Postoperative pain after laparoscopic sleeve gastrectomy: comparison of three analgesic schemes (isolated intravenous analgesia, epidural analgesia associated with intravenous analgesia and port-sites infiltration with bupivacaine associated with intravenous analgesia)

2016 ◽  
Vol 31 (1) ◽  
pp. 231-236 ◽  
Author(s):  
Jaime Ruiz-Tovar ◽  
Jose Luis Muñoz ◽  
Juan Gonzalez ◽  
Lorea Zubiaga ◽  
Alejandro García ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Intravenous Analgesia

Postoperative Analgesia after Radical Retropubic Prostatectomy

2006 ◽  
Vol 105 (4) ◽  
pp. 784-793 ◽  
Author(s):  
Anil Gupta ◽  
Federica Fant ◽  
Kjell Axelsson ◽  
Dag Sandblom ◽  
Jan Rykowski ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Short Form ◽  
Radical Retropubic Prostatectomy ◽  
Thoracic Epidural Analgesia ◽  
Short Form 36 ◽  
Thoracic Epidural ◽  
Retropubic Prostatectomy ◽  
Intravenous Analgesia

Background Postoperative pain after radical retropubic prostatectomy can be severe unless adequately treated. Low thoracic epidural analgesia and patient-controlled intravenous analgesia were compared in this double-blind, randomized study. Methods Sixty patients were randomly assigned to receive either low thoracic epidural analgesia (group E) or patient-controlled intravenous analgesia (group P) for postoperative pain relief. All patients had general anesthesia combined with thoracic epidural analgesia during the operation. Postoperatively, patients in group E received an infusion of 1 mg/ml ropivacaine, 2 microg/ml fentanyl, and 2 microg/ml adrenaline, 10 ml/h during 48 h epidurally, and a placebo patient-controlled intravenous analgesia pump intravenously. Patients in group P received a patient-controlled intravenous analgesia pump with morphine intravenously and 10 ml/h placebo epidurally. Pain, the primary outcome variable, was measured using the numeric rating scale at rest (incision pain and "deep" visceral pain) and on coughing. Secondary outcome variables included gastrointestinal function, respiratory function, mobilization, and full recovery. Health-related quality of life was measured using the Short Form-36 questionnaire, and plasma concentration of fentanyl was measured in five patients to exclude a systemic effect of fentanyl. Results Incisional pain and pain on coughing were lower in group E compared with group P at 2-24 h, as was deep pain between 3 and 24 h postoperatively (P < 0.05). Maximum expiratory pressure was greater in group E at 4 and 24 h (P < 0.05) compared with group P. No difference in time to home discharge was found between the groups. The mean plasma fentanyl concentration varied from 0.2 to 0.3 ng/ml during 0-48 h postoperatively. At 1 month, the scores on emotional role, physical functioning, and general health of the Short Form-36 were higher in group E compared with group P. However, no group x time interaction was found in the Short Form-36. Conclusions The authors found evidence for better pain relief and improved expiratory muscle function in patients receiving low thoracic epidural analgesia compared with patient-controlled analgesia for radical retropubic prostatectomy. Low thoracic epidural analgesia can be recommended as a good method for postoperative analgesia after abdominal surgery.

The association of sex with pain scores and perioperative opioid administration following laparoscopic sleeve gastrectomy

2021 ◽  
Author(s):  
Sadeq A Quraishi ◽  
Sonika Seth ◽  
Luis Fernando Gonzalez-Ciccarelli ◽  
Mohammad Dahlawi ◽  
Renan Ferrufino ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Postoperative Pain ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Postoperative Pain Management ◽  
Self Report ◽  
Single Center ◽  
Pain Scores ◽  
Opioid Administration ◽  
Lower Pain ◽  
Linear Regressions

Aim: We investigated whether sex is associated with pain scores and opioid administration after laparoscopic sleeve gastrectomy. Materials & methods: We performed a single-center, retrospective analysis of laparoscopic sleeve gastrectomy patients from December 2016–July 2018. Multivariable linear regressions were performed to investigate the association of sex with pain scores and opioid administration. Results: Baseline pain scores were similar between women and men (n = 266; 78% women). Men reported lower pain scores in all phases of care and received more opioids during their hospitalization (ß = 25.48; 95% CI: 5.77–45.20; p = 0.01), compared with women. Conclusion: Our data suggest that women self-report greater postoperative pain scores, while men received more opioids during their hospitalization. Further studies are needed to understand the reasons for such differences in postoperative pain management.

scholarly journals Postoperative patient-controlled epidural analgesia in patients with spondylodiscitis and posterior spinal fusion surgery

2016 ◽  
Vol 24 (6) ◽  
pp. 965-970 ◽  
Author(s):  
Florian Gessler ◽  
Haitham Mutlak ◽  
Karima Tizi ◽  
Christian Senft ◽  
Matthias Setzer ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Functional Capacity ◽  
Spinal Surgery ◽  
Posterior Spinal Fusion ◽  
Infectious Complications ◽  
Complication Rates ◽  
Spinal Fusion Surgery ◽  
Intravenous Analgesia ◽  
Prolonged Recovery

OBJECTIVE The value of postoperative epidural analgesia after major spinal surgery is well established. Thus far, the use of patient-controlled epidural analgesia (PCEA) has been denied to patients undergoing debridement and instrumentation in spondylodiscitis, with the risk of increased postoperative pain resulting in prolonged recovery. The value of PCEA with special regard to infectious complications remains to be clarified. The present study examined the value of postoperative PCEA in comparison with intravenous analgesia in patients with spondylodiscitis undergoing posterior spinal surgery. METHODS Thirty-two patients treated surgically for spondylodiscitis of the thoracic and lumbar spine were prospectively included in a database and retrospectively reviewed for this study. Postoperative antibiotic treatment, functional capacity, pain levels, side effects, and complications were documented. Sixteen patients were given patient-demanded intravenous analgesia (PIA) followed by 16 patients assigned to PCEA. If PCEA was applied, the insertion of an epidural catheter was performed under the direct visual guidance of the surgeon at the end of the surgery. RESULTS Three patients intended for PCEA treatment were excluded due to predefined exclusion criteria. Postoperative pain was significantly lower in the PCEA group during the first 48 hours after surgery (p = 0.03). As determined by the trunk control test conducted at 8 (p < 0.001), 24 (p = 0.004), 48 (p = 0.015), 72 (p = 0.0031), and 96 hours (p < 0.001), patients in the PCEA treatment group displayed significantly increased mobilization capacity compared with those of the PIA group. Time until normal accomplishment of all mobilization maneuvers was reduced in the PCEA group compared with that in the PIA group (p = 0.04). No differences in complication rates were observed between the 2 groups (p = 0.52). CONCLUSIONS PCEA may reduce postoperative pain and lead to earlier achievement of functional capacity at a low complication rate in patients with surgically treated lumbar and thoracic spondylodiscitis.

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