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Patient-controlled analgesia

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https://www.readbyqxmd.com/read/28213593/randomised-double-blind-parallel-group-placebo-controlled-study-to-evaluate-the-analgesic-efficacy-and-safety-of-vvz-149-injections-for-postoperative-pain-following-laparoscopic-colorectal-surgery
#1
Srdjan S Nedeljkovic, Darin J Correll, Xiaodong Bao, Natacha Zamor, Jose L Zeballos, Yi Zhang, Mark J Young, Johanna Ledley, Jessica Sorace, Kristen Eng, Carlyle P Hamsher, Rajivan Maniam, Jonathan W Chin, Becky Tsui, Sunyoung Cho, Doo H Lee
INTRODUCTION: In spite of advances in understanding and technology, postoperative pain remains poorly treated for a significant number of patients. In colorectal surgery, the need for developing novel analgesics is especially important. Patients after bowel surgery are assessed for rapid return of bowel function and opioids worsen ileus, nausea and constipation. We describe a prospective, double-blind, parallel group, placebo-controlled randomised controlled trial testing the hypothesis that a novel analgesic drug, VVZ -149, is safe and effective in improving pain compared with providing opioid analgesia alone among adults undergoing laparoscopic colorectal surgery...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28212102/prediction-of-patient-controlled-analgesic-consumption-a-multimodel-regression-tree-approach
#2
Yuh-Jyh Hu, Tien-Hsiung Ku, Yu-Hung Yang, Jia-Ying Shen
Several factors contribute to individual variability in postoperative pain; therefore, individuals consume postoperative analgesics at different rates. Although many statistical studies have analyzed postoperative pain and analgesic consumption, most have identified only the correlation and have not subjected the statistical model to further tests in order to evaluate its predictive accuracy. In this study involving 3052 patients, a multistrategy computational approach was developed for analgesic consumption prediction...
February 13, 2017: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/28211285/can-local-infiltration-analgesia-increase-satisfaction-in-postoperative-short-term-pain-control-in-total-knee-arthroplasty
#3
David Barastegui, I Robert, E Palau, S Haddad, M Reverte-Vinaixa, L Lorente, M Cots
BACKGROUND: One of the major challenges to total knee arthroplasty (TKA) is optimal pain control. Effective analgesia is capital in fast-track surgery programs to allow patient's early functional outcomes. OBJECTIVES: Compare length of stay (LOS) short-term pain control, and patients' satisfaction at 1 month between local infiltration analgesia (LIA) combined with femoral nerve block (FNB) and FNB only in patients undergoing TKA. PATIENTS AND METHODS: Two hundred and fifty-four patients were included in a randomized prospective study and distributed in two groups...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28208979/evaluation-of-the-efficacy-of-bupivacaine-0-5-alone-or-with-clonidine-1%C3%AE-g-kg-versus-control-in-a-single-level-paravertebral-blockin-patients-undergoing-pcnl-procedure
#4
Trupti S Kamble, Charulata Mahesh Deshpande
INTRODUCTION: Percutaneous Nephrolithotomy (PCNL) is a widely used procedure to remove complex upper tract renal calculi by means of a nephroscope. Although less invasive, PCNL is associated with significant pain owing to soft tissue injury. Most of these patients have mild to moderately compromised renal function. An anaesthesia plan that reduces intraoperative requirement of anaesthetics, analgesics, muscle relaxants and postoperative requirement of systemic analgesics is essential...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207529/comparison-of-the-pro-postoperative-analgesia-of-intraoperative-dexmedetomidine-with-and-without-loading-dose-following-general-anesthesia-a-prospective-randomized-controlled-clinical-trial
#5
Wei Fan, Haikou Yang, Yong Sun, Jun Zhang, Guangming Li, Ying Zheng, Yi Liu
Intraoperative dexemdetomidine (DEX) with or without loading dose is well-established to improve postoperative pain control in patient-controlled analgesia (PCA). This study was designed to compare the pro-analgesia effect between the 2 in patients received general anesthesia.Seventy patients shceduced abdominal surgery under general anesthesia were randomly assigned into 3 groups which were maintained using propofol/remifentanil/Ringer solution (PRR), propofol/remifentanil/dexmedetomidine with (PRDw) or without (PRDo) a loading dose of dexmedetomidine before induction...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28203561/comparative-prospective-case-control-study-of-open-versus-laparoscopic-pyeloplasty-in-children-with-ureteropelvic-junction-obstruction-long-term-results
