scholarly journals Comparison of preoperative infraorbital block with peri-incisional infiltration for postoperative pain relief in cleft lip surgeries

2004 ◽  
Vol 37 (02) ◽  
pp. 105-109 ◽  
Author(s):  
V. Gaonkar ◽  
Swati R. Daftary
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Cleft Lip ◽  
Randomized Study ◽  
Hemodynamic Stability ◽  
Cleft Lip Repair ◽  
Recovery From Anesthesia

ABSTRACTIn this prospective, randomized study, children undergoing cleft lip surgery were either given infra-orbital nerve block (n=25) or peri-incisional infiltration (n=25) pre-operatively with 0.25% bupivacaine in 1:2,00,000 adrenaline.The overall course of anesthesia in both the groups was smooth, with excellent hemodynamic stability, indicating better pain relief during the intra-operative period. The concentration of the anesthetic agent required was reduced and recovery from anesthesia was rapid and complete. There was excellent postoperative analgesia. The children were calm and comfortable postoperatively.We conclude that infra-orbital nerve block with 0.25% bupivacaine with adrenaline provides more prolonged analgesia than peri-incisional infiltration in cleft lip repair. Infra-orbital block given by modified approach is easy to perform and free of side-effects.

Bilateral Extraoral, Infraorbital Nerve Block for Postoperative Pain Relief After Cleft Lip Repair in Pediatric Patients

2009 ◽  
Vol 63 (1) ◽  
pp. 59-62 ◽  
Author(s):  
Suna Akin Takmaz ◽  
Hale Yarkan Uysal ◽  
Afsin Uysal ◽  
Ugur Kocer ◽  
Bayazit Dikmen ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Nerve Block ◽  
Cleft Lip ◽  
Pediatric Patients ◽  
Infraorbital Nerve ◽  
Postoperative Pain Relief ◽  
Cleft Lip Repair

scholarly journals Infraorbital nerve block for postoperative pain following cleft lip repair in children

2014 ◽  
Author(s):  
Gustavo Feriani ◽  
Eric Hatanaka ◽  
Maria R Torloni ◽  
Edina MK da Silva
Keyword(s):  
Postoperative Pain ◽  
Nerve Block ◽  
Cleft Lip ◽  
Infraorbital Nerve ◽  
Cleft Lip Repair

Postoperative analgesia after radical prostatectomy with high-dose intrathecal morphine and intravenous naloxone: A retrospective review

2018 ◽  
Vol 5 (6) ◽  
pp. 331-339 ◽  
Author(s):  
Annette Rebel, MD ◽  
Paul Sloan, MD ◽  
Michael Andrykowski, PhD
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Radical Prostatectomy ◽  
Respiratory Depression ◽  
Postoperative Analgesia ◽  
Intrathecal Morphine ◽  
Major Surgery ◽  
High Dose ◽  
The Mean

Background and methods: Intrathecal opioids (ITOs) have been used for decades to control postoperative pain. Intrathecal opioid dosing is limited, however, by opioid-related side effects, most importantly respiratory depression. To overcome these limitations, we combined intrathecal morphine with a continuous intravenous (IV) postoperative naloxone infusion to control opioid-related side effects. The purpose of this study is to document the efficacy and safety of high-dose intrathecal morphine combined with postoperative naloxone infusion to provide postoperative analgesia after major surgery. After IRB approval, a retrospective chart analysis was performed on 35 patients who had a radical prostatectomy from 2004 to 2006. All patients received a single injection of ITOs before anesthesia, a typical general anesthestic, followed by naloxone infusion at 5 μg/kg/h started 1 hour post-ITOs and continued for 22 hours postoperatively. The following information was collected: patient age, height, weight, anesthesia technique/time, and dose of ITOs given. Postoperative pain relief was assessed for 48 hours using the Visual Analog Score (VAS) for pain (0, no pain; 10, worst pain), perioperative opioid use, NSAID consumption, and ability of patient to ambulate. The safety of this novel treatment was assessed with opioid-related side effects and vital signs. All data are reported as mean (SD).Results: Mean ITOs given were morphine 1.3 (0.3) mg combined with fentanyl 56 (9) μg. The intrathecal morphine dose ranged from 0.8 to 1.7 mg. The mean worst pain VAS in the first 12 hours postoperatively was only 1.0 (1.7). The first NSAID dose was given 6.6 (3.1) hours post-ITOs. The first opioid on the floor was given an average of 22.6 (14.5) hours post-ITOs. A mean of only 5.7 (12.3) morphine equivalents were required on postoperative day 1 (POD 1). On POD 2, the mean worst pain VAS was only 2.6 (2.2) with only 5.7 (6.2) morphine equivalents needed to provide pain relief. On POD 1, 25 patients required no additional opioids for their entire hospital stay. Overall, 11 of 35 patients did not require any additional postoperative opioids. Thirtyfour patients (97 percent) were able to ambulate in the first 12 hours postoperatively. No opioid-induced respiratory depression was observed. Opioid-related side effects (pruritus, nausea) were infrequent and minor.Conclusions: High-dose ITOs combined with postoperative IV naloxone infusion provided excellent analgesia for radical prostate surgery. IV naloxone infusion appeared to control opioid side effects without diminishing the analgesia. No serious adverse effects were noted.

