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Post-Operative pain control

Ming-Jie Kuang, Chao Han, Jian-Xiong Ma, Fei Li, Jie Zhao, Lin Fu, Xin-Long Ma
PURPOSE: Autologous platelet gel, developed from fresh autologous blood, is a breakthrough in the promotion and acceleration of soft tissue and bone repair. The application of autologous platelet gel has been reported to improve haemostasis and promote function recovery. We screened the randomized controlled trials and controlled clinical trials of high quality to investigate whether autologous platelet gel makes a better performance for postoperative bleeding and functional recovery in patients after total knee arthroplasty...
October 19, 2016: International Journal of Surgery
Tarik Sammour, Ahmed W H Barazanchi, Andrew G Hill
BACKGROUND: The aim of this systematic review was to update previous PROSPECT ( ) review recommendations for the management of pain after excisional haemorrhoidectomy. METHODS: Randomized studies and reviews published in the English language from July 2006 (end date of last review) to March 2016, assessing analgesic, anaesthetic, and operative interventions pertaining to excisional haemorrhoidectomy in adults, and reporting pain scores, were retrieved from the EMBASE and MEDLINE databases...
October 20, 2016: World Journal of Surgery
Mina Alvandipour, Shahram Ala, Hasan Tavakoli, Jamshid Yazdani Cherati, Afshin Shiva
INTRODUCTION: The most frequent problems after anal fistulotomy are pain, bleeding, and delayed or impaired wound healing. Topical Sucralfate preparation has been used to treat a wide variety of wounds. In this study, we investigate effects of 10% sucralfate ointment on wound healing and postoperative pain after fistulotomy. METHODS AND MATERIALS: A total of 41 patients undergoing anorectal fistulotomy were included in this randomized, blinded, controlled trial and were randomly allocated to either sucralfate ointment (every 12 h) or placebo...
October 17, 2016: International Journal of Surgery
Mohammad Zarei, Arvin Najafi, Pejman Mansouri, Sadaf Sadeghi-Yazdankhah, Houshang Saberi, Mehran Moradi, Mahmoud Farzan
OBJECTIVES: Despite the progress in understanding acute pain physiology during recent decade, eighty percent of patients still suffer from post-operative discomfort. Pregabalin is an anticonvulsant agent that is approved for painful neuropathies in diabetic patients and post herpetic neuralgia. The main objective of the present study was to compare the improvement in post-operative pain management and patient lifestyle in 3 groups, as first group received placebo, second who received Pregabalin for one day and the last group those who received it for 14 days...
October 17, 2016: Clinical Neurology and Neurosurgery
Tulay Sagkal Midilli, Nazmiye Ciray Gunduzoglu
This study was conducted to determine the effects of Reiki on pain and vital signs when applied for 15 minutes to the incision area of the body after cesarean section surgery. The study was single-blinded, randomized, and double-controlled (Reiki, sham Reiki, and control groups). Forty-five patients, equalized by age and number of births, were randomly assigned to the Reiki, sham Reiki, and control groups. The treatment, which was applied to the patients in these 3 groups, was applied for 15 minutes to the incision area of body in the first 24 and 48 hours after the operation within 4 to 8 hours of the application of standard analgesics...
November 2016: Holistic Nursing Practice
K Ye, R Wang, J Qin, X Yang, M Yin, X Liu, M Jiang, X Lu
OBJECTIVE: The hypothesis that post-operative short-term compression therapy improves operation related complications in patients with uncomplicated varicose veins after endovenous laser ablation (EVLA) treatment was tested. METHODS: In this randomized trial, patients with uncomplicated varicose veins (C2 according to the CEAP classification) treated with EVLA at a single institution from January 2012 to November 2013 were enrolled. Before EVLA, patients were randomized into two groups based on whether or not (control group) they wore an elastic compression stocking (ECS group) post-operatively...
October 16, 2016: European Journal of Vascular and Endovascular Surgery
Ivana Burazor, Stamenko Susak
OBJECTIVE: After stent or bypass surgery blood pressure (BP) can go up for multiple reasons among which are: stress and tense of the patient unsure about the future, the pain of the cut and because some of the blood pressure medication, which the patient was receiving preoperatively may get withdrawn post operatively, thereby leading to shooting up the BP. In certain patients, BP actually comes down after surgery and returns back to the pre-operative levels 4 to 6 weeks down the track...
