Comparison of peritonsillar infiltration of tramadol and lidocaine for the relief of post-tonsillectomy pain

2012 ◽  
Vol 126 (11) ◽  
pp. 1138-1141 ◽  
Author(s):  
M H Heiba ◽  
A Atef ◽  
M Mosleh ◽  
R Mohamed ◽  
M El-Hamamsy
Keyword(s):  
Pain Control ◽  
Local Anaesthetics ◽  
Tracheal Extubation ◽  
Visual Analogue Scale Pain ◽  
Analgesic Drugs ◽  
Peritonsillar Infiltration ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
Post Operation

AbstractBackground:Several studies have reported the use of peritonsillar infiltrations of local anaesthetics and/or locally active analgesic drugs for the relief of post-tonsillectomy pain, with variable results in terms of quality and duration of analgesia. We aimed to compare the effects of peritonsillar infiltration of lidocaine versus tramadol versus placebo on post-tonsillectomy pain.Methods:Sixty patients over the age of 10 years undergoing bilateral elective tonsillectomy under general anaesthesia were randomised into three groups. The first group received peritonsillar infiltration of tramadol, the second 2 per cent lidocaine and the third normal saline. In all groups, peritonsillar infiltration was carried out after tonsillectomy but prior to tracheal extubation. Post-operative comparisons were made to assess the quality of pain control and the patients' analgesic requirements.Results:Peritonsillar infiltration of tramadol provided an analgesic effect comparable to that of lidocaine in the first 6 hours post-operation, as reflected by visual analogue scale pain scores and opioid requirements, which were lower compared with the placebo group.Conclusion:Peritonsillar infiltration of tramadol provided pain control in the first 6 hours post-tonsillectomy which was comparable to that of lidocaine.

scholarly journals Role of Oxycodone Hydrochloride in Treating Radiotherapy-Related Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yinxia Wang ◽  
Ligang Xing
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Control ◽  
Analgesic Drugs ◽  
Oxycodone Hydrochloride ◽  
Radiation Esophagitis

Radiotherapy is commonly used to treat cancer patients. Besides the curable effect, radiotherapy also could relieve the pain of cancer patients. However, cancer pain is gradually alleviated about two weeks after radiotherapy. In addition, cancer patients who receive radiotherapy may also suffer from pain flare or radiotherapy-induced side effects such as radiation esophagitis, enteritis, and mucositis. Pain control is reported to be inadequate during the whole course of radiotherapy (before, during, and after radiotherapy), and quality of life is seriously affected. Hence, radiotherapy is suggested to be combined with analgesic drugs in clinical guidelines. Previous studies have shown that radiotherapy combined with oxycodone hydrochloride can effectively alleviate cancer pain. In this review, we firstly presented the necessity of analgesia during the whole course of radiotherapy. We also sketched the role of oxycodone hydrochloride in radiotherapy of bone metastases and radiotherapy-induced oral mucositis. Finally, we concluded that oxycodone hydrochloride shows good efficacy and tolerance and could be used for pain management before, during, and after radiotherapy.

Re-motion total wrist arthroplasty: 39 non-rheumatoid cases with a mean follow-up of 7 years

2019 ◽  
Vol 44 (9) ◽  
pp. 946-950 ◽  
Author(s):  
Stefan M. Froschauer ◽  
Maximilian Zaussinger ◽  
Dietmar Hager ◽  
Manfred Behawy ◽  
Oskar Kwasny ◽  
...  
Keyword(s):  
Radial Component ◽  
Visual Analogue Scale Pain ◽  
Wrist Flexion ◽  
Level Of Evidence ◽  
Pain Scores ◽  
Total Wrist Arthroplasty ◽  
Flexion Extension ◽  
Analogue Scale Pain ◽  
Wrist Arthroplasty

