The effect of scalp block or local wound infiltration versus systemic analgesia on post-craniotomy pain relief

2021 ◽  
Author(s):  
Juliana Skutulienė ◽  
Gediminas Banevičius ◽  
Diana Bilskienė ◽  
Andrius Macas
Keyword(s):  
Pain Relief ◽  
Wound Infiltration ◽  
Scalp Block

scholarly journals Continuous Preperitoneal Infusion of Ropivacaine Provides Effective Analgesia and Accelerates Recovery after Colorectal Surgery

2007 ◽  
Vol 107 (3) ◽  
pp. 461-468 ◽  
Author(s):  
Marc Beaussier ◽  
Hanna El’Ayoubi ◽  
Eduardo Schiffer ◽  
Maxime Rollin ◽  
Yann Parc ◽  
...  
Keyword(s):  
Pain Relief ◽  
Colorectal Resection ◽  
Controlled Trial ◽  
Plasma Concentrations ◽  
Postoperative Recovery ◽  
Morphine Consumption ◽  
Major Surgery ◽  
Preperitoneal Space ◽  
Wound Infiltration ◽  
Open Colorectal Resection

Background Blockade of parietal nociceptive afferents by the use of continuous wound infiltration with local anesthetics may be beneficial in a multimodal approach to postoperative pain management after major surgery. The role of continuous preperitoneal infusion of ropivacaine for pain relief and postoperative recovery after open colorectal resections was evaluated in a randomized, double-blinded, placebo-controlled trial. Methods After obtaining written informed consents, a multiholed wound catheter was placed by the surgeon in the preperitoneal space at the end of surgery in patients scheduled to undergo elective open colorectal resection by midline incision. They were thereafter randomly assigned to receive through the catheter either 0.2% ropivacaine (10-ml bolus followed by an infusion of 10 ml/h during 48 h) or the same protocol with 0.9% NaCl. In addition, all patients received patient-controlled intravenous morphine analgesia. Results Twenty-one patients were evaluated in each group. Compared with preperitoneal saline, ropivacaine infusion reduced morphine consumption during the first 72 h and improved pain relief at rest during 12 h and while coughing during 48 h. Sleep quality was also better during the first two postoperative nights. Time to recovery of bowel function (74 +/- 19 vs. 105 +/- 54 h; P = 0.02) and duration of hospital stay (115 +/- 25 vs. 147 +/- 53 h; P = 0.02) were significantly reduced in the ropivacaine group. Ropivacaine plasma concentrations remained below the level of toxicity. No side effects were observed. Conclusions Continuous preperitoneal administration of 0.2% ropivacaine at 10 ml/h during 48 h after open colorectal resection reduced morphine consumption, improved pain relief, and accelerated postoperative recovery.

High-Dose Ropivacaine Wound Infiltration for Pain Relief After Inguinal Hernia Repair

1998 ◽  
Vol 23 (2) ◽  
pp. 189-196 ◽  
Author(s):  
Nils Pettersson ◽  
B-M Emanuelsson ◽  
Håkan Reventlid ◽  
Robert G. Hahn
Keyword(s):  
Pain Relief ◽  
Hernia Repair ◽  
Plasma Concentrations ◽  
High Dose ◽  
Hernia Surgery ◽  
Wound Infiltration ◽  
Surgeon General ◽  
Pain Scores ◽  
Control Pain ◽  
Pain At Rest

Background and ObjectivesEarly data on ropivacaine, a recently introduced local anesthetic, indicate a longer duration of skin analgesia than with bupivacaine, along with lower toxicity. The objective of this study was to evaluate ropivacaine 7.5 mg/mL for wound infiltration pain relief after hernia surgery, in higher doses than used before, in an open, nonrandomized design.MethodsTwenty otherwise healthy men underwent elective unilateral open hernia repair by the same surgeon. General anesthesia was used during surgery, and infiltration of the operating field with 300 mg (n = 10) or 375 mg (n = 10) ropivacaine, 7.5 mg/mL, was employed for postoperative pain relief. Any sign of an adverse event was recorded. Plasma concentrations of ropivacaine were monitored. Pain at rest and on mobilization was regularly assessed over 24 hours by a visual analog scale. Patients' ability to walk and void and the need for supplementary analgesics were recorded.ResultsNo serious adverse effects occurred. Plasma concentrations showed large variations but no toxic levels. No significant differences between the two groups were detected in pain scores which were low in both groups, at rest or on mobilization, or in the consumption of supplementary analgesics. At 4 hours, 19 patients were able to walk. Within 8 hours of surgery, all patients had passed urine without any problem. Wound healing was normal.ConclusionsInfiltration of ropivacaine 7.5 mg/mL during hernia surgery can be employed safely in doses of 300 mg and 375 mg to control pain after hernia surgery. The lower dose is recommended, since the higher one did not give any clinically relevant advantages.

scholarly journals Effect of Scalp Block on Postoperative Pain Relief in Craniotomy Patients

2006 ◽  
Vol 34 (2) ◽  
pp. 224-227 ◽  
Author(s):  
I. Bala ◽  
B. Gupta ◽  
N. Bhardwaj ◽  
B. Ghai ◽  
V. K. Khosla
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Pain Relief ◽  
Scalp Block
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