scholarly journals Ankle Nerve Block Adjuvant to General Anesthesia Reduces Postsurgical Pain and Improves Functional Outcomes in Hallux Valgus Surgery

2018 ◽  
Vol 27 (3) ◽  
pp. 236-240 ◽  
Author(s):  
Mustafa C. Kir ◽  
Gulay Kir
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Hospital Stay ◽  
General Anesthesia ◽  
Hallux Valgus ◽  
Functional Outcomes ◽  
Length Of Hospital Stay ◽  
Postoperative Pain Management ◽  
Group A ◽  
Group B

Objective: Postoperative pain is a frequent problem after orthopedic procedures like hallux valgus surgery. The aim of this study was to evaluate whether ankle block improves early and mid-term functional outcomes and postoperative pain management after hallux valgus surgery in patients receiving general anesthesia. Subjects and Methods: This randomized controlled trial investigated 60 patients who underwent hallux valgus surgery under general anesthesia. Patients were prospectively randomized into 2 groups: general anesthesia only (group A) and ankle block added to general anesthesia (group B). Age, body-mass index, tourniquet time, duration of surgery, first analgesic need time, perioperative analgesic regimen, visual analog scale (VAS), American Orthopedic Foot and Ankle Score (AOFAS), and length of hospital stay were recorded. Independent variables were analyzed by t test. Nonparametric data were analyzed by the Mann-Whitney U test. Results: Patient age, demographics, and body mass indices were similar between the 2 groups. The average length of hospital stay was significantly longer in group A (p < 0.01). Group B had a longer time to first analgesic need than group A (p < 0.01). Patients in group B required less analgesic during the postoperative period. Preoperative VAS and AOFAS scores were not statistically dif ferent between the 2 groups. The postoperative day 1 VAS score was significantly lower in group B than in group A. Follow-up visits at 3, 6, and 12 months showed significantly lower VAS and higher AOFAS scores in group B than group A. Conclusion: Ankle block added to general anesthesia may improve early and mid-term postoperative functional outcomes and postoperative pain management in patients who undergo hallux valgus surgery.

scholarly journals A Comparison between Bupivacaine Alone and Bupivacaine with Tramadol in Epidural Block for Postoperative Pain Management

Esculapio ◽  
2021 ◽  
Vol 16 (4 (oct 2020 - dec 2020)) ◽  
Author(s):  
Saadia Khaleeq ◽  
Azib Ali ◽  
Sahir Shafiq ◽  
Muhammad Muazzam Butt ◽  
Mudassar Aslam ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Pain Score ◽  
Postoperative Pain Management ◽  
Epidural Block ◽  
Vas Score ◽  
Group A ◽  
The Mean ◽  
Group B

Objective: This study was designed to compare the mean pain score with bupivacaine versus tramadol plus bupivacaine in patients undergoing surgery under general anesthesia. Randomized Controlled Study. Anesthesia department of SIMS medical college/Services Hospital, Lahore. Duration is 13 months from 20th August2017 till 24th September 2018. Method: 80 patients aged 20-60 years of ASA I & II status, undergoing elective surgery were selected. Patients were randomly divided into two groups (Group A and B) of 40 each, using random numbers table. An epidural catheter was placed at L3-L4 intervertebral level. Group A was given 30 ml of 0.125% bupivacaine and Group B was given 25mg Tramadol plus 0.125% bupivacaine mixture in the same volume. General anesthesia was induced with IV Propofol 2mg/kg and atracurium 0.5mg/kg. After recovery from anesthesia, patients were shifted to HDU. Post-operative pain was assessed using the 10-point VAS score. Injection nalbuphine 0.1mg/kg was given as rescue analgesic when VAS score became more than 4. Results: The mean age of patient in Group A was 37.5 ± 9.1 years and 38.6 ± 7.0 years in Group B. Mean BMI in Group A was 33.2 ± 4.3 and 32.2 ± 4.2 in Group B. The mean pain score after 12 hours of surgery was 3.6 ± 0.8 in Group A and 1.5 ± 0.9 in Group B, p value was significant. Conclusion: Thus, the present study concludes that epidural administration of tramadol as adjuvant with bupivacaine is more effective in postoperative pain relief as compared to bupivacaine alone. Key Words: Bupivacaine, Epidural, Postoperative pain, Tramadol. How to Cite: Khaleeq S, Ali A, Shafiq S, Butt M M, Aslam M, Jehangir MU. A Comparison between Bupivacaine alone and Bupivacaine with Tramadol in epidural block for postoperative pain management. Esculapio.2021;17(1): page number. Esculapio.2020;16(04):101-104.

