scholarly journals Comparison of two analgesic block techniques for circumcision: dorsal penile nerve block and caudal block

2020 ◽  
Vol 7 (2) ◽  
pp. 360
Author(s):  
Fatih Gokalp ◽  
Onur Karsli
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Pain Scale ◽  
Caudal Block ◽  
Anesthetic Care ◽  
Dorsal Penile Nerve Block ◽  
Significant Difference ◽  
The Difference ◽  
Dorsal Penile Nerve ◽  
Analgesic Block

Background: Circumcision is most common and oldest surgery but also could be frightening for children because of postoperative pain. Authors aim to evaluate postoperative pain conditions of patients by using the visual pain scale (VPS).Methods: Between 2016 and 2018, 168 children undergone circumcision. The patients were splitted into three groups depend on their anesthetic care; the dorsal penile block (DPNB), caudal block (CB) and combine block.Results: The mean age were 95.3±20.9 (65-186) months. There was no significant difference between the CB and combine block in VPS at 1st, 3rd hours and second days (p=0.19, p=0.39 and p=0.9 respectively). The VPS significantly higher in the DPNB arm when compared with caudal and combine block arm at 1st and 3rd hours (p<0.01 and p<0.01 respectively) but there was no significant difference between the DPNB and caudal block at second days (p=0.9). There was no significant difference between groups for analgesic requirements (p=0.07). Incidences of nausea and vomiting were seen rarely especially in the DPNB arm and the difference was not statistically significant among the groups (p=0.9).Conclusions: CB and DPNB are effective techniques for pain relief following penile surgery. CB has superior to DPNB at 1st and 3rd hours but no difference at follow up. Both techniques are appropriate methods for postoperative pain relief. 

scholarly journals Effect of topical bupivacaine on post-tonsillectomy pain relief in children

2021 ◽  
Vol 3 (2) ◽  
Author(s):  
Musa Kallamu Suleiman ◽  
Abdulkarim Aitek Abdullahi ◽  
Alhassan Datti Mohammed ◽  
Kufre Robert Iseh ◽  
Abdulrahman Aliyu ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Pain Intensity ◽  
Normal Saline ◽  
Pain Scale ◽  
Inclusion Criteria ◽  
Tonsillar Fossa ◽  
The Difference ◽  
Group B

Tonsillectomy is a common surgery performed in paediatric otorhinolaryngology and is usually accompanied by considerable postoperative pain. Earlier literature has shown the use of topical bupivacaine for post-tonsillectomy pain relief to be promising. This study was conducted to evaluate the efficacy of topical bupivacaine application on post-tonsillectomy pain relief. Fifty consenting patients scheduled for tonsillectomy that met the inclusion criteria were enrolled in the study and assigned into two groups of 25 patients each. Group B had their tonsillar fossa packed with 0.5% bupivacaine soaked gauze for 5 minutes while Group S had normal saline. Pain intensity was measured at 1, 2, 4, 12 and 24 hours postoperatively, using the Faces Pain Scale- Revised (FPS-R). Mean scores for groups B and S at 1, 2, 4, 8, 12, 24 hours were 1.96±1.17, 2.40±0.82, 2.8±1.0, 2.88±1.17, 3.08±0.99, and 3.04±1.02 and 3.36±1.38, 4.72±1.62, 3.92±1.35, 3.76±1.45, 4.00±1.41, 3.38±0.98 respectively. The difference was significant at 1 and 2 hours only (P≤0.05). Post-tonsillectomy pain was reduced in the first two hours by application of bupivacaine soaked gauze.

A Comparison of the Postoperative Analgesic Effectiveness of Ultrasound-Guided Dorsal Penile Nerve Block and Ultrasound-Guided Pudendal Nerve Block in Circumcision

2020 ◽  
Vol 104 (11-12) ◽  
pp. 871-877
Author(s):  
Volkan Ozen ◽  
Dogakan Yigit
Keyword(s):  
Postoperative Complications ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Pudendal Nerve ◽  
Pain Scale ◽  
Ultrasound Guided ◽  
Pudendal Nerve Block ◽  
Dorsal Penile Nerve Block ◽  
Significant Difference ◽  
Dorsal Penile Nerve

