scholarly journals Efficacy of Nalbuphine with Flurbiprofen on Multimodal Analgesia with Transverse Abdominis Plane Block in Elderly Patients Undergoing Open Gastrointestinal Surgery: A Randomized, Controlled, Double-Blinded Trial

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Yu Mao ◽  
Yuanyuan Cao ◽  
Bin Mei ◽  
Lijian Chen ◽  
Xuesheng Liu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Elderly Patients ◽  
Pain Intensity ◽  
Gastrointestinal Surgery ◽  
Postoperative Nausea And Vomiting ◽  
Multimodal Analgesia ◽  
Transverse Abdominis ◽  
Intravenous Analgesia ◽  
Double Blinded ◽  
Different Doses

Objective. To assess different doses of nalbuphine with flurbiprofen compared to sufentanil with flurbiprofen in multimodal analgesia efficacy for elderly patients undergoing gastrointestinal surgery with a transverse abdominis plane block (TAPB). Methods. 158 elderly patients scheduling for elective open gastrointestinal surgery under general anesthesia and TAPB were randomly assigned to four groups according to different doses of nalbuphine with flurbiprofen in postoperative intravenous analgesia (PCIA). Postoperative pain intensity, effective pressing numbers of PCIA, and adverse effects were recorded at 6, 12, 24, and 48 hours after surgery. Results. Postoperative pain intensity, effective pressing numbers, and the incidence of postoperative nausea and vomiting (PONV) were similar among the four groups after surgery, while the severity of PONV was decreased in Group L compared with Group S at 6, 12, and 48 h after surgery. No individual experienced pruritus, respiratory depression, or hypotension. Conclusions. Low dose of nalbuphine (15 μg·kg−1·ml−1) combined with flurbiprofen is superior for elderly patients undergoing elective open gastrointestinal surgery with TAPB in terms of the efficient postoperative analgesia and decreased severity of PONV. This trial is registered with NCT02984865.

Application of preoperative assessment of pain induced by venous cannulation in predicting postoperative pain in patients under laparoscopic nephrectomy: a prospective study

2020 ◽  
Author(s):  
Fei Peng ◽  
Yanshuang Li ◽  
Yanqiu Ai ◽  
Jianjun Yang ◽  
Yanping Wang
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Pain Score ◽  
Preoperative Assessment ◽  
Laparoscopic Nephrectomy ◽  
Venous Cannulation ◽  
Clinical Trial Registry ◽  
Rescue Analgesia ◽  
Intravenous Analgesia ◽  
Vas Scores

Abstract Backgroud: Postoperative pain is the most prominent concern among surgical patients. It has been reported that venous cannulation-induced pain can predict postoperative pain after laparoscopic cholecystectomy within 90 mins. Its potential in predicting postoperative pain in patients with patient-controlled intravenous analgesia (PCIA) is worth establishing. The purpose of this study was to investigate the application of VCP in predicting postoperative pain in patients with PCIA during the first 24 h after laparoscopic nephrectomy. Methods: 120 patients scheduled for laparoscopic nephrectomy. The nurse recorded the preoperative venous cannulation-induced pain score estimated by patients, and dichotomized the patients into VAS scores < 2.0 group or VAS scores ≥ 2.0 group . After general anesthesia and surgery, all the patients received the patient-controlled intravenous analgesia (PCIA) with sufentanil. The VAS scores at rest and on coughing at 2 h, 4 h, 8 h, 12 h, 24 h, the effective number of presses and the number of needed rescue analgesia within 24 h after surgery were recorded. Results: Venous cannulation-induced pain score was significantly correlated with postoperative pain intensity at rest (rs = 0.64) and during coughing (rs = 0.65), effective times of pressing (rs = 0.59), additional consumption of sufentanil (rs = 0.58). Patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units reported higher levels of postoperative pain intensity at rest (P < 0.0005) and during coughing (P < 0.0005), needed more effective times of pressing (P < 0.0005) and additional consumption of sufentanil (P < 0.0005), and also needed more rescue analgesia (P = 0.01). The odds of risk for moderate or severe postoperative pain (OR 3.5, 95% CI 1.3-9.3) was significantly higher in patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units compared to those < 2.0 VAS units. Conclusions: Preoperative venous cannulation-induced pain can be used to predict postoperative pain intensity in patients with PCIA during the first 24 h after laparoscopic nephrectomy. Trial registration: We registered this study in a Chinese Clinical Trial Registry (ChiCTR) center on July 6 2019 and received the registration number: ChiCTR1900024352. Key words: Venous cannulation, Pain, Postoperative pain, Pain prediction

