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Post operative analgesia

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15 papers 25 to 100 followers
By Giovanni Gambino M.D. Ph.D.
Ryash Vather, Rachel Josephson, Rebekah Jaung, Arman Kahokehr, Tarik Sammour, Ian Bissett
OBJECTIVE: To investigate the therapeutic value of Gastrografin in shortening duration of prolonged postoperative ileus (PPOI) after elective colorectal surgery. BACKGROUND: Gut wall edema is central to the pathogenesis of PPOI. Hyperosmotic, orally administered, water-soluble contrast media such as Gastrografin are theoretically capable of mitigating this edema. METHODS: A double-blinded, placebo-controlled, randomized trial was conducted...
July 2015: Annals of Surgery
F Ris, J M Findlay, R Hompes, A Rashid, J Warwick, C Cunningham, O Jones, N Crabtree, I Lindsey
INTRODUCTION: Opioid sparing in postoperative pain management appears key in colorectal enhanced recovery. Transversus abdominis plane (TAP) blocks offer such an effect. This study aimed to quantify this effect on pain, opioid use and recovery of bowel function after laparoscopic high anterior resection. METHODS: This was a retrospective analysis of prospective data on 68 patients. Patients received an epidural (n=24), intravenous morphine patient controlled analgesia (PCA, n=22) or TAP blocks plus PCA (n=22) determined by anaesthetist preference...
November 2014: Annals of the Royal College of Surgeons of England
Michael J Hughes, Nicholas T Ventham, Stephen McNally, Ewen Harrison, Stephen Wigmore
IMPORTANCE: The optimal analgesic technique following open abdominal surgery within an enhanced recovery protocol remains controversial. Thoracic epidural is often recommended; however, its role is increasingly being challenged and alternative techniques are being suggested as suitable replacements. OBJECTIVE: To determine by meta-analysis whether epidurals are superior to alternative analgesic techniques following open abdominal surgery within an enhanced recovery setting in terms of postoperative morbidity and other markers of recovery...
December 2014: JAMA Surgery
Deborah S Keller, Bridget O Ermlich, Nicholas Schiltz, Bradley J Champagne, Harry L Reynolds, Sharon L Stein, Conor P Delaney
BACKGROUND: Superior early pain control has been suggested with transversus abdominis plane blocks, but evidence-based recommendations for transversus abdominis plane blocks and their effects on patient outcomes are lacking. OBJECTIVE: The aim of this study was to determine whether transversus abdominis plane blocks improve early postoperative outcomes in patients undergoing laparoscopic colorectal resection already on an optimized enhanced recovery pathway. DESIGN: This study is based on a prospective, randomized, double-blind controlled trial...
November 2014: Diseases of the Colon and Rectum
Karl A LeBlanc, Drake Bellanger, V Keith Rhynes, Mark Hausmann
BACKGROUND: Postoperative pain management and narcotic usage after inguinal hernia repair is an important concern for anesthesiologists and surgeons. Regional anesthesia incisional infiltration techniques may reduce the need for systemic medications. STUDY DESIGN: Double-blind study of 52 patients undergoing open hernia repair with the Prolene Hernia System prospectively randomized to receive either 0.5% bupivacaine or saline continuously for 48 hours at 2 mL/hour through use of an elastomeric continuous infusion pump (ONQ Pain Relief System)...
February 2005: Journal of the American College of Surgeons
Carmen Mabel Arroyo-Novoa, Milagros I Figueroa-Ramos, Christine Miaskowski, Geraldine Padilla, Steven M Paul, Pablo Rodríguez-Ortiz, Nancy A Stotts, Kathleen A Puntillo
OBJECTIVE: The purpose of this study was to evaluate differences in pain intensity, pain quality, physiological measures, and adverse effects when patients received morphine with saline (MS) compared with morphine and a small dose of ketamine (MK) before an open wound care procedure (WCP). METHODS: A randomized, cross-over design was used to determine whether the addition of a small dose of ketamine would potentiate morphine's analgesic effects and decrease WCP pain intensity...
September 2011: Clinical Journal of Pain
Martin Hübner, Catherine Blanc, Didier Roulin, Michael Winiker, Sylvain Gander, Nicolas Demartines
OBJECTIVE: To compare epidural analgesia (EDA) to patient-controlled opioid-based analgesia (PCA) in patients undergoing laparoscopic colorectal surgery. BACKGROUND: EDA is mainstay of multimodal pain management within enhanced recovery pathways [enhanced recovery after surgery (ERAS)]. For laparoscopic colorectal resections, the benefit of epidurals remains debated. Some consider EDA as useful, whereas others perceive epidurals as unnecessary or even deleterious...