scholarly journals Epidural administration of ketamine or fentanyl with bupivacaine for postoperative analgesia – A comparative study

2014 ◽  
Vol 22 (1) ◽  
pp. 21-25
Author(s):  
Abdullah Al Maruf ◽  
Iqbal Hosain Chowdhury ◽  
Kazi Ashkar Lateef ◽  
Manzoorul Haq Laskar ◽  
Md Mustafa Kamal
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Epidural Administration ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea ◽  
Inguinal Surgery

The purpose of the study was to compare the analgesic effectiveness of epidural administration of ketamine mixed bupivacaine with fentanyl mixed bupivacaine in the management of postoperative pain. This prospective study was carried out in CMH, Bogra in one calendar year from July 2004 to June 2005. For postoperative pain management 100 patients of both sex, age ranging between 20 to 50 years, ASA physical status I and II scheduled for lower abdominal, pelvic and inguinal surgery were included in the study. All patients were divided into two groups. Epidural catheter was inserted in each patient through space between L3 to L2. Surgery was done under epidural anaesthesia in both groups. In group A (n=50) surgery was done with 0.5% bupivacaine and fentanyl (bupivacaine 1.5 ml/segment + fentanyl 2?g/ml). In group B (n=50) surgery was done with 0.5% bupivacaine and ketamine (bupivacaine 1.5ml/segment + ketamine 0.3mg/kg body weight). Epidural analgesia was continued in postoperative ward with 6 ml 0.25% bupivacaine + fentanyl 2?g/ml in group A and with 6 ml 0.25% bupivacaine + ketamine 0.3mg/kg bodyweight in group B, 4 hourly for 24 hours. The efficacy of analgesia was assessed by using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Mean VAS and mean VRS were less than 3 in both groups, which proved adequate postoperative analgesia. Differences of mean VAS and mean VRS between two groups were statistically not significant. Haemodynamic parameters, respiration and oxygenation were within normal range in both groups. Postoperative complications, like inadequate analgesia, post operative nausea and vomiting (PONV), headache and vertigo were less in both groups. It was observed that epidural administration of both bupivacaine mixed with ketamine and bupivacaine mixed with fentanyl found safe, effective and tolerable for postoperative pain management. DOI: http://dx.doi.org/10.3329/jbsa.v22i1.18097 Journal of BSA, 2009; 22(1): 21-25

scholarly journals SUCCESS OF PERCUTANEOUS NEPHROLITHOTOMY: COMPARING SPINAL ANESTHESIA WITH GENERAL ANESTHESIA

2015 ◽  
Vol 22 (2) ◽  
Author(s):  
Ari Astram ◽  
Ponco Birowo ◽  
Nur Rasyid ◽  
P Pryambodho ◽  
C Susilo
Keyword(s):  
Hospital Stay ◽  
General Anesthesia ◽  
Spinal Anesthesia ◽  
Average Length ◽  
Length Of Hospital Stay ◽  
General Anesthesia Group ◽  
Anesthesia Group ◽  
Group A ◽  
Group B ◽  
Surgery Duration

