scholarly journals Assessment of ropivacaine postoperative analgesic effect after periapical maxillary incisors surgery

2012 ◽  
Vol 69 (5) ◽  
pp. 405-408 ◽  
Author(s):  
Milos Tijanic ◽  
Nikola Buric ◽  
Goran Jovanovic ◽  
Simona Stojanovic ◽  
Milan Spasic
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Analgesic Effect ◽  
Postoperative Treatment ◽  
Control Group ◽  
Study Group ◽  
Mean Values ◽  
Periapical Lesions ◽  
Topical Anesthetics ◽  
First Occurrence

Background/Aim. Ropivacaine is a relatively new longacting local anesthetic. The aim of this study was to compare the postoperative analgesic effect of topical anesthetics ropivacaine 0.75% and lidocaine 2% with adrenaline in the postoperative treatment of periapical lesions in the maxilla. Methods. The study was conducted on 60 subjects, divided into two groups. The study-group received 0.75% ropivacaine without a vasoconstrictor, while the control group was treated with 2% lidocaine with adrenaline (1 : 80.000). Block anesthesia for n. infraorbitalis was used and local anesthetics were applied also on the palatine side for the end branches of n. nasopalatinus. The following parameters were observed: time elapsed from the application of an anesthetic until the first occurrence of pain after the surgery and first intake of an analgesic, the intensity of initial pain, pain intensity 6 h after the application of anesthetics and the total number of analgesics taken within 24 h after the completion of surgery. Results. The pain appeared statistically significantly earlier in the patients who had been given lidocaine with adrenaline (p < 0.001), while statistically significantly higher mean values of initial postoperative pain (p < 0.05) and pain intensity 6 h after the intervention (p < 0.01) were also registered in the same group of patients. In the period of 24 h upon the intervention, the study-group patients were taking less analgesics as compared to the control-group subjects (46.6% vs 73.3%), who were given analgesics earlier, although no statistically significant differences were observed related to the number of analgesic doses taken. Conclusion. The results of our study indicate a better postoperative analgesic effect of ropivacaine as compared to lidocaine with adrenaline.

scholarly journals The Effect of Adding Low-Dose Naloxone to Intrathecal Morphine on Postoperative Pain and Morphine Related Side Effects after Cesarean Section: A Double-Blind, Randomized, Clinical Trial

2019 ◽  
Vol 7 (23) ◽  
pp. 3979-3983 ◽  
Author(s):  
Saloumeh Peivandi ◽  
Mohammad Reza Habibi ◽  
Afshin Gholipour Baradari ◽  
Abdolmajid Gholinataj ◽  
Ali Habibi ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Spinal Anaesthesia ◽  
Postoperative Nausea ◽  
Low Dose ◽  
Intrathecal Morphine ◽  
Control Group ◽  
Study Group ◽  
Double Blind

BACKGROUND: Nowadays, spinal anaesthesia is a suitable choice for most elective and emergency cesarean section (C-section) deliveries. AIM: This study aimed to determine the effect of adding low-dose naloxone to intrathecal morphine on postoperative pain and morphine related side effects after C-section. MATERIAL AND METHODS: In the present double-blind, randomised clinical trial, 70 women aged over 18 years, who were candidates for elective medical C-section under spinal anaesthesia were selected and randomly assigned to either the study group or the control group. For spinal anaesthesia, 10 mg of Bupivacaine plus 100 μg of morphine was administered for all patients. However, patients in the study group received 20 µg of naloxone intrathecally; but the patients in the control group only received normal saline as a placebo. After surgery, patient-controlled analgesia (PCA) pump with paracetamol (Apotel®) was connected to each patient. The intensity of postoperative pain in the patients was evaluated and recorded using Visual Acuity Screening (VAS) at 2, 4, 6 and 24 hours after the surgery. The patients were also examined for postoperative nausea and pruritus. RESULTS: Regardless of the groups to which the patients were assigned, a significant difference in pain intensity was observed during the study period (time effect; p < 0.001). Although the intensity of pain was lower in the study group, the difference was not statistically significant (group effect; p = 0.84). Also, there was no group time interaction between pain intensity and the times studied (p = 0.61). The incidence rates of postoperative nausea and pruritus were significantly lower in the study group compared to the control group (p < 0.001). CONCLUSION: According to the results of this study, adding low dose naloxone to intrathecal morphine did not significantly change postoperative pain intensity in the patients undergone elective C-section using spinal anaesthesia; however, significantly decreased the severity of postoperative nausea and pruritus.

scholarly journals Effect of Expressive Arts Therapy Interventions on Comfort of Children Undergoing Surgery

2020 ◽  
Vol 1 (4) ◽  
pp. 13
Author(s):  
Zeinab F. El Sayed ◽  
Bothayna N. Sadek
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Expressive Arts ◽  
Control Group ◽  
Physical Parameters ◽  
Study Group ◽  
Expressive Arts Therapy ◽  
Significant Difference ◽  
Anxiety Levels ◽  
Therapy Interventions

Context: Children undergoing surgery may experience pain and discomfort. Unfortunately, it is not always possible to completely prevent postoperative pain and discomfort with analgesics. Therefore, there is an increasing interest in non-pharmacological interventions through expressive arts therapy. Aim: This study aimed to evaluate the effect of expressive arts therapy interventions on the comfort of children undergoing surgery. Methods: A quasi-experimental design utilized in this study. This study conducted at the Pediatric Surgical Department in Children's Hospital affiliated to Ain Shams University, Cairo, Egypt, on a purposive sample of 84 children undergoing surgery. Children randomly assigned to two equal groups (control group 42 and study group 42). A child's assessment record was used to gather data related to characteristics of the studied children and surgery data. Pain assessment record to assess the child's physiological and physical parameters of pain. A Numeric Pain Rating Scale to assess a child's pain intensity. State-Trait-Anxiety Inventory for Children to