“Effects of Single-dose Preoperative Pregabalin on Postoperative Pain and Opioid Consumption in Cleft Orthognathic Surgery”

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Abdullah M. Said ◽  
Ema Zubovic ◽  
Austin Y. Ha ◽  
Gary B. Skolnick ◽  
Sybill D. Naidoo ◽  
...  
Keyword(s):  
Single Dose ◽  
Postoperative Pain ◽  
Orthognathic Surgery ◽  
Opioid Consumption

scholarly journals 4326 Effects of Single-dose Preoperative Pregabalin on Postoperative Pain and Opioid Consumption in Cleft Orthognathic Surgery

2020 ◽  
Vol 4 (s1) ◽  
pp. 29-29
Author(s):  
Abdullah Said ◽  
Ema Zubovic ◽  
Austin Y Ha ◽  
Gary B Skolnic ◽  
Jacob AuBuchon ◽  
...  
Keyword(s):  
Single Dose ◽  
Postoperative Pain ◽  
Orthognathic Surgery ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Opioid Consumption ◽  
Control Group ◽  
Assessment Scores ◽  
Pain Scores ◽  
Post Operative Pain

OBJECTIVES/GOALS: The current opioid epidemic has placed post-operative pain management under scrutiny. Limiting post-operative pain can decrease overall opioid usage in the recovery period, especially after orthognathic surgery. Several studies have illustrated the efficacy of pregabalin in decreasing postoperative pain and opioid usage in adults undergoing orthognathic surgery. We aim to study the effects of a single dose of preoperative pregabalin on postoperative pain and total opioid consumption after orthognathic surgery in individuals with cleft lip and palate. METHODS/STUDY POPULATION: This was a retrospective cohort study of consecutive patients who received Le Fort I midface advancement between June 2012 and July 2019 by one of two surgeons at a single institution. We took advantage of our institution’s implementation, beginning in 2016, of a one-time dose of preoperative pregabalin for LeFort I midface advancement. All patients had diagnosed cleft lip and palate. The treatment group received a one-time preoperative dose of pregabalin. The control group did not receive pregabalin. Total morphine milligram equivalents (MME) consumption was calculated by adding intraoperative opioid administration and postoperative opioid consumption during admission. Postoperative pain control during admission consisted of oral oxycodone and intravenous (IV) hydromorphone or morphine. Duration of hospitalization and pain intensity assessed with the numeric pain rating scale (0-10) were also recorded. The mean postoperative pain assessment scores during admission was calculated for each patient. The median of these individual mean pain assessment scores for each group was subsequently computed. RESULTS/ANTICIPATED RESULTS: Twenty-three patients (14 males, 9 females) were included in this study; 12 patients received pregabalin (median dose: 150mg, range: 100-200mg). Mean age (years) at operation of the pregabalin (18.3 ± 1.9) and control groups (17.8 ± 1.9) were also equivalent (p = 0.571). Median hospital stay for both groups was 1.0 day. The pregabalin group had significantly lower consumption of total opioids during admission (total MME 70.95 MME; IQR: 24.65-150.17) compared to the control group (138.00 MME; IQR: 105.00-232.48) (MU = 31.00, p = 0.031). Although pain scores in the treatment group (3.21 ± 2.03) were lower than in the control group (3.71 ± 2.95), the difference was not statistically significant (p = 0.651, 95% Cl [−1.75, 2.75]). DISCUSSION/SIGNIFICANCE OF IMPACT: Based on the results, a one-time preoperative oral dose of pregabalin before orthognathic surgery in patients with cleft lip and palate reduced total opioid consumption during admission. However, there was no difference in length of stay or pain scores within the two groups. A single preemptive oral dose of pregabalin should be considered an effective adjunct to pain management protocols in patients undergoing orthognathic surgery.

scholarly journals COMPARATIVE EVALUATION OF POSTOPERATIVE PAIN SCORES AND OPIOID CONSUMPTION IN SEPTORHINOPLASTY AFTER ADMINISTRATION OF SINGLE-DOSE PRE-EMPTIVE PARACETAMOL AND IBUPROFEN: A RANDOMIZED CONTROLLED TRAIL

