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epidural morphine consumption

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https://www.readbyqxmd.com/read/29864216/continuous-intravenous-perioperative-lidocaine-infusion-for-postoperative-pain-and-recovery-in-adults
#1
REVIEW
Stephanie Weibel, Yvonne Jelting, Nathan L Pace, Antonia Helf, Leopold Hj Eberhart, Klaus Hahnenkamp, Markus W Hollmann, Daniel M Poepping, Alexander Schnabel, Peter Kranke
BACKGROUND: The management of postoperative pain and recovery is still unsatisfactory in a number of cases in clinical practice. Opioids used for postoperative analgesia are frequently associated with adverse effects, including nausea and constipation, preventing smooth postoperative recovery. Not all patients are suitable for, and benefit from, epidural analgesia that is used to improve postoperative recovery. The non-opioid, lidocaine, was investigated in several studies for its use in multimodal management strategies to reduce postoperative pain and enhance recovery...
June 4, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29864042/comparison-of-the-efficacy-of-different-analgesia-treatments-for-total-knee-arthroplasty-a-network-meta-analysis
#2
Peilong Dong, Xiaobo Tang, Rongrong Cheng, Jian Wang
BACKGROUND AND AIM: The severe pain after total knee arthroplasty (TKA) brings many patients more suffering, longer hospital stay and higher expenses. This study was designed to assess the relative efficacy of several clinical treatments for postoperative analgesia of TKA through network meta-analysis (NMA) based on multiple published randomized controlled trials. METHODS: Embase and PubMed were utilized to conduct this network meta-analysis from inception until 2016...
June 2, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29845327/comparative-outcomes-of-epidural-steroids-versus-placebo-after-lumbar-discectomy-in-lumbar-disc-herniation-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#3
Alisara Arirachakaran, Montree Siripaiboonkij, Saran Pairuchvej, Kittipong Setrkraising, Pritsanai Pruttikul, Chaiwat Piyasakulkaew, Jatupon Kongtharvonskul
Treatment for lumbar disc herniation after failed conservative treatment is discectomy. Discectomy can significantly relieve back pain as well as radicular symptoms. However, many patients with lumbar discectomy experience moderate-to-severe back pain and radicular leg pain. The results of application of epidural steroids (ES) for pain management after lumbar discectomy have previously been inconclusive. We have conducted a systematic review and meta-analysis aims to compare outcomes (efficacy and complications) of epidural steroid application and placebo after discectomy in lumbar disc herniation...
May 29, 2018: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/29788532/the-effect-of-adding-magnesium-sulfate-to-epidural-bupivacaine-and-morphine-on-post-thoracotomy-pain-management-a-randomized-double-blind-clinical-trial
#4
Behrooz Farzanegan, Mahdi Zangi, Kimia Saeedi, Ali Khalili, Mehdi Rajabi, Alireza Jahangirifard, Habib Emami, Amir Ali Mahboobipour, Shadi Baniasadi
Post-thoracotomy pain is very severe and may cause pulmonary complications. Thoracic epidural analgesia can greatly decrease the pain experience and its consequences. However, finding new methods to decrease the amount of administered opioids is an important issue of research. We aimed to evaluate the effect of adding epidural magnesium sulfate to bupivacaine and morphine on pain control and the amount of opioid consumption after thoracotomy. Eighty patients undergoing thoracotomy at a tertiary cardiothoracic referral centre were enrolled in a randomized, double-blind trial...
May 22, 2018: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29624542/effects-of-combined-lower-thoracic-epidural-general-anesthesia-on-pain-control-in-patients-undergoing-elective-lumbar-spine-surgery-a-randomized-controlled-trial
#5
Marvin Thepsoparn, Jariya Sereeyotin, Patt Pannangpetch
STUDY DESIGN: Randomized controlled trial. OBJECTIVE: Our objective was to compare postoperative pain relief and operating field condition of single shot low thoracic epidural anesthesia combined with general anesthesia versus general anesthesia alone. SUMMARY OF BACKGROUND DATA: Prior studies have suggested that continuous epidural analgesia provides better postoperative pain relief and less intraoperative blood loss, but with the risk of the epidural catheter contaminating the surgical field...
