scholarly journals Epidurinės nejautros poveikis skausmo malšinimui ir žarnyno funkcijos atsitaisymui po gaubtinės ir tiesiosios žarnos rezekcijos

2008 ◽  
Vol 6 (3) ◽  
pp. 0-0
Author(s):  
Renatas Tikuišis ◽  
Povilas Miliauskas ◽  
Narimantas Evaldas Samalavičius ◽  
Giedrė Rudinskaitė
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Colorectal Surgery ◽  
Epidural Analgesia ◽  
Colorectal Resection ◽  
Solid Food ◽  
Postoperative Pain Relief ◽  
Control Group ◽  
Narcotic Analgesics ◽  
Open Colorectal Resection

Renatas Tikuišis, Povilas Miliauskas, Narimantas Evaldas Samalavičius, Giedrė RudinskaitėVilniaus universiteto Onkologijos institutas, Santariškių g. 1, LT-08660 VilniusEl paštas: [email protected] Įvadas / tikslas Palyginti su sistemine analgezija opiatais, atliekant atviras gaubtinės ir tiesiosios žarnos operacijas, epidurinė nejautra efektyviau malšina skausmą ir ją sukėlus sumažėja pooperacinio žarnų nepraeinamumo dažnis. Šio tyrimo tikslas – nustatyti epidurinės analgezijos poveikį skausmo malšinimui ir žarnyno funkcijos atsitaisymui po gaubtinės ir tiesiosios žarnos operacijų. Ligoniai ir metodai Tyrime dalyvavo 50 ligonių, kuriems buvo atlikta gaubtinės arba tiesiosios žarnos rezekcija. Tai buvo perspektyvusis tyrimas, kuris truko dvejus metus. Atsitiktinės atrankos būdu ligoniai buvo suskirstyti į tiriamąją (T) ir kontrolinę (K) grupes. Po 25 ligonius pateko į kiekvieną grupę. T grupės ligoniams buvo taikyta epidurinė nejautra, o K grupės – švirkščiami narkotiniai analgetikai į veną ir penkis raumenis. Buvo vertinamas narkotinių analgetikų suvartojimas, skausmo intensyvumas po operacijos, žarnyno funkcijos atsitaisymo laikas ir laikas, kai ligonis pradėjo vartoti kietą maistą. Rezultatai Abi grupės pagal operacijos apimtį ir ligonių charakteristiką buvo labai panašios. T grupės ligoniams reikėjo mažiau narkotinių analgetikų, jiems skausmo intensyvumas buvo mažesnis, jų žarnyno veikla atsitaisė anksčiau ir jie anksčiau pradėjo vartoti kietą maistą, palyginti su K grupės ligoniais. Išvada Epidurinės analgezijos metodas yra pranašesnis už intraveninį skausmo malšinimo metodą, taip pat mažiau suvartojama narkotinių analgetikų. Epidurinė analgezija pagreitina žarnyno funkcijos atsitaisymą, todėl ligoniai anksčiau pradeda valgyti kietą maistą po atvirų gaubtinės ir tiesiosios žarnos operacijų. Reikšminiai žodžiai: epidurinė analgezija, intraveninė analgezija, gaubtinės žarnos rezekcija, tiesiosios žarnos rezekcija Influence of epidural analgesia on postoperative pain relief and gastrointestinal recovery after colorectal resection Renatas Tikuišis, Povilas Miliauskas, Narimantas Evaldas Samalavičius, Giedrė RudinskaitėVilnius University, Institute of Oncology, Santariškių str. 1, LT-08660 Vilnius, LithuaniaE-mail: [email protected] Backgound / objective Epidural analgesia provides superior analgesia with a lower incidence of postoperative ileus as compared with systemic opiate analgesia in open colorectal surgery. The aim of this study was to determine the effects of epidural analgesia on the outcome after colorectal surgery. Patients and methods Fifty patients were enrolled in this investigation. Open colorectal resection was performed for all these patients. The patients were randomly assigned into two groups: the study group (T) and the control group (K). Epidural analgesia was used for 25 patients of group T, and intravenous-intramuscular analgesia was used for 25 patients of group K. Consumption of narcotic analgesics, pain intensity, gastrointestinal recovery time and solid food tolerated time were investigated. Results There were no significant differences in the type of operations and preoperative patients’ characteristics between the groups. Consumption of narcotic analgesics was lower in group T, and analgesia was more effective in the epidural group. The mean time of peristalsis and solid food tolerance was earlier in group T as compared with group K. Conclusion Epidural analgesia provides a significant benefit as regards analgesic consumption, postoperative pain relief and the recovery of gastrointestinal function in patients undergoing open colorectal resection. Keywords: epidural analgesia, intravenous analgesia, colorectal surgery

The Use of Intrathecal Morphine for Postoperative Pain Relief After Liver Resection: A Comparison with Epidural Analgesia

2006 ◽  
Vol 102 (4) ◽  
pp. 1157-1163 ◽  
Author(s):  
Lesley De Pietri ◽  
Antonio Siniscalchi ◽  
Alexia Reggiani ◽  
Michele Masetti ◽  
Bruno Begliomini ◽  
...  
Keyword(s):  
Liver Resection ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Intrathecal Morphine ◽  
Postoperative Pain Relief

Continuous Thoracic Epidural Analgesia for Postoperative Pain Relief Following Thoracotomy

