scholarly journals Comparison of Continuous Infusion versus  Automated Bolus for Postoperative Patient-controlled Analgesia with Popliteal Sciatic Nerve Catheters

2009 ◽  
Vol 110 (1) ◽  
pp. 150-154 ◽  
Author(s):  
Manuel Taboada ◽  
Jaime Rodríguez ◽  
Maria Bermudez ◽  
Marcos Amor ◽  
Beatriz Ulloa ◽  
...  
Keyword(s):  
Pain Relief ◽  
Continuous Infusion ◽  
Local Anesthetic ◽  
Patient Controlled Analgesia ◽  
Dosing Regimen ◽  
Postoperative Patient ◽  
Pain Scores ◽  
Dosing Regimens ◽  
To Receive ◽  
Infusion Technique

Background This investigation was designed to compare a new methodology of automated regular bolus with a continuous infusion of local anesthetic for continuous popliteal sciatic block; both regimens were combined with patient-controlled analgesia (PCA). Methods Fifty patients undergoing hallux valgus repair were randomly allocated to receive an infusion of 0.125% levobupivacaine administered through a popliteal catheter as an automated regular bolus (n = 25) or as a continuous infusion (n = 25), both combined with PCA. Postoperative pain scores, incremental doses delivered by the PCA, local anesthetic consumed per hour, and the need for rescue tramadol analgesia were recorded. Results Both dosing regimens provided similar postoperative analgesia. Consumption of local anesthetic (5.14 ml/h, 5-5.75 ml/h) and dose request from the PCA (1, 0-5.4) was lower in the automated bolus group as compared to the continuous infusion group (5.9 ml/h, 5.05-7.8 ml/h; doses by PCA: 6.5, 0-20.5; P < 0.05). The need for rescue tramadol was similar in the two groups. Conclusion In continuous popliteal sciatic block, local anesthetic administered as an automated regular bolus in conjunction with PCA provided similar pain relief as a continuous infusion technique combined with PCA; however, the new dosing regimen reduced the need for additional PCA and the overall consumption of local anesthetic.

scholarly journals Variation in the Blood Concentration/Analgesic Response Relationship during Patient-Controlled Analgesia with Alfentanil

1991 ◽  
Vol 19 (4) ◽  
pp. 555-560 ◽  
Author(s):  
H. Owen ◽  
J. C. Currie ◽  
J. L. Plummer
Keyword(s):  
Blood Concentration ◽  
Drug Prescription ◽  
Response Relationship ◽  
Patient Controlled Analgesia ◽  
Fixed Rate ◽  
Postoperative Patient ◽  
To Receive ◽  
Satisfactory Analgesia ◽  
Analgesic Response ◽  
Rate Infusion

The effect of supplementing postoperative patient-controlled analgesia (PCA) with a mandatory fixed-rate infusion was studied using alfentanil. Patients were assigned by lottery to receive alfentanil PCA with a bolus of 200 or 300 mcg or alfentanil PCA with a bolus of 100 or 200 mcg plus an infusion of 900 mcg/hr, such that ten patients received each treatment. Seven patients receiving PCA only, compared to two in the groups receiving infusion, were withdrawn due to inadequate pain relief (0.1 > P > 0.05). One patient receiving PCA only was withdrawn because of a low respiratory rate, whereas three patients receiving PCA plus infusion developed respiratory depression. Patients prescribed PCA plus infusion received significantly more alfentanil but did not describe less pain than patients prescribed PCA only. The blood alfentanil concentration immediately prior to demands was significantly higher in the PCA plus infusion groups. These results suggest that during PCA therapy the drug prescription influences the blood concentration associated with satisfactory analgesia.

scholarly journals Music Intervention to Orthopedic Patients: A Possible Alternative Solution to Control Pain

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Chuchu Wang ◽  
Fanli Tian
Keyword(s):  
Pain Relief ◽  
Pain Control ◽  
Music Intervention ◽  
Postoperative Patient ◽  
Pain Scores ◽  
Mp3 Players ◽  
Patient Pain ◽  
Quasi Experimental ◽  
Control Pain ◽  
Orthopedic Patients

