scholarly journals Analgesic Effects of Different κ-Receptor Agonists Used in Daytime Laparoscopic Cholecystectomy

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wanjun Zhou ◽  
Jiawu Wang ◽  
Chengyun Hu ◽  
Feibiao Dai ◽  
Zhetao Zhang ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visceral Pain ◽  
Pain Treatment ◽  
Morphine Group ◽  
Receptor Agonists ◽  
Analgesic Effects ◽  
Vas Scores ◽  
Prophylactic Use ◽  
Pain At Rest ◽  
Κ Receptor

Background. Comparing the effect of two different κ-receptor agonists, nalbuphine and oxycodone, and regular morphine in patients for prophylactic analgesia of acute pain after daytime laparoscopic cholecystectomy. Methods. One hundred and twenty-four patients undergoing laparoscopic cholecystectomy were randomly allocated to receive nalbuphine (group N), oxycodone (group O), and morphine (group M). The three groups were all given intravenous injection (iv.) of 0.15 mg/kg injection before incision and 0.05 mg/kg injection at the end of pneumoperitoneum. The Visual Analogue Scale (VAS) scores (incision, visceral, and shoulder) and Ramsay sedation scores at 1, 2, 4, 8, 12, 16, 20, and 24 hours after surgery, the time of extubation, the incidence of postoperative adverse events, the satisfaction of pain treatment, and the duration of stay after surgery were all recorded. Results. Compared with group M, the VAS scores of visceral pain at rest decreased in group N and group O at 1-8 h after surgery ( P < 0.05 ). The VAS scores of visceral pain at movement in group N decreased longer than those in group O ( P < 0.05 ). Compared with that of group M, the postoperative time in Ramsay sedation score of group O increased longer than that of group N ( P < 0.05 ). Compared with group N, patients had worse sleep quality in group O, longer length of stay in group M, and lower satisfaction in both groups. Conclusion. Compared with morphine, prophylactic use of the κ-receptor agonists, nalbuphine and oxycodone, during laparoscopic cholecystectomy can reduce postoperative visceral pain. Furthermore, the nalbuphine group had fewer adverse reactions, better analgesia, and better satisfaction.

scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2019 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Visceral Pain ◽  
Single Incision ◽  
Rectus Sheath ◽  
Ultrasound Guided ◽  
Rectus Sheath Block ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Vas Scores

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incision pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, butorphanol on postoperative analgesia in patients undergoing SILC. Methods: All 116 patients who met the criteria were randomly divided into four groups: (Ⅰ) (n=29) general anesthesia combined with patient controlled intravenous analgesia (PCIA) (sufentanil 100ug); (Ⅱ) (n=29) general anesthesia combined with PCIA (butorphanol 8mg); (Ⅲ) (n=29) ultrasound-guided RSB combined with PCIA (sufentanil 100ug). (Ⅳ) (n=29) RSB combined with PCIA (butorphanol 8mg). Outcomes included visual analog scale (VAS) scores of incisional and visceral pain at rest and cough at 2,6,12 and 24h postoperatively, if a patient’s pain score＞3, then butorphanol 2mg was administered intravenously. the dose of butorphanol and opioids, the pressing numbers of PCIA, the length of hospital stay and the incidence of postoperative adverse events. Results: Both rest and cough pain scores were lower during first 2,6 hours in group Ⅲ than groupⅠ, similarly, group Ⅳwas significantly lower than groupⅡ. GroupⅠneeded more butorphanol as rescue analgesic for pain relief than group Ⅲ, group Ⅳ was better than group Ⅱ. In the above pairwise comparisons, it was clear that group Ⅲ and group Ⅳ had lower VAS scores. VAS scores of visceral pain was lower in groupⅡ at 2, 6 and 12 h after surgery compared with the groupⅠ. In the both groups Ⅲ and Ⅳ, the group Ⅳ was also lower than groupⅢ. Overall, RSB combined with PCIA (butorphanol 8mg) is the best match. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC. Trial registration: The study was registered prospectively with the Chinese Clinical Trial Registry（reg no.ChiCTR1900020738), obtained ethics committee of Affiliated Hospital of Nantong University approval (approved number: 2018-K067).

scholarly journals Efficacy of ultrasound-guided rectus sheath block, butorphanol for single-incision laparoscopic cholecystectomy: A prospective, randomized, clinical trial

2019 ◽  
Author(s):  
Huimin Fu ◽  
Chaochao Zhong ◽  
Yongtao Gao ◽  
Xingguo Xu
Keyword(s):  
Clinical Trial ◽  
Laparoscopic Cholecystectomy ◽  
General Anesthesia ◽  
Visceral Pain ◽  
Single Incision ◽  
Rectus Sheath ◽  
Ultrasound Guided ◽  
Rectus Sheath Block ◽  
Single Incision Laparoscopic Cholecystectomy ◽  
Vas Scores

