scholarly journals Effectiveness of continuous wound infusion of 0.5% ropivacaine by On-Q pain relief system for postoperative pain management after open nephrectomy

2008 ◽  
Vol 101 (6) ◽  
pp. 841-847 ◽  
Author(s):  
E. Forastiere ◽  
M. Sofra ◽  
D. Giannarelli ◽  
L. Fabrizi ◽  
G. Simone
2021 ◽  
Vol 5 (4) ◽  
pp. 1-6
Author(s):  
Tanudeep Kaur ◽  

Pain is an unpleasant sensory and emotional experience causing agony and several side effects in a postoperative patient. Thus effective postoperative pain management has a humanitarian role with additional medical and economic benefits Paracetamol (PCM) has been widely used as an effective analgesic and antipyretic for over a century with an established safety profile, and Tramadol is a commonly used intravenous drug for postoperative pain relief.


2017 ◽  
Vol 2 (20;2) ◽  
pp. sE33-sE52 ◽  
Author(s):  
Chi-Wai Cheung

Background: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. Objectives: To evaluate the use of oral oxycodone for acute postoperative pain management. Study Design: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. Methods: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015. The search terms used were “oral strong opioids,” “postsurgical,” “postoperative,” “post-surgical,” and “postoperative.” Treatment interventions were compared for analgesic efficacy, rescue medication use, side effects, recovery, length of hospital stay, and patient satisfaction. Results: There were 26 clinical trials included in the review. Oral oxycodone showed superior postoperative analgesic efficacy compared with placebo in patients undergoing laparoscopic cholecystectomy, abdominal or pelvic surgery, bunionectomy, breast surgery, and spine surgery. When compared with intravenous opioids, oral oxycodone provided better or comparable pain relief following knee arthroplasty, spine surgery, caesarean section, laparoscopic colorectal surgery, and cardiac surgery. One study of dental postsurgery pain reported inferior pain control with oral oxycodone versus rofecoxib. (withdrawn from the US market due to cardiac safety concerns). In many studies, the demand for rescue analgesia and total opioid consumption were reduced in the oxycodone treatment arm. Patients receiving oral oxycodone experienced fewer opioid-related side effects than those on other opioids, and had a similar occurrence of postoperative nausea and vomiting as patients on placebo. Furthermore, oral oxycodone did not prolong hospital stay and was associated with lower drug costs compared with epidural and intravenous analgesics. Oxycodone administered as part of a multimodal analgesic regimen produced superior pain relief with fewer side effects and a reduced hospital stay. Limitation: There is a limited number of randomized double blinded studies in individual surgical operations, thus making it more difficult to come up with definitive conclusions. Conclusion: Oral oxycodone appears to offer safe and effective postoperative analgesia, and is a well-accepted and reasonable alternative to standard intravenous opioid analgesics. Key words: Postoperative, pain, analgesia, oral oxycodone, opioid


2014 ◽  
Author(s):  
Selvi Kumar

<p>Surgery is a most common source of acute pain and effective postoperative pain management is crucial for wound healing and recovery. Opiods are the mainstay for acute pain management but have various adverse effects including death. The multimodal approach involves the use of multiple drugs with varying mechanism of action to achieve optimal pain relief with less adverse effects. Intravenous acetaminophen (IVAPAP) is a new addition to the multimodal approach that appears to afford effective pain relief with a low risk profile. The purpose of this research study was to examine the impact of IVAPAP use in multimodal pain management on decreased opioid consumption and decreased average length of hospital stay in the post colectomy population. A comparative two group retrospective chart review was conducted, with a total of 72 charts meeting the inclusion criteria. Group 1(n=36) study subjects who received IVAPAP for pain management were compared to Group 2(n=36) subjects who had not received IVAPAP after colectomy. Results demonstrated that Group 1, those who had received IVAPAP, used less opioids during the postoperative period as compared to those in Group 2 who had not received IVAPAP; there was no difference in length of stay between the groups. Further research related to the use of multimodal pain management strategies in general, and related to IVAPAP in particular, is indicated. Recommendations and implications for advanced practice nursing are presented and discussed.</p>


2008 ◽  
Vol 18 (11) ◽  
pp. 498-503 ◽  
Author(s):  
Nicola Bourne

Managing acute pain in opioid tolerant patients can be a significant challenge. This article will provide an overview of the terminology used when managing acute pain in these patients. This understanding is essential to ensure adequate pain relief while avoiding opioid withdrawal. It is also crucial that these patients are identified and that sufficient peri- and postoperative pain management plans are formulated. This article will present an overview of the terms tolerance, physical dependence and addiction. The literature on the management of acute pain in opioid tolerant patients will be considered. Finally an audit that explores and compares the practises of a group of London hospitals, with regard to managing post-surgical pain in opioid-dependent patients will be discussed.


2001 ◽  
Vol 94 (2) ◽  
pp. 230-238 ◽  
Author(s):  
Thomas G. Standl ◽  
Ernst-Peter Horn ◽  
Michael Luckmann ◽  
Marc-Alexander Burmeister ◽  
Stefan Wilhelm ◽  
...  

Background Continuous spinal anesthesia is frequently used for intraoperative anesthesia but rarely for postoperative pain management. Because even small doses of local anesthetics can be associated with motor deficits, subarachnoid opioid injection may be an alternative. Methods Eighty patients randomly received a subarachnoid injection of 10 microg sufentanil, 5 mg bupivacaine, 2.5 microg sufentanil plus 2.5 mg bupivacaine, or saline through 28-gauge spinal microcatheters for early postoperative pain relief after major lower-limb surgery (n = 20 in each group). Hemodynamic and respiratory parameters, pain scores, and motor function were monitored, and sufentanil concentrations in plasma and cerebrospinal fluid were measured. Ten additional patients received up to three repetitive injections of 10 microg sufentanil over 24 h. Results All drugs provided excellent pain relief within 15 min after injection, lasting 128 +/- 61 min with sufentanil, 146 +/- 74 min with bupivacaine, and 167 +/- 78 min with the mixture. Patients receiving bupivacaine showed the highest cephalad extension of sensory block (median, T6) and the most intense motor block, whereas patients given only sufentanil had no motor deficit. The duration of analgesia was shorter after subsequent sufentanil injection (100-115 min) than after the first injection (198 +/- 70 min). Six of 50 patients with sufentanil experienced a short episode of respiratory depression within 30 min after the first injection. Cerebrospinal fluid concentrations of sufentanil peaked at 5 min after injection (183 +/- 167 ng/ml) but were at the level of detection in the plasma. Conclusions Sufentanil injected through microspinal catheters provided profound pain relief without impairing motor function when compared with bupivacaine. However, close monitoring remains mandatory in this setting.


2015 ◽  
Vol 44 (1) ◽  
pp. 42-53 ◽  
Author(s):  
Hyun-Chang Kim ◽  
Jun-Yeol Bae ◽  
Tae Kyong Kim ◽  
Yunseok Jeon ◽  
Jeong Jin Min ◽  
...  

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