We evaluated the outcomes of the Re-motion total wrist arthroplasty in 39 non-rheumatoid patients. The mean follow-up was 7 years (range 3–12). Postoperative wrist flexion-extension and radial-ulnar deviation as well as the scores of the Disability of Arm Shoulder and Hand questionnaire and the visual analogue scale pain scores improved significantly. Complications occurred in 13 wrists, five of which required further surgery. The most frequent complication was impingement between the scaphoid and the radial implant (n = 5), which can be avoided by complete or almost complete scaphoid resection. Periprosthetic radiolucency developed around the radial component in three cases and three radial screws loosened. Despite the incidence of high implant survival in 38 of 39 wrists over 7 years (97%), the complication rate is not satisfying. Knowledge of the risk of complications and patient selection are essential when making the decision to choose wrist arthroplasty over arthrodesis. Level of evidence: IV

scholarly journals Analgesic efficacy of meloxicam with or without a buprenorphine patch in cats after ovariohysterectomy

2018 ◽  
Vol 63 (No. 6) ◽  
pp. 279-286
Author(s):  
SY Heo ◽  
SJ Kim ◽  
NS Kim
Keyword(s):  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Small Sample Size ◽  
Analgesic Efficacy ◽  
Small Sample ◽  
Visual Analogue Scale Pain ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
Group A ◽  
Group B

The purpose of this prospective double blind clinical study was to evaluate the analgesic efficacy of meloxicam with/without a buprenorphine patch for pain management after ovariohysterectomy in cats. Cats were randomly divided into two groups: ten cats were treated with meloxicam s.c. after ovariohysterectomy (Group A), and eight cats were treated with s.c. meloxicam and a 20 µg/h buprenorphine transdermal patch (Group B). For patch treatment, the cat’s hair was clipped on the left side in the thoracic area. Pain scores were assessed at 0.5, 1, 2, 4, 6, 8, 24 and 30 h post-ovariohysterectomy extubation. To evaluate postoperative pain, 4A-VET pain scale and visual analogue scale pain scores were used. In addition, blood was collected from all cats to determine the cortisol levels at –2 h and at 0.5, 4, 6 and 24 h after extubation. The 4A-VET scores for Group B were significantly lower at 1, 4, 6, 8, 24 and 30 h than the scores for Group A. The visual analogue scale pain scores for Group B were significantly lower at 4, 6, 24 and 30 h than the scores for Group A. Serum cortisol concentrations were not significantly different between Groups A and B at any of the measured intervals. There was a significant positive correlation between postoperative visual analogue scale and 4A-VET pain scores in both groups. Our results should be subject to careful interpretation as the study was limited by its small sample size and by observer subjectivity.

Intraoperative Methadone for the Prevention of Postoperative Pain

2015 ◽  
Vol 122 (5) ◽  
pp. 1112-1122 ◽  
Author(s):  
Glenn S. Murphy ◽  
Joseph W. Szokol ◽  
Michael J. Avram ◽  
Steven B. Greenberg ◽  
Jesse H. Marymont ◽  
...  
Keyword(s):  
Cardiac Surgery ◽  
Pain Management ◽  
Tracheal Extubation ◽  
Perceived Quality ◽  
Pain Scores ◽  
Methadone Group ◽  
Group 2 ◽  
Postoperative Morphine ◽  
Fentanyl Group

Abstract Background: The intensity of pain after cardiac surgery is often underestimated, and inadequate pain control may be associated with poorer quality of recovery. The aim of this investigation was to examine the effect of intraoperative methadone on postoperative analgesic requirements, pain scores, patient satisfaction, and clinical recovery. Methods: Patients undergoing cardiac surgery with cardiopulmonary bypass (n = 156) were randomized to receive methadone (0.3 mg/kg) or fentanyl (12 μg/kg) intraoperatively. Postoperative analgesic requirements were recorded. Patients were assessed for pain at rest and with coughing 15 min and 2, 4, 8, 12, 24, 48, and 72 h after tracheal extubation. Patients were also evaluated for level of sedation, nausea, vomiting, itching, hypoventilation, and hypoxia at these times. Results: Postoperative morphine requirements during the first 24 h were reduced from a median of 10 mg in the fentanyl group to 6 mg in the methadone group (median difference [99% CI], −4 [−8 to −2] mg; P < 0.001). Reductions in pain scores with coughing were observed during the first 24 h after extubation; the level of pain with coughing at 12 h was reduced from a median of 6 in the fentanyl group to 4 in the methadone group (−2 [−3 to −1]; P < 0.001). Improvements in patient-perceived quality of pain management were described in the methadone group. The incidence of opioid-related adverse events was not increased in patients administered methadone. Conclusions: Intraoperative methadone administration resulted in reduced postoperative morphine requirements, improved pain scores, and enhanced patient-perceived quality of pain management.