<b><i>Aim:</i></b> The aim of this study was to compare the postoperative analgesic effectiveness of the 2 block types. We also aimed to evaluate the effect of these block types on the postoperative complications and parental satisfaction. <b><i>Materials and Methods:</i></b> This prospective observational study was conducted between April and July 2019 at a training and research hospital. Patients aged between 5 and 12 years in the ASA I-II group, who were scheduled for circumcision, were included in the study. The primary outcome was the pain measured using the Children’s Hospital Eastern Ontario Pain Scale and the Faces Pain Scale-Revised. The secondary outcomes were the postoperative complications and parenteral satisfactions. <b><i>Results:</i></b> The number of patients receiving a pudendal block (<i>n</i> = 40) and dorsal penile nerve block (DPNB) block (<i>n</i> = 40) was equal. No statistically significant difference was found between the groups that were administered a DPNB and pudendal block in terms of pain scores (<i>p</i> &#x3e; 0.05). We did not observe any postoperative block-related complications or side effects. Parents reported excellent satisfaction in both groups. <b><i>Discussion:</i></b> Ultrasound (US)-guided pudendal nerve block and US-guided DPNB provided effective and long-lasting postoperative analgesia for circumcision surgery. <b><i>Conclusions:</i></b> This study has shown that both blocks provide postoperative analgesia with similar effectiveness and ensured a very comfortable period at the circumcision surgery. Clinicians can use either of these techniques depending on their clinical circumstances and experience.

Postoperative Pain Relief: The Comparison of Bupivacaine before Incision and Near Closure of Wound

2021 ◽  
Vol 15 (10) ◽  
pp. 2622-2624
Author(s):  
Haq dad Durrani ◽  
Rafia Kousar ◽  
Ejaz Iqbal ◽  
Muhammad Abdul Aziz ◽  
Syed Aushtar Abbas Naqvi ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Subcutaneous Tissue ◽  
Difficult Problem ◽  
P Value ◽  
Trial Methodology ◽  
Analgesic Requirement ◽  
Rescue Analgesia ◽  
Post Operative Pain ◽  
Significant Difference

Background: Pain is the most common and most difficult problem faced by patients after operation. Due to inadequate management 30-70% patients suffer from post-operative pain. Acute pain resulting in chronic pain reduces quality of life and creates economic burden. Aim: To compare post-operative pain relief between infiltration of 0.25% bupivacaine into skin and subcutaneous tissue in the line of incision before incision and along edges of wound near completion of procedure. Study design: Randomized control trial Methodology: Sixty four patients were randomly divided into two groups i.e. (0.25% Bupivacaine 6 to 30ml) at the site of incision into skin and subcutaneous tissue Preincision (Group P) and (0.25% Bupivacaine 6 to 30ml) along the edges of wound at near closure of procedure (Group C). Intensity of pain was assessed on visual analogue scale in the recovery room, 3, 6 and 24 hours postoperatively.The time of first dose of rescue analgesia within 24 hours was also noted in both groups. Results: There was no statistically significant difference between two groups regarding age (p-value = 0.324), gender i.e. males (p=0.545) females (p=0.763) and duration of operation (P=Value=0.208). The mean time of rescue analgesia in Group P and Group C in minutes was 318.12±149.47 and 374.84±125.67 respectively (p value =1.5) reflecting no statistically significant difference. Conclusion: Postoperative analgesia and analgesic requirement do not differ significantly whether bupivacaine is infiltrated before incision or just before closure of wound. Keywords: Postoperative pain, bupivacaine, rescue analgesia, Preincision

scholarly journals Thermography in persistent postoperative pain after knee surgery

2020 ◽  
Vol 8 (5_suppl4) ◽  
pp. 2325967120S0033
Author(s):  
David Friedrich ◽  
Manuel Köhne
Keyword(s):  
Postoperative Pain ◽  
Control Region ◽  
Local Anaesthesia ◽  
Level Of Evidence ◽  
Total N ◽  
Diagnosis And Therapy ◽  
Significant Difference ◽  
Thermographic Image ◽  
Persistent Postoperative Pain ◽  
The Difference