Electro-Acupuncture Decreases Postoperative Pain and Improves Recovery in Patients Undergoing a Supratentorial Craniotomy

2014 ◽  
Vol 42 (05) ◽  
pp. 1099-1109 ◽  
Author(s):  
Li-Xin An ◽  
Xue Chen ◽  
Xiu-Jun Ren ◽  
Hai-Feng Wu
Keyword(s):  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Tumor Resection ◽  
Postoperative Nausea And Vomiting ◽  
Control Group ◽  
Anesthesia Induction ◽  
Supratentorial Tumor ◽  
Intravenous Analgesia ◽  
Group A ◽  
Vas Scores

We performed this study to examine the effect of electro-acupuncture (EA) on postoperative pain, postoperative nausea and vomiting (PONV) and recovery in patients after a supratentorial tumor resection. Eighty-eight patients requiring a supratentorial tumor resection were anesthetized with sevoflurane and randomly allocated to a no treatment group (Group C) or an EA group (Group A). After anesthesia induction, the patients in Group A received EA at LI4 and SJ5, at BL63 and LR3 and at ST36 and GB40 on the same side as the craniotomy. The stimulation was continued until the end of the operation. Patient-controlled intravenous analgesia (PCIA) was used for the postoperative analgesia. The postoperative pain scores, PONV, the degree of dizziness and appetite were recorded. In the first 6 hours after the operation, the mean total bolus, the effective times of PCIA bolus administrations and the VAS scores were much lower in the EA group (p < 0.05). In the EA group, the incidence of PONV and degree of dizziness and feeling of fullness in the head within the first 24 hours after the operation was much lower than in the control group (p < 0.05). In the EA group, more patients had a better appetite than did the patients in group C (51.2% vs. 27.5%) (p < 0.05). The use of EA in neurosurgery patients improves the quality of postoperative analgesia, promotes appetite recovery and decreases some uncomfortable sensations, such as dizziness and feeling of fullness in the head.

scholarly journals Efficacy of Anesthetic Agents to Delay Pain Onset After Periodontal Surgery

2011 ◽  
Vol 58 (2) ◽  
pp. 57-60 ◽  
Author(s):  
Joao Paulo Steffens ◽  
Márcia Thaís Pochapski ◽  
Fábio André Santos ◽  
Gibson Luiz Pilatti
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Pain Perception ◽  
Clinical Signs ◽  
Periodontal Surgery ◽  
Anesthetic Agents ◽  
Parallel Group ◽  
Group 2 ◽  
Double Blinded ◽  
Group 1

Abstract The aim of this study was to evaluate the influence of 2 anesthetic agents on patients' postoperative pain perception after periodontal surgery. For this parallel-group, double-blinded, randomized clinical trial, 36 open flap debridement surgeries were performed on patients who presented with periodontal disease with clinical signs of inflammation after nonsurgical treatment on at least 1 quadrant. Patients were allocated to 1 of the following groups: group 1, 2% lidocaine with 1 ∶ 100,000 epinephrine; group 2, 2% mepivacaine with 1 ∶ 100,000 norepinephrine. Pain intensity was assessed using the visual analog scale during the first 8 hours after surgery. All patients received 750-mg acetaminophen tablets, which they were instructed to take as a rescue medication if necessary. The results demonstrated that postoperative pain intensity was statistically lower in group 2 than in group 1 at the 1-, 2-, and 3-hour periods after surgery, although the pain intensity for all groups could be considered mild. In conclusion, patients in both groups reported similar mild pain after periodontal surgery.

scholarly journals HTX-011 effectively reduces postoperative pain intensity and opioid use in the elderly

2021 ◽  
Author(s):  
Tina Yip ◽  
Jia Hu ◽  
Pamela S Hawn ◽  
Amy Yamamoto ◽  
Gary Oderda
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Elderly Patients ◽  
Pain Intensity ◽  
Local Anesthetic ◽  
Extended Release ◽  
The Elderly ◽  
Opioid Consumption ◽  
Opioid Use ◽  
Clinical Trial Registration

