Pre‐emptive administration of gabapentinoids to reduce postoperative pain and opioid usage following oral and maxillofacial surgical procedures

Oral Surgery ◽  
2021 ◽  
Author(s):  
Surya A. Bhavaraju ◽  
John S. Vorrasi ◽  
Sandeep Talluri ◽  
Mythili Kalladka ◽  
Junad Khan
Keyword(s):  
Postoperative Pain ◽  
Surgical Procedures

scholarly journals Otoplasty: a graduated approach

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ahmed Soliman Ismail
Keyword(s):  
Postoperative Pain ◽  
Surgical Procedures ◽  
Adult Patients ◽  
Surgical Results ◽  
Auricular Cartilage ◽  
Surgical Time ◽  
Common Presentation ◽  
Ear Deformity ◽  
Surgical Tool ◽  
Bat Ear

Abstract Background Bat ear deformity is a common presentation among the ENT patients (22.5%). Many surgical procedures have been described to manage such a problem. A thorough study of the anatomical anomalies contributing to such deformity is required by any plastic surgeon in handling this anomaly. Results Modified anterior scoring (Chong-Chet) was done on 45 bat ear deformities in 31 patients. Good surgical results were obtained in 97.7% of patients, and the surgical time ranged from 60 t0 90 min. Postoperative pain and infection were minimal and effectively managed. Conclusions The modified Chong-Chet anterior scoring is a reliable and effective surgical tool for managing bat ear deformity done through one postauricular incision. This technique could be used in young as well as adult patients because it renders the auricular cartilage easier to manipulate.

scholarly journals Postoperative Pain, an Unmet Problem in Day or Overnight Italian Surgery Patients: A Prospective Study

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Sara Campagna ◽  
Maria Delfina Antonielli D’Oulx ◽  
Rosetta Paradiso ◽  
Laura Perretta ◽  
Silvia Re Viglietti ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Surgical Procedures ◽  
Pain Therapy ◽  
Pain Treatment ◽  
Day Surgery ◽  
North West ◽  
Local Practices ◽  
Surgery Rates ◽  
A Prospective Study ◽  
Postoperative Pain Treatment

Background. Because of economic reasons, day surgery rates have steadily increased in many countries and the trend is to perform around 70% of all surgical procedures as day surgery. Literature shows that postoperative pain treatment remains unfulfilled in several fields such as orthopedic and general surgery patients. In Italy, the day surgery program is not yet under governmental authority and is managed regionally by local practices. Aim. To investigate the trends in pain intensity and its relation to type of surgeries and pain therapy protocols, in postoperative patients, discharged from three different Ambulatory Surgeries located in North West Italy (Piedmont region). Method. The present study enrolled 276 patients who undergone different surgical procedures in ambulatory regimen. Patients recorded postoperative pain score twice a day, compliance with prescribed drugs, and pain related reasons for contacting the hospital. Monitoring lasted for 7 days. Results. At discharge, 72% of patients were under weak opioids, 12% interrupted the treatment due to side effects, 17% of patients required extra drugs, and 15% contacted the hospital reporting pain problems. About 50% of patients experienced moderate pain during the first day after surgery. Results from our study show that most of the patients experienced avoidable pain after discharge.

scholarly journals The Effect of Intraoperative Methadone Compared to Morphine on Postsurgical Pain: A Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 2020 ◽  
pp. 1-9 ◽  
Author(s):  
Mark C. Kendall ◽  
Lucas J. Alves ◽  
Kristi Pence ◽  
Taif Mukhdomi ◽  
Daniel Croxford ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Randomized Controlled Trials ◽  
Surgical Procedures ◽  
Meta Analysis ◽  
Analgesic Efficacy ◽  
Opioid Consumption ◽  
Cochrane Library ◽  
Postanesthesia Care Unit ◽  
Controlled Trials ◽  
Randomized Controlled

Background and Objectives. Methadone is commonly used in chronic pain, but it is not frequently used as an intraoperative analgesic. Several randomized studies have compared intraoperative methadone to morphine regarding postsurgical analgesia, but they have generated conflicting results. The aim of this investigation was to compare the analgesic efficacy of intraoperative methadone to morphine in patients undergoing surgical procedures. Methods. We performed a quantitative systematic review of randomized controlled trials in PubMed, Embase, Cochrane Library, and Google Scholar electronic databases. Meta-analysis was performed using the random effects model, weighted mean differences (WMD), standard deviation, 95% confidence intervals, and sample size. Methodological quality was evaluated using Cochrane Collaboration’s tool. Results. Seven randomized controlled trials evaluating 337 patients across different surgical procedures were included. The aggregated effect of intraoperative methadone on postoperative opioid consumption did not reveal a significant effect, WMD (95% CI) of −0.51 (−1.79 to 0.76), (P=0.43) IV morphine equivalents. In contrast, the effect of methadone on postoperative pain demonstrated a significant effect in the postanesthesia care unit, WMD (95% CI) of −1.11 (−1.88 to −0.33), P=0.005, and at 24 hours, WMD (95% CI) of −1.35 (−2.03 to −0.67), P<0.001. Conclusions. The use of intraoperative methadone reduces postoperative pain when compared to morphine. In addition, the beneficial effect of methadone on postoperative pain is not attributable to an increase in postsurgical opioid consumption. Our results suggest that intraoperative methadone may be a viable strategy to reduce acute pain in surgical patients.