September 2016: Journal of Hypertension
N Swathi, N Ashwini, Mukesh I Shukla
INTRODUCTION: To compare the efficacy of combination of epidural local anesthetic with tramadol and butorphanol in major abdominal surgeries. AIMS: To evaluate duration of analgesia, analgesic efficacy, and safety profile of two groups of drugs-epidural butorphanol with bupivacaine and epidural tramadol with bupivacaine. MATERIALS AND METHODS: A prospective, randomized controlled, double-blinded study was undertaken in 50 patients scheduled for major abdominal surgeries...
September 2016: Anesthesia, Essays and Researches
Ashok Kumar Saxena, Geetanjali T Chilkoti, Anand K Chopra, Basu Dev Banerjee, Tusha Sharma
BACKGROUND: The present study was undertaken to evaluate the incidence of chronic persistent post-surgical pain (CPPP) and the role of signal transduction genes in patients undergoing staging laparotomy for carcinoma ovary. METHODS: The present observational study was undertaken following institutional ethical committee approval and informed consent from all the participants. A total 21 patients of ASA grade I to III with age 20-70 years, scheduled for elective staging laparotomy for carcinoma ovary were included...
October 2016: Korean Journal of Pain
Jyothi Subramanya, Natasha Curtiss, Aswini Balachandran, Jonathan Duckett
OBJECTIVE: Vaginal packs are commonly inserted after pelvic organ prolapse (POP) surgery to absorb excess blood loss and to reduce haematoma formation. Randomised trials have shown little benefit in terms of reduced haematoma formation. However, the amount of blood loss absorbed on the pack has not been studied. The use of packs has financial costs and is associated with catheterisation and may delay hospital discharge. If packs are not effective in reducing blood loss and haematoma formation there could be an argument that packs should not be used at all...
September 30, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
J S Berger, A Gonzalez, A Hopkins, T Alshaeri, D Jeon, S Wang, R L Amdur, R Smiley
BACKGROUND: The appropriate dose of intrathecal morphine for post-cesarean analgesia is unclear. With the inclusion of routine non-steroidal anti-inflammatory drugs, the required dose of morphine may be significantly less than the 200-300μg common a decade ago. We performed a two-center, prospective, randomized, blinded trial comparing three doses of intrathecal morphine, combined with routine intravenous ketorolac, in 144 healthy women undergoing elective cesarean delivery. METHODS: Patients received an intrathecal injection of hyperbaric bupivacaine 12mg, fentanyl 15μg and a randomized dose of 50, 100, or 150μg morphine in a volume of 2...
August 28, 2016: International Journal of Obstetric Anesthesia
Maren E Hilton, Terence Gioe, Siamak Noorbaloochi, Jasvinder A Singh
BACKGROUND: Previous studies suggested that pre-operative comorbidity was a risk factor for worse outcomes after TKA. To our knowledge, studies have not examined whether postoperative changes in comorbidity impact pain and function outcomes longitudinally. Our objective was to examine if increasing comorbidity postoperatively is associated with worsening physical function and pain after primary total knee arthroplasty (TKA). METHODS: We performed a retrospective chart review of veterans who had completed Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-36 (SF36) surveys at regular intervals after primary TKA...
October 7, 2016: BMC Musculoskeletal Disorders
Lars Peter Holst Andersen
The hormone, melatonin is produced with circadian rhythm by the pineal gland in humans. The melatonin rhythm provides an endogenous synchronizer, modulating e.g. blood pressure, body temperature, cortisol rhythm, sleep-awake-cycle, immune function and anti-oxidative defence. Interestingly, a number of experimental animal studies demonstrate significant dose-dependent anti-nociceptive effects of exogenous melatonin. Similarly, recent experimental- and clinical studies in humans indicate significant analgesic effects...