Aim: HTX-011 (ZYNRELEF™) is an extended-release, dual-acting local anesthetic containing bupivacaine and meloxicam. In bunionectomy and herniorrhaphy studies, HTX-011 resulted in less postoperative pain and less opioid consumption versus bupivacaine HCl. Here we evaluate HTX-011 in patients aged ≥65 years. Materials & methods: Patients received placebo, bupivacaine HCl or HTX-011 following surgery. End points included pain intensity, total opioid consumption, opioid-free patients and safety. Results: HTX-011-treated patients reported lower postoperative pain through 72 h versus bupivacaine HCl and placebo. Elderly patients administered HTX-011 used fewer opioids versus bupivacaine HCl, and a greater proportion remained opioid-free through 72 h. HTX-011 was well tolerated with a safety profile similar to bupivacaine HCl and placebo. Conclusion: HTX-011 maintained effectiveness and was well tolerated in elderly patients. Clinical Trial Registration: NCT03295721 and NCT03237481

scholarly journals The effect of oxycodone on postoperative pain and inflammatory cytokine release in elderly patients undergoing laparoscopic gastrectomy

2020 ◽  
Author(s):  
Wei-long Lao ◽  
Qi-liang Song ◽  
Zong-ming Jiang ◽  
Wen-di Chen ◽  
Xian-he Zheng ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Elderly Patients ◽  
Laparoscopic Gastrectomy ◽  
Rating Scale ◽  
Visceral Pain ◽  
Numerical Rating Scale ◽  
Pulmonary Inflammation ◽  
Postoperative Nausea And Vomiting ◽  
Numerical Rating ◽  
American Society

Abstract Background To evaluate the effect of oxycodone on postoperative pain and inflammation in elderly patients undergoing laparoscopic gastrectomy. Methods Sixty patients who were of both sexes, American Society of Anesthesiologists Physical Status (ASA-PS) Class I or II, over 65 years of age and undergoing an elective laparoscopic radical gastrectomy were randomly divided into two groups: an oxycodone group (Group O) and a sufentanil group (Group S). The postoperative analgesia regimen was as follows: 40 mg of parecoxib sodium and 0.1 mg/kg of oxycodone was intravenously injected into Group O before the abdomen closure, while 40 mg of parecoxib sodium and 0.1 μg/kg of sufentanil was injected intravenously into Group S. Both groups were infiltrated with 20 ml of 1% ropivacaine at the end of the operation. The concentrations of IL-6 and IL-10 were measured immediately after the operation and one hour, six hours and twenty-four hours after the operation (T1-4). The numerical rating scale (NRS), the Ramsay sedation score, analgesic-related adverse events, postoperative pulmonary inflammation events and the postoperative stay were recorded. Results Compared with Group S, the serum IL-6 concentrations of Group O decreased at T3 and T4, while the serum IL-10 concentrations increased (P < 0.05). In Group O, the serum IL-6 concentrations at T3 and T4 were lower than those at T1 (P < 0.05). The incidence of postoperative nausea and vomiting（PONV）and pulmonary inflammation in Group O was lower than that in Group S (P < 0.05). At each time point, the NRS of visceral pain in Group O was lower than that in Group S. At six and twenty-four hours after extubation, the NRS of incision pain in Group O was lower than that in Group S (P < 0.05). Conclusion Oxycodone can regulate the level of inflammatory cytokines and reduce postoperative inflammatory response.

Application of preoperative assessment of pain induced by venous cannulation in predicting postoperative pain in patients under laparoscopic nephrectomy: a prospective observational study 

2020 ◽  
Author(s):  
Fei Peng ◽  
Yanshuang Li ◽  
Yanqiu Ai ◽  
Jianjun Yang ◽  
Yanping Wang
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Prospective Observational Study ◽  
Preoperative Assessment ◽  
Laparoscopic Nephrectomy ◽  
Venous Cannulation ◽  
Rescue Analgesia ◽  
Intravenous Analgesia ◽  
Vas Scores ◽  
Response Group

