The effect of postoperative epidural analgesia vs NCA morphine on pain and rehabilitation after surgery for hip fracture: A randomized, doubleblinded, placebo-controlled study

2005 ◽  
Vol 22 (Supplement 34) ◽  
pp. 107
Author(s):  
N. B. Foss ◽  
B. B. Kristensen ◽  
M. T. Kristensen ◽  
P S. Jensen ◽  
H. Kehlet
Keyword(s):  
Hip Fracture ◽  
Epidural Analgesia ◽  
Controlled Study ◽  
Postoperative Epidural Analgesia

scholarly journals Comparison of Ropivacaine with Fentanyl vs Bupivacaine with Fentanyl for Postoperative Epidural Analgesia in Total Knee Arthroplasty: A Prospective, Randomized, Single-blinded Controlled Study

2017 ◽  
Vol 2 (2) ◽  
pp. 51-57
Author(s):  
Meenoti P Potdar ◽  
Ajay Tomar ◽  
Laxmi Kamat
Keyword(s):  
Total Knee Arthroplasty ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Adverse Effects ◽  
Epidural Analgesia ◽  
Knee Arthroplasty ◽  
Controlled Study ◽  
Rescue Analgesia ◽  
Total Knee ◽  
Postoperative Epidural Analgesia

ABSTRACT Aim The primary aim of the study was to compare epidural ropivacaine with fentanyl and epidural bupivacaine with fentanyl for postoperative epidural analgesia after total knee arthroplasty (TKA). The secondary objective was to assess the outcomes of passive and active mobilizations postoperatively, requirement of rescue analgesia, and adverse effects, such as nausea vomiting, sedation, numbness, motor weakness, hypotension, and respiratory depression. Materials and methods After obtaining hospital ethics committee approval and written informed consent, 100 patients were randomly allocated to two groups of 50 each. Group B received 0.125% bupivacaine with fentanyl (2 μg/mL) epidurally for postoperative pain relief. Group R received 0.2% ropivacaine with fentanyl (2 μg/mL) epidurally for postoperative pain relief. Patients of American Society of Anesthesiologists (ASA) grades I to II of both sexes undergoing elective TKA and giving written consent were included in the study. Patients with coagulation disorders, history of spine surgery, vertebral deformities, and having contraindications for spinal analgesia were excluded from the study. All patients were preoperatively assessed and clinically evaluated thoroughly. They received conventional combined spinal epidural anesthesia followed by epidural infusion in the postoperative period of ropivacaine fentanyl or bupivacaine fentanyl as per the allocation. The postoperative epidural analgesia was supplemented with intravenous (IV) paracetamol 1 gm TDS, and rescue analgesia, if needed, was given with IV tramadol 50 mg. All patients were monitored for postoperative pain by the visual analog scale (VAS), requirement of rescue analgesia, hemodynamic parameters, sedation scores, and adverse effects. How to cite this article Potdar MP, Tomar A, Kamat L. Comparison of Ropivacaine with Fentanyl vs Bupivacaine with Fentanyl for Postoperative Epidural Analgesia in Total Knee Arthroplasty: A Prospective, Randomized, Single-blinded Controlled Study. Res Inno in Anesth 2017;2(2):51-57.

Effect of Postoperative Epidural Analgesia on Rehabilitation and Pain after Hip Fracture Surgery

2005 ◽  
Vol 102 (6) ◽  
pp. 1197-1204 ◽  
Author(s):  
Nicolai Bang Foss ◽  
Morten Tange Kristensen ◽  
Billy Bjarne Kristensen ◽  
Pia Søe Jensen ◽  
Henrik Kehlet
Keyword(s):  
Hip Fracture ◽  
Epidural Analgesia ◽  
Significant Risk ◽  
Motor Dysfunction ◽  
Orthopedic Procedures ◽  
Double Blind Study ◽  
Hip Fracture Surgery ◽  
Physical Functions ◽  
Fracture Surgery ◽  
Postoperative Epidural Analgesia

Background Hip fracture surgery usually carries a high demand for rehabilitation and a significant risk of perioperative morbidity and mortality. Postoperative epidural analgesia may reduce morbidity and has been shown to facilitate rehabilitation in elective orthopedic procedures. No studies exist on the effect of postoperative epidural analgesia on pain and rehabilitation after hip fracture surgery. Methods Sixty elderly patients were included in a randomized, double-blind study comparing 4 days of continuous postoperative epidural infusion of 4 ml/h bupivacaine, 0.125%, and 50 mug/ml morphine versus placebo. Both patient groups received balanced analgesia and intravenous nurse-controlled analgesia with morphine. All patients followed a well-defined multimodal rehabilitation program. Pain, ability to participate in four basic physical functions, and any factors restricting participation were assessed on the first 4 postoperative days during physiotherapy. Results Epidural analgesia provided superior dynamic analgesia during all basic physical functions, and patients were significantly less restricted by pain, which was the dominating restricting factor in the placebo group. Motor blockade was not a restricting factor during epidural analgesia. Despite improved pain relief, scores for recovery of physical independence were not different between groups. Conclusion Postoperative epidural analgesia after hip fracture surgery provides superior analgesia attenuating pain as a restricting factor during rehabilitation without motor dysfunction. However, superior analgesia did not translate into enhanced rehabilitation. Future studies with multimodal rehabilitation are required to establish whether superior analgesia can be translated into enhanced rehabilitation and reduced morbidity in hip fracture patients.