#6
Lisandro A Piaggio, Juan P Corbetta, Santiago Weller, Ricardo Augusto Dingevan, Víctor Duran, Javier Ruiz, Juan C Lopez
INTRODUCTION: We compare open pyeloplasty (OP) versus laparoscopic pyeloplasty (LP) in children in a multicenter, prospective, case-control study. MATERIALS AND METHODS: From May 2007 to March 2009, a program was established at Hospital Garrahan, the reference center, to perform LP with a mentoring surgeon that would attend the institution once a month. Every new case of ureteropelvic junction obstruction (UPJO) diagnosed in the reference institution was offered to participate in the study...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28203020/-effect-of-continuous-femoral-nerve-block-combined-with-periarticular-local-infiltration-analgesia-on-early-operative-functional-recovery-after-total-knee-arthroplasty-a-randomized-double-blind-controlled-study
#7
Y Deng, T L Jiang, X X Yang, M Li, J Wang, X Y Guo
OBJECTIVE: To investigate the effects of early rehabilitation training after total knee arthroplasty surgery by continuous femoral nerve block (CFNB) with or without periarticular local infiltration analgesia (PLIA). METHODS: In this randomized, double-blind, controlled study, 100 patients under-going primary unilateral total knee arthroplasty in patients with knee osteoarthritis were enrolled. All the patients received CFNB for postoperative analgesia before combined spinal epidural anesthesia...
February 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28199752/effect-of-transversus-abdominis-plane-block-in-combination-with-general-anesthesia-on-perioperative-opioid-consumption-hemodynamics-and-recovery-in-living-liver-donors-the-prospective-double-blinded-randomized-study
#8
Mehmet Ali Erdogan, Ulku Ozgul, Muharrem Uçar, Rıdvan Yalin, Yusuf Ziya Colak, Cemil Çolak, Huseyin Ilksen Toprak
BACKGROUND: Transversus abdominis plane (TAP) block provides effective postoperative analgesia after abdominal surgeries. It can be also a useful strategy to reduce perioperative opioid consumption, support intraoperative hemodynamic stability and promote early recovery from anesthesia. The aim of this prospective randomized double-blind study was to assess the effect of subcostal TAP blocks on perioperative opioid consumption, hemodynamic and recovery time in living liver donors. METODS: The prospective, double-blinded, randomized controlled study was conducted with 49 living liver donors, aged 18-65 years, who were scheduled to undergo right hepatectomy...
February 15, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28198598/coblation-%C3%A2-intracapsular-tonsillectomy-tonsillotomy-in-children-a-prospective-study-of-500-consecutive-cases-with-long-term-follow-up
#9
A W Hoey, N M Foden, S Hadjisymeou Andreou, F Noonan, A K Chowdhury, Greig S R, E L Sproson, D Allin, N Amin, K M Wouters, N E Jonas, D J Tweedie
OBJECTIVES: Intracapsular tonsillectomy (tonsillotomy) has been used internationally, mainly in the management of obstructive sleep apnoea, rather than recurrent tonsillitis, with little published data evaluating its use for this latter indication. We present long-term prospective data from 500 paediatric cases undergoing Coblation(®) intracapsular tonsillectomy, for both obstructive and infective indications. DESIGN: Prospective case series, March 2013-January 2016, all with completed follow up...
February 15, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28197774/popliteal-block-for-lower-limb-surgery-in-children-with-cerebral-palsy-effect-on-sevoflurane-consumption-and-postoperative-pain-a-randomized-double-blinded-controlled-trial
#10
Derya Ozkan, Emel Gonen, Taylan Akkaya, Mesut Bakir
PURPOSE: The aim of this study was to evaluate the effects of a preoperative popliteal block on sevoflurane consumption, postoperative pain, and analgesic consumption in children with cerebral palsy (CP) following lower limb surgery. METHODS: Fifty-four patients undergoing lower limb surgery were randomized to receive either a popliteal block + general anaesthesia (group P, n = 27) or general anaesthesia without a popliteal block (group C, n = 27). After anesthesia induction with 50% N2O, O2, and 8% sevoflurane, a popliteal block was given to group P patients with ultrasound guidance as a single dose of 0...
