scholarly journals Efficiency and safety of pharmacotherapy for postoperative pain in cardiac surgery

2021 ◽  
Vol 20 (3) ◽  
pp. 2683
Author(s):  
D. A. Sychev ◽  
T. E. Morozova ◽  
D. A. Shatskiy ◽  
E. V. Shikh
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Period ◽  
Multimodal Analgesia ◽  
Early Postoperative Period ◽  
Current Review ◽  
Negative Effect ◽  
Safe Technique

Intraoperative injury with the formation of a sternotomy wound is inevitably accompanied by postoperative pain, which has a negative effect on the postoperative period and prognosis of patients. Today, moderate and severe pain affects at least half of patients in the early postoperative period after cardiac surgery. Inadequate pain relief in the early postoperative period can lead to chronic pain, which significantly reduces the quality of life of patients. The concept of multimodal analgesia with different painkillers is a priority, effective and safe technique both after cardiac surgery and in other areas of surgery. The current review article is devoted to the analysis of efficacy and safety of various drug groups for postoperative pain relief in cardiac surgery.

scholarly journals OPRM1 and ABCB1 Polymorphisms and Their Effect on Postoperative Pain Relief With Piritramide

2015 ◽  
pp. S521-S527 ◽  
Author(s):  
O. BARTOŠOVÁ ◽  
O. POLANECKÝ ◽  
F. PERLÍK ◽  
S. ADÁMEK ◽  
O. SLANAŘ
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Adverse Effects ◽  
Postoperative Period ◽  
Receptor Gene ◽  
Early Postoperative Period ◽  
Postoperative Pain Relief ◽  
Intensity Difference ◽  
Pain Intensity Difference ◽  
118G Allele

Genetic factors may contribute to the differential response to opioids. The aim of this study was to evaluate the association between polymorphisms of µ1-opioid receptor gene OPRM1 (rs1799971), and P-glycoprotein transporter gene ABCB1 (rs1045642, rs2032582), and piritramide efficacy under postoperative patient-controlled analgesia (PCA). In 51 patients, OPRM1 variant was associated with decreased efficacy in early postoperative period evidenced by sum of pain intensity difference in the 0-6 h postoperative period (SPID0-6), (F=3.27, p=0.029). Mean (SD) SPID0-6 was observed in the 118AA genotype 22.9 (6.1) mm, which was significantly higher from the 118GG genotype 10.0 (4.4) mm, p=0.006. The lowest cumulative dose was recorded in 118AA genotype 19.1 (9.8) mg, which was significantly less than in the 118GG genotype group 36.6 (6.1) mg, p=0.017. Opioid–induced adverse effects were observed in 11, 30, and 100 % of patients in 118AA, 118AG, and 118GG genotype groups, respectively (p<0.05). Piritramide efficacy and safety was not significantly affected by ABCB1 (rs1045642, rs2032582) polymorphisms. Variant OPRM1 118G allele is associated with decreased acute postoperative pain relief after piritramide. Decreased efficacy leads to higher drug consumption under PCA settings, which however, does not fully compensate insufficient pain relief, but increases incidence of adverse effects.

scholarly journals Multicenter study of the effectiveness of postoperative pain relief in Ukraine using paracetаmol in surgical hospitals – “ROZUM”

Pain medicine ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 4-14
Author(s):  
Dmytro Dmitriev ◽  
Ya Feleshtynskyi ◽  
S Vasyliuk ◽  
V Shaprynskyi ◽  
Yu Derkach ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Multicenter Study ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Multimodal Analgesia ◽  
Surgical Patients ◽  
Postoperative Pain Relief

This article is devoted to the effectiveness of postoperative pain relief in surgical hospitals in Ukraine. Multicenter study of the effectiveness of postoperative pain relief in Ukraine using paracetаmol in surgical hospitals – ROZUM is descibed. The effectiveness of multimodal analgesia and other analgesia in the postoperative period has been determined. Predictors of inadequate pain relief in surgical patients were identified, and the risks of pain syndrome development in a surgical hospital were assessed. The use of paracetamol in the schemes of multim

scholarly journals Dexmedetomidine as a part of multimodal analgesia in postoperative period in trauma patients

