that selectively affects the nociceptive process and has been used for pain relief after surgery. However, the relationship between gabapentin and postoperative pain in spinal surgery is still controversial. OBJECTIVE: To assess the efficacy of the pre-emptive use of gabapentin in spinal surgery. STUDY DESIGN: A meta-analysis of randomized controlled studies...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149143/efficacy-of-magnesium-sulfate-added-to-local-anesthetic-in-a-transversus-abdominis-plane-block-for-analgesia-following-total-abdominal-hysterectomy-a-randomized-trial
#9
Kelany A Abd-Elsalam, Khaled M Fares, Montaser A Mohamed, Mohamed F Mohamed, Ahmad M Abd El-Rahman, Moaaz M Tohamy
BACKGROUND: Major abdominal surgeries are associated with severe pain, which can affect respiratory and cardiac functions if insufficiently treated; this increases postoperative morbidity. OBJECTIVE: We aim at evaluating the efficacy of magnesium sulfate as an adjuvant to local anesthetic in an ultrasound-guided transversus abdominis plane (TAP) block for postoperative analgesia in total abdominal hysterectomy. STUDY DESIGN: A prospective, randomized, double-blinded clinical trial...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#10
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148201/current-perspectives-on-the-role-of-tonsillectomy
#11
REVIEW
Samuel R Greig
Tonsillectomy is one of the most common paediatric surgical procedures performed in Australasia. The aim of this paper is to provide an up-to-date review of the indications for the procedure (and the evidence base for each of these indications), as well as describe the surgical technique and perioperative management and risks for a non-surgical audience. The primary indications for tonsillectomy are obstructive sleep apnoea (OSA) (where it is most commonly performed in association with adenoidectomy) and recurrent pharyngotonsillitis...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29145987/outpatient-total-knee-arthroplasty-are-we-there-yet-part-2
#12
REVIEW
Andrew Krause, Zain Sayeed, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The method by which surgeons conduct outpatient total knee procedures has yet to be fully elucidated. Literature demonstrates different experiences from various care protocols in place across the nation. This article reviews current recommendations for implementing successful total knee arthroplasty (TKA) and unicompartmental knee arthroplasty outpatient protocols. Specifically, information regarding anesthesia and analgesia modalities, perioperative care, operative technique, and postoperative care within outpatient TKA pathways is discussed...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145981/total-hip-arthroplasty-in-the-outpatient-setting-what-you-need-to-know-part-2
#13
REVIEW
Zain Sayeed, Leila Abaab, Mouhanad El-Othmani, Vinay Pallekonda, William Mihalko, Khaled J Saleh
The intra- and postoperative phases of outpatient total hip arthroplasty (THA) vary by institution and surgeon. An understanding of an evidence-based approach to enhancing the intra- and postoperative phases of the care continuum is warranted to offer high-value care to outpatient candidates. This article will discuss methods for implementing successful outpatient THA protocols. Specifically it reviews information regarding anesthesia and analgesia modalities, intraoperative considerations, and postoperative rehabilitation amenable to outpatient THA...
January 2018: Orthopedic Clinics of North America
https://www.readbyqxmd.com/read/29145272/the-efficiency-of-intravenous-acetaminophen-for-pain-control-following-total-knee-and-hip-arthroplasty-a-systematic-review-and-meta-analysis
#14
Limin Liang, Ying Cai, Aixiang Li, Chuangen Ma
BACKGROUND: This meta-analysis aimed to evaluate the efficiency and safety of intravenous acetaminophen as an adjunct to multimodal analgesia for pain control after total joint arthroplasty (TJA). METHODS: PubMed, Embase, Web of science, Medline, and Cochrane library databases were systematically searched. Randomized controlled trials (RCTs) and non-RCTs were included. Fixed/random effect model was used according to the heterogeneity tested by I statistic. Meta-analysis was performed using Stata 11...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29144627/laparoscopic-nephrectomy-outside-gerota-fascia-and-en-bloc-ligation-of-the-renal-hilum-for-management-of-inflammatory-renal-diseases
#15
Liang Ma, Yanlan Yu, Guangju Ge, Gonghui Li
OBJECTIVES: This study aims to improve laparoscopic nephrectomy techniques for inflammatory renal diseases (IRD) and to reduce complications. MATERIALS AND METHODS: Thirty-three patients underwent laparoscopic nephrectomy for IRD, with a method of outside Gerota fascia dissection and en-bloc ligation and division of the renal pedicle. Operative time, blood loss, complications, analgesia requirement, post-operative recovery of intestinal function and hospital stay were recorded...
