Assessment of postoperative analgesic effect of rectus sheath block for patients who had emergency midline laparatomy, in University of Gondar Compressive Specialized Hospital, Northwest Ethiopia: an observational prospective cohort study.

2019 ◽  
Author(s):  
Wubie Birlie Chekol ◽  
Hailu Yimer Tawuye ◽  
zewuditu abdissa denu ◽  
Abatneh Feleke agegnehu
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Prospective Cohort Study ◽  
Analgesic Effect ◽  
Prospective Cohort ◽  
Rectus Sheath ◽  
Exposed Group ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Rectus Sheath Block

Abstract Background : Postoperative pain is a major concern after midline abdominal surgeries. Rectus sheath block (RSB) has been indicated after midline laparatomy ; however, the analgesic effect of landmark technique on postoperative pain was not well investigated. Objectives: we tested the hypothesis that RSB reduces pain scores, decreased total analgesic consumption and prolong first analgesic request time after emergency midline laparatomy . Methods : Prospective cohort study was done from February 1 to May 10, 2018. Eighty eight patients were observed in this study, 44 in the RSB group and 44 in the non exposed group. Pain severity was assessed in first 24 hours postoperative period in terms of total analgesic consumption, first analgesic request time and visual analogue scale (VAS) score at 1 hour , 2 hours , 4 hours , 6 hours , 8 hours , 10 hours, 12 hours and 24 hours. Results : The RSB group had significantly reduced VAS score at rest and on movement at (1, 2, 4, 6 and 8 hours), but not at (10, 12 and 24 hours) point assessed. Patients in RSB group had reduced tramadol requirement compared to non exposed group in 24 hours (255.68±80.13) VS (314.77±97.40), P=0.003). The 24 hours diclofenac consumption was significantly lowered in RSB group (75 ( 75-150) than non exposed group (150 ( 75-150), P=0.031.Mean time to first analgesic request was significantly longer in RSB group (372.95±131.41) than non exposed group (50.34±14.12), p≤0 . 001). Conclusions : The RSB group resulted in less pain scores, reduced total analgesic utilization and stayed for longer time for first analgesic request. Therefore we recommend RSB as part of multimodal analgesia after emergency midline laparatomy. Keywords: midline abdominal surgery, rectus sheath block, abdominal field block

scholarly journals The impact of postpartum depressive symptoms on self-reported infant health and analgesic consumption at the age of 12 months: A prospective cohort study

2021 ◽  
Vol 136 ◽  
pp. 388-397
Author(s):  
Aleksi Ruohomäki ◽  
Elena Toffol ◽  
Ville Airaksinen ◽  
Katri Backman ◽  
Raimo Voutilainen ◽  
...  
Keyword(s):  
Cohort Study ◽  
Depressive Symptoms ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Infant Health ◽  
Postpartum Depressive Symptoms ◽  
Analgesic Consumption ◽  
The Impact

scholarly journals Predictive Factors of Postoperative Pain and Postoperative Anxiety in Children Undergoing Elective Circumcision: A Prospective Cohort Study

2015 ◽  
Vol 28 (4) ◽  
pp. 244 ◽  
Author(s):  
Nick Zavras ◽  
Stella Tsamoudaki ◽  
Vasileia Ntomi ◽  
Ioannis Yiannopoulos ◽  
Efstratios Christianakis ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Prospective Cohort Study ◽  
Predictive Factors ◽  
Prospective Cohort

scholarly journals Towards Opioid-Free Elective Spine Surgery: A Prospective Cohort Study

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Ahilan Sivaganesan ◽  
Amanda Wright ◽  
Regis W Haid ◽  
Praveen V Mummaneni ◽  
Richard Berkman
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Spine Surgery ◽  
Prospective Cohort ◽  
Multivariate Regression ◽  
Opioid Use ◽  
Pain Scores ◽  
Patient Reported ◽  
Average Pain ◽  
Student’S T