Abstract Background: Postoperative pain is the most prominent concern among surgical patients. It has previously been reported that venous cannulation-induced pain (VCP) can be used to predict postoperative pain after laparoscopic cholecystectomy within 90 mins in the recovery room. Its potential in predicting postoperative pain in patients with patient-controlled intravenous analgesia (PCIA) is worth establishing. The purpose of this prospective observational study was to investigate the application of VCP in predicting postoperative pain in patients with PCIA during the first 24 h after laparoscopic nephrectomy.Methods: 120 patients scheduled for laparoscopic nephrectomy were included in this study. A superficial vein on the back of the hand was cannulated with a standard-size peripheral venous catheter (1.1×3.2 mm) by a nurse in the preoperative areas.Then the nurse recorded the VAS score associated with this procedure estimated by patients, and dichotomized the patients into low response group (VAS scores < 2.0) or high response group (VAS scores ≥ 2.0). After general anesthesia and surgery, all the patients received the patient-controlled intravenous analgesia (PCIA) with sufentanil. The VAS scores at rest and on coughing at 2 h, 4 h, 8 h, 12 h, 24 h, the effective number of presses and the number of needed rescue analgesia within 24 h after surgery were recorded. Results: Peripheral venous cannulation-induced pain score was significantly correlated with postoperative pain intensity at rest (rs = 0.64) and during coughing (rs = 0.65), effective times of pressing (rs = 0.59), additional consumption of sufentanil (rs = 0.58). Patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units reported higher levels of postoperative pain intensity at rest (P < 0.0005) and during coughing (P < 0.0005), needed more effective times of pressing (P < 0.0005) and additional consumption of sufentanil (P < 0.0005), and also needed more rescue analgesia (P = 0.01) during the first 24 h. The odds of risk for moderate or severe postoperative pain (OR 3.5, 95% CI 1.3-9.3) was significantly higher in patients with venous cannulation-induced pain intensity ≥ 2.0 VAS units compared to those < 2.0 VAS units. Conclusions: Preoperative assessment of pain induced by venous cannulation can be used to predict postoperative pain intensity in patients with PCIA during the first 24 h after laparoscopic nephrectomy.Trial registration: We registered this study in a Chinese Clinical Trial Registry (ChiCTR) center on July 6 2019 and received the registration number: ChiCTR1900024352.

scholarly journals Role of Ketamine in Multimodal Analgesia Protocol for Bariatric Surgery

Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 96 ◽  
Author(s):  
Greta Kasputytė ◽  
Aurika Karbonskienė ◽  
Andrius Macas ◽  
Almantas Maleckas
Keyword(s):  
Bariatric Surgery ◽  
Gastric Bypass ◽  
Side Effects ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Postoperative Analgesia ◽  
Multimodal Analgesia ◽  
Gastric Plication ◽  
Duration Of Surgery ◽  
Very High

Background and Objectives: Acute postoperative pain is one of the most undesirable experiences for a patient in the postoperative period. Many options are available for the treatment of postoperative pain. One of the methods of multimodal analgesia is a combination of opioids and adjuvant agents, such as ketamine. The aim of this study was to evaluate the effect of a pre-incisional single injection of low-dose ketamine on postoperative pain after remifentanil infusion in patients undergoing laparoscopic gastric bypass or gastric plication surgery. Materials and Methods: The prospective, randomized, double-blinded and placebo-controlled trial took place at the Hospital of the Lithuanian University of Health sciences KaunoKlinikos in 2015–2017. A total of 32 bariatric patients (9 men and 23 women) were randomly assigned to receive a single pre-incisional injection of ketamine (0.15 mg/kg (LBM)) (ketamine, K group) or saline (placebo, S group). Standardized protocol of anesthesia and postoperative pain management was followed for all patients. Postoperative pain intensity, postoperative morphine requirements, incidence of side effects and patients’ satisfaction with postoperative analgesia were recorded. Results: Thirty-two patients undergoing bariatric surgery: 18 (56.25%; gastric bypass) and 14 (43.75%; gastric plication) were examined. Both groups did not differ in demographic values, duration of surgery and anesthesia and intraoperative drug consumption. Postoperative pain scores were similar in both groups (p = 0.105–0.941). Morphine consumption was 10.0 (7.0–12.5 mg) in group S and 9.0 (3.0–15.0 mg) in group K (p = 0.022). The incidence of side effects was similar in both groups (p = 0.412). Both groups demonstrated very high satisfaction with postoperative analgesia. Conclusions: Pre-incisional single dose ketamine reduces postoperative opioids consumption, but does not have an effect of postoperative pain intensity and side effects after remifentanil infusions. Very high patient satisfaction is achieved if standard multimodal analgesia protocol with an individual assessment of pain and dosage of medications is followed.

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