scholarly journals Four-Week Pain Profile and Patient Non-Adherence to Pharmacological Pain Therapy After Day Surgery

2020 ◽  
Vol 10 (3) ◽  
Author(s):  
Ina Callebaut ◽  
Steffe Jorissen ◽  
Caroline Pelckmans ◽  
Noor Berends ◽  
Martijn Droogmans ◽  
...  
Keyword(s):  
Inguinal Hernia ◽  
Postoperative Pain ◽  
Hernia Repair ◽  
Inguinal Hernia Repair ◽  
Surgical Procedures ◽  
Pain Therapy ◽  
Knee Arthroscopy ◽  
Shoulder Arthroscopy ◽  
Pain Scores ◽  
Average Pain

Background: Nowadays, complicated and painful surgical procedures are encouraged to be carried out in an ambulatory setting. Objectives: The current study aimed to assess 4-week postoperative pain profiles of 4 painful ambulatory surgical procedures. We analyzed the prevalence of and reasons for non-adherence and partial adherence of patients to a predefined treatment schedule after the ambulant surgery. Methods: The current study analyzed data from a large randomized trial by evaluating the effect of postoperative pain medication on acute postoperative pain at home during the first 4 postoperative days (POD) in patients scheduled for ambulatory hemorrhoid surgery, shoulder or knee arthroscopy, and inguinal hernia repair. Postoperative pain intensity was assessed at POD 0, 1, 2, 3, 4, 7, 14, and 28 via the Numeric Rating Scale (NRS). Adherence was assessed on POD 1, 2, 3, and 4. Results: Median average pain scores were above an NRS of 3 during the first postoperative week after shoulder arthroscopy and even above 4 during the first postoperative week after hemorrhoid surgery. 26% of patients undergoing shoulder arthroscopy and hemorrhoid surgery still had moderate pain 1 week after surgery. Median average pain scores were below an NRS of 3 during the whole study period after inguinal hernia repair and knee arthroscopy. 24.61% of patients did not use the study medication as prescribed, 5.76% of whom were non-adherent, and 18.85% were partially adherent. Conclusions: Each type of ambulant surgery has its unique postoperative pain profile. New strategies should be developed for pain therapy at home, particularly after the ambulatory arthroscopic shoulder surgery and hemorrhoid surgery. Non-adherence is uncommon if they are provided with a multimodal analgesic home kit together with clear verbal, written instructions, and intensive follow-up.

scholarly journals Comparison of Analgesic Efficacy of Caudal Dexamethasone versus Intravenous Dexamethasone as an Adjuvant to Caudal Block in Pediatric Patients Undergoing Lower limb orthopedic Surgeries

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
G S Mohamed ◽  
A A Abdelatif ◽  
M Menshawey ◽  
A A S Mansour
Keyword(s):  
Postoperative Pain ◽  
Surgical Procedures ◽  
Postoperative Analgesia ◽  
Lower Limb ◽  
Pediatric Population ◽  
Anesthetic Techniques ◽  
Caudal Block ◽  
Caudal Anesthesia ◽  
Analgesic Regimen ◽  
Better Than

Abstract Background Lower limb orthopedic surguries are one of the most frequently performed surgical procedures in the pediatric population. Using optimal analgesic regimen provide safe and effective analgesia, reduce postoperative stress response and accelerate recovery from surgery. Regional anesthetic techniques are commonly used to facilitate pain control in pediatric surgical procedures. The most commonly used techniques in pediatrics is caudal block. Aim of the Work This study is conducted to evaluate the analgesic effect of dexamethasone when given systemically versus caudally as an adjuvant to caudal block for children undergoing lower limb orthopedic surgeries. Patients and Methods The study was conducted on 50 randomly chosen patients in Ain Shams University Hospitals after approval of the medical ethical committee. Patients were divided randomly into two groups, each group consisted of 25 patients. Results The results of the study revealed that dexamethasone 0.1 mg/kg, when used as an adjuvant to caudal anesthesia, can significantly prolong the duration of postoperative analgesia. It is better than IV dexamethasone at similar doses in controlling postoperative pain. Conclusion From our study, we can conclude that dexamethasone 0.1 mg/kg, when used as an adjuvant to caudal anesthesia, can significantly prolong the duration of postoperative analgesia. It is better than IV dexamethasone at similar doses in controlling postoperative pain.