2018 ◽  
Vol 9 (3) ◽  
pp. 50-53
Author(s):  
N. V. Kutsevolova ◽  
Yu. E. Makhno ◽  
A. E. Kuklenko ◽  
E. V. Vasiliauskiene ◽  
I. V. Andronova ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Period ◽  
Severe Pain ◽  
Pain Treatment ◽  
Pain Syndrome ◽  
Multimodal Analgesia ◽  
Trauma Patients ◽  
Endoprosthetic Replacement ◽  
Postoperative Pain Treatment

Despite the large arsenal of analgetics acting through different pharmacological mechanisms and the development of various anesthesia methods, the problem of postoperative pain treatment still remains urgent. Providing a complete pain relief after a surgery remains a desired, but not always a reachable goal. According to the literature, 30 to 75% of patients undergoing surgery suffer from the severe pain syndrome in the postoperative period. This article presents the experience with the use of a prolonged intravenous infusion of Dexmedetomidine as a part of multimodal analgesia in patients who underwent endoprosthetic replacement of large joints.

scholarly journals Proactive local anesthesia with ropivacaine in the prevention of pain after hemorrhoidectomy

2020 ◽  
pp. 57-61
Author(s):  
Z. M. Abdulatipova ◽  
M. A. Danilov ◽  
A. V. Leontiev ◽  
A. A. Khachaturian ◽  
G. G. Saakian ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Local Anesthesia ◽  
Postoperative Period ◽  
Comparison Group ◽  
Early Postoperative Period ◽  
Main Group ◽  
Spinal Block ◽  
Open Hemorrhoidectomy ◽  
Adequate Pain Relief

Introduction. Assessment of proactive local anesthesia’s influence on how early postoperative period after hemorrhoidectomy undergoes.Materials and methods. The object of the study were 50 patients operated on for chronic combined hemorrhoids (stage 3). In the period from November 2018 to June 2019, they all had open hemorrhoidectomy made according to the standard method. All operations were performed under spinal anesthesia. Patients were divided into the main group (n = 26), operated on under proactive local anesthesia (PLA) with 0,75% ropivacaine solution and a comparison group (n = 24) that had not had PLA. The introduction was carried out immediately before hemorrhoidectomy after the spinal block was performed at 5 points. Pain was assessed with the help of questionnaires based on a visual analogue scale (VAS), 2, 4, 8, 24, 48 hours after surgery.Results. The level of postoperative pain in the main group was lower than in the comparison group (p<0.05) and did not exceed 1,78 points by VAS. In the comparison group, the level of postoperative pain after 8 and 24 hours on average exceeded 5 points by VAS. Patients of the main group did not need postoperative anesthesia in 68,5% (n = 17) cases, while in the comparison group 57% patients (n = 17), needed from 3 to 5 injections of NSAID to provide adequate pain relief.Conclusion. The use of a 0,75% ropivacaine solution for PLA reduces pain after hemorrhoidectomy, which does not lead to the need for additional analgesia in the early postoperative period and improves the patient’s quality of life.

scholarly journals Nefopam hydrochloride as a component of multimodal analgesia in the postoperative period

Pain medicine ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 68-75
Author(s):  
Andrii Semenenko
Keyword(s):  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Multimodal Analgesia ◽  
Early Postoperative Period ◽  
Modern Approach ◽  
Surgical Interventions ◽  
Reduction Of Pain ◽  
Effective Drugs

The modern approach to the multimodal scheme of postoperative analgesia includes the mandatory use of drugs that have a small number of side effects and at the same time have a polymodal effect on the pathogenetic links of pain development. Nefopam hydrochloride is able to prevent the development of: opioid hyperalgesia, stop pain stimuli without respiratory depression, affect platelet aggregation and the condition of the mucous membrane and motility of the gastrointestinal tract, which distinguishes it from classical NSAIDs. Nefopam hydrochloride is characterized by a low risk of addiction with prolonged use, a pronounced anti-sensory effect, especially significant at the stage of awakening and in the early postoperative period. Postoperative analgesia based on nefopam hydrochloride as a component of multimodal analgesia is effective and safe in the absence of absolute contraindications. The planned use of nefopam hydrochloride for the correction of pain reduces complications in the postoperative period and improves the quality of life of patients. Nefopam hydrochloride is one of the most effective drugs for the correction of postoperative tremor syndrome. The use of nefopam hydrochloride as a drug, which is a part of premedication before surgical interventions and a component of multimodal analgesia, improves the quality of the postoperative period due to: reduction of pain syndrome, planned correction of postoperative tremor syndrome and correction of complications arising from inadequate treatment of pain syndrome.

scholarly journals Assessment of pain during rest and during activities in the postoperative period of cardiac surgery

