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Post operative analgesia

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https://www.readbyqxmd.com/read/29769505/efficacy-of-0-5-hyperbaric-bupivacaine-with-dexamethasone-versus-0-5-hyperbaric-bupivacaine-alone-in-spinal-anaesthesia-for-patient-undergoing-lower-abdominal-urological-and-lower-limb-orthopedic-surgeries
#1
M M Haque, M A Aleem, F H Haque, A B Siddique, R Afrose
Spinal anaesthesia with local anaesthetics has limited duration. Different additives have been used to prolong spinal anaesthesia. The aim of this study was to determine the efficacy of adding dexamethasone to bupivacaine in spinal anaesthesia specially whether it would prolong the duration of sensory block/ surgical analgesia and post-operative analgesia/pain free period or not. This randomized, prospective, double-blind, clinical study was conducted in the Department of Anaesthesia, Analgesia and Critical Care of Combined Military Hospital, Chittagong from October 2016 to August 2017...
April 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29768487/an-observational-study-the-utility-of-perfusion-index-as-a-discharge-criterion-for-pain-assessment-in-the-postanesthesia-care-unit
#2
Chun-Lin Chu, Yi-You Huang, Ying-Hou Chen, Ling-Ping Lai, Huei-Ming Yeh
Acute post-operative pain can remain untreated if patients cannot express themselves. The perfusion index (PI) may decrease when pain activates sympathetic tone and may increase after analgesics are administered. We evaluated if the perfusion index is a feasible indicator for objectively assessing pain relief in the postanesthesia care unit (PACU) and calculated the changes in PI measurements at the time of discharge from the PACU relative to baseline PI measurements to examine if the PI is a useful criterion for discharging patients from the postanesthesia care unit...
2018: PloS One
https://www.readbyqxmd.com/read/29759061/role-of-ultrasound-guided-transversus-abdominis-plane-block-as-a-component-of-multimodal-analgesic-regimen-for-lower-segment-caesarean-section-a-randomized-double-blind-clinical-study
#3
Ashok Jadon, Priyanka Jain, Swastika Chakraborty, Mayur Motaka, Sudhansu Sekhar Parida, Neelam Sinha, Amit Agrawal, Asit Kumar Pati
BACKGROUND: While opioids are the mainstay for post-operative analgesia after lower segment caesarean section, they are associated with various untoward effects. Ultrasound guided transversus abdominis plane (TAP) block has been postulated to provide effective analgesia for caesarean section. We evaluated the analgesic efficacy of this block for post caesarean analgesia in a randomised controlled trial. METHODS: One hundred thirty-nine mothers undergoing caesarean delivery were randomised to receive TAP block with either 20 ml 0...
May 14, 2018: BMC Anesthesiology
https://www.readbyqxmd.com/read/29756750/validation-of-the-pmd100tm-and-its-noltm-index-to-detect-nociception-at-different-infusion-regimen-of-remifentanil-in-patients-under-general-anaesthesia
#4
Pierre-André Stöckle, Marco Julien, Rami Issa, Elizabeth Décary, Véronique Brulotte, Pierre Drolet, Margaret Henri, Madeleine Poirier, Jean-François Latulippe, Marc Dorais, Olivier Verdonck, Louis-Philippe Fortier, Philippe Richebé
BACKGROUND: The NOL index is based on multiparametric analysis of heart rate (HR), skin conductance, wave plethysmography, and their time derivative. Our objective was to evaluate the NOL to detect standardized nociceptive stimuli with various remifentanil dosages under general anaesthesia. METHODS: A prospective, observational study at a single center (NCT02602379) included 40 ASA I to III patients undergoing laparotomy under remifentanil-desflurane anaesthesia with epidural analgesia...
May 14, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29750760/prospective-randomized-controlled-comparison-of-local-anesthetic-infusion-pump-versus-depofoam-bupivacaine-for-pain-management-after-unilateral-delayed-deep-inferior-epigastric-perforator-free-flap-reconstruction
#5
James Gatherwright, Rebecca Knackstedt, Amir Ghaznavi, Steven Bernard, Graham Schwarz, Andrea Moreira, Raffi Gurunluoglu, Risal Djohan
BACKGROUND: Effective postsurgical analgesia is a critical aspect of patient recovery. The goal of this prospective, randomized, controlled, blinded study was to examine the effect that liposomal bupivacaine delivered via a transversus abdominis plane (TAP) block has on pain control in women undergoing unilateral deep inferior epigastic perforator reconstruction. METHODS: IRB approval was granted for this prospective study. Patients were eligible if they were undergoing unilateral, delayed DIEP reconstruction...