Abstract INTRODUCTION The opioid crisis is a national emergency. We conducted a prospective cohort study to determine whether elective spine surgery can be performed without any opioids whatsoever. METHODS Every consecutive elective spine surgery performed by author R.A.B. between January 1st and December 31st of 2018 was included. For cohort A, between January and April 15th, opioids were minimized but PRN doses were given. For cohort B, between April 15th and December, the goal was to eliminate opioids altogether. Pain scores were collected at discharge, 1 wk, and 1-mo follow-up. Patient-reported outcomes (PRO) were collected at baseline and at 3 mo for lumbar procedures. Emergency room visits and readmissions were tracked. Student's t-tests were used to compare pain scores and PROs, and multivariate regression analyses were performed to understand drivers of opioid use. RESULTS A total of 158 patients were included. In cohort A, 37.9% of patients took no opioids between PACU and 1 mo. Average pain scores were 5.2 in PACU and 2.5 at 1 mo. In cohort B, 86.7% took no opioids after PACU. Average pain scores were 4.2 in PACU and 2.5 at 1 mo. Both cohorts had equivalent improvements in PROs. Multivariate regression revealed that, adjusting for case mix differences, cohort B had lower odds of opioid use after PACU (P < .0001). Moreover, preoperative opioid use is a driver of postoperative opioid use (P = .02), whereas procedure type/invasiveness is not. CONCLUSION We have shown that opioid-free spine surgery, including lumbar fusions, is feasible and effective. In all 87% of patients in our opioid-elimination cohort took no opioids from PACU until 1 mo after surgery, and 94% were taking none at the 1-mo visit. Pain scores and PROs were favorable. We have also shown that preoperative opioids are a driver of postoperative opioid use, however procedural invasiveness is not.

Continuous use of antipsychotics and its association with mortality and hospitalization in institutionalized Chinese older adults: an 18-month prospective cohort study

2011 ◽  
Vol 23 (10) ◽  
pp. 1640-1648 ◽  
Author(s):  
Tuen-Ching Chan ◽  
James Ka-Hay Luk ◽  
Yat-Fung Shea ◽  
Ka-Hin Lau ◽  
Felix Hon-Wai Chan ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Nursing Homes ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Exposed Group ◽  
Control Group ◽  
Chinese Older Adults ◽  
Influenza A H1n1 ◽  
Continuous Use

ABSTRACTBackground: Previous meta-analyses have suggested that antipsychotics are associated with increased mortality in dementia patients with behavioral and psychological symptoms (BPSD). Subsequent observational studies, however, have produced conflicting results. In view of this controversy and the lack of any suitable pharmacological alternative for BPSD, this study aimed to investigate the relationship between continuous use of antipsychotics and mortality as well as hospitalizations in Chinese older adults with BPSD residing in nursing homes.Methods: This was a prospective cohort study conducted in nursing homes in the Central & Western and Southern Districts of Hong Kong from July 2009 to December 2010. Older adults were stratified into the exposed group (current users of antipsychotics) and control group (non-users). Demographics, comorbidity according to the Charlson Comorbidity Index (CCI), Barthel Index (BI(20)), Abbreviated Mental Test (AMT), and vaccination status for pandemic Influenza A (H1N1) 2009, seasonal influenza and pneumococcus were collected at baseline. Subjects were followed up at 18 months. All-cause mortality and all-cause hospitalizations were recorded.Results: 599 older adults with dementia from nine nursing homes were recruited. The 18-month mortality rate for the exposed group was 24.1% while that for control group was 27.5% (P = 0.38). The exposed group also had a lower median rate of hospitalizations (56 (0–111) per 1000 person-months vs 111 (0–222) per 1000 person-months, median (interquartile range), p<0.001).Conclusions: The continuous use of antipsychotics for BPSD does not increase mortality among Chinese older adults with dementia living in nursing homes. Furthermore, our results show that the use of antipsychotics can lead to decreased hospitalizations.

scholarly journals Comparison of Postoperative Pain between Patients who underwent Primary and Repeated Caesarean Section: A Prospective Cohort Study

2019 ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Cesarean Section ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Analogue Scale ◽  
Visceral Pain ◽  
Significant Difference ◽  
Repeat Cesarean Section