scholarly journals Efficiency and safety of intrathecal morphine for analgesia after hysterectomy

2020 ◽  
Vol 148 (5-6) ◽  
pp. 322-327
Author(s):  
Milanka Tatic ◽  
Dragan Ladjinovic ◽  
Sanja Skeledzija-Miskovic ◽  
Ranko Zdravkovic ◽  
Dragana Radovanovic ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Intrathecal Morphine ◽  
Randomized Study ◽  
Numeric Rating Scale ◽  
Time Interval ◽  
Subjective Feeling ◽  
Group A

Introduction/Objective. This prospective, randomized study was done to determine the efficiency and safety of the administration of intrathecal morphine chloride combined with the local anesthetic levobupivacaine given to female patients subjected to hysterectomy to ensure postoperative analgesia. Methods. The study sample consisted of 50 patients who were to undergo hysterectomy with adnexectomy and they were divided into two groups of 25 each. The patients in group A were given the combination of 0.3 mg of morphine chloride with 1.7 ml of 0.5% levobupivacaine immediately before the surgery, whereas the patients in group B were intravenously administered 5 mg of morphine chloride before the end of surgery, and after the surgery at certain time intervals. The postoperative pain was assessed at the first, sixth, 12th, and 24th hour by Numeric Rating Scale (NRS). Side effects, such as nausea, vomiting, itching and respiratory depressions were followed as well. Results. The postoperative pain was less expressed at any time interval both at rest and on exertion in group A (p < 0.001) and therefore the need for additional analgesia was less in group A (p < 0.001). The subjective feeling of satisfaction with postoperative analgesia was statistically significant in group A (p < 0.001). Conclusion. Intrathecal administration of morphine chloride combined with levobupivacaine ensures better postoperative analgesia after hysterectomy than intravenous morphine chloride, their side effects being equally frequent..

scholarly journals Efficacy of Perineural versus Systemic Dexamethasone to prolong analgesia after Supraclavicular Nerve Block in patients undergoing Wrist Arthroscopy

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
A E Mohammed ◽  
A A Abdellatif ◽  
H Shokry ◽  
A A N H Refaat
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Normal Saline ◽  
Sensory Block ◽  
Postoperative Pain Management ◽  
Wrist Arthroscopy ◽  
Analgesic Requirement ◽  
Group 2

Abstract Background Poorly controlled acute pain after surgery is associated with a varity of unwanted postoperative consequences, including patient suffering, distress, myocardial ischemia, prolonged hospital stay and increase of chronic pain. Neuroaxial block is used for postoperative pain management and decrease analgesic use. Wrist arthroscopy is a very common surgery and performed as a day case surgery and need good postoperative analgesia. Many adjuvant drugs are added to bupivacaine to prolong the duration of sensory block like opioids and dexamethasone. Objective The aim of this thesis was to study the effect of adding both perineural & systemic dexamethasone as an adjuvant to bupivacaine in supraclavicualr nerve block. The comparison included the the effect on hemodynamics, postoperative pain & postoperative analgesic requirement. Methods In our study, 40 patients were randomly divided into two equal groups: Group #1 (20 patients): Block with 18 ml Bupivacaine 0.5% (+ 2 ml Dexamethasone ‘8 mg’) & 2 ml normal saline was injected IV. Group #2 (20 patients): Block with 18 ml Bupivacaine 0.5% (+ 2 ml normal saline) & 2 ml Dexamethasone ‘8 mg’ was injected IV. Results Our study showed that addition of 8 mg dexamethasone to bupivacaine in supraclavicular nerve block whether perineural or intravenous prolonged postoperative analgesia with negligible side effects however, slight better outcome for the perineural route. Conclusion Dexamethasone was seen to be a potent adjunct to local anaesthetic to prolong post operative analgesia with negligible side effects with slightly better outcome to the perineural route.