Abstract Background: Whether rectus sheath block (RSB) combined with butorphanol can relieve incision pain and visceral pain in patients undergoing single-incision laparoscopic cholecystectomy (SILC) remains unknown. The goal of this study was to assess the efficacy of ultrasound-guided bilateral RSB, butorphanol on postoperative analgesia in patients undergoing SILC. Methods: All 116 patients who met the criteria were randomly divided into four groups: (Ⅰ) (n=29) general anesthesia combined with patient controlled intravenous analgesia (PCIA) (sufentanil 100ug); (Ⅱ) (n=29) general anesthesia combined with PCIA (butorphanol 8mg); (Ⅲ) (n=29) ultrasound-guided RSB combined with PCIA (sufentanil 100ug). (Ⅳ) (n=29) RSB combined with PCIA (butorphanol 8mg). Outcomes included visual analog scale (VAS) scores of incisional and visceral pain at rest and cough at 2,6,12 and 24h postoperatively, if a patient’s pain score＞3, then butorphanol 2mg was administered intravenously. the dose of butorphanol and opioids, the pressing numbers of PCIA, the length of hospital stay and the incidence of postoperative adverse events. Results: Both rest and cough pain scores were lower during first 2,6 hours in group Ⅲ than groupⅠ, similarly, group Ⅳwas significantly lower than groupⅡ. GroupⅠneeded more butorphanol as rescue analgesic for pain relief than group Ⅲ, group Ⅳ was better than group Ⅱ. In the above pairwise comparisons, it was clear that group Ⅲ and group Ⅳ had lower VAS scores. VAS scores of visceral pain was lower in groupⅡ at 2, 6 and 12 h after surgery compared with the groupⅠ. In the both groups Ⅲ and Ⅳ, the group Ⅳ was also lower than groupⅢ. Overall, RSB combined with PCIA (butorphanol 8mg) is the best match. Conclusions: Ultrasound-guided RSB combined with butorphanol can provide sufficient pain treatment after SILC. Trial registration: The study was registered prospectively with the Chinese Clinical Trial Registry（reg no.ChiCTR1900020738), obtained ethics committee of Affiliated Hospital of Nantong University approval (approved number: 2018-K067).

scholarly journals New ibuprofen derivatives with thiazolidine-4-one scaffold with improved pharmaco-toxicological profile

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Ioana-Mirela Vasincu ◽  
Maria Apotrosoaei ◽  
Sandra Constantin ◽  
Maria Butnaru ◽  
Liliana Vereștiuc ◽  
...  
Keyword(s):  
Analgesic Effect ◽  
Visceral Pain ◽  
Biological Effects ◽  
Maximum Effect ◽  
Tail Flick ◽  
Paw Edema ◽  
Cell Viability Assay ◽  
Thermal Nociception ◽  
Analgesic Effects ◽  
Anti Inflammatory

Abstract Background Aryl-propionic acid derivatives with ibuprofen as representative drug are very important for therapy, being recommended especially for anti-inflammatory and analgesic effects. On other hand 1,3-thiazolidine-4-one scaffold is an important heterocycle, which is associated with different biological effects such as anti-inflammatory and analgesic, antioxidant, antiviral, antiproliferative, antimicrobial etc. The present study aimed to evaluated the toxicity degree and the anti-inflammatory and analgesic effects of new 1,3-thiazolidine-4-one derivatives of ibuprofen. Methods For evaluation the toxicity degree, cell viability assay using MTT method and acute toxicity assay on rats were applied. The carrageenan-induced paw-edema in rat was used for evaluation of the anti-inflammatory effect while for analgesic effect the tail-flick test, as thermal nociception in rats and the writhing assay, as visceral pain in mice, were used. Results The toxicological screening, in terms of cytotoxicity and toxicity degree on mice, revealed that the ibuprofen derivatives (4a-n) are non-cytotoxic at 2 μg/ml. In addition, ibuprofen derivatives reduced carrageenan-induced paw edema in rats, for most of them the maximum effect was recorded at 4 h after administration which means they have medium action latency, similar to that of ibuprofen. Moreover, for compound 4d the effect was higher than that of ibuprofen, even after 24 h of administration. The analgesic effect evaluation highlighted that 4 h showed increased pain inhibition in reference to ibuprofen in thermal (tail-flick assay) and visceral (writhing assay) nociception models. Conclusions The study revealed for ibuprofen derivatives, noted as 4 m, 4 k, 4e, 4d, a good anti-inflammatory and analgesic effect and also a safer profile compared with ibuprofen. These findings could suggest the promising potential use of them in the treatment of inflammatory pain conditions.