Aims and Objective. Pain is a common problem associated with postoperative orthopedic patients; the current study is aimed at evaluating music intervention as an alternative method to control pain. Methodology. The experimental design of the current study was comparative, descriptive, and quasi-experimental. 38 postoperative orthopedic patients were equipped with pocket-size MP3 players with prerecorded music tracks (instrumental and lyrical) in Hindi, English, and Urdu. After that, pre-post-pain scores were recorded with the help of designed brief patient logs. Ultimately, a satisfactory survey was completed at discharge. Major Findings. It was found that during the intervention of music, the pain was significantly reduced from 5.40 to 2.98. There was a slight relationship between listening time and pain relief. It was also found that the feedback was extremely positive and each patient suggested the use of music to others with 96.6% recommendation. Conclusion. From the current study, it was found that music intervention can be beneficial to postoperative patient pain control. Further, it is hoped that the findings of the current experimental work will lead to improvements in the care of postoperative patients.

scholarly journals Comparison of Two Anesthetic Methods for Intravitreal Ozurdex Injection

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
V. Levent Karabaş ◽  
Berna Özkan ◽  
Çiğdem Akdağ Koçer ◽  
Özgül Altıntaş ◽  
Dilara Pirhan ◽  
...  
Keyword(s):  
Pain Relief ◽  
Pain Score ◽  
Branch Retinal Vein Occlusion ◽  
Subconjunctival Hemorrhage ◽  
Vein Occlusion ◽  
Pain Scores ◽  
Lidocaine Injection ◽  
Group 2 ◽  
To Receive ◽  
Group 1

Purpose. To determine whether subconjunctival lidocaine injection maintains additional anesthetic effect during intravitreal Ozurdex injection.Methods. 63 patients who were diagnosed as central or branch retinal vein occlusion and planned to receive Ozurdex injection for macular edema were prospectively included in the study. The patients were randomized into one of the two anesthetic groups. The first group received topical proparacaine drop and lidocaine applied pledget. The second group received subconjunctival lidocaine injection in addition to the anesthetics in group 1.Results. Mean pain score was1.90±2.39in group 1 and 1.71 ± 2.09 in group 2 (p=0.746). Mean subconjunctival hemorrhage grade was1.67±0.17in group 1 and0.90±0.14in group 2 (p=0.001). There was no relationship between the amount of subconjunctival hemorrhage and pain score of the patients.Conclusions. There was no difference in pain scores between the two anesthetic methods. The addition of subconjunctival lidocaine injection offered no advantage in pain relief compared to lidocaine-applied pledgets.

scholarly journals Research Status of Preemptive Analgesia and its Application in Clinical Anesthesia

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Jingjing Tan ◽  
Ning Dou ◽  
Gang Bai ◽  
Weiji Qiu ◽  
Yan Zhao
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Treatment Method ◽  
Clinical Applications ◽  
Preemptive Analgesia ◽  
Peripheral Sensitization ◽  
Patient Controlled Analgesia ◽  
Postoperative Patient ◽  
The Central Nervous System ◽  
Clinical Anesthesia

The most effective treatment for postoperative pain is to reduce it by preventing or reducing the sensitivity and sensory disturbance on the central nervous system during the operation, prolonging the pain-relief time and reducing the use of analgesics. Preemptive analgesia refers to the intervention of central neuraxis sensitization and peripheral sensitization to prevent the expansion and spread of pain, so as to achieve postoperative pain-relief. In postoperative patient-controlled analgesia, preemptive analgesia has become a common treatment method for anesthesiologists. However, the clinical specifications for advanced analgesia are still lacking. Based on this, this paper reviews the use of advanced analgesia drugs and their clinical applications

Trigger Finger Corticosteroid Injection With and Without Local Anesthetic: A Randomized, Double-Blind Controlled Trial

Hand ◽  
2019 ◽  
pp. 155894471988466
Author(s):  
J. Randall Patrinely ◽  
Shepard P. Johnson ◽  
Brian C. Drolet
Keyword(s):  
Local Anesthetic ◽  
Corticosteroid Injection ◽  
Controlled Trial ◽  
Treatment Method ◽  
Trigger Finger ◽  
Injection Pain ◽  
Double Blind ◽  
Pain Scores ◽  
Injection Methods ◽  
To Receive