March 15, 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29745977/a-simple-technique-for-relocating-chronic-cied-leads-to-a-sub-pectoral-position-for-relief-of-erosion-and-pain
#6
Aaron B Hesselson
BACKGROUND: Methodology specific for moving superficial chronically implanted trans-venous pacing leads to a sub-pectoral pocket is not described in the literature. Relocation of pre-pectoral leads and generator to a sub-muscular pocket for relief of erosion and pain with minimal pectoral trauma is possible by applying a variant of a previously described sub-mammary tunneling technique. METHODS: All patients presenting for device follow-up, elective battery replacement, or system upgrade over an 8-month period were considered for relocation if experiencing significant thinning or pain over their pre-pectoral implant...
May 10, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29745071/short-term-outcomes-in-patients-with-colon-cancer-treated-with-robotic-right-colectomy
#7
Argyrios Ioannidis, Konstantinos Kontzoglou, Gregory Kouraklis, Nikolaos Machairas, Periklis Chrysoheris, Fotis Antonakopoulos, Michalis Konstantinidis, Dimitrios Filippou, Panagiotis Skandalakis, Konstantinos Konstantinidis
PURPOSE: To report a single surgeon series of consecutive robotic right colectomies (RRC) performed for non-metastatic right colon cancer. METHODS: A retrospective review of a prospectively maintained database of patients who underwent elective robotic right colectomy for right colon adenocarcinoma was conducted. Patients with stage 0-III disease were included in the study. Outcomes evaluated included operative time, number of lymph nodes harvested, estimated blood loss, time to return of bowel function, length of hospital stay, complications and a minimum of 6-month follow up...
March 2018: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/29743064/patient-directed-self-management-of-pain-padsmap-compared-to-treatment-as-usual-following-total-knee-replacement-a-randomised-controlled-trial
#8
Katherine H O Deane, Richard Gray, Paula Balls, Clare Darrah, Louise Swift, Alan B Clark, Garry R Barton, Sophie Morris, Sue Butters, Angela Bullough, Helen Flaherty, Barbara Talbot, Mark Sanders, Simon T Donell
BACKGROUND: Self-administration of medicines by patients whilst in hospital is being increasingly promoted despite little evidence to show the risks and benefits. Pain control after total knee replacement (TKR) is known to be poor. The aim of the study was to determine if patients operated on with a TKR who self-medicate their oral analgesics in the immediate post-operative period have better pain control than those who receive their pain control by nurse-led drug rounds (Treatment as Usual (TAU))...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29740979/otoplasty-techniques-in-children-a-comparative-study-of-outcomes
#9
Puvesh Punj, Hsu Phie Chong, Thomas P Cundy, Michelle Lodge, Roger Woods
BACKGROUND: Numerous otoplasty techniques have been described in the literature to correct prominent ears; however, few have focused on the complication rates. We reviewed our experience aiming to assess peri-operative care requirements and complication rates. METHOD: We conducted a retrospective review of 207 otoplasty procedures performed in 119 patients over a 5-year period (2009-2014) at the Women's and Children's Hospital, Adelaide. Information pertaining to demographic details, length of stay, otoplasty technique and complications (early and late) were obtained...
May 8, 2018: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29740688/the-safety-and-efficacy-of-oxycodone-versus-fentanyl-in-percutaneous-microwave-ablation-of-a-liver-tumour-abutting-the-capsule
#10
Wen-Tao Wu, Zhen-Yu Jia, Yu Chen, Qi-Feng Chen, Qing-Quan Zu, Zheng-Qiang Yang, Sheng Liu, Hai-Bin Shi
PURPOSE: The present study compared the safety and efficacy of oxycodone with those of fentanyl under non-intubated general anaesthesia in percutaneous microwave ablation (MWA) of a liver tumour abutting the capsule. MATERIALS AND METHODS: Thirty-eight patients underwent MWA of liver cancers abutting the capsule. Patients received 0.1 mg/kg oxycodone (O group) or 1 μg/kg fentanyl (F group) prior to the start of ablation. Both groups received continuous infusions of propofol for non-intubated general anaesthesia during ablation...
