Comparison of the effects of buprenorphine and methadone in combination with medetomidine followed by intramuscular alfaxalone for anaesthesia of cats undergoing ovariohysterectomy

Objectives The aim of this study was to compare the quality of anaesthesia and analgesia between methadone and buprenorphine in combination with medetomidine after induction with intramuscular (IM) alfaxalone in cats undergoing ovariohysterectomy. Methods Fifty-one female cats (American Society of Anesthesiologists status I–II), with a median age of 12 months (range 2–60 months), weighing a mean ± SD of 2.5 ± 0.5 kg, were recruited to the study. Cats were randomly allocated to receive medetomidine (600 µg/m2) and buprenorphine (180 µg/m2) (group MB) or medetomidine (500 µg/m2) and methadone (5 mg/m2) (group MM) IM. Anaesthesia was induced 15 mins later using alfaxalone (3 mg/kg) IM. Anaesthesia was maintained with isoflurane in oxygen. All cats received meloxicam preoperatively. Quality of premedication and induction and intraoperative physiological parameters were recorded. Atipamezole (50% of medetomidine dose) was administered at the end of surgery. Cats were assessed postoperatively by the same blinded observer using a simple descriptive scale, numeric rating scale, dynamic interactive visual analogue scale (DIVAS) and UNESP-Botucatu multidimensional composite pain scales, at 10, 20 and 30 mins post-extubation. Parametric and non-parametric data were compared using Student’s t-test or Mann–Whitney U-tests, respectively. Results Forty-one cats completed the study. No significant differences were detected between groups before or during anaesthesia. No cats required rescue analgesia. DIVAS scores at 10 mins were significantly less in the MM group compared with the MB. No differences between groups at any other time points were detected using the four metrology instruments. Conclusions and relevance Both protocols provided good anaesthesia conditions for ovariohysterectomy in the cat.

Download Full-text

Predictors of Successful Early Discharge for Total Hip and Knee Arthroplasty in Octogenarians

HSS Journal ® ◽

10.1177/15563316211030631 ◽

2021 ◽

pp. 155633162110306

Author(s):

Andrew B. Kay ◽

Danielle Y. Ponzio ◽

Courtney D. Bell ◽

Fabio Orozco ◽

Zachary D. Post ◽

...

Keyword(s):

Range Of Motion ◽

Knee Arthroplasty ◽

Early Discharge ◽

Readmission Rates ◽

Patients Âgés ◽

Total Hip ◽

Hip And Knee Arthroplasty ◽

Student’S T ◽

American Society ◽

American Society Of Anesthesiologists

Background: Decreased length of stay after total joint arthroplasty (TJA) is becoming a more common way to contain healthcare costs and increase patient satisfaction. There is little evidence to support “early” discharge in elderly patients. Purpose: We sought to identify preoperative factors that correlated with early discharge (by postoperative day [POD] 1) in comparison to late discharge (after POD2) in octogenarians after TJA. Methods: In a retrospective cohort study from a single institution, we identified 482 patients ages 80 to 89 who underwent primary TJA from January 2014 to December 2017; 319 had total knee arthroplasty (TKA) and 163 had total hip arthroplasty (THA). Data collected included preoperative knee range of motion (ROM), demographics, and comorbidities; 90-day readmission and mortality rates were also evaluated. P values for continuous data were calculated using student’s t test and for categorical data using χ2 testing. Results: Of octogenarian patients, 30.9% were discharged by POD1. Early discharge was associated with being male, married, and nonsmoking, as well as having an American Society of Anesthesiologists (ASA) score of 2, independent preoperative ambulation, and a postoperative caregiver. Type of procedure (TKA vs THA), body mass index, laterality, preoperative range of motion (ROM) for TKA, and single vs multilevel home did not affect the probability of early discharge. Discharge on POD1 was not associated with increased 90-day readmission rates. There were no deaths. Conclusion: Early discharge for octogenarians can be successfully implemented in a select subset of patients without increasing 90-day readmission or death rates. There are multiple factors that predict successful early discharge.

Download Full-text

A Comparison of Behavioral Pain Scales to the Numeric Rating Scale in a Post Anesthesia Care Setting

Journal of PeriAnesthesia Nursing ◽

10.1016/j.jopan.2013.04.139 ◽

2013 ◽

Vol 28 (3) ◽

pp. e48-e49 ◽

Cited By ~ 1

Author(s):

Debra Marshall ◽

Scarlette Evans-Harrop ◽

Pamela Beacham ◽

Tonya Gryniv-Chavis ◽

Janet Stevens ◽

...