1987 ◽  
Vol 67 (5) ◽  
pp. 787-791 ◽  
Author(s):  
WILLIAM G. LOGAS ◽  
NABIL EL-BAZ ◽  
ABDEL EL-GANZOURI ◽  
MARC CULLEN ◽  
EDGAR STAREN ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Epidural Analgesia ◽  
Thoracic Epidural Analgesia ◽  
Postoperative Pain Relief ◽  
Thoracic Epidural

scholarly journals Preemptive Caudal Ropivacaine: An Effective Analgesic during Degenerative Lumbar Spine Surgery

2017 ◽  
Vol 11 (1) ◽  
pp. 113-119 ◽  
Author(s):  
Shashwat Kumar ◽  
Jagannath Manickam Palaniappan ◽  
Anantha Kishan
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Epidural Injection ◽  
Epidural Block ◽  
Postoperative Pain Relief ◽  
Control Group ◽  
Lumbosacral Spine ◽  
Study Group ◽  
Group I ◽  
Caudal Epidural

<sec><title>Study Design</title><p>This was a prospective, randomized, controlled trial comprising 60 patients undergoing lumbosacral spine (noninstrumentation/nonfusion) surgery.</p></sec><sec><title>Purpose</title><p>The purpose of this study was to evaluate the efficacy of 0.2% ropivacaine (20 mL) administered alone as a single, preoperative, caudal epidural block injection versus that of intravenous analgesics in providing effective postoperative analgesia to patients undergoing lumbosacral spine surgery.</p></sec><sec><title>Overview of Literature</title><p>Various studies have shown the effectiveness of a caudal epidural injection (bupivacaine or ropivacaine) in providing postoperative analgesia in combination with steroids or other analgesics. This study uniquely analyzed the efficacy of a single injection of caudal epidural ropivacaine in providing postoperative pain relief.</p></sec><sec><title>Methods</title><p>Sixty patients who were scheduled to undergo surgery for degenerative lumbar spine disease (noninstrumentation/nonfusion) were consecutively divided into two groups, group R (Study) and group I (Control). 30 group R patients received a caudal epidural block with 20 mL of 0.2% ropivacaine after the administration of general anesthesia. 30 group I patients received no preoperative analgesia. Intravenous analgesics were administered during the postoperative period after a complaint of pain. Various parameters indicating analgesic effect were recorded.</p></sec><sec><title>Results</title><p>There was a significant delay in the average time to the first demand for rescue analgesia in the study group, suggesting significantly better postoperative pain relief than that in the control group. In comparison with the control group, the study group also showed earlier ambulation with minimal adverse effects. The requirement for intraoperative fentanyl was higher in the control group than that in the study group.</p></sec><sec><title>Conclusions</title><p>Preemptive analgesia with a single epidural injection of ropivacaine is a safe, simple, and effective approach, providing better postoperative pain relief, facilitating early mobilization, and decreasing the intraoperative requirement for opioid administration.</p></sec>

Use of preperitoneal wound catheter for continuous local anaesthesia after laparoscopic colorectal surgery

2019 ◽  
Vol 98 (9) ◽  
pp. 356-361
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Colorectal Surgery ◽  
Paralytic Ileus ◽  
Colorectal Resection ◽  
Opioid Analgesic ◽  
Control Group ◽  
Subjective Perception ◽  
Analgesic Therapy ◽  
Opioid Administration

Introduction: The main cause of postoperative pain after abdominal surgery is the wound where laparotomy is made. Recently, laparoscopic procedures have become common in colorectal surgery. Although improving the tolerance of the surgery, postoperative pain management still remains a discussed problem. The use of an epidural catheter used to be generally recommended in the open surgery era; however, an ideal strategy for postoperative analgesic therapy after laparoscopy remains unclear. Reduced administration of opioid analgesic drugs after colorectal resection is a generally accepted goal. Preperitoneal catheter insertion for continuous local anaesthetic (LA) infusion in the wound after surgery is a simple alternative to other pain management methods. Methods: Retrospective analysis of analgotherapy outcomes in patients undergoing laparoscopic colorectal resection procedures, divided in three patient groups according to the type of analgesia: Group 1: use of a catheter for local wound infusion (KAT) n=73; group 2: epidural analgesia (EPI) n=23; and control group 3 with combined parenteral and subcutaneous analgesia (CON) n=66. The main objective of this study was to analyse postoperative pain and the consumption of opioid analgesics in the first three days from the surgery and the incidence of any complications related to the analgesic therapy. Results: Opioid consumption in KAT and EPI groups was significantly lower compared to CON in the first 72 hours from the surgery. The lowest postoperative pain was measured in the EPI group. Subjective perception of pain, measured using VAS, was not significantly different between the KAT and CON groups. In KAT patients, vomiting was statistically less frequent than in CON patients. There was no significantly different incidence of paralytic ileus in the KAT and CON groups and no paralytic ileus was observed in the EPI group. There was no increased incidence of SSI (surgical site infections) in the KAT group compared to the other groups. Conclusion: The use of the catheter was assessed as safe. Insertion and management of the catheter is unsophisticated, and we did not observe any complications in terms of application of the catheter or toxic side effects of the LA. The use of the catheter clearly reduced opioid administration in the postoperative period compared to the control group (CON) with combined parenteral and subcutaneous analgesics. The best pain control measured using the visual analog scale (VAS) was observed in the EPI group.

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