Effects of postoperative epidural analgesia on recurrence-free and overall survival in patients with nonsmall cell lung cancer

2014 ◽  
Vol 26 (1) ◽  
pp. 3-17 ◽  
Author(s):  
Juan P. Cata ◽  
Vijaya Gottumukkala ◽  
Dilip Thakar ◽  
Dinesh Keerty ◽  
Rodolfo Gebhardt ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Epidural Analgesia ◽  
Cell Lung Cancer ◽  
Nonsmall Cell Lung Cancer ◽  
Postoperative Epidural Analgesia

A Prospective, Double-Blind, Randomized, Placebo-Controlled Study of Dexmedetomidine as an Adjunct to Epidural Analgesia After Thoracic Surgery

2005 ◽  
Vol 19 (5) ◽  
pp. 630-635 ◽  
Author(s):  
Staffan Wahlander ◽  
Robert J. Frumento ◽  
Gebhard Wagener ◽  
Beatrice Saldana-Ferretti ◽  
Rajeev R. Joshi ◽  
...  
Keyword(s):  
Epidural Analgesia ◽  
Thoracic Surgery ◽  
Controlled Study ◽  
Double Blind

Effect of Continuous Postoperative Epidural Analgesia on Intestinal Motility

1989 ◽  
Vol 5 (2) ◽  
pp. 310
Author(s):  
H. AHN ◽  
A. BRONGE ◽  
K. JOHANSSON ◽  
H. YG ◽  
J. LINDHAGEN
Keyword(s):  
Epidural Analgesia ◽  
Intestinal Motility ◽  
Postoperative Epidural Analgesia

scholarly journals EFFECT OF POSTOPERATIVE EPIDURAL ANALGESIA AFTER MAJOR ORTHOPEDIC SURGERIES, A RETROSPECTIVE STUDY

2016 ◽  
Vol 3 (2) ◽  
pp. 20-25
Author(s):  
Laxmi Pathak
Keyword(s):  
Retrospective Study ◽  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Epidural Catheter ◽  
Medical Sciences ◽  
Study Results ◽  
Epidural Catheterization ◽  
American Society ◽  
Upper Abdominal ◽  
Postoperative Epidural Analgesia

INTRODUCTION: Epidural analgesia has been used in many major surgeries like upper abdominal surgery, cardio-thoracic surgery, orthopedic surgery etc. Epidural analgesia is one of the commonly used methods of postoperative pain control despite its associated complications. So, this study was conducted to find out its effectiveness in major orthopedic surgeries done in Universal College of Medical Sciences. MATERIAL AND METHODS: A retrospective study was done at Universal College of Medical Sciences & Teaching Hospital, Bhairahawa, Nepal from July 2012 to June 2014. Data of 57 patients, aged between 17 to 91 years having American Society of Anesthesiologists (ASA) physical status 1 and 2 who had undergone major orthopedic surgeries under spinal anesthesia and lumber epidural catheterization were collected and important information regarding anesthesia and surgery, epidural catheter and postoperative epidural analgesia, any complications if occurred throughout the study period were recorded. Departmental Protocol for epidural analgesia was followed in these patients. Patients who received intraoperative epidural anesthesia or analgesia and any other anesthetic or analgesic agents were excluded in this study. RESULTS: This study found epidural analgesia, a very effective way to relieve pain in patients undergoing major orthopedic surgeries, when given according to the Departmental Protocol. There were no any complications related to epidural analgesia till 4th postoperative day. Out of 57, only 2 patients received injection Ketorolac intravenously as a rescue analgesic at the same day of operation before epidural top up. Average time to demand for analgesic after the last dose of epidural top up was 21.933 hours. All patients were mobilized around their beds on 2nd postoperative day. The average postoperative days of hospital stay was only 6.5 days. CONCLUSION: Epidural mixture of Bupivacaine-morphine in lower dose and concentration given as an intermittent bolus dosing via lumber epidural catheter is safe and very effective in relieving postoperative pain after major orthopedic surgeries without any significant complications.Journal of Universal College of Medical Sciences (2015) Vol.03 No.02 Issue 10   

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