Keyword(s):

Care Setting ◽

Rating Scale ◽

Numeric Rating Scale ◽

Anesthesia Care ◽

Pain Scales ◽

Numeric Rating

Download Full-text

Painful diabetic polyneuropathy and quality of life in Danish type 2 diabetic patients

Scandinavian Journal of Pain ◽

10.1016/j.sjpain.2017.04.026 ◽

2017 ◽

Vol 16 (1) ◽

pp. 173-173 ◽

Cited By ~ 4

Author(s):

Sandra Sif Gylfadottir ◽

Diana Hedevang Christensen ◽

Sia Kromann Nicolaisen ◽

Reimar Wernich Thomsen ◽

Jens Steen Nielsen ◽

...

Keyword(s):

Quality Of Life ◽

Pain Intensity ◽

Rating Scale ◽

Diabetic Polyneuropathy ◽

Numeric Rating Scale ◽

Diabetic Patients ◽

Type 2 Diabetic Patients ◽

Type 2 Diabetic

Abstract Background and aims Painful polyneuropathy (PPN) is a disabling complication of diabetes. This study aims to determine its prevalence and relationship with Quality of Life (QoL) in a nationwide prospective cohort of incident recently diagnosed Danish type 2 diabetic patients. Methods We sent a detailed questionnaire on neuropathy, pain and QoL to 6726 patients prospectively enrolled from general practitioners and hospital specialist outpatient clinics into the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients who reported pain in both feet and a score ≥3 on the Douleur Neuropathique (DN4) questionnaire were considered to have possible PPN. QoL and pain intensity were measured on a numeric rating scale (NRS, 0–10). The Michigan Neuropathy Screening Instrument (MNSI) was used to assess neuropathy. Results A total of 5371 (79.8%) returned a complete questionnaire. 848 (15.8%) recently diagnosed type 2 diabetic patients reported pain in both feet. Of the 619 patients with pain who completed the DN4 questionnaire, 404 (65.2%) had a DN4 score ≥ 3, corresponding to a prevalence in the total population of possible PPN of 10.3%. Mean pain intensity was 5.2 (SD 2.2) and 89% had a MNSI score ≥ 3. Patients with possible PPN had a substantially lower QoL score than those without PPN (median QoL score 6 versus 8 (p < 0.001)), also when correcting for MNSI score. Conclusions Ten percent of newly diagnosed type 2 diabetic patients in Denmark had possible PPN. Patients with PPN had lower QoL than patients without PPN.

Download Full-text

Effectiveness of mebeverine in patients with post-cholecystectomy gastrointestinal spasm: results of prospective observational program “odyssey”

Terapevticheskii arkhiv ◽

10.26442/terarkh201890840-47 ◽

2018 ◽

Vol 90 (8) ◽

pp. 40-47 ◽

Cited By ~ 1

Author(s):

I V Maev ◽

Yu A Kucheravy ◽

V V Tsukanov ◽

E Yu Eremnia ◽

D N Andreev ◽

...

Keyword(s):

Quality Of Life ◽

Abdominal Pain ◽

Surgical Treatment ◽

Rating Scale ◽

Clinical Symptoms ◽

Gastrointestinal Symptoms ◽

Marked Change ◽

Numeric Rating Scale ◽

Observational Assessment

Aim: to assess the effectiveness of mebeverine 200 mg BID in patients with post-cholecystectomy gastrointestinal spasm not requiring surgical treatment. Materials and methods. 218 patients were included in 16 clinical centers in 14 cities in Russia. All patients had post-cholecystectomy gastrointestinal spasms, not requiring surgical treatment and received mebeverine (Duspatalin®) 200 mg BID. The observational assessment period lasted from the moment of their inclusion into the study up to 6 weeks post inlusion. The therapy results were evaluated using visual analog scales (GPA and 11-point numeric rating scale) by patient self-assessment of the dynamics of spasm/discomfort and other post-cholecystectomic gastrointestinal symptoms after 2 and 6 weeks of treatment. Gastrointestinal Quality of Life Index (GIQLI) was used to assess patient quality of life. Results and discussion. All 218 patients completed the 2-week mebeverine treatment course, 101 of them finished the 6-week course (“prolonged population”). Significant positive changes in the relief of abdominal pain and dyspepsia were noted as well as normalization of stool frequency and consistency. A more marked change in values was observed during prolonged (up to 6 weeks) therapy. Both 2-week and 6-week mebeverine courses led to a normalization of patient quality of life. After 6 week therapy, an effect of mebeverine on the quality of life 91% of patients was observed comparable to cholecystectomy itself, speficially related to the quality of life subscore ‘symptoms’. Conclusion. The results of our study demonstrate that mebeverine (Duspatalin®) therapy leads to an effective elimination of clinical symptoms associated with post-cholecystectomy GI-spasm disorders, like abdominal pain, symptoms of dyspepsia and stooldisorders. A more marked change in values was observed during prolonged (up to 6 weeks) therapy.