Procedure-specific Risk Factor Analysis for the Development of Severe Postoperative Pain

2014 ◽  
Vol 120 (5) ◽  
pp. 1237-1245 ◽  
Author(s):  
Hans J. Gerbershagen ◽  
Esther Pogatzki-Zahn ◽  
Sanjay Aduckathil ◽  
Linda M. Peelen ◽  
Teus H. Kappen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Chronic Pain ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Surgical Procedures ◽  
Rating Scale ◽  
Random Effect ◽  
Numeric Rating Scale ◽  
Younger Age ◽  
Severe Postoperative Pain

Abstract Background: Many studies have analyzed risk factors for the development of severe postoperative pain with contradictory results. To date, the association of risk factors with postoperative pain intensity among different surgical procedures has not been studied and compared. Methods: The authors selected precisely defined surgical groups (at least 150 patients each) from prospectively collected perioperative data from 105 German hospitals (2004–2010). The association of age, sex, and preoperative chronic pain intensity with worst postoperative pain intensity was studied with multiple linear and logistic regression analyses. Pooled data of the selected surgeries were studied with random-effect analysis. Results: Thirty surgical procedures with a total number of 22,963 patients were compared. In each surgical procedure, preoperative chronic pain intensity and younger age were associated with higher postoperative pain intensity. A linear decline of postoperative pain with age was found. Females reported more severe pain in 21 of 23 surgeries. Analysis of pooled surgical groups indicated that postoperative pain decreased by 0.28 points (95% CI, 0.26 to 0.31) on the numeric rating scale (0 to 10) per decade age increase and postoperative pain increased by 0.14 points (95% CI, 0.13 to 0.15) for each higher score on the preoperative chronic pain scale. Females reported 0.29 points (95% CI, 0.22 to 0.37) higher pain intensity. Conclusions: Independent of the type and extent of surgery, preoperative chronic pain and younger age were associated with higher postoperative pain. Females consistently reported slightly higher pain scores regardless of the type of surgery. The clinical significance of this small sex difference has to be analyzed in future studies.

scholarly journals Alternative Approach to the Management of Postoperative Pain after Pediatric Surgical Procedures

2014 ◽  
Vol 7 (2) ◽  
pp. 125-129 ◽  
Author(s):  
Lourdes Santos-Pinto ◽  
Marco Paschoal ◽  
Juliana Souza ◽  
Cyneu Pansani
Keyword(s):  
Postoperative Pain ◽  
Surgical Procedures ◽  
Alternative Approach

scholarly journals Postoperative Pain in Complex Ophthalmic Surgical Procedures: Comparing Practice with Guidelines

Pain Medicine ◽  
2014 ◽  
Vol 15 (6) ◽  
pp. 1036-1042 ◽  
Author(s):  
Mladen Lesin ◽  
Zeljka Duplancic Sundov ◽  
Marko Jukic ◽  
Livia Puljak
Keyword(s):  
Postoperative Pain ◽  
Surgical Procedures

scholarly journals KSHARAKARMA IN SHALAKYA TANTRA: A REVIEW

2021 ◽  
Vol 12 (3) ◽  
pp. 131-134
Author(s):  
Shifali Sahu ◽  
V R Hiremath ◽  
Shashikala K ◽  
Gururaj N
Keyword(s):  
Cost Effectiveness ◽  
Postoperative Pain ◽  
Surgical Procedures ◽  
Effective Management

Kshara is one of the Ayurvedic modalities used from the ancient period for the treatment of various diseases. Acharya Sushruta who is worshipped as the "Father of Surgery" is the pioneer of Kshara Kalpana. Kshara karma is important among all the "Anushastra karma". It is multifunctional hence advised in several urdhwajatrugata vikaras according to stage and predominance of Doshas. Kshara application is the best one, taking into consideration of its convenience, easy adaptability, cost-effectiveness, and curative. It also has mild postoperative pain, no bleeding, minimum hospitalization and fewer chances of recurrence. The correct way of adopting the procedure has been considered as wealth and a strong weapon in the Ayurvedic pharmacopeia. There is a need of adopting such Para surgical procedures, doing research works, and popularize it in Shalakya practice for effective management and cure of the urdhawavikaras.

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