Aims and Objectives: Background: Postoperative persistent pain occurs in approximately 10% of surgically treated patients. It incapacitates and reduces quality of life in those affected. The aetiology is poorly understood, predictive factors are currently unknown, diagnosis and therapy are difficult. Objectives: To evaluate the benefit of dermal thermography in the diagnosis and therapy of persistent postoperative pain. Study design: retrospective, Level of evidence IV Materials and Methods: A single surgeon performed highly standardized ACL reconstructions, arthroscopies and total endoprotheses of the knee. Patients were seen six weeks postoperative for clinical and thermographic evaluation. Regions of interest were defined for the affected knee, a control region defined for the contralateral knee. The thermographic image was used to pinpoint a site for subcutaneous local anaesthesia. The clinical evaluation was then repeated. Results: Patients in total (n=133), arthroscopy (n=21), total endoprothesis (n=42), ACL (n=50). If the temperature difference (TD) between the site of pathology and the average ipsilateral knee temperature was negative, pathology was classified as hypothermic (n=19), otherwise hyperthermic (n=94). Arthroscopically treated patients showed a TD of 0,88 ± 0,39 °C in hyperthermic (n=12) and -0,811 ± 0,623 °C in hypothermic (n=9) knees. Prosthetically treated patients showed a TD of 1,29 ± 0,51 °C in hyperthermic (n=37) and -0,88 ± 0,33 °C in hypothermic (n=5) knees. ACL treated patients showed a TD of 1,20 ± 0,48 °C in hyperthermic (n=45) and -0,62 ± 0,41 °C in hypothermic (n=5) knees. The difference in temperature between the site of pathology and the average temperature of the ipsilateral knee was significant for all subgroups: arthroscopy-hypothermic p < 0,001, arthroscopy-hypothermic p < 0,005; endoprothesis-hyperthermic p < 0,001, endoprothesis-hypothermic p < 0,004; ACL-hyperthermic p < 0,001, ACL-hypothermic p < 0,027. In contrast to the hyperthermic groups (for all p < 0,001), there was no significant difference between the site of pathology and the contralateral control region in the hypothermic groups. All patients reported a reduction of pain and better mobility after subcutaneous infiltration with Scandicain 2% at the thermographically defined site of pathology. Conclusion: Thermography is useful to pinpoint sites of pathology in persistent postoperative pain. Two types of thermal abnormality could be identified at the site of pathology: hypo- and hyperthermic. Local anaesthesia at the site of pathology resulted in pain reduction and improved mobility. Further studies are necessary to understand the postoperative thermal changes in order to devise a suitable therapy.

scholarly journals Epidural Morphine by the Thoracic or Lumbar Routes in Cholecystectomy. Effect on Postoperative Pain and Respiratory Variables

1989 ◽  
Vol 17 (2) ◽  
pp. 166-169 ◽  
Author(s):  
E. Hakanson ◽  
M. Bengtsson ◽  
H. Rutberg ◽  
A. M. Ulrick
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Analogue Scale ◽  
Epidural Morphine ◽  
Morphine Group ◽  
Thoracic Epidural ◽  
Respiratory Parameters ◽  
Significant Difference ◽  
Elective Cholecystectomy ◽  
Respiratory Variables

Thirty-seven women undergoing elective cholecystectomy were randomised into two groups, receiving either lumbar epidural morphine (group L) or epidural morphine via the thoracic route (group T). The effect on pain relief was assessed by a visual analogue scale and included both resting pain and ‘provoked’ pain. Respiratory parameters (PEF, FEVI and FVC) were also studied. The patients were investigated preoperatively, and 4, 6, 12 and 24 hours after the start of surgery. No significant difference was observed between the groups concerning pain relief or respiratory performance. We conclude that after cholecystectomy lumbar epidural morphine is as effective as thoracic epidural morphine in relieving postoperative pain.

scholarly journals Using intravenous acetaminophen in the reduction of opioids in spinal cord surgeries by patient-controlled analgesia

2018 ◽  
Vol 5 (12) ◽  
pp. 3883
Author(s):  
Vadoud Nourouzi ◽  
Ali Mohammadian ◽  
Khatereh Isazadehfar ◽  
Sona Rasouli
Keyword(s):  
Spinal Cord ◽  
Placebo Group ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Pain Score ◽  
Postoperative Recovery ◽  
Opioid Use ◽  
Hospitalization Period ◽  
Significant Difference ◽  
Pain Pump