scholarly journals Comparative Evaluation of Clonidine as an Adjunct to Ropivacaine for Caudal Block Anaesthesia in Children Undergoing Sub-Umbilical Surgeries

2021 ◽  
Vol 10 (44) ◽  
pp. 3785-3790
Author(s):  
Priyash Verma ◽  
Ravishankar R.B.
Keyword(s):  
Epidural Space ◽  
Pain Control ◽  
Motor Blockade ◽  
Pain Scores ◽  
Caudal Analgesia ◽  
Significant Difference ◽  
Key Words Analgesia ◽  
Caudal Epidural

BACKGROUND Studies suggest that clonidine can improve the duration of analgesia, quality of pain control when used with ropivacaine for caudal blocks in children. This study was designed to understand the effects of caudally administered ropivacaine 0.25 % (1ml/kg) alone and ropivacaine 0.25 % (1ml/kg) with clonidine 2 mcg/kg, in children between 2- 10 years. METHODS Sixty children posted for various sub-umbilical surgical procedures were included after written informed consent and ethics committee approval. Children were randomly divided into 2 groups of 30 each: Group R —ropivacaine 0.25 % 1 ml/kg into caudal epidural space and Group RC—ropivacaine 0.25 % 1 ml/kg and clonidine 2 mcg/kg into caudal epidural space. RESULTS The mean age of patients was similar with no statistical difference (4.83 vs 5.36, P = 0.3353). The duration of anaesthesia was significantly longer in the RC group (544.83 minutes vs 268.00 minutes, P < 0.0001). The effect size was very high (Cohen d=23.86). The pain score was comparable up to 1 hour for the two groups. But 2 hours later, the pain scores were significantly lower for the ropivacaine and clonidine groups. The effect on motor blockade was similar in both groups with no motor blockade at 4 hours follow up. 5 cases of urinary retention were seen in the study with no statistically significant difference in terms of complication rate between the two groups. No case of hypotension or bradycardia was seen. There was a significant difference between the two groups in terms of cardiovascular parameters (HR, SBP, DBP) after administration of drugs. CONCLUSIONS The addition of clonidine to ropivacaine for caudal blocks in children was associated with better quality of pain control and a longer duration of analgesia without any additional motor blockade. There was no significant difference seen in terms of complication. KEY WORDS Analgesia Duration, Caudal Analgesia, Clonidine, Pain Control, Ropivacaine.

Comparative outcomes of radiofrequency endoluminal ablation, invagination stripping, and cryostripping in the treatment of great saphenous vein insufficiency

2006 ◽  
Vol 21 (2) ◽  
pp. 60-64 ◽  
Author(s):  
L Stötter ◽  
I Schaaf ◽  
A Bockelbrink
Keyword(s):  
Saphenous Vein ◽  
Great Saphenous Vein ◽  
Life Questionnaire ◽  
Short Term ◽  
Activity Impairment ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
Duplex Doppler ◽  
One Year

Objective: Prospective, randomized comparison of short-term and one-year postoperative outcomes after radiofrequency endoluminal ablation (REA) of the great saphenous vein (GSV), saphenofemoral junction (SFJ) ligation with extended tributary ligation and invagination GSV stripping, and SFJ ligation with extended tributary ligation and GSV cryostripping. Methods: In all, 60 consenting patients were randomly allocated to three groups and treated contemporaneously over a nine-month period. Clinical, duplex Doppler, analogue scale pain scoring and activity impairment assessments were performed one day postoperatively, and after one, two, and six weeks, and then repeated after one year, adding patient satisfaction scoring and the CIVIQ 2 quality-of-life questionnaire, specifically designed for lower limb venous insufficiency. Results: Immediate success was achieved in 19/20 REA limbs with one open segment that subsequently spontaneously closed, in 20/20 invagination stripping limbs, and in 18/20 cryostripped limbs, two having residual open segments. Cumulative up to six-week impairment scores, cumulative up to six-week pain scores, and time to return to full activity were all statistically superior for REA patients. At one year, segmental recanalization on less than 10 cm was detected in two REA patients, and for all REA patients the GSV trunk was sonographically no longer visible, beginning from 10 cm below the SFJ. REA patients continued to be significantly more satisfied with both their operative procedures and the cosmetic appearance of their treated lower extremity compared with patients in the two other treatment cohorts. Conclusion: REA offers significant short-term, patient-oriented advantages over extended ligation and invagination or cryostripping through one year.