October 2016: Danish Medical Journal
A Geisler, J B Dahl, A P H Karlsen, E Persson, O Mathiesen
BACKGROUND: The majority of clinical trials regarding post-operative pain treatment focuses on the average analgesic efficacy, rather than on efficacy in individual patients. It has been argued, that in acute pain trials, the underlying distributions are often skewed, which makes the average unfit as the only way to measure efficacy. Consequently, dichotomised, individual responder analyses using a predefined 'favourable' response, e.g. Visual Analogue Scale (VAS) pain scores ≤ 30, have recently been suggested as a more clinical relevant outcome...
October 3, 2016: Acta Anaesthesiologica Scandinavica
Liqin Deng, Lihua Zhang, Haiying Zhao, Fengxiang Song, Gang Chen, Hanyue Zhu
OBJECTIVES: Remifentanil may induce hyperalgesia. Recent studies implicate a close relationship between post-surgical hyperalgesia and phosphorylation and activation of p38 mitogen-activated protein kinase (p38MAPK) in the spinal microglia. This study aimed to investigate whether the combination of post-surgical and remifentanil-induced hyperalgesia worsens post-operative pain and whether phosphorylated p38MAPK (phospho-p38MAPK) in the spinal dorsal horn in rats is involved in remifentanil-induced postoperative hyperalgesia...
October 2016: Neurological Research
Katherine H Dobie, Yaping Shi, Matthew S Shotwell, Warren S Sandberg
STUDY OBJECTIVE: Regional anesthesia and analgesia for shoulder surgery is most commonly performed via interscalene nerve block. We developed an ultrasound-guided technique that specifically targets the C5 nerve root proximal to the traditional interscalene block and assessed its efficacy for shoulder analgesia. DESIGN: Prospective case series. SETTING: Vanderbilt Bone and Joint Surgery Center. PATIENTS: Patients undergoing shoulder arthroscopy at an ambulatory surgery center...
November 2016: Journal of Clinical Anesthesia
C Lutz, L Baverel, P Colombet, J Cournapeau, F Dalmay, N Lefevre, R Letartre, J-F Potel, X Roussignol, T Cucurulo, E Servien
BACKGROUND: Anterior cruciate ligament (ACL) repair is increasingly performed on an out-patient basis. In France, however, concern about post-operative pain remains a strong barrier to out-patient ACL repair. The primary objective of this study was to compare post-operative pain after ACL repair as out-patient versus in-patient surgery. The secondary objectives were to assess the time-course of post-operative pain and to identify factors associated with pain intensity. MATERIAL AND METHODS: A multicentre, prospective, comparative, non-randomised study was conducted in France for the French Society for Arthroscopy (SFA) symposium...
September 27, 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
Omar E Aly, Douglas H Black, Haroon Rehman, Irfan Ahmed
BACKGROUND: Appendicectomy is a well-established surgical procedure used in the management of acute appendicitis. The operation can be performed with minimally invasive surgery or as an open procedure. A further development in the minimally invasive appendicectomy technique has been the introduction of single incision laparoscopic surgery (SILA). AIM: To ascertain any differences in outcomes from available trials comparing SILA with conventional multi-incision laparoscopic appendicectomy (CLA)...
October 2, 2016: International Journal of Surgery
Stephen King, Elizabeth S Roberts, Jonathan N King
BACKGROUND: Few pharmaceuticals are registered in cats for the management of post-operative pain and inflammation. The objective of this study was to assess the field efficacy and safety of an injectable formulation of the nonsteroidal anti-inflammatory drug robenacoxib in cats undergoing surgery. The study was a multi-center, prospective, randomized, masked, parallel-group, placebo-controlled clinical trial. A total of 349 cats were enrolled and underwent surgery comprising forelimb onychectomy, as an example of orthopedic surgery, plus either ovariohysterectomy or castration...
September 29, 2016: BMC Veterinary Research
A Rajeev, N Tumia, K Karn, S Kashyap, D Mayne
Pain control plays a key role in joint-replacement -surgery. As a surgeon the challenge is to reduce pain to an acceptable level in the post-operative period. The aim of the study was to assess the efficacy of bolus -local anaesthesia, infusion in to the surgical site and nerve blocks with femoral nerve catheter and its functional outcome. A prospective audit of 114 patients undergoing total knee arthroplasty were carried out.The patients were divided in to three groups : Group 1 (n = 27) received a bolus injection of 20 ml 0...
August 2016: Acta Orthopaedica Belgica
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