2014 ◽  
Vol 22 (1) ◽  
pp. 136-143 ◽  
Author(s):  
Larissa Coelho de Mello ◽  
Silvio Fernando Castro Rosatti ◽  
Priscilla Hortense
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Postoperative Complications ◽  
Postoperative Period ◽  
Pain Assessment ◽  
Descriptive Study ◽  
Deep Breathing ◽  
Cohort Design ◽  
Surgical Recovery ◽  
Over Time

OBJECTIVE: to assess the intensity and site of pain after Cardiac Surgery through sternotomy during rest and while performing five activities. METHOD: descriptive study with a prospective cohort design. A total of 48 individuals participated in the study. A Multidimensional Scale for Pain Assessment was used. RESULTS: postoperative pain from cardiac surgery was moderate during rest and decreased over time. Pain was also moderate during activities performed on the 1st and 2nd postoperative days and decreased from the 3rd postoperative day, with the exception of coughing, which diminished only on the 6th postoperative day. Coughing, turning over, deep breathing and rest are presented in decreased order of intensity. The region of the sternum was the most frequently reported site of pain. CONCLUSION: the assessment of pain in the individuals who underwent cardiac surgery during rest and during activities is extremely important to adapt management and avoid postoperative complications and delayed surgical recovery.

scholarly journals TAP-block as a component of multimodal analgesia for postoperative anesthesia in obstetrics and gynecology

Pain medicine ◽  
2018 ◽  
Vol 3 (2) ◽  
pp. 67-74 ◽  
Author(s):  
Ye. V. Grigimalsky ◽  
A. Y. Garga
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Multimodal Analgesia ◽  
Postoperative Pain Relief ◽  
Obstetrics And Gynecology ◽  
Tap Block ◽  
Actual Problem ◽  
Advantages And Disadvantages ◽  
Obstetrics And Gynaecology

Postoperative pain relief is still quite actual problem in medicine, particularly in obstetrics and gynaecology. The most appropriate method of adequate post-operative anesthesia is multimodal analgesia. This article describes the features of multimodal analgesia using TAP-block combined with NSAIDs in obstetric and gynaecological patients, advantages and disadvantages of this combination and our own experience of applying this method in our clinic.

Regional blockade for prolonged anesthesia in enucleation and evisceration

Reflection ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 47-55
Author(s):  
I.G. Oleshchenko ◽  
◽  
О.P. Mishchenko ◽  
М.А. Gasparyan ◽  
◽  
...  
Keyword(s):  
Postoperative Period ◽  
Choroidal Melanoma ◽  
Opioid Analgesics ◽  
Early Postoperative Period ◽  
Alternative Methods ◽  
Combined Method ◽  
Retrobulbar Anesthesia ◽  
Pterygopalatine Ganglion ◽  
Systemic Side Effects

Regional anesthesia is widely used in ophthalmology both as an independent method and in combination. Retrobulbar anesthesia has risks of complications and is undesirable in the surgical treatment of choroidal melanoma due to the risk of metastasis of tumor cells when it is performed. Therefore, it is necessary to search for alternative methods of regional blockades in order to create prolonged anesthesia. Purpose. To develop and evaluate the clinical efficacy of pterygopalatine blockade as a component of combined method of anesthesia for evisceration or enucleation of the eyeball. Methods. A comparative analysis of the effectiveness of intraoperative anesthesia and the course of postoperative period was carried out in patients of two clinical groups formed depending on the method of anesthesia. Results. Intraoperative monitoring of hemodynamics in the groups did not differ. The nature of pain in the patients of the compared groups in the postoperative period had significant differences in presence and intensity of pain on the scale of verbal sensations. Discussion. Use of pterygopalatine blockade with levobupivacaine in combination with dexamethasone as an adjuvant allows getting a prolonged analgesic, anti-inflammatory and decongestant effect. This makes it possible to avoid the use of opioid analgesics in the early postoperative period, that is, to avoid such systemic side effects as nausea, dizziness, and in rare cases vomiting, which generally improves the quality of the postoperative period. Conclusions. Use of pterygopalatine ganglion blockade with local prolonged-acting anesthetic levobupivacaine and dexamethasone as an adjuvant based on inhaled anesthesia with sevoflurane provides safe and effective anesthesia in patients with evisceration or enucleation of the eyeball, both in the intra- and postoperative period. Key words: enucleation; evisceration; pterygopalatine blockade; dexamethasone.

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