November 19, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/29140959/comparison-of-continuous-proximal-versus-distal-adductor-canal-blocks-for-total-knee-arthroplasty-a-randomized-double-blind-noninferiority-trial
#16
Adam W Meier, David B Auyong, Stanley C Yuan, Shin-E Lin, James M Flaherty, Neil A Hanson
BACKGROUND AND OBJECTIVES: Adductor canal blocks (ACBs) are associated with improved analgesia, preserved quadriceps strength, and decreased length of hospitalization after total knee arthroplasty (TKA). However, controversy remains regarding the ideal location of a continuous block within the adductor canal, and it remains unclear whether similar clinical benefits are obtained irrespective of block location. In this randomized, double-blind, noninferiority study, we hypothesized that a continuous proximal ACB provides postoperative analgesia that is no worse than a continuous distal ACB...
November 14, 2017: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/29139193/higher-doses-of-intraoperative-analgesia-are-associated-with-lower-levels-of-persistent-pain-and-less-analgesic-consumption-six-months-after-total-hip-arthroplasty
#17
F von Dincklage, A Jakuscheit, J Weth, G Lichtner, C Jurth, B Rehberg-Klug
BACKGROUND: Persistent postoperative pain is a major health problem affecting nearly 30% of all patients undergoing total hip arthroplasty. Previous studies have demonstrated an association between the intensity of acute postoperative pain and persistent pain, but this association might be an epiphenomenon of insufficient intraoperative analgesia. In this study, we investigated the association between the intraoperative level of analgesia and the persistent postoperative pain 6 months after surgery...
November 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29135692/ultrasound-with-neurostimulation-compared-with-ultrasound-guidance-alone-for-lumbar-plexus-block-a-randomised-single-blinded-equivalence-trial
#18
Vanlapa Arnuntasupakul, Theerawat Chalachewa, Prangmalee Leurcharusmee, Worakamol Tiyaprasertkul, Roderick J Finlayson, De Q Tran
BACKGROUND: Ultrasound-guided lumbar plexus blocks usually require confirmatory neurostimulation. A simpler alternative is to inject local anaesthetic inside the posteromedial quadrant of the psoas muscle under ultrasound guidance. OBJECTIVE: We hypothesised that both techniques would result in similar total anaesthesia time, defined as the sum of performance and onset time. DESIGN: A randomised, observer-blinded, equivalence trial (equivalence margin = 7...
November 11, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/29135586/increased-hyperalgesia-and-proinflammatory-cytokines-in-the-spinal-cord-and-dorsal-root-ganglion-after-surgery-and-or-fentanyl-administration-in-rats
#19
Lu Chang, Fang Ye, Quehua Luo, Yuanxiang Tao, Haihua Shu
BACKGROUND: Perioperative fentanyl has been reported to induce hyperalgesia and increase postoperative pain. In this study, we tried to investigate behavioral hyperalgesia, the expression of proinflammatory cytokines, such as interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α), and the activation of microglia in the spinal cord and dorsal root ganglion (DRG) in a rat model of surgical plantar incision with or without perioperative fentanyl. METHODS: Four groups of rats (n = 32 for each group) were subcutaneously injected with fentanyl at 60 μg/kg or normal saline for 4 times with 15-minute intervals...
November 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29135493/relationship-between-postoperative-pain-and-overall-30-day-complications-in-a-broad-surgical-population-an-observational-study
#20
Regina L M van Boekel, Michiel C Warlé, Renske G C Nielen, Kris C P Vissers, Rob van der Sande, Ewald M Bronkhorst, Jos G C Lerou, Monique A H Steegers
OBJECTIVE: The aim of this study was to establish the relationship between postoperative pain and 30-day postoperative complications. BACKGROUND: Only scarce data are available on the association between postoperative pain and a broad range of postoperative complications in a large heterogeneous surgical population. METHODS: Having postoperative pain was assessed in 2 ways: the movement-evoked pain score on the Numerical Rating Scale (NRS-MEP) and the patients' opinion whether the pain was acceptable or not...
November 13, 2017: Annals of Surgery
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