Background: The first-line treatment for trigger finger is a corticosteroid injection. Although the injectable solution is often prepared with a local anesthetic, we hypothesize that patients receiving an injection with anesthetic will experience more pain at the time of injection. Methods: C Patients with trigger finger were prospectively randomized into 2 cohorts to receive triamcinolone (1 mL, 40 mg) plus 1% lidocaine with epinephrine (1 mL) or triamcinolone (1 mL, 40 mg) plus normal saline (1 mL, placebo). Both patient and surgeon were blinded to the treatment arm. The primary outcome was pain measured using a (VAS) immediately following the injection. Results: Seventy-three patients with a total of 110 trigger fingers were enrolled (57 lidocaine with epinephrine and 53 placebo). Immediate postinjection pain scores were significantly higher for injections containing lidocaine with epinephrine compared with placebo (VAS 3.5 vs 2.0). Conclusions: In the treatment of trigger finger, corticosteroid injections are effective and have relatively little associated pain. This study shows there is more injection-associated pain when lidocaine with epinephrine is included with the corticosteroid. Therefore, surgeons looking to decrease injection pain should exclude the anesthetic, but they should discuss the trade-off of foregoing short-term anesthesia with patients. Using only a single drug (ie, corticosteroid alone) is not only less painful but is also more simple, efficient, and safe; this has therefore become our preferred treatment method.

Continuous Infusion of Local Anesthetic at Iliac Crest Bone-Graft Sites for Postoperative Pain Relief

2006 ◽  
Vol 88 (12) ◽  
pp. 2606-2612 ◽  
Author(s):  
Steven J. Morgan ◽  
Kyle J. Jeray ◽  
Laurel H. Saliman ◽  
Howard J. Miller ◽  
Allison E. Williams ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Bone Graft ◽  
Continuous Infusion ◽  
Local Anesthetic ◽  
Iliac Crest ◽  
Postoperative Pain Relief ◽  
Iliac Crest Bone Graft

CONTINUOUS INFUSION OF LOCAL ANESTHETIC AT ILIAC CREST BONE-GRAFT SITES FOR POSTOPERATIVE PAIN RELIEF

2006 ◽  
Vol 88 (12) ◽  
pp. 2606-2612 ◽  
Author(s):  
STEVEN J. MORGAN ◽  
KYLE J. JERAY ◽  
LAUREL H. SALIMAN ◽  
HOWARD J. MILLER ◽  
ALLISON E. WILLIAMS ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Bone Graft ◽  
Continuous Infusion ◽  
Local Anesthetic ◽  
Iliac Crest ◽  
Postoperative Pain Relief ◽  
Iliac Crest Bone Graft

Postoperative Continuous Paravertebral Anesthetic Infusion for Pain Control in Posterior Cervical Spine Surgery: A Case-Control Study

2010 ◽  
Vol 66 (suppl_1) ◽  
pp. ons-99-ons-107 ◽  
Author(s):  
James B. Elder ◽  
Daniel J. Hoh ◽  
Charles Y. Liu ◽  
Michael Y. Wang
Keyword(s):  
Cervical Spine ◽  
Continuous Infusion ◽  
Local Anesthetic ◽  
Infusion Pump ◽  
Third Party ◽  
Study Patient ◽  
Cervical Spine Surgery ◽  
Pain Scores ◽  
Infusion Device ◽  
Lower Pain

Abstract Introduction: Patients who undergo posterior cervical spinal fusion procedures frequently experience significant postoperative pain. Use of a local anesthetic continuous infusion pump after surgery may improve these outcome variables. Methods: After posterior cervical spine fusion procedures, 25 consecutive patients received continuous infusion of 0.5% bupivacaine into the subfascial aspects of the wound via an elastomeric pump. Data were collected prospectively by third party assessment using standard nursing protocols. This included numeric pain scores and opiate use over the first 4 postoperative days (PODs), length of hospitalization, and complications. In a retrospective analysis, we compared each study patient to a control patient who did not receive the continuous infusion of bupivacaine. Demographic variables and surgical procedure were similar among matched cases. Results: Patients receiving continuous local anesthetic infusion used significantly less narcotics (P < .05) during the first 4 PODs: 24.4% on day 1, 34.1% on day 2, 53.5% on day 3, and 58.1% on day 4. A lower average pain score was observed among study patients on each POD (P < .05): 31.5% less on day 1, 13.0% on day 2, 24.0% on day 3, and 35.7% on day 4. Patients with the infusion device were discharged home earlier (POD 4.9 versus 6.7; P = .024) and demonstrated improvement in time to ambulation, first bowel movement, and discontinuation of the patient-controlled analgesia machine. No complications were associated with the device. Conclusion: Patients with the local anesthetic continuous infusion device required less narcotics and reported lower pain scores than control patients on each of the first 4 PODs. These results suggest that continuous infusion of local anesthetic into the paravertebral tissue during the immediate postoperative period is a safe and effective technique that achieves lower pain scores and narcotic use and improves multiple postoperative outcome variables.