April 2015: Annals of Surgery
Ammara A Watkins, Timothy V Johnson, Adam B Shrewsberry, Paymon Nourparvar, Tarik Madni, Colyn J Watkins, Paul L Feingold, David A Kooby, Shishir K Maithel, Charles A Staley, Viraj A Master
BACKGROUND: Postoperative pain is an unavoidable consequence of open abdominal surgery. Although cryotherapy, the application of ice to a surgical wound site, has been shown to be effective in reducing postoperative pain in orthopaedic, gynecologic, and hernia operations, it has not been assessed in patients who undergo major open abdominal operations. We hypothesized that patients who receive cryotherapy would report lower pain scores as a primary outcomes measure. STUDY DESIGN: Patients undergoing abdominal operations with midline incisions were randomized to receive cryotherapy for a minimum of 24 hours in time intervals dictated by patient preference vs no cryotherapy...
September 2014: Journal of the American College of Surgeons
Teruya Komatsu, Atsunari Kino, Mari Inoue, Terumasa Sowa, Koji Takahashi, Takuji Fujinaga
BACKGROUND: Appropriate postoperative analgesia is crucial in fast-track surgery, which is a multimodal therapeutic strategy that aims toward enhanced postoperative recovery and shortened hospital stay. Paravertebral block (PVB) has been reported to be as effective as thoracic epidural blockade (TEB), but PVB is not often employed for video-assisted thoracoscopic surgery (VATS) for 2 reasons. First, TEB is still the gold standard for thoracic surgery, and second, thoracoscopic insertion of a PVB catheter is challenging...
2014: International Journal of Surgery
(no author information available yet)
BACKGROUND: Recent evidence has suggested an association between postoperative non-steroidal anti-inflammatory drugs (NSAIDs) and increased operation-specific complications. This study aimed to determine the safety profile following gastrointestinal surgery across a multicentre setting in the UK. METHODS: This multicentre study was carried out during a 2-week interval in September-October 2013. Consecutive adults undergoing elective or emergency gastrointestinal resection were included...
October 2014: British Journal of Surgery
Daniel M Pöpping, Nadia Elia, Hugo K Van Aken, Emmanuel Marret, Stephan A Schug, Peter Kranke, Manuel Wenk, Martin R Tramèr
OBJECTIVE: To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia. BACKGROUND: It remains controversial whether adding epidural analgesia to general anesthesia decreases postoperative morbidity and mortality. METHODS: We searched CENTRAL, EMBASE, PubMed, CINAHL, and BIOSIS till July 2012. We included randomized controlled trials comparing epidural analgesia (with local anesthetics, lasting for ≥ 24 hours postoperatively) with systemic analgesia in adults having surgery under general anesthesia, and reporting on mortality or any morbidity endpoint...
June 2014: Annals of Surgery
Fuad Alkhoury, Colin Knight, Steven Stylianos, Jeannette Zerpa, Raquel Pasaron, JoAnne Mora, Alexandra Aserlind, Leopoldo Malvezzi, Cathy Burnweit
Purpose. To compare narcotic versus nonnarcotic outpatient oral pain management after pediatric laparoscopic appendectomy. Methods. In a prospective study from July 1, 2010, to March 30, 2011, children undergoing laparoscopic appendectomy on a rapid discharge protocol were treated with either nonnarcotic or narcotic postoperative oral analgesia. Two surgeons in a four-person faculty group employed the nonnarcotic regimen, while the other two used narcotics. Days of medication use, time needed for return to normal activity, and satisfaction rate with the pain control method were collected...
2014: Minimally Invasive Surgery
Sooyoung Cho, Youn-Jin Kim, Dong-Yeon Kim, Soon-Sup Chung
PURPOSE: Transversus abdominis plane (TAP) block is a newly developed and effective peripheral block involving the nerves of the anterior abdominal wall for lower abdominal surgery. We evaluated the postoperative analgesic efficacy of ultrasound-guided TAP block using 20 mL of 0.5% levobupivacaine in patients undergoing open appendectomy. METHODS: Forty-four patients undergoing appendectomy were assigned either to undergo a right sided-TAP block (group I, n = 22), or to receive standard care (group II, n = 22)...
September 2013: Journal of the Korean Surgical Society
Huseyin Yilmaz, Oguzhan Arun, Seza Apiliogullari, Fahrettin Acar, Husnu Alptekin, Akın Calisir, Mustafa Sahin
PURPOSE: Minimally invasive surgical technics have benefits such as decreased pain, reduced surgical trauma, and increased potential to perform as day case surgery, and cost benefit. The primary aim of this prospective, randomized, controlled study was to compare the effects of single incision laparoscopic cholecystectomy (SILC) and conventional laparoscopic cholecystectomy (CLC) procedures regarding postoperative pain. METHODS: Ninety adult patients undergoing elective laparoscopic cholecystectomy were included in the study...
October 2013: Journal of the Korean Surgical Society
N T Ventham, M Hughes, S O'Neill, N Johns, R R Brady, S J Wigmore
BACKGROUND: Local anaesthetic wound infiltration techniques reduce opiate requirements and pain scores. Wound catheters have been introduced to increase the duration of action of local anaesthetic by continuous infusion. The aim was to compare these infiltration techniques with the current standard of epidural analgesia. METHODS: A meta-analysis of randomized clinical trials (RCTs) evaluating wound infiltration versus epidural analgesia in abdominal surgery was performed...
September 2013: British Journal of Surgery
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