Download Full-text

Post-caesarean section pain and quality of sleep among mothers who delivered by caesarean section under spinal anesthesia

Malahayati International Journal of Nursing and Health Science ◽

10.33024/minh.v3i2.3473 ◽

2021 ◽

Vol 3 (2) ◽

pp. 110-116

Author(s):

Ririn Harini ◽

Juwitasari Juwitasari ◽

Lilis Setyowati ◽

Rifdah Dita Oktavia

Keyword(s):

Caesarean Section ◽

Sleep Quality ◽

Rating Scale ◽

Healing Process ◽

Numeric Rating Scale ◽

Wound Healing Process ◽

P Value ◽

Poor Sleep ◽

Pain Level

Background: Post caesarean section mothers commonly feel pain in the post-operative area during the wound healing process. Most post-operative mothers feel the pain sensation as a disturbance and lowering their quality of sleep.Purpose: To determine pain level and identify the relationship of pain level and sleep quality among mothers who delivered by caesarean section under spinal anaesthesia.Method: The descriptive non-experimental correlative study design identified 50 mothers from Inpatient Ward Wava Husada Hospital of Kepanjen, Malang, East Java, Indonesia at April 2020. The Post-caesarean section pain level identified by using the Numeric Rating Scale (NRS) and the sleep quality is measured using Pittsburgh Sleep Quality Index (PSQI) questionnaire.Results: 38 mothers (76%) had severe pain level and most of them (43 mothers) had poor sleep quality. The Spearman correlation test showed that there was a relationship between the Post-caesarean section pain level and sleep quality, p value = 0.000 (p <0.05) and r = 0.314.Conclusion: The post-caesarean section pain levels among mothers who delivered by caesarean section under spinal anaesthesia should be identified earlier as we would like to encourage the nursing staff to give further intervention to maintain their sleep quality.

Download Full-text

Erector spine plane block as postoperative rescue analgesia in thoracic surgery

Tumori Journal ◽

10.1177/0300891620915783 ◽

2020 ◽

Vol 106 (5) ◽

pp. 388-391

Author(s):

Marco Rispoli ◽

Roberta Tamburri ◽

Moana Rossella Nespoli ◽

Marianna Esposito ◽

Dario Maria Mattiacci ◽

...

Keyword(s):

Thoracic Surgery ◽

Rating Scale ◽

Dynamic Assessment ◽

Case Series ◽

Blood Gas Analysis ◽

Numeric Rating Scale ◽

Forced Expiratory Volume ◽

Gas Analysis ◽

Rescue Analgesia ◽

Surgical Ward

Objective: Erector spine plane block (ESPB) is a newly defined regional anesthesia technique performed by injection of local anesthetic beneath the erector spine muscle. We tested ESPB as a regional rescue analgesia bedside technique to be performed in the thoracic surgical ward, reporting a 7-patient case series. Methods: We report our experience in rescue analgesia after thoracic surgery. During the postoperative stay, numeric rating scale (NRS) score >3 and inability to perform physiotherapy or effective cough due to postoperative pain represented the criteria for proposing rescue analgesia with ESPB. NRS at rest and during movements was recorded; blood gas analysis and spirometry were performed to evaluate PaO2/FiO2 (P/F), forced vital capacity (FVC), and forced expiratory volume in 1 second (FEV1) before ESPB execution. After performing the ESPB, static and dynamic NRS, P/F, and FVC and FEV1 were recorded at 40 minutes and 80 minutes. Results: NRS had a reduction at rest and in dynamic assessment. The P/F did not improve but spirometric measures improved. FVC had a relevant improvement only after 80 minutes; FEV1 was increased after 40 minutes. Conclusion: The use of ESPB as postoperative rescue analgesia can offer several advantages due to effective rescue analgesia and safety that makes it easy to perform in the thoracic surgical ward or in an outpatient clinic setting.