Comparison of programmed intermittent bolus infusion and continuous infusion for postoperative patient-controlled analgesia with thoracic paravertebral block catheter: a randomized, double-blind, controlled trial

2019 ◽  
Vol 44 (2) ◽  
pp. 240-245 ◽  
Author(s):  
Lulu Chen ◽  
Yiquan Wu ◽  
Yaoyao Cai ◽  
Yingchao Ye ◽  
Li Li ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Continuous Infusion ◽  
Local Anesthetic ◽  
Lung Resection ◽  
Paravertebral Block ◽  
Patient Controlled Analgesia ◽  
Double Blind ◽  
Bolus Infusion ◽  
Intermittent Bolus ◽  
Video Assisted

Background and objectivesIn this randomized, double-blind, controlled study, we hypothesized that programmed intermittent bolus infusion (PIBI) of local anesthetic for continuous paravertebral block (PVB), combined with patient-controlled analgesia (PCA), provided better pain control, better patient satisfaction, and decreased in local anesthetic consumption when compared with a continuous infusion (CI) combined with PCA, after video-assisted thoracoscopic unilateral lung resection surgery.MethodsPreoperatively, patients undergoing video-assisted thoracoscopic unilateral lung resection surgery received ipsilateral paravertebral catheters inserted at the level of thoracic vertebrae 4 and 5. All the subjects received an initial bolus of 15 mL 0.375% ropivacaine via the catheters. Subjects were randomized to receive 0.2 % ropivacaine 8 mL/h as either PIBI (n=17) or CI (n=17) combined with a PCA pump. The pain scores, frequency of PCA, local anesthetic consumption, patient satisfaction, and the need for rescue analgesia with tramadol were recorded until 48 hours postoperative.ResultsThe numeric rating scale scores in the PIBI group were significantly lower than the CI group at 4, 8, 12 hours and 4, 8, 12, 24 hours postoperatively, at rest, and during coughing, respectively. PCA local anesthetic consumption (30 mg (20–60 mg) vs 120 mg (70–155 mg), p=0.000) and frequency of PCA use over 48 hours (3 (2–6) vs 12 (7–15.5), p=0.000) was lower in the PIBI group as compared with the CI group. Additionally, the PIBI group showed greater patient satisfaction. The need for tramadol rescue was similar in the two groups.ConclusionsIn PVBs, local anesthetic administered as a PIBI in conjunction with PCA provided superior postoperative analgesia to a CI combined with PCA in patients undergoing video-assisted thoracoscopic unilateral lung resection surgery.Clinical trial registrationChiCTR-IOR-17011253.

scholarly journals Indomethacin as Adjunct Analgesia following Open Cholecystectomy

1994 ◽  
Vol 22 (1) ◽  
pp. 25-29 ◽  
Author(s):  
G. A. Turner ◽  
J. Gorringe
Keyword(s):  
Placebo Group ◽  
Statistical Difference ◽  
Open Cholecystectomy ◽  
Patient Controlled Analgesia ◽  
Pain Scores ◽  
Lower Pain ◽  
Wound Drain ◽  
The Mean ◽  
To Receive ◽  
Elective Cholecystectomy

Fifty patients scheduled for elective cholecystectomy were randomised to receive either indomethacin suppositories 200 mg p.r. at the end of anaesthesia, followed by 100 mg bd for three days, or placebo supppositories according to the same regimen. All patients were given intravenous pethidine via patient-controlled analgesia (PCA) postoperatively. The mean dose of pethidine required by the patients in the indomethacin group was significantly less than that used by the placebo group, the cumulative dose after three days being 530.7 mg (SD 664.0) and 1151.0 mg (682.0) for the indomethacin and placebo groups respectively. At the same time the patients in the indomethacin group had lower pain scores both at rest and with movement, though this was only statistically significant on the first day on movement. There was no statistical difference between the groups with respect to the incidence of nausea, indigestion, proctitis, volume of drainage from the wound drain, or width of bruising around the wounds. Serum creatinine levels were compared pre- and postoperatively where possible and showed no change in either group.

Sign in / Sign up

Export Citation Format

Share Document