April 5, 2018: Spine
https://www.readbyqxmd.com/read/29553101/pain-perception-after-colorectal-surgery-a-propensity-score-matched-prospective-cohort-study
#6
Fabian Grass, Matthieu Cachemaille, David Martin, Nicolas Fournier, Dieter Hahnloser, Catherine Blanc, Nicolas Demartines, Martin Hübner
The purpose of this prospective cohort study was to compare multimodal pain management and pain perception after open vs. laparoscopic colorectal surgery within enhanced recovery care. Pain scores at rest and at mobilization were prospectively assessed in consecutive patients using Visual Analog Scales (VAS 0-10) and consumption of different analgesics was recorded daily until 96 hours postoperatively. Uni- and multivariate risk factors for pain peaks (≥ 4/10) were identified by logistic regression and compared between two propensity score matched groups (open vs...
2018: Bioscience Trends
https://www.readbyqxmd.com/read/29379383/comparison-of-single-shot-intrathecal-morphine-injection-and-continuous-epidural-bupivacaine-for-post-operative-analgaesia-after-elective-abdominal-hysterectomy
#7
Wan Mohd Nazaruddin Wan Hassan, Anafairos Md Nayan, Azmi Abu Hassan, Rhendra Hardy Mohamad Zaini
Background: Abdominal hysterectomy (AH) is painful. The aim of this study was to compare intrathecal morphine (ITM) and epidural bupivacaine (EB) for their analgaesia effectiveness after this surgery. Methods: Thirty-two patients undergoing elective AH were randomised into Group ITM (ITM 0.2 mg + 2.5 mL 0.5% bupivacaine) ( n = 16) and Group EB (0.25% bupivacaine bolus + continuous infusion of 0.1% bupivacaine-fentanyl 2 μg/mL) ( n = 16).The procedure was performed before induction, and all patients subsequently received standard general anaesthesia...
December 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29374667/epidurals-in-pancreatic-resection-outcomes-e-pro-study-protocol-for-a-randomised-controlled-trial
#8
Linda Ma Pak, Simon Haroutounian, William G Hawkins, Lori Worley, Monika Kurtz, Karen Frey, Menelaos Karanikolas, Robert A Swarm, Michael M Bottros
INTRODUCTION: Epidural analgesia provides an important synergistic method of pain control. In addition to reducing perioperative opioid consumption, the deliverance of analgesia into the epidural space, effectively creating a sympathetic blockade, has a multitude of additional potential benefits, from decreasing the incidence of postoperative delirium to reducing the development of persistent postsurgical pain (PPSP). Prior studies have also identified a correlation between the use of epidural analgesia and improved oncological outcomes and survival...
January 26, 2018: BMJ Open
https://www.readbyqxmd.com/read/29233569/continuous-adductor-canal-blocks-provide-superior-ambulation-and-pain-control-compared-to-epidural-analgesia-for-primary-knee-arthroplasty-a-randomized-controlled-trial
#9
Erdan Kayupov, Kamil Okroj, Adam C Young, Mario Moric, Timothy J Luchetti, Gilat Zisman, Asokumar Buvanendran, Tad L Gerlinger, Craig J Della Valle
BACKGROUND: Adductor canal blocks (ACBs) are an alternative to femoral nerve blocks that minimize lower extremity weakness. However, it is unclear whether this block will provide analgesia that is equivalent to techniques, such as epidural analgesia. The purpose of this randomized controlled trial was to compare continuous ACBs with epidural analgesia for primary total knee arthroplasty. METHODS: Following institutional review board approval, 145 patients were randomized to 1 of 3 groups: combined spinal-epidural (CSE), spinal + continuous ACB (CACB), or general + CACB...
April 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29135475/using-activity-trackers-to-quantify-postpartum-ambulation-a-prospective-observational-study-of-ambulation-after-regional-anesthesia-and-analgesia-interventions
#10
Julia Ma, Rachel Martin, Bokman Chan, Michael Gofeld, Michael P Geary, John G Laffey, Faraj W Abdallah
BACKGROUND: Early postoperative ambulation is associated with enhanced functional recovery, particularly in the postpartum population, but ambulation questionnaires are limited by recall bias. This observational study aims to objectively quantify ambulation after neuraxial anesthesia and analgesia for cesarean delivery and vaginal delivery, respectively, by using activity tracker technology. The hypothesis was that vaginal delivery is associated with greater ambulation during the first 24 h postdelivery, compared to cesarean delivery...