scholarly journals Oxycodone versus morphine for analgesia after laparoscopic endometriosis resection

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lijun Niu ◽  
Lihong Chen ◽  
Yanhua Luo ◽  
Wenkao Huang ◽  
Yunsheng Li
Keyword(s):  
Respiratory Depression ◽  
Visceral Pain ◽  
Deep Infiltrating Endometriosis ◽  
Trial Registry ◽  
Clinical Trial Registry ◽  
Morphine Group ◽  
Registration Number ◽  
To Receive ◽  
Registry Record ◽  
Infiltrating Endometriosis

Abstract Background The objective of this study was to compare the analgesic potency of oxycodone versus morphine after laparoscopic deep infiltrating endometriosis resection. Methods Fifty patients undergoing laparoscopic deep infiltrating endometriosis resection were randomized to receive oxycodone or morphine intravenous-PCA after surgery. The primary outcome was opioid consumption during the 24 h after surgery. Secondary outcomes included time to first request for analgesia, the number of bolus, pain, sedation, nausea, vomiting, respiratory depression, and bradycardia. The prominent pain that caused patients to press the analgesic device was also recorded. Results Oxycodone consumption (14.42 ± 2.83) was less than morphine consumption (20.14 ± 3.83). Compared with the morphine group, the total number of bolus (78 vs 123) was less and the average time to first request for analgesia (97.27 ± 59.79 vs 142.17 ± 51) was longer in the oxycodone group. The incidence of nausea was higher in the morphine group than in the oxycodone group at 0–2 h (45.45% vs 17.19%), 2–4 h (50% vs 17.19%),12–24 h (40.91% vs 13.04%) and 0–24 h (39.17% vs 19.13%). The overall incidence of vomiting was higher in the morphine group (27.27% vs 13.92%). There was no difference in visual analogue scale score, the incidence of respiratory depression, and bradycardia between groups. Of the three types of pain that prompted patients to request analgesia, the incidence of visceral pain was highest (59.9%, P < 0.01). Conclusion Oxycodone was more potent than morphine for analgesia after laparoscopic endometriosis resection, and oxycodone has fewer side effects than morphine. Name of the registry: Chinese Clinical Trial Registry Trial registration number: ChiCTR1900021870 URL of trial registry record:http://www.chictr.org.cn/edit.aspx?pid=35799&htm=4 Date of registration: 2019/3/13 0:00:00

scholarly journals Movement-Evoked Pain Versus Pain at Rest in Postsurgical Clinical Trials and Meta-Analyses: Protocol for a Follow-Up Systematic Review

10.2196/15309 ◽  
2020 ◽  
Vol 9 (1) ◽  
pp. e15309
Author(s):  
Daenis Camiré ◽  
Jason Erb ◽  
Henrik Kehlet ◽  
Timothy Brennan ◽  
Ian Gilron
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Postoperative Pain ◽  
Primary Outcome ◽  
Outcome Measure ◽  
Pain Treatment ◽  
Pain Outcome ◽  
Meta Analyses ◽  
Pain At Rest

Background Postoperative pain is one of the most prevalent and disabling complications of surgery that is associated with personal suffering, delayed functional recovery, prolonged hospital stay, perioperative complications, and chronic postsurgical pain. Accumulating evidence has pointed to the important distinction between pain at rest (PAR) and movement-evoked pain (MEP) after surgery. In most studies including both measures, MEP has been shown to be substantially more severe than PAR. Furthermore, as MEP is commonly experienced during normal activities (eg, breathing, coughing, and walking), it has a greater adverse functional impact than PAR. In a previous systematic review conducted in 2011, only 39% of reviewed trials included MEP as a trial outcome and 52% failed to identify the pain outcome as either PAR or MEP. Given the recent observations of postsurgical pain trials that continue to neglect the distinction between PAR and MEP, this updated review seeks to evaluate the degree of progress in this area. Objective This updated review will include postsurgical clinical trials and meta-analyses in which the primary outcome was early postoperative pain intensity. The primary outcome for this review is the reporting of MEP (vs PAR) as an outcome measure for each trial and meta-analysis. Secondary outcomes include whether trials and meta-analyses distinguished between PAR and MEP. Methods To be consistent with the 2011 review that we are updating, this review will again focus on randomized controlled trials and meta-analyses, from Medical Literature Analysis and Retrieval System Online and EMBASE databases, focusing on pain treatment after thoracotomy, knee arthroplasty, and hysterectomy in humans. Trials and meta-analyses will be characterized as to whether or not they assessed PAR and MEP; whether their pain outcome acknowledged the distinction between PAR and MEP; and, for trials assessing MEP, which pain-evoking maneuver(s) were used. Results Scoping review and pilot data extraction are under way, and the results are expected by March 2020. Conclusions It is our belief that every postsurgical analgesic trial should include MEP as an outcome measure. The previous 2011 review was expected to have an impact on more widespread assessment of MEP in subsequent postoperative pain treatment trials. Thus, the purpose of this follow-up review is to reevaluate the frequency of use of MEP as a trial outcome, compared with PAR, in more recently published postoperative pain trials. Trial Registration PROSPERO CRD42019125855; https://tinyurl.com/qw9dty8 International Registered Report Identifier (IRRID) DERR1-10.2196/15309

