Mean analgesic consumption is inappropriate for testing analgesic efficacy in post-operative pain: analysis and alternative suggestion

The analgesic efficacy and safety of ketorolac tromethamine (ketorolac), a potent analgesic with anti-inflammatory and antipyretic activities, were evaluated and compared with Doleron, a combination analgesic, in 115 patients with moderate to severe orthopaedic post-operative pain. This was a randomized, double-blind (double-dummy), parallel-group comparison of a single oral dose of one capsule of 10 mg ketorolac with a single oral dose of two Doleron tablets (each tablet contained 150 mg dextropropoxyphene napsylate, 350 mg aspirin and 150 mg phenazone). During the 6 h following treatment, 80% of ketorolac treated patients and 82% of Doleron treated patients experienced adequate pain relief. There were no statistically significant differences in the overall analgesic efficacy between the treatment groups. Three patients (one on ketorolac, two on Doleron) withdrew because of adverse events (vomiting). Nausea (two patients in each treatment group), vertigo (none on ketorolac, three on Doleron) and sore throat (none on ketorolac, two on Doleron) were the only drug-related adverse events reported by more than one person in a treatment group during the trial. A total of 82% of patients given ketorolac and 76% given Doleron experienced no adverse events. A single oral dose of 10 mg ketorolac was shown to be as effective and safe as two Doleron tablets in the treatment of moderate to severe orthopaedic post-operative pain.

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A Comparison of Naproxen, Indomethacin and Acetylsalicylic Acid in Pain after Varicose Vein Surgery

Journal of International Medical Research ◽

10.1177/030006057800600216 ◽

1978 ◽

Vol 6 (2) ◽

pp. 152-156 ◽

Cited By ~ 6

Author(s):

Ulla Aromaa ◽

Kari Asp

Keyword(s):

Side Effects ◽

Acetylsalicylic Acid ◽

Postoperative Analgesia ◽

Varicose Vein ◽

Randomized Study ◽

Analgesic Efficacy ◽

Varicose Vein Surgery ◽

Double Blind ◽

Post Operative Pain ◽

Minor Surgery

Oral naproxen in doses of 500 mg and 750 mg daily was compared with oral indomethacin, 75 mg daily, in a double-blind, completely randomized study of patients with post-operative pain after out-patient varicose vein surgery. Altogether, 120 patients were studied. In the study 750 mg naproxen proved to be equal in respect of analgesic efficacy to 75 mg indomethacin, and it was clearly superior to 1500 mg acetylsalicylic acid. Naproxen, 500 to 750 mg daily, afforded adequate postoperative analgesia in 98% of patients. The side-effects were mild. On the basis of the study, naproxen can be recommended as a pain-relieving drug after minor surgery, particularly when an antiphlogistic effect is also desirable.

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Administration of fentanyl before remifentanil-based anaesthesia has no influence on post-operative pain or analgesic consumption

Acta Anaesthesiologica Scandinavica ◽

10.1111/j.1399-6576.2007.01471.x ◽

2007 ◽

Vol 52 (1) ◽

pp. 149-154 ◽

Cited By ~ 12

Author(s):

H. LENZ ◽

J. RAEDER ◽

S. C. HOYMORK

Keyword(s):

Analgesic Consumption ◽

Post Operative Pain

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The randomised prospective comparative study to see the duration of analgesia following intravenous or rectal acetaminophen after adenotonsillectomy in children

International Journal of Contemporary Pediatrics ◽

10.18203/2349-3291.ijcp20191500 ◽

2019 ◽

Vol 6 (3) ◽

pp. 1119

Author(s):

Neerupam Gupta ◽

Naine Bhadrala ◽

Jasmeen . ◽

Saloni .

Keyword(s):

Analgesic Efficacy ◽

Cost Effective ◽

Surgical Trauma ◽

Age Group ◽

Pain Medicine ◽

Pediatric Pain ◽

Pain Scores ◽

Group I ◽

Post Operative Pain ◽

Prospective Comparative Study

Background: The greatest advance in pediatric pain medicine is the recognition that untreated pain is a significant cause of morbidity and even mortality after surgical trauma. Author compared the analgesic efficacy and duration of analgesia of rectal acetaminophen and I.V. acetaminophen.Methods: A total of 80 children in the age group of 2-5 years were randomly selected and divided into 2 groups. Group I received 15 mg/kg I.V. paracetamol and group II received 40 mg/kg rectal acetaminophen. Post-operative pain scores were measured using Face, Legs, Activity, Cry and Consolability scale and duration of analgesia were recorded and compared.Results: The pain scores in group I was lower immediately after extubation and at 30 minutes post extubations but at one, two and four hours the pains score were comparable in both the groups. At 6 hours, the pain score was significantly more in I.V. group and also the duration of analgesia was 9-10 hours in rectal acetaminophen group where as in I.V. group, it was 5-6 hours.Conclusions: Rectal acetaminophen 40 mg/kg produces prolonged analgesia as compared to I.V. paracetamol 15 mg/kg and also is more convenient and cost effective and is devoid of side effects of I.V. cannulation.