May 8, 2018: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/29736375/the-effect-of-adjunct-caudal-block-on-postoperative-analgesia-in-robot-assisted-laparoscopic-radical-prostatectomy-a-prospective-randomized-controlled-single-blinded-pilot-study-in-a-tertiary-centre
#11
Kenneth Chen, Allen Sim, Alex Ford Kan
Objective: Caudal block provides satisfactory postoperative pain relief in lower abdominal operations. This pilot study explores its safety and effect on postoperative pain control in patients who underwent robot-assisted laparoscopic radical prostatectomy (RARP). Methods: From 2013 to 2014, 40 consecutive patients were randomized into two groups - one received caudal block using ropivacaine immediately after operation, the other received standard analgesia. Primary outcome measure was pain score based on 11-point Likert scale (0-10) recorded at recovery room, and at 6, 12, 24, 48, and 72 h after operation...
April 2018: Asian Journal of Urology
https://www.readbyqxmd.com/read/29732387/transversus-abdominis-plane-blockade-as-part-of-a-multimodal-postoperative-analgesia-plan-in-patients-undergoing-radical-cystectomy
#12
Richard S Matulewicz, Mehul Patel, Brian J Jordan, Jacqueline Morano, Brendan Frainey, Yasin Bhanji, Mahreen Bux, Antoun Nader, Shilajit D Kundu, Joshua J Meeks
Background: Radical cystectomy (RC) is a morbid procedure with frequent complications that may benefit from implementation of an enhanced recovery after surgery (ERAS) protocol. Objective: To examine the benefits of a multimodal analgesic plan that uses continuous transversus abdominis plane (TAP) blockade as part of an ERAS protocol after RC. Methods: A retrospective comparison of consecutive patients undergoing RC over a 4-year period was conducted...
April 26, 2018: Bladder Cancer
https://www.readbyqxmd.com/read/29730268/thoracic-paravertebral-block-versus-thoracic-epidural-analgesia-for-post-operative-pain-control-in-open-pancreatic-surgery-a-randomized-controlled-trial
#13
Jacob L Hutchins, Anthony J Grandelis, Alexander M Kaizer, Eric H Jensen
STUDY OBJECTIVE: The purpose of this study was to compare the efficacy of bilateral ultrasound guided thoracic paravertebral catheters to a thoracic epidural after open pancreatic surgery. DESIGN: This was a prospective non-blinded randomized controlled trial. SETTING: Academic hospital operating room, postoperative recovery area, and ward. PATIENTS: 53 patients aged 18 and above who had open pancreatic surgery. INTERVENTIONS: Patients received either bilateral thoracic paravertebral block at T8 with an infusion of 0...
May 3, 2018: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/29725865/post-operative-weaning-of-opioids-after-ambulatory-surgery-the-importance-of-physician-stewardship
#14
REVIEW
Brandon Roth, Adjoa Boateng, Allison Berken, Daniel Carlyle, Nalini Vadivelu
PURPOSE OF REVIEW: We performed a systematic review to elucidate the current guidelines on weaning patients from opioids in the post-operative ambulatory surgery setting, and how pain management intraoperatively can impact this process. DESIGN: The review highlights the most up-to-date research from clinical trials, patient reports, and retrospective studies regarding both the current guidelines and weaning of opioid analgesia in ambulatory surgery setting. RECENT FINDINGS: A striking paucity of convincing evidence exists on ambulatory postoperative pain management discontinuation or weaning of pain medications...
May 3, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29721629/direct-visualization-transversus-abdominis-plane-blocks-offer-superior-pain-control-compared-to-ultrasound-guided-blocks-following-open-posterior-component-separation-hernia-repairs
#15
J A Doble, J S Winder, S R Witte, E M Pauli
PURPOSE: Transversus abdominis plane (TAP) blockade with long-acting anesthetic can be used during open ventral hernia repair (VHR) with posterior component separation (PCS). TAP block can be performed under ultrasound guidance (US-TAP) or under direct visualization (DV-TAP). We hypothesized that US-TAP and DV-TAP provide equivalent postoperative analgesia following open VHR. METHODS: A retrospective review of patients undergoing open VHR with PCS who received TAP blocks with 266 mg of liposomal bupivacaine was performed...