scholarly journals Lactoferrin and Its Potential Impact for the Relief of Pain: A Preclinical Approach

2021 ◽  
Vol 14 (9) ◽  
pp. 868
Author(s):  
Beatriz Godínez-Chaparro ◽  
Fabiola Guzmán-Mejía ◽  
Maria Elisa Drago-Serrano
Keyword(s):  
Pain Treatment ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Kidney Injury ◽  
Analgesic Efficacy ◽  
Intestinal Bleeding ◽  
Ulcer Formation ◽  
Analgesic Effects ◽  
Density Lipoprotein Receptor ◽  
Anti Inflammatory

Pain is one of the most disabling symptoms of several clinical conditions. Neurobiologically, it is classified as nociceptive, inflammatory, neuropathic and dysfunctional. Opioids and nonsteroidal anti-inflammatory drugs (NSAIDs) are conventionally prescribed for the treatment of pain. Long-term administration of opioids results in the loss of analgesic efficacy, leading to increased dosage, tolerance, and addiction as the main drawbacks of their use, while the adverse effects of NSAIDs include gastric ulcer formation, intestinal bleeding, acute kidney injury, and hepatotoxicity. Lactoferrin is an iron-binding, anti-inflammatory glycoprotein that displays analgesic activities associated, in part, by interacting with the low-density lipoprotein receptor-related protein (LRP), which may result in the regulation of the DAMP–TRAF6–NFκB, NO–cGMP–ATP K+-sensitive channel and opioid receptor signaling pathways. This review summarizes and discusses for the first time the analgesic effects of lactoferrin and its presumable mechanisms based on pre-clinical trials. Given its anti-nociceptive and anti-inflammatory properties, lactoferrin may be used as an adjunct to enhance the efficacy and to decrease the tolerogenic effects of canonical therapeutic drugs prescribed for pain treatment.

Rabbit vas deferens: A specific bioassay for opioid κ-receptor agonists

1981 ◽  
Vol 73 (2-3) ◽  
pp. 235-236 ◽  
Author(s):  
Tetsuo Oka ◽  
Kazuko Negishi ◽  
Mitsuaki Suda ◽  
Teruhiko Matsumiya ◽  
Toshiyuki Inazu ◽  
...  
Keyword(s):  
Vas Deferens ◽  
Receptor Agonists ◽  
Rabbit Vas Deferens ◽  
Κ Receptor

QUADRATUS LUMBORUM BLOCK IN PATIENTS OF LAPAROSCOPIC CHOLECYSTECTOMY FOR POSTOPERATIVE ANALGESIA

2021 ◽  
pp. 187-189
Author(s):  
Garima Anant ◽  
Aman Kaur ◽  
Prakriti Prakriti
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Study Data ◽  
Detailed History ◽  
Quadratus Lumborum Block ◽  
Post Operative Pain ◽  
Quadratus Lumborum ◽  
Fentanyl Consumption ◽  
Vas Scores ◽  
Group 2 ◽  
Group 1

Background: Quadratus lumborum block is done ultrasonographically in thoracolumbar fascial plane at the level of quadratus lumborum muscle to decrease post-operative pain in patients who underwent laparoscopic cholecystectomy . Methods: A prospective, randomized and comparative study was conducted in Pt. B.D. Sharma PGIMS, Rohtak. After informed and written consent, patients were recruited in the study and assigned into 2 groups. A detailed history was taken and examination was carried out. Group 1 patients received Inj.. diclofenac IM (intramuscular) 75 mg and in group 2 Bilateral QL (quadratus lumborum) block was given using 15 ml of 0.25 percent levobupivacaine. The results were measured by VAS score and 24hrs fentanyl consumption. At the end of the study, data was compiled and analyzed using SPSS version 17. Results: In the present study, there was no statistical signicant difference between the two groups. We found that the patients who received quadratus lumborum block had lesser fentanyl consumption and the VAS scores were also better.

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