Objective: The purpose of this study compared the outcome of PCNL under general and spinal anesthesia for the outcome. Material & Methods: PCNL had been performed from 2000 until 2011 with total 760 PCNL divided into 220 PCNL using general anesthesia (Group A) and the remaining 540 PCNL using spinal anesthesia (Group B) The data of both groups were evaluated with Chi square test, and Mann-Whitney test. Result: Stone free rate in Group A was 71.37% similar with Group B 72.97% (p > 0.05). Spinal anesthesia was used more often in patient who had previous surgery 65.5% compared with general anesthesia 36.82% (p < 0.05). The average surgery duration in Group A was longer than group B (77.10 ± 35.59 minutes vs 68.42 ± 30.55 minutes) (p < 0.05). The average length of hospital stay in Group B was shorter than Group A (3.90 ± 2.72 days vs 5.47 ± 4.25 days) (p < 0.05). There was no difference between Group A and Group B in complication and the needs of tranfusion. Conclusion: PCNL under spinal anesthsia was feasible and safe even better in the shorter surgery duration and the length of hospital stay.

scholarly journals Role of intraperitoneal instillation of bupivacaine after laparoscopic cholecystectomy for post-operative pain management: a randomized controlled trial

2020 ◽  
Vol 7 (10) ◽  
pp. 3239
Author(s):  
Pramatha Nath Datta ◽  
Arijit Roy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Management ◽  
Hospital Stay ◽  
Rating Scale ◽  
Length Of Hospital Stay ◽  
Control Group ◽  
Rescue Analgesia ◽  
Group A ◽  
Group B

Background: Intra peritoneal (IP) local anaesthesia (LA) is a simple, cheap and safest method of providing post-operative (post-op) analgesia after laparoscopic cholecystectomy (LC). In this research, the role of intraperitoneal (IP) instillation of bupivacaine on post-op pain was studied. Post-op pain at 6, 12 and 24 hours was assessed using numeric rating scale. The degree of ambulation postoperatively at 6 and 24 hours and the requirement of analgesics was taken into account. The length of hospital stay was also a factor.Methods: A total of 76 patients during January 2018 to December 2018, undergoing LC, fitting the inclusion criteria were included randomly and divided in to two groups, bupivacaine group (B) and control group (A) based on a pre-generated random number sequence by the principal investigator. The surgical outcome was compared based on multiple parameters and the primary outcome measures were the post-op pain and analgesic requirement.Results: Degree of ambulation at 6 hours was significantly better in group B, compared to group A (p=0.008). The requirement of first dose of rescue analgesia was found to be within 6 hours (post-op) in 34 patients of group A (89.47%) as compared to 13 patients of group B (34.21%), was found to be statistically significant (p<0.001). There was statistically significant (p=0.002) difference with respect to length of hospital stay between the two groups.Conclusions: In our study we found that IP bupivacaine (0.5%) is an effective, economical, safe method of post-op pain management with better post-op recovery. 

scholarly journals Comparative evaluation of nebulised 3% saline versus nebulised 0.9% saline in the treatment of acute bronchiolitis

2019 ◽  
Vol 6 (3) ◽  
pp. 1182
Author(s):  
Pragalatha Kumar A. ◽  
Indhuja Rajarathinam ◽  
Aruna Gowdra
Keyword(s):  
Hospital Stay ◽  
Severity Score ◽  
Length Of Hospital Stay ◽  
Signs And Symptoms ◽  
Clinical Severity ◽  
Controlled Study ◽  
Acute Bronchiolitis ◽  
Clinical Severity Score ◽  
Group A ◽  
Group B

Background: Acute bronchiolitis is the most common respiratory tract infection in young children. Despite the high prevalence of acute bronchiolitis, no consensus exists on the management. Studies have shown that except oxygen therapy, no other treatment found to be effective. Hence, the present study was conducted to find out the efficacy of nebulised 3% saline versus is 0.9% saline for the treatment of acute bronchiolitis.Methods: A prospective randomized controlled study of 150 children between the age group of 2 months to 24 months with signs and symptoms of Acute Bronchiolitis admitted to Indira Gandhi Institute of Child Health, Bangalore from January 2016 to December 2016 formed the study group, they were randomized into 2 groups, one received 3% saline nebulization and the other received 0.9% saline.Results: A total of 150 children were enrolled in the study, 75 children (group A) received 0.9% saline and 75 children (group B) received 3% saline. At 24 hours, the mean clinical severity score for group A was 2.49±1.03 and group B was 2.16±0.49 (P=0.013). The duration of hospital stay was shorter (1-3 days) in 3% saline with a mean of 2.35 days and was longer (3-5 days) in 0.9% saline with mean value of 4.04 days which was statistically significant (p <0.001).Conclusions: 3% saline nebulization can be used as an effective treatment for acute bronchiolitis. It significantly reduced the clinical severity score and length of hospital stay compared to 0.9% normal saline.