2021 ◽  
Vol 9 (10) ◽  
pp. 1136-1143
Author(s):  
Alshehri a ◽  
◽  
Ali Abdullah A. ◽  
Keyword(s):  
Single Dose ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Opioid Analgesics ◽  
Opioid Consumption ◽  
Control Group ◽  
Time Intervals ◽  
Pain Scores ◽  
Group A ◽  
Group B

Introduction Septorhinoplasty operates on cartilage and bone of the nose and is ensued by severe postoperative pain. The objective of this study is to evaluate effects of preoperative administration of intravenous (IV) paracetamol and ibuprofen on postoperative pain scores in patients undergoing septorhinoplasty. Methodology 150 patients undergoing septorhinoplasty were randomly assigned into three groups with 50 patients in each group. The control group (Group A) was administered 100 ml saline solution, paracetamol group (Group B) was administered 1000 mg IV paracetamol in 100 ml saline and ibuprofen group (Group C) was administered 800 mg IV ibuprofen in 100 ml saline before surgery. Opioid analgesics were employed to achieve postoperative analgesia. Postoperative pain was evaluated using Visual Analogue Scale (VAS). Postoperative opioid consumption and adverse effects were also recorded for each patient. Results In comparison with Group A, VAS in Group B and Group C was statistically lower in all the time intervals (p<0.05). In 1st and 6th hours postoperatively, VAS in Group C was lower than Group B (p<0.05). In control group, total opioid consumption was highest in all time intervals (p<0.05). In Group C, total opioid consumption was significantly lower than Group B at 0-6 and 6-12 hours interval. (p<0.05). Conclusion- Single-dose pre-emptive administration of ibuprofen has more profound postoperative analgesic effect than paracetamol during first 6 hours in septorhinoplasty. After first 6 hours of the procedure, there is no difference in analgesic effect between ibuprofen and paracetamol.

scholarly journals Perioperative Single Dose Systemic Dexamethasone for Postoperative Pain

2011 ◽  
Vol 115 (3) ◽  
pp. 575-588 ◽  
Author(s):  
Gildàsio S. De Oliveira ◽  
Marcela D. Almeida ◽  
Honorio T. Benzon ◽  
Robert J. McCarthy
Keyword(s):  
Single Dose ◽  
Postoperative Pain ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Opioid Consumption ◽  
Opioid Use ◽  
Analgesic Effects ◽  
Preoperative Administration

Background Dexamethasone is frequently administered in the perioperative period to reduce postoperative nausea and vomiting. In contrast, the analgesic effects of dexamethasone are not well defined. The authors performed a meta-analysis to evaluate the dose-dependent analgesic effects of perioperative dexamethasone. Methods We followed the PRISMA statement guidelines. A wide search was performed to identify randomized controlled trials that evaluated the effects of a single dose systemic dexamethasone on postoperative pain and opioid consumption. Meta-analysis was performed using a random-effect model. Effects of dexamethasone dose were evaluated by pooling studies into three dosage groups: low (less than 0.1 mg/kg), intermediate (0.11-0.2 mg/kg) and high (≥ 0.21 mg/kg). Results Twenty-four randomized clinical trials with 2,751 subjects were included. The mean (95% CI) combined effects favored dexamethasone over placebo for pain at rest (≤ 4 h, -0.32 [0.47 to -0.18], 24 h, -0.49 [-0.67 to -0.31]) and with movement (≤ 4 h, -0.64 [-0.86 to -0.41], 24 h, -0.47 [-0.71 to -0.24]). Opioid consumption was decreased to a similar extent with moderate -0.82 (-1.30 to -0.42) and high -0.85 (-1.24 to -0.46) dexamethasone, but not decreased with low-dose dexamethasone -0.18 (-0.39-0.03). No increase in analgesic effectiveness or reduction in opioid use could be demonstrated between the high- and intermediate-dose dexamethasone. Preoperative administration of dexamethasone appears to produce a more consistent analgesic effect compared with intraoperative administration. Conclusion Dexamethasone at doses more than 0.1 mg/kg is an effective adjunct in multimodal strategies to reduce postoperative pain and opioid consumption after surgery. The preoperative administration of the drug produces less variation of effects on pain outcomes.

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