March 2018: Anesthesiology
https://www.readbyqxmd.com/read/29063665/a-retrospective-comparison-of-thoracic-epidural-infusion-and-multimodal-analgesia-protocol-for-pain-management-following-the-minimally-invasive-repair-of-pectus-excavatum
#11
Janice Y Man, Harshad G Gurnaney, Scott R Dubow, Theresa J DiMaggio, Gina R Kroeplin, N Scott Adzick, Wallis T Muhly
BACKGROUND: Pain management following minimally invasive repair of pectus excavatum is variable. We recently adopted a comprehensive multimodal analgesic protocol that standardizes perioperative analgesic management. We hypothesized that patients managed with this protocol would use more opioids postoperatively, have similar pain control, and shorter length of stay compared to patients managed with thoracic epidural infusion. AIMS: We retrospectively compared opioid consumption, pain scores, and length of stay between a cohort of patients managed with our multimodal analgesic protocol and a cohort managed with a thoracic epidural infusion...
December 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29033723/postoperative-pain-management-in-patients-undergoing-thoracoscopic-repair-of-pectus-excavatum-a-retrospective-analysis-of-opioid-consumption-and-adverse-effects-in-adolescents
#12
Ralph Beltran, Giorgio Veneziano, Tarun Bhalla, Brian Kenney, Dmitry Tumin, Bruno Bissonnette, Joseph D Tobias
INTRODUCTION: Although the Nuss procedure provides excellent cosmetic results for the correction of pectus excavatum, the provision of analgesia following such procedures can be challenging. METHODS: The current study retrospectively reviews our experience over a 2.5 year period with thoracic epidural analgesia (TE), paravertebral blockade (PVB), and intravenous opioids delivered via patient-controlled analgesia (PCA) to provide postoperative analgesia. RESULTS: The study cohort included 30 patients (mean age = 15...
October 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28958698/predictors-of-chronic-neuropathic-pain-after-scoliosis-surgery-in-children
#13
Florence Julien-Marsollier, Raphaelle David, Julie Hilly, Christopher Brasher, Daphné Michelet, Souhayl Dahmani
BACKGROUND: Numerous publications describe chronic pain following surgery in both adults and children. However, data in the paediatric population are still sparse and both prevalence of chronic pain after surgery and risk factors of this complication still undetermined. METHODS: We prospectively evaluated the prevalence of chronic pain and its neuropathic pain component at 1 year following correction of idiopathic scoliosis in children less than 18 years of age...
September 22, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/28956744/efficacy-and-safety-of-a-continuous-wound-catheter-in-open-abdominal-partial-hepatectomy
#14
Lu Che, Xin Lu, Li-Jian Pei
Objective To investigate the efficacy and safety of continuous local anesthetic wound infiltration following open abdominal partial hepatectomy. Methods We performed a prospective, non-randomized, concurrent and controlled study. Patients undergoing open abdominal partial hepatectomy, according to their willingness, accepted one of the following managements for the postoperative pain: continuous wound catheter (CWC) infiltration, patient-controlled epidural analgesia (PCEA), patient-controlled intravenous analgesia of morphine (PCIAM), and patient-controlled intravenous analgesia of sufentanil (PCIAS)...
September 27, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28868167/comparing-the-effects-of-combined-general-epidural-anaesthesia-and-general-anaesthesia-on-serum-cytokine-levels-in-radical-cystectomy
#15
Meltem Savran Karadeniz, Orkhan Mammadov, Hayriye Şentürk Çiftci, Sebahat Akgül Usta, Kamil Pembeci
OBJECTIVE: Surgical stress combined with general anaesthesia (GA) suppresses the immune system and leads to cancer cell growth and premature metastasis in major oncological interventions. Epidural analgesia decreases the need for inhalation agents and opioids during surgery by suppressing sympathetic and neuroendocrine responses in the postoperative period. This study aimed to compare the effects of combined general/epidural anaesthesia (GEA)+patient-controlled epidural analgesia (PCEA) and GA+IV patient-controlled analgesia (PCA) on serum tumour necrosis factor-alpha TNF-α), interleukin-1 beta (IL-1β) and interferon-gamma (IFN-γ) levels in patients undergoing radical cystectomy...