May 2, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29720755/a-comparative-study-to-evaluate-ultrasound-guided-transversus-abdominis-plane-block-versus-ilioinguinal-iliohypogastric-nerve-block-for-post-operative-analgesia-in-adult-patients-undergoing-inguinal-hernia-repair
#16
Kirti Kamal, Parul Jain, Teena Bansal, Geeta Ahlawat
Background and Aims: Both transversus abdominis plane (TAP) block and combined ilioinguinal-iliohypogastric (IIN/IHN) blocks are used routinely under ultrasound (USG) guidance for postoperative pain relief in patients undergoing inguinal hernia surgery. This study compares USG guided TAP Vs IIN/IHN block for post-operative analgesic efficacy in adults undergoing inguinal hernia surgery. Methods: Sixty adults aged 18 to 60 with American Society of Anesthesiologsts' grade I or II were included...
April 2018: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/29717288/effects-of-adding-intrathecal-dexmedetomidine-to-hyperbaric-bupivacaine-for-saddle-spinal-block-in-adults-undergoing-peri-anal-surgeries
#17
Binod Gautam, Sushila Moktan Lama, Mona Sharma
BACKGROUND: Saddle spinal block is the first choice anesthetic technique for adults undergoing peri-anal surgeries. It prevents unnecessary high levels of analgesia and sympathetic block. However, it may not provide prolonged analgesia. This study aims to investigate analgesic effects of dexmedetomidine when added to hyperbaric bupivacaine in saddle spinal block. METHODS: Fifty otherwise healthy adults scheduled for uncomplicated peri-anal surgery were randomly allocated into two equal groups in this double-blinded study...
March 13, 2018: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/29707356/the-role-of-local-anaesthetic-techniques-in-eras-protocols-for-thoracic-surgery
#18
REVIEW
Seamus Crumley, Stefan Schraag
The use of enhanced recovery after surgery (ERAS), as in other surgical specialties, is an emerging concept in cardio-thoracic surgery but there is still a lack of effective protocols to reduce the burden of surgery on the patient, shorten the period of postoperative recovery, and reduce the likelihood of chronic pain developing. The use of local anaesthetic (LA) techniques, such as thoracic epidural analgesia (TEA) and paravertebral blocks (PVB), as an adjunct to anaesthesia are considered key components, though there is little data for direct comparison of the techniques...
March 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29691094/first-experience-of-the-egyptian-national-cancer-institute-using-the-robot-assisted-laparoscopic-approach-in-radical-hysterectomies-for-cervical-cancer
#19
Ashraf Saad Zaghloul, Ahmed Mahmoud El-Minawi, Mohamed Atef ElKordy, Amr Kamal Younes, Ahmed Mostafa Mahmoud, Waleed Mohamed Fadlalla, Gamal Amira Mohamed
AIM OF WORK: Robotics in surgery led to an improvement of visualization, a better handling of tissues and better suturing. This study aimed to document the first experience of the Egyptian National Cancer Institute (NCI) using the robot-assisted laparoscopic approach in radical hysterectomies for cervical cancer and to highlight observed advantages, disadvantages, morbidity and oncological outcomes. PATIENTS AND METHODS: Data of cases that had either early cervical cancer (stage IB-IIA1 with a tumor ≥2 cm) or locally advanced cervical cancer (Stage IIA2-IIB after chemo-radiotherapy) were collected prospectively...
April 21, 2018: Journal of the Egyptian National Cancer Institute
https://www.readbyqxmd.com/read/29662278/comparison-of-efficacy-of-bupivacaine-with-dexmedetomidine-versus-bupivacaine-alone-for-transversus-abdominis-plane-block-for-post-operative-analgesia-in-patients-undergoing-elective-caesarean-section
#20
A Ramya Parameswari, Prabha Udayakumar
Background: Increasing rate of Caesarean sections and inadequate pain relief following Caesarean section is seen in almost all parts of the world. Transversus abdominis plane block is gaining popularity as a part of multimodal analgesia for post-operative pain relief following abdominal surgeries. Aim: To compare bupivacaine and bupivacaine with dexmedetomidine in transversus abdominis plane block for pain relief after Caesarean section. Method: American Society of Anaesthesiologists I and II parturients with no comorbidities admitted for elective Caesarean section were included in the study...
April 2018: Journal of Obstetrics and Gynaecology of India
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