scholarly journals Comparison of conventional fenestration discectomy with Transforaminal endoscopic lumbar discectomy for treating lumbar disc herniation:minimum 2-year long-term follow-up in 1100 patients

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Quanyi Li ◽  
Yongchun Zhou
Keyword(s):  
Hospital Stay ◽  
Lumbar Disc ◽  
Length Of Hospital Stay ◽  
Bed Rest ◽  
Intraoperative Blood Loss ◽  
Postoperative Length ◽  
Group A ◽  
Group B ◽  
Endoscopic Lumbar Discectomy

Abstract Purpose To compare the efficacy of conventional interlaminar fenestration discectomy (IFD) with transforaminal endoscopic lumbar discectomy (TELD) for treating lumbar disc herniation (LDH). Methods The clinical data of 1100 patients who had been diagnosed with LDH between January 2012 and December 2017 were retrospectively analysed. IFD was performed on 605 patients in Group A, whereas TELD was performed on 505 patients in Group B. The Oswestry Disability Index, Visual Analogue Scale for pain and modified MacNab criteria were used to evaluate the outcomes. The surgery duration, intraoperative blood loss, postoperative off-bed activity and postoperative length of hospital stay were recorded. Results The follow-up period ranged from 24 to 60 months, with an average of 43 months. The excellent and good outcome rates were 93.5% in Group A and 92.6% in Group B. There was no significant difference in efficacy between the groups (P > 0.05). However, Group B had significantly less intraoperative blood loss and shorter bed rest duration and postoperative length of hospital stay than Group A (P < 0.05). There were two cases of postoperative recurrence in Group A and three in Group B. Conclusions Although conventional IFD and TELD had similar levels of efficacy in treating LDH, TELD had several advantages. There was less intraoperative bleeding, shorter length of hospital stay and shorter bed rest duration. It can be considered a safe and effective surgical option for treating LDH.

The Effect of Preoperative Education on Postoperative Pain After Joint Surgery: An Integrative Literature Review

2017 ◽  
Vol 23 (1) ◽  
pp. 42-46 ◽  
Author(s):  
Mary Ashley Barry
Keyword(s):  
Total Knee Arthroplasty ◽  
Pain Management ◽  
Postoperative Pain ◽  
Literature Review ◽  
Knee Arthroplasty ◽  
Length Of Hospital Stay ◽  
Postoperative Pain Management ◽  
Postoperative Phase ◽  
Preoperative Education ◽  
Total Knee

As the number of total knee arthroplasty surgeries continues to increase and the length of hospital stay is trending down, preoperative education continues to be an important factor to support positive postoperative outcomes. The purpose of this literature review is to examine whether preoperative education for patients undergoing total knee arthroplasty affects postoperative pain management compared to those who do not receive this education. Findings from the literature review indicate that receiving preoperative education before a total knee arthroplasty does not impact pain management in the postoperative phase.

scholarly journals Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Lupi Lestari ◽  
Elizeus Hanindito ◽  
Arie Utariani
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Preemptive Analgesia ◽  
Acute Postoperative Pain ◽  
Numeric Rating

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

scholarly journals Adrenaline and Dexamethasone, vs Adrenaline and Fluticasone, vs Adrenaline alone in Bronchiolitis: A Randomized Controlled Trial

2020 ◽  
pp. 20-28
Author(s):  
Jayendra R. Gohil ◽  
Atul M. Sheladiya ◽  
N. B. Adithya ◽  
Ratna D. Bhojak
Keyword(s):  
Hospital Stay ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Length Of Hospital Stay ◽  
Primary Objective ◽  
Assessment Instrument ◽  
Clinical Severity ◽  
Group A ◽  
The Difference ◽  
Group B