August 2017: Turkish Journal of Anaesthesiology and Reanimation
https://www.readbyqxmd.com/read/28856110/the-analgesic-efficiency-of-ultrasound-guided-rectus-sheath-analgesia-compared-with-low-thoracic-epidural-analgesia-after-elective-abdominal-surgery-with-a-midline-incision-a-prospective-randomized-controlled-trial
#16
Hany Mahmoud Yassin, Ahmed Tohamy Abd Elmoneim, Hatem El Moutaz
BACKGROUND: Ultrasound-guided rectus sheath blockade has been described to provide analgesia for midline abdominal incisions. We aimed to compare thoracic epidural analgesia (TEA) and rectus sheath analgesia (RSA) with respect to safety and efficacy. METHODS: Sixty patients who underwent elective laparotomies through a midline incision were assigned randomly to receive either continuous TEA (TEA group, n = 31) or intermittent RSA (RSA group, n = 29). The number of patients who required analgesia, the time to first request analgesia, the interval and the cumulative morphine doses consumption during 72 hours postoperatively, and pain intensity using visual analog score (VAS) at rest and upon coughing were reported in addition to any side effects related to both techniques or administered drugs...
June 2017: Anesthesiology and Pain Medicine
https://www.readbyqxmd.com/read/28794528/post-operative-effectiveness-of-continuous-wound-infiltration-continuous-epidural-infusion-and-intravenous-patient-controlled-analgesia-on-post-operative-pain-management-in-patients-undergoing-spinal-surgery
#17
Anshuman Singh, Parul Jindal, Gurjeet Khurana, Ranjeet Kumar
BACKGROUND AND AIMS: Very few studies have compared continuous wound infiltration (CWI), continuous epidural infusion (CEI) and intravenous Patient Controlled Analgesia (PCA) with morphine in spine surgery. This study compared these modalities in patients undergoing microdissectomy. METHODS: This prospective, randomized control trial was conducted on 75 patients of American Society of Anesthesiologists' physical status I or II undergoing microdiscectomy. Patients in all the three groups received morphine 1 mg IV, with a lockout period of 10 min after each bolus, and the maximum allowed dose was 15 mg/5 h postoperatively...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28677829/intravenous-lignocaine-in-colorectal-surgery-a-systematic-review
#18
REVIEW
Wiremu S MacFater, Jamie-Lee Rahiri, Melanie Lauti, Bruce Su'a, Andrew G Hill
BACKGROUND: Colorectal surgery leads to morbidity during recovery including pain and fatigue. Intravenous (IV) lignocaine (IVL) has both analgesic and anti-inflammatory effects that may improve post-operative pain and recovery. The aim of this review is to compare the effectiveness of IVL to other perioperative analgesia regimens for reducing pain and opioid consumption following colorectal surgery. METHODS: Using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement, a literature search was conducted to identify randomized clinical trials that compared IVL with IV placebo or epidural anaesthesia in open or laparoscopic colorectal surgery...
November 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28619696/postoperative-pain-management-in-spanish-hospitals-a-cohort-study-using-the-pain-out-registry
#19
Mauricio Polanco-García, Jaume García-Lopez, Neus Fàbregas, Windfried Meissner, Margarita M Puig
Pain after surgery remains a problem worldwide, although there are no published data on postoperative outcomes in Spain. We evaluated 2,922 patients on the first day after surgery in 13 tertiary care Spanish hospitals, using the PAIN-OUT questionnaire. The aims were to: assess postoperative outcomes and anesthetic/analgesic management in Orthopedics (ORT) and General Surgery (GEN) patients; explore the influence of the analgesic therapy on outcomes and opioid requirements; evaluate and compare outcomes and analgesic management according to surgical procedure...
October 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/28604179/bolus-administration-of-intravenous-lidocaine-reduces-pain-after-an-elective-caesarean-section-findings-from-a-randomised-double-blind-placebo-controlled-trial
#20
RANDOMIZED CONTROLLED TRIAL
Afshin Gholipour Baradari, Abolfazl Firouzian, Farshad Hasanzadeh Kiabi, Amir Emami Zeydi, Mohammad Khademloo, Zeinab Nazari, Masoumeh Sanagou, Maedeh Ghobadi, Ensieh Fooladi
We conducted a randomised double-blind, placebo-controlled trial to assess whether a bolus dose of lidocaine during the induction of general anaesthesia would reduce postoperative pain over 24 h. Level of satisfaction with pain control at 48 h after surgery and Apgar score were also examined. A total of 100 women aged 20-35 years, who were candidates for elective caesarean section (CS) were randomised to receive either 1.5 mg/kg lidocaine or placebo during the induction of general anaesthesia. Results showed that lidocaine decreased pain intensity over 24 h after surgery (p < ...
July 2017: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
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