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Comparison of Analgesic Efficacy of Transversus Abdominis Plane Block Versus Infiltration of Local Anaesthetic into Surgical Wound In Emergency Laparotomies: A Randomized Control Trial

Esculapio ◽

10.51273/esc20.251642 ◽

2021 ◽

Vol 16 (4 (oct 2020 - dec 2020)) ◽

Author(s):

Anum Anwar ◽

Hina Nabi Ahmed ◽

Lala Rukh Bangash ◽

Farah Arshad ◽

Sahira Nawaz ◽

...

Keyword(s):

Pain Score ◽

Local Anaesthetic ◽

Randomized Control Trial ◽

Analgesic Efficacy ◽

Transversus Abdominis ◽

Emergency Laparotomy ◽

Tap Block ◽

Surgical Wound ◽

Post Operative Pain ◽

Randomized Control

Objective: To compare mean pain score of bilateral TAP block versus infiltration of local anaesthetic into surgical wound on for emergency laparotomies. Method: Randomized control trial. Emergency Operation Theatre in Department of Anaesthesiology at Mayo Hospital, Lahore from 1st April 2016 to 31st October 2016. Laparotomy 150 patients were arbitrarily allocated two groups Group T (receiving bilateral TAP block) and Group L (local infiltration) by random number table method after informed consent. TAP block was administered bilaterally by using 20ml of 0.25% bupivacaine in group T using a 21-gauge needle with the help of “Double Pop Technique” at midaxillary point at height of umbilicus. While in group L surgical incision site was injected with 20ml of 0.25% bupivacaine immediately after closure of skin. Pain was evaluated by Visual analogue scale (VAS) at 6-hour interval postoperatively. Results were statistically analysed using SPSS version 20.0 and t-test was applied to compare mean pain score of two groups. Results: Mean pain score in patients receiving bilateral TAP block 3.000±0.717 were significantly reduced (p value 0.003) versus mean scores in patients receiving infiltration of local anaesthetic into surgical wound in emergency laparotomies 6.08±1.171. Conclusion: Bilateral TAP block reduced post-operative pain significantly in patients undergone emergency laparotomy. Key Words: Emergency laparotomy, TAP block, local anaesthetic, bupivacaine, post-operative pain, analgesia. How to Cite: Anwar A, Nabi H.A, Bangash L.R, Arshad F, Nawaz S. Comparison of analgesic efficacy of transversus abdominis plane block versus infiltration of local anaesthetic into surgical wound in emergency laparotomies: a randomized control trial. Esculapio.2020;16(04):8-13.

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Analgesic Efficacy of Quadratus Lumborum Block in Infants Undergoing Pyeloplasty

Surgeries ◽

10.3390/surgeries2030028 ◽

2021 ◽

Vol 2 (3) ◽

pp. 278-285

Author(s):

Paul F. Chisolm ◽

Nikhi P. Singh ◽

Ian Cummins ◽

Robert A. Oster ◽

Damon Cox ◽

...

Keyword(s):

Monitoring Program ◽

Analgesic Efficacy ◽

Standard Of Care ◽

Pain Scale ◽

Prescription Database ◽

Opioid Prescription ◽

Hemodynamic Variables ◽

Post Operative Pain ◽

Quadratus Lumborum ◽

Infant Pain

Post-operative analgesic management is challenging in infants and opioids have been the standard of care. However, they are associated with adverse effects which may negatively impact infants. In this retrospective cohort study, we sought to explore the postoperative analgesic efficacy of quadratus lumborum (QL) block in the infant population undergoing dorsal lumbotomy pyeloplasty. Chart review of 34 infants (≤12 months) who underwent dorsal lumbotomy pyeloplasty between 2016–2020 was performed. Post-operative pain was assessed using externally validated pain scales (CRIES & FLACC) and monitored hemodynamics (pulse and blood pressure). Opioid doses were standardized by using morphine milligram equivalency (MME). The Prescription Database Monitoring Program (PDMP) was utilized to determine if discharge opioid prescriptions were filled. Of 34 patients, 13 received the QL block. Mean age at the time of surgery was 6.2 months ± 3.2 months. The QL group received 0.8 MME postoperatively, whereas the non-QL group received 0.9 MME (p = 0.82). The QL group (20%) filled their discharge opioid prescription less frequently compared to non-QL group (100%) (p = 0.002). There were no observed differences between pain scale or hemodynamic variables. Further studies are warranted to explore QL block’s efficacy for post-operative infant pain management.

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