scholarly journals Comparison of Various Techniques of Anesthesia for Surgical Management of Diabetic Foot

2020 ◽  
Vol 5 (2) ◽  
pp. 62-65
Author(s):  
Kapil S. Divekar ◽  
Karishma D. Mehta ◽  
Pancham Mehta ◽  
Payal P. Prajapati ◽  
Kamla H. Mehta
Keyword(s):  
Side Effects ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Surgical Management ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Diabetic Foot ◽  
Hemodynamic Stability ◽  
Unilateral Spinal Anesthesia ◽  
Group A

Background: Diabetes mellitus is a multisystem disease caused by an absolute or relative deficiency of insulin secretion or resistance or a combination of both. Anesthesia in them is of special concern because of complex polypharmacy, an inappropriate dose of oral hypoglycemic agents or insulin and errors in converting IV insulin to usual medication. The objective is to compare the various techniques of anesthesia for surgical management of diabetic foot in terms of intraoperative hemodynamic stability, perioperative problems related to anesthesia techniques, postoperative analgesia. Subjects and Methods: Sixty adult diabetic patients of both gender of ASA grade II-III, aged 35years undergoing surgical management of diabetic foot were elected and separated into three groups, Group A: general anesthesia with tracheal intubation, Group B: unilateral spinal anesthesia with injection 0.5% bupivacaine heavy 1.5ml (7.5mg), Group C: popliteal nerve block via lateral approach by injecting 30 ml 0.5% bupivacaine. Parameters like pulse rate, mean arterial blood pressure, respiratory rate and SpO2 were recorded at regular intervals. Postoperative pain, perioperative side effects, complications and problems related to anesthetic techniques were noted. The analysis is done by unpaired t-test and chi-square test. Results: Group C patients were hemodynamic stable than Group A and B. Post-op analgesia was prolonged in Group C. Perioperative side effects were more found in Group A. Conclusion: Popliteal nerve block and unilateral spinal anesthesia provide better hemodynamic stability and postoperative analgesia with negligible side effects as compared to general anesthesia for surgical management of diabetic foot.

scholarly journals USG guided femoral nerve block vs fascia iliaca compartment block as post-operative analgesia in hip fracture patients

2018 ◽  
Vol 6 (9) ◽  
pp. 3057 ◽  
Author(s):  
Usha Shukla ◽  
Mizma Jahan ◽  
Shagufta Naaz ◽  
Swati Srivastava
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Femoral Nerve Block ◽  
Femoral Nerve ◽  
P Value ◽  
Analgesic Consumption ◽  
Group 3 ◽  
Fascia Iliaca Compartment Block

Background: Adequate postoperative analgesia facilitates early mobilization which is important to reduce postoperative morbidity. Here, we intended to compare the efficacy of two different nerve blocks for postoperative pain relief in fractured neck of femur patients.Methods: One hundred and five patients posted either for dynamic hip screw or proximal femoral nail implantation under spinal anaesthesia were randomly allocated to three groups. At the end of surgery, group 1 received femoral nerve block (FNB) and group 2 received fascia iliaca compartment block (FICB) for postoperative pain relief. These blocks were ultrasound guided. Group 3 received no block and acted as control. Patients’ pain was evaluated by Visual Analogue Scale (VAS) both at rest and at passive elevation of leg. Rescue analgesia was given when VAS score exceeded 3. Heart rate, mean arterial blood pressure, respiratory rate and total analgesic consumption in first 24 hours were also recorded.Results: Groups 1 and 2 had similar duration of analgesia of around 8 hours (P value = 0.727). Analgesic consumption in both these groups were similar (P value = 0.648). These groups had less pain, less analgesic requirement and more stable haemodynamics as compared to group 3. No adverse effect was seen due to application of block.Conclusions: FICB can be an effective alternative to femoral nerve block, because of its relative simplicity in technique and less invasiveness. Hence FICB holds considerable promise as an effective postoperative analgesia.

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