Download Full-text

Effect of Pregabalin on Radiotherapy-Related Neuropathic Pain in Patients With Head and Neck Cancer: A Randomized Controlled Trial

Journal of Clinical Oncology ◽

10.1200/jco.18.00896 ◽

2019 ◽

Vol 37 (2) ◽

pp. 135-143 ◽

Cited By ~ 8

Author(s):

Jingru Jiang ◽

Yi Li ◽

Qingyu Shen ◽

Xiaoming Rong ◽

Xiaolong Huang ◽

...

Keyword(s):

Quality Of Life ◽

Adverse Event ◽

Neuropathic Pain ◽

Rating Scale ◽

Short Form ◽

Controlled Trial ◽

Numeric Rating Scale ◽

Mood States ◽

Numeric Rating

Purpose Neuropathic pain is an unavoidable treatment-related adverse event among patients with head and neck cancer who are undergoing radiotherapy. We aimed to test the efficacy and safety of pregabalin versus placebo in the treatment of radiotherapy-related neuropathic pain. Patients and Methods This randomized, double-blind, placebo-controlled trial was conducted in four centers in China. Eligible patients with a mean pain intensity score of 4 or more on an 11-point numeric rating scale were randomly assigned to receive either active treatment with a flexible dose of pregabalin or placebo for 16 weeks. The primary efficacy outcome was pain reduction measured on the numeric rating scale. Result There were 128 patients who received treatment as randomly assigned. Pain intensity reduction was 2.44 in the pregabalin arm and 1.58 in the placebo arm at week 16, yielding an adjusted mean difference of 0.87 (95% CI, 0.30 to 1.44; P = .003). In the pregabalin arm, 38 patients (59.4%) achieved at least 30% pain relief versus 21 (32.8%) in the placebo arm ( P = .006). Nineteen patients (29.7%) in the pregabalin group and five (7.8%) in the placebo group achieved 50% or greater pain relief ( P = .003). Total scores on the Profile of Mood States-Short Form, pain severity and functional interference of Brief Pain Inventory-Short Form, as well as the physiology and psychology domain of the WHO Quality of Life-BREF all were reduced significantly at week 16 in patients who received pregabalin compared with those who received placebo. There was no significant difference ( P = .29) in the incidence of experiencing at least one adverse event in the pregabalin arm (n = 35; 54.7%) versus the placebo arm (n = 29; 45.3%). Conclusion Patients treated with pregabalin with radiotherapy-related neuropathic pain had greater pain alleviation, better mood states, and higher quality of life compared with patients in the placebo group, with a good tolerability.

Download Full-text

Extended Duration Regional Analgesia for Total Knee Arthroplasty: A Randomised Controlled Trial Comparing Five Days to Three Days of Continuous Adductor Canal Ropivacaine Infusion

Anaesthesia and Intensive Care ◽

10.1177/0310057x1804600311 ◽

2018 ◽

Vol 46 (3) ◽

pp. 326-331 ◽

Cited By ~ 5

Author(s):

S. C. Sargant ◽

M. J. Lennon ◽

R. J. Khan ◽

D. Fick ◽

H. Robertson ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Rating Scale ◽

Intervention Group ◽

Numeric Rating Scale ◽

Secondary Outcome ◽

Quality Of Recovery ◽

Adductor Canal ◽

Total Knee ◽

Numeric Rating

There is a growing body of evidence in favour of continuous adductor canal block (CACB) for total knee arthroplasty. However, there are no studies describing the optimal duration of the infusion. At our institution the usual practice was to stop the infusion on day three. Our hypothesis was that extending the infusion to five days would improve analgesia and quality of recovery. A prospective, non-blinded, randomised trial was undertaken. Patients received a continuous infusion of 0.2% ropivacaine via an adductor canal catheter for either three or five days. Primary outcome was pain while walking during the 24-hour period up to day five (numeric rating scale from 0 to 10). The minimum clinically important difference was set at 1.5 on the numeric rating scale. Secondary outcome measures included quality of recovery, mobility, pain while walking on postoperative day six, Oxford Knee Scores, and complications. Eighty-six patients were recruited with 43 randomised to each group. Seventy-eight were analysed. Median pain scores reported on day five were significantly better in the intervention group (1 versus 3, P=0.003). Furthermore, quality of recovery (QOR-15) scores were significantly better in the intervention group (133.6 versus 123.4, P=0.017). No statistically significant difference between groups was identified for other secondary outcome measures. CACB prolonged to five days provides superior analgesia and a higher quality of recovery on postoperative days four and five compared to a three-day infusion. This benefit did not extend beyond the period of infusion.

Download Full-text