February 14, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28192247/comparison-of-peri-articular-liposomal-bupivacaine-and-standard-bupivacaine-for-postsurgical-analgesia-in-total-knee-arthroplasty-a-systematic-review-and-meta-analysis
#11
REVIEW
Xi Wang, Lin Xiao, Zhiyuan Wang, Guanghui Zhao, Jianbing Ma
OBJECTIVE: This meta-analysis aimed to compare the efficacy and safety of intraoperative peri-articular liposomal bupivacaine and standard bupivacaine in patients undergoing total knee arthroplasty. METHODS: A systematic search was performed in Medline (1966-2016.9), PubMed (1966-2016.9), Embase (1980-2016.9), ScienceDirect (1985-2016.9) and the Cochrane Library. Only high-quality studies were selected. Meta-analysis was performed using Stata 11.0 software. RESULTS: Three randomized controlled trials (RCTs) and two non-randomized controlled trials (Non-RCTs), including 1214 patients met the inclusion criteria...
February 10, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28185289/effect-of-epidural-compared-to-patient-controlled-intravenous-analgesia-on-outcomes-for-patients-undergoing-liver-resection-for-neoplastic-disease
#12
Shelby Allen, Amy DeRoche, Lu Adams, Karen Valerie Slocum, Clancy J Clark, Nora F Fino, Perry Shen
BACKGROUND: Epidural analgesia is routinely used for postoperative pain control following abdominal surgeries, yet data regarding the safety and efficacy of epidural analgesia is controversial. METHODS: Pain-related and clinical perioperative data were extracted and correlated with baseline clinicopathologic data and method of analgesia (epidural vs. intravenous patient-controlled analgesia) in patients who underwent hepatectomy from 2012 to 2014. Chronic pain was defined by specific narcotic requirements preoperatively...
February 10, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28185011/continuous-intraoperative-epidural-infusions-affect-recovery-room-length-of-stay-and-analgesic-requirements-a-single-center-observational-study
#13
Aalap C Shah, Bala G Nair, Charles F Spiekerman, Laurent A Bollag
PURPOSE: Continuous intraoperative epidural analgesia may improve post-operative pain control and decrease opioid requirements. We investigate the effect of epidural infusion initiation before or after arrival in the post-anesthesia care unit on recovery room duration and post-operative opioid use. METHODS: We performed a retrospective chart review of abdominal, thoracic and orthopedic surgeries where an epidural catheter was placed prior to surgery at the University of Washington Medical Center during a 24 month period...
February 9, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28184266/utility-of-ultrasound-guided-transversus-abdominis-plane-block-for-day-case-inguinal-hernia-repair
#14
Luciano Frassanito, Sara Pitoni, Gianluigi Gonnella, Sergio Alfieri, Miryam Del Vicario, Stefano Catarci, Gaetano Draisci
BACKGROUND: The transversus abdominis plane (TAP) block is a regional anesthesia technique that effectively reduces the pain intensity and use of analgesia in abdominal surgery. The aim of this study was to determine the utility of the ultrasound-guided TAP block in improving the efficacy of the ultrasound-guided ilioinguinal/iliohypogastric nerve (IIN/IHN) block for intraoperative anesthesia and postoperative pain control in day-case inguinal hernia repair (IHR). METHODS: We conducted a descriptive study of patients undergoing elective primary unilateral open IHR...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28183576/the-benefits-of-ultrasound-guided-continuous-sensory-nerve-blockade-in-the-setting-of-burn-injury-a-case-report-of-bilateral-continuous-superficial-peroneal-nerve-blockade-in-a-patient-with-severe-sleep-apnea
#15
Vladislav Shick, Evan E Lebovitz, Emerson Conrad
The management of pain after burn injuries is a clinical challenge magnified in patients with significant comorbidities. Presently, burn pain is treated via a wide variety of modalities, including systemic pharmacotherapy and regional analgesia. Although the latter can provide effective pain control in patients with burn injuries, it is relatively underused. Furthermore, the development of ultrasound guidance has allowed for novel approaches and sparing of motor nerve blockade with preference toward sensory-specific analgesia that has not been possible previously...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183564/the-effect-of-tramadol-plus-paracetamol-on-consumption-of-morphine-after-coronary-artery-bypass-grafting