Abstract Background: The presences of differences in post-operative pain are unclear between the primipara who underwent a primary cesarean section and multipara who underwent first repeat cesarean section. The study aimed to explore the possible difference in postoperative pain between primipara and multipara. Methods: A prospective cohort study was carried out, and only women who underwent cesarean deliveries under spinal anesthesia were included. Postoperative patient-controlled intravenous analgesia was performed for all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen, and the pump was programmed as 2.0 mL/h background infusion, and loading dose of 1 mL with a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using visual analogue scale, and inadequate analgesia was defined as visual analogue scale ≥40 during the postoperative 48 hours. Additionally, the patients’ pain statuses on postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results: From January to May 2017, a total of 168 patients (67 primipara and 101 multipara) were included. The relative risk for multipara to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primipara. In patients under 30 years old, inadequate analgesia on visceral pain in the multipara was higher than that on the primipara (RR, 3.56 [1.05 to 12.04], P=0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multipara and primipara (33.7%vs.40.2%, P=0.381). No difference was found in PCIA consumption between two groups. (111.1 ± 36.0mL vs. 110.9 ± 37.3mL, P=0.979) Additionally, a significantly higher incidence of pain at 4 weeks after the surgery was noted in the primipara compared to the multipara (62.2%vs.37.7%, P=0.011). Conclusions: Multipara who underwent first repeat cesarean section have lower risk to experience inadequate analgesia on incision pain during the first 48 hours after surgery compared to primipara. While multipara under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain.

scholarly journals Analgesic effect of caudal and IL/IH nerve blockade among children undergoing inguinal surgeries: A prospective cohort study, 2019

2020 ◽  
Vol 27 ◽  
pp. 123-129
Author(s):  
Yusuf Yimer ◽  
Ayub Mohammed ◽  
Siraj Ahmed ◽  
Adugna Aregawi ◽  
Suleiman Jemal ◽  
...  
Keyword(s):  
Cohort Study ◽  
Prospective Cohort Study ◽  
Analgesic Effect ◽  
Prospective Cohort ◽  
Nerve Blockade

scholarly journals Comparison of postoperative pain between patients who underwent primary and repeated cesarean section: a prospective cohort study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Guangyou Duan ◽  
Guiying Yang ◽  
Jing Peng ◽  
Zhenxin Duan ◽  
Jie Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Cesarean Section ◽  
Prospective Cohort Study ◽  
Prospective Cohort ◽  
Analogue Scale ◽  
Visceral Pain ◽  
Significant Difference ◽  
Repeat Cesarean Section

Abstract Background The differences in post-operative pain are unclear between the primiparas who underwent a primary cesarean section and multiparas who underwent their first repeat cesarean section. The study aimed to explore the possible differences in postoperative pain between primiparas and multiparas. Methods A prospective cohort study was performed only including women who underwent cesarean deliveries under spinal anesthesia. Postoperative patient-controlled intravenous analgesia (PCIA) was administered to all subjects with 0.2 mg/kg hydromorphone and 4 mg/kg flurbiprofen; the pump was programmed as 2.0 mL/h background infusion with a loading dose of 1 mL and a lockout period of 15 min. Postoperative incision and visceral pain intensity were evaluated using the visual analogue scale, and inadequate analgesia was defined as a visual analogue scale score ≥ 40 during 48 h post-operation. Additionally, the patients’ pain statuses in postoperative week 1 and week 4 were also assessed during follow-up via telephone. Results From January to May 2017, a total of 168 patients (67 primiparas and 101 multiparas) were included. The relative risk for multiparas to experience inadequate analgesia on incision pain was 0.42 (95% CI: 0.25 to 0.74) compared to primiparas. In patients aged < 30 years, inadequate analgesia on visceral pain was higher in multiparas than in primiparas (RR, 3.56 [1.05 to 12.04], P = 0.025). There was no significant difference in the combined incidence of inadequate analgesia in both types of pain between the multiparas and primiparas (33.7% vs. 40.2%, P = 0.381). No difference was found in PCIA use between the two groups (111.1 ± 36.0 mL vs. 110.9 ± 37.3 mL, P = 0.979). In addition, a significantly higher incidence of pain was noted 4 weeks post-surgery in primiparas than that in multiparas (62.2% vs. 37.7%, P = 0.011). Conclusion Multiparas who underwent their first repeat cesarean section have a lower for inadequate analgesia on incision pain during the first 48 h after surgery than primiparas. Multiparas aged under 30 years may be more prone to experiencing postoperative inadequate analgesia on visceral pain. Trail Registration ClinicalTrial.gov: NCT03009955, Date registered: December 30, 2016.

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