Outcomes of ulnotriquetral split tear repair: a report of 96 patients

2019 ◽  
Vol 44 (10) ◽  
pp. 1036-1040 ◽  
Author(s):  
Nicholas J. Clark ◽  
Nicholas Munaretto ◽  
David Ivanov ◽  
Richard A. Berger ◽  
Sanjeev Kakar
Keyword(s):  
Range Of Motion ◽  
Visual Analogue Scale Pain ◽  
Level Of Evidence ◽  
Superficial Infection ◽  
Excellent Outcome ◽  
Pain Scores ◽  
Analogue Scale Pain ◽  
The Mean ◽  
And Function

Ninety-six wrists (56 right and 40 left) in 96 patients (36 males and 60 females, mean age 38, range 15–77 years) underwent repair of ulnotriquetral ligament split tears between 2007 and 2016. Mayo wrist scores, visual analogue scale pain scores, and objective measures including grip strength and range of motion were obtained. Patients were assessed after a mean follow-up of 21 months (range 6–112 months). Ulnotriquetral split tear repair resulted in substantial improvements in pain and function. The mean Mayo wrist score improved from 57 preoperatively to 81 postoperatively, with 84% of patients achieving a good or excellent outcome. Pain scores decreased from 5.8 to 1.2. Grip improved from 25 kg to 29 kg. There was no significant change in range of motion of the wrist. Complications were noted in eight patients, with three experiencing continued pain, four with dysaesthesia of the dorsal sensory ulnar nerve, and one superficial infection. Arthroscopic ulnotriquetral split tear repair significantly reduced pain and improved Mayo wrist scores. Level of evidence: IV

SHORT VERSUS LONG-ACTING LOCAL ANAESTHETIC IN OPEN CARPAL TUNNEL RELEASE: WHICH PROVIDES BETTER PREEMPTIVE ANALGESIA IN THE FIRST 24 HOURS?

Hand Surgery ◽  
2013 ◽  
Vol 18 (01) ◽  
pp. 45-47 ◽  
Author(s):  
Z. H. Chan ◽  
V. Balakrishnan ◽  
A. McDonald
Keyword(s):  
Carpal Tunnel ◽  
Local Anaesthetic ◽  
Carpal Tunnel Release ◽  
Local Anaesthetics ◽  
Pain Scores ◽  
Carpal Tunnel Surgery ◽  
Significant Difference ◽  
Long Acting ◽  
Open Carpal Tunnel Release

Open carpal tunnel release is commonly performed under local anaesthesia. No study has compared intra-operative short- versus long-acting local anaesthetics as preemptive analgesics in carpal tunnel surgery. In this single-blinded prospective study, 100 consecutive carpal tunnel releases were performed by a single surgeon at one institution with either lignocaine (n = 50) or ropivacaine (n = 50). Allocation was performed via the method of alternation. Subjects were given a questionnaire to answer the following: (1) time to first incidence of pain, (2) quality of first night's sleep, and (3) mean numerical pain scores in the first 24 hours. The time to the first postoperative pain was significantly shorter in the lignocaine group (5.58 vs. 9.17 hours, p < 0.035). There were no significant difference in the incidence of poor first night's sleep (16% vs. 26%, p = 0.28) or mean pain scores in the first day (3.6 vs. 2.9, p = 0.16). Existing evidence advocates for long-acting intraoperative local anaesthetic because it results in a longer duration of postoperative analgesia, however, our study suggests that it may also result in a poorer first night's sleep.