Background: Proper management of postoperative pain results in improved quality of patient's' life, early postoperative recovery, reduced hospitalization period and decreased treatment costs. Regarding significant efficacy and higher pain relief functions, opioids are amongst the best pain relief drugs. However, use of theses narcotics as pain killers is somehow controversial. Current study investigated the effects of IV acetaminophen in reduced use of opioids in surgeries of spinal cord by PCA method.Methods: Current double blinded clinical trial study performed upon 86 patients of 20-70 years of age who candidate for spinal CD implant with ASA class I or II. Patients randomly divided into two groups of IV Acetaminophen therapy (N=43) and placebo group (N=43) and each group were put equally under general anesthesia in which both received pain pump containing Fentanyl during recovery. Patients were examined regarding pain score, amount of opioid use and request for extra narcotics and the related complications including nausea, vomiting, dizziness, allergy, gastrointestinal bleeding and Ileus every 6 hours for 24 hours and the obtained results were recorded.Results: Regarding VAS, pain was significantly lower during 24 hours of study in IV Acetaminophen group (p<0.05). Mean use of opioid via pain pump was significantly lower in IV Acetaminophen group compared with placebo group (p=0.00). Request for extra doses of narcotics was higher in placebo group while regarding demand for extra pain relief, there was no significant difference between both groups. Regarding other results, no significant difference observed between both study groups.Conclusions: Results of the study indicated that use of a combination of IV acetaminophen along with opioids would be much more effective than use of narcotics alone in postoperative pain control of CD implant surgery of spinal cord and that leads to lower pain score and decreased use of opioids and its related complications.

scholarly journals Clinical use of the parasympathetic tone activity index as a measurement of postoperative analgaesia in dogs undergoing ovariohysterectomy

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Ismael Hernández-Avalos ◽  
Alex Valverde ◽  
José Antonio Ibancovichi-Camarillo ◽  
Pedro Sánchez-Aparicio ◽  
Sergio Recillas-Morales ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Activity Index ◽  
Pain Scale ◽  
Objective Method ◽  
Clinical Use ◽  
Significant Difference ◽  
Clinical Relationship ◽  
Baseline Values ◽  
Parasympathetic Tone ◽  
The University

Abstract Introduction While the current tools to assess canine postoperative pain using physiological and behavioural parameters are reliable, an objective method such as the parasympathetic tone activity (PTA) index could improve postoperative care. The aim of the study was to determine the utility of the PTA index in assessing postoperative analgaesia. Material and Methods Thirty healthy bitches of different breeds were randomly allocated into three groups for analgaesic treatment: the paracetamol group (GPARAC, n = 10) received 15 mg/kg b.w., the carprofen group (GCARP, n = 10) 4 mg/kg b.w., and the meloxicam group (GMELOX, n = 10) 0.2 mg/kg b.w. for 48 h after surgery. GPARAC was medicated orally every 8 h, while GCARP and GMELOX were medicated intravenously every 24 h. The PTA index was used to measure the analgaesia–nociception balance 1 h before surgery (baseline), and at 1, 2, 4, 6, 8, 12, 16, 20, 24, 36, and 48 h after, at which times evaluation on the University of Melbourne Pain Scale (UMPS) was made. Results The baseline PTA index was 65 ± 8 for GPARAC, 65 ± 7 for GCARP, and 62 ± 5 for GMELOX. Postoperatively, it was 65 ± 9 for GPARAC, 63 ± 8 for GCARP, and 65 ± 8 for GMELOX. No statistically significant difference existed between baseline values or between values directly after treatments (P = 0.99 and P = 0.97, respectively). The PTA index showed a sensitivity of 40%, specificity of 98.46% and a negative predictive value of 99.07%. Conclusion Our findings suggest that the PTA index measures comfort and postoperative analgaesia objectively, since it showed a clinical relationship with the UMPS.

scholarly journals The Effect of Pain Training Before Thoracotomy Operation on Postoperative Pain Levels

2020 ◽  
Author(s):  
Emel Gündüz ◽  
Hakan Keskin
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Postoperative Pain ◽  
Pain Scale ◽  
Pain Scores ◽  
Extubation Time ◽  
Significant Difference ◽  
The World ◽  
The Hours ◽  
Vas Scores

INTRODUCTION: Postoperative pain is a condition that patients frequently complain about all over the world. The aim of this study was to investigate the effect of pain training before elective thoracotomy on postoperative pain levels in patients. METHODS: 100 patients who underwent thoracotomy for any reason were included in the study. Patients were given a 20-30-minute training on postoperative pain and how the pain is controlled, and what the patient can do to minimize the pain 24-48 hours before thoracotomy. The patients were divided into two groups; those that were trained and those that were not trained. Extubation time was accepted as baseline (0 hour). At the hours of 4, 8, 12, 16, 20 and 24, patients were asked about their pain on the visual pain scale (VAS). Respiratory rate, blood pressure, heart rate, and oxygen saturation levels were recorded at the hours. RESULTS: When VAS scores were compared between the two groups, no significant difference was found in the values measured at the 4th hour whereas there was a significant difference between the subsequent values. DISCUSSION AND CONCLUSION: The results of this study showed that pain training before thoracotomy operation gradually decreased postoperative VAS pain scores in patients.

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