Background and Objectives: There is no consensus over which drug best reduces symptoms in Bronchiolitis syndrome. The primary objective of our study is to establish comparative effect of adrenaline nebulisation alone and combination of adrenaline nebulisation plus injectable dexamethasone and adrenaline nebulisation plus fluticasone nebulisation in the treatment of clinical cases of bronchiolitis. Methods: 100 patients diagnosed clinically as bronchiolitis were enrolled in study from 1 month to 24 months of age. Patients were enrolled by purposive sampling. Patients with respiratory distress assessment instrument score [RDAI] of 4 to 15 were chosen, randomized into three groups and treatment given till patient fullfilled discharge criteria. Group A (n=33) were given nebulised adrenaline alone, Group B (n=34) were given nebulised adrenaline plus injectable dexamethasone and Group C (n=33) were given nebulised adrenaline plus nebulised fluticasone. Results: The mean reduction in clinical severity-RDAI score was 1.75 ±0.86 in Group A, 2.30 ± 0.68 in Group B and 1.42 ± 0.9 in Group C when measured in terms of difference in clinical scores between day 1 and 2 (p=0.0003). Mean duration of hospital stay in the group A was (4.93±1.95 days), Group C (4.78±1.83) and Group B (3.91 ±1.37 days). The difference of stay between the Groups A and B was 1.02±0.58 days vs 0.87± 0.46 days in groups B and C (p-0.0048). Reduction in the length of hospital stay in group B was 22% compared to Group A & 19% compared to Group C (p-0.0048). Side effects were tachycardia in six patients. Conclusion: Combination of adrenaline nebulization and injectable dexamethasone was found significantly better as compared to nebulised adrenaline plus nebulised fluticasone and nebulised adrenaline alone in patients of clinical bronchiolitis in reducing severity of clinical symptoms and duration of hospitalization.

scholarly journals Oral Oxycodone for Acute Postoperative Pain: A Review of Clinical Trials

2017 ◽  
Vol 2 (20;2) ◽  
pp. sE33-sE52 ◽  
Author(s):  
Chi-Wai Cheung
Keyword(s):  
Clinical Trials ◽  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Hospital Stay ◽  
Spine Surgery ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Acute Postoperative Pain

Background: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. Objectives: To evaluate the use of oral oxycodone for acute postoperative pain management. Study Design: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. Methods: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015. The search terms used were “oral strong opioids,” “postsurgical,” “postoperative,” “post-surgical,” and “postoperative.” Treatment interventions were compared for analgesic efficacy, rescue medication use, side effects, recovery, length of hospital stay, and patient satisfaction. Results: There were 26 clinical trials included in the review. Oral oxycodone showed superior postoperative analgesic efficacy compared with placebo in patients undergoing laparoscopic cholecystectomy, abdominal or pelvic surgery, bunionectomy, breast surgery, and spine surgery. When compared with intravenous opioids, oral oxycodone provided better or comparable pain relief following knee arthroplasty, spine surgery, caesarean section, laparoscopic colorectal surgery, and cardiac surgery. One study of dental postsurgery pain reported inferior pain control with oral oxycodone versus rofecoxib. (withdrawn from the US market due to cardiac safety concerns). In many studies, the demand for rescue analgesia and total opioid consumption were reduced in the oxycodone treatment arm. Patients receiving oral oxycodone experienced fewer opioid-related side effects than those on other opioids, and had a similar occurrence of postoperative nausea and vomiting as patients on placebo. Furthermore, oral oxycodone did not prolong hospital stay and was associated with lower drug costs compared with epidural and intravenous analgesics. Oxycodone administered as part of a multimodal analgesic regimen produced superior pain relief with fewer side effects and a reduced hospital stay. Limitation: There is a limited number of randomized double blinded studies in individual surgical operations, thus making it more difficult to come up with definitive conclusions. Conclusion: Oral oxycodone appears to offer safe and effective postoperative analgesia, and is a well-accepted and reasonable alternative to standard intravenous opioid analgesics. Key words: Postoperative, pain, analgesia, oral oxycodone, opioid

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