#16
Dilek Altun, Özlem Çınar, Emre Özker, Ayda Türköz
STUDY OF OBJECTIVE: To compare the effects of oral tramadol+paracetamol combination on morphine consumption following coronary artery bypass grafting (CABG) in the patient-controlled analgesia (PCA) protocol. DESIGN: A prospective, double-blind, randomized, clinical study. SETTING: Single-institution, tertiary hospital. PATIENTS: Fifty cardiac surgical patients undergoing primary CABG surgery. INTERVENTIONS: After surgery, the patients were allocated to 1 of 2 groups...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183557/parturient-recall-of-neuraxial-analgesia-risks-impact-of-labor-pain-vs-no-labor-pain
#17
Christopher M Burkle, David A Olsen, Hans P Sviggum, Adam K Jacob
STUDY OBJECTIVE: Information exchange between anesthesia providers and parturients about neuraxial analgesia risks often occurs in the presence of labor pain. This study examined whether the presence of pain impacted the level of recall of information provided to parturients regarding risks of neuraxial techniques. DESIGN: Single-center, nonrandomized study. SETTING: Labor and delivery suite and postpartum patient rooms in a large academic medical center...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28183036/which-one-is-more-effective-for-analgesia-in-infratentorial-craniotomy-the-scalp-block-or-local-anesthetic-infiltration
#18
Eren Fatma Akcil, Ozlem Korkmaz Dilmen, Hayriye Vehid, Lutfiye Serap Ibısoglu, Yusuf Tunali
OBJECTIVES: The most painful stages of craniotomy are the placement of the pin head holder and the skin incision. The primary aim of the present study is to compare the effects of the scalp block and the local anesthetic infiltration with bupivacaine 0.5% on the hemodynamic response during the pin head holder application and the skin incision in infratentorial craniotomies. The secondary aims are the effects on pain scores and morphine consumption during the postoperative 24h. METHODS: This prospective, randomized and placebo controlled study included forty seven patients (ASA I, II and III)...
January 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/28178436/femoral-versus-multiple-nerve-blocks-for-analgesia-after-total-knee-arthroplasty
#19
Anatoli Stav, Leonid Reytman, Roger Sevi, Michael Yohay Stav, Devorah Powell, Yanai Dor, Mickey Dudkiewicz, Fuaz Bayadse, Ahud Sternberg, Michael Soudry
BACKGROUND: The PROSPECT (Procedure-Specific Postoperative Pain Management) Group recommended a single injection femoral nerve block in 2008 as a guideline for analgesia after total knee arthroplasty. Other authors have recommended the addition of sciatic and obturator nerve blocks. The lateral femoral cutaneous nerve is also involved in pain syndrome following total knee arthroplasty. We hypothesized that preoperative blocking of all four nerves would offer superior analgesia to femoral nerve block alone...
January 30, 2017: Rambam Maimonides Medical Journal
https://www.readbyqxmd.com/read/28178091/investigating-the-efficacy-of-dexmedetomidine-as-an-adjuvant-to-local-anesthesia-in-brachial-plexus-block-a-systematic-review-and-meta-analysis-of-18-randomized-controlled-trials
#20
Nasir Hussain, Vincent Paul Grzywacz, Charles Andrew Ferreri, Amit Atrey, Laura Banfield, Naum Shaparin, Amaresh Vydyanathan
BACKGROUND AND OBJECTIVES: Dexmedetomidine has been thought to be an effective adjuvant to local anesthetics in brachial plexus blockade. We sought to clarify the uncertainty that still exists as to its true efficacy. METHODS: A meta-analysis of randomized controlled trials was conducted to assess the ability of dexmedetomidine to prolong the duration and hasten the onset of motor and sensory blockade when used as an adjuvant to local anesthesia for brachial plexus blockade versus using local anesthesia alone (control)...
March 2017: Regional Anesthesia and Pain Medicine
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