Hallux Varus Correction With Extensor Hallucis Longus Tendon Transfer and Reverse Scarf Osteotomy

2021 ◽  
pp. 193864002098597
Author(s):  
Don Thong Siang Koh ◽  
Keen Wai Chong ◽  
Nicholas Eng Meng Yeo
Keyword(s):  
Hallux Valgus ◽  
Tendon Transfer ◽  
Visual Analogue Scale Pain ◽  
Scarf Osteotomy ◽  
Hallux Varus ◽  
Pain Scores ◽  
Valgus Angle ◽  
Extensor Hallucis Longus ◽  
Analogue Scale Pain ◽  
American Orthopaedic

Introduction Hallux varus is the medial deviation of the hallux. Although rare, it can cause discomfort, functional weakness, difficulty with shoe wear, and dissatisfactory cosmesis. This study reports 3 cases of hallux varus treated using extensor hallucis longus (EHL) tendon transfer with or without the use of reverse scarf osteotomy (RSO). Methods This cases series studies the technique of using EHL tendon transfer and the role for RSO in the surgical correction of hallux varus. Indication for RSO included osseous overcorrection in the index hallux valgus surgery or as an adjunct when EHL tendon transfer alone was unable to restore alignment. Patients were followed-up for 24 months and their postoperative outcomes were recorded. Results All patients were female between the ages 55 to 67 years. Radiological parameters after surgery improved in all patients. The mean hallux-valgus angle was corrected from −23.7 ± 3.5° to −3.2 ± 2.0° postoperatively ( P < .05). Intermetatarsal angle was increased from 5.0 ± 1.9° to 6.7 ± 1.0° ( P = .065). Distal metatarsal articular angle improved from −28.9 ± 7.6° to −7.8 ± 3.7° ( P < .05). Mean American Orthopaedic Foot and Ankle Society scores improved from 37 ± 24 to 75 ± 9 ( P = .064) at 24 months. In addition, visual analogue scale pain scores reduced from 5 ± 1.5 to 1 ± 1 ( P < .05). All patients reported being satisfied with the procedure, and no complications were reported at 24 months after surgery. Conclusion Hallux varus correction using EHL tendon transfer with or without RSO appears to provide satisfactory results at 24 months. Levels of Evidence Level V: Expert opinion, Techniques

scholarly journals A Posterior TAP Block Provides More Effective Analgesia Than a Lateral TAP Block in Patients Undergoing Laparoscopic Gynecologic Surgery: A Retrospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Sakatoshi Yoshiyama ◽  
Hironobu Ueshima ◽  
Ryomi Sakai ◽  
Hiroshi Otake
Keyword(s):  
Retrospective Study ◽  
General Anesthesia ◽  
Transversus Abdominis ◽  
Gynecologic Surgery ◽  
Tap Block ◽  
Analgesic Drugs ◽  
Pain Scores ◽  
Laparoscopic Gynecologic Surgery ◽  
Effective Analgesia

Background. There are a few papers that compared the lateral transversus abdominis plane (TAP) block with the posterior TAP block. Our study aimed to compare retrospectively the quality of analgesia after laparoscopic gynecologic surgery using the lateral TAP block with general anesthesia versus the posterior TAP block with general anesthesia. Method. Sixty-seven adult female patients were included in this retrospective study. Of these patients, thirty-four patients received the lateral TAP block with general anesthesia (lat. TAP group), and the rest of thirty-three patients received the posterior TAP block with general anesthesia (pos. TAP group). Pain scores both at rest and at movement and the use of additional analgesic drugs were recorded in the postoperative care unit within twenty-four hours after the operation. Postoperative complications were noted. Results. Patients who received pos. TAP reported lower visual analog scale (VAS) pain scores in all points, within twenty-four hours after the operation, than patients who received lat. TAP. Moreover, with the use of additional analgesic drugs, the incidence of nausea and vomiting during the first twenty-four hours after surgery was lower in the pos. TAP group than in the lat. TAP group. Conclusion. The posterior TAP block provided more effective analgesia than the lateral TAP block in patients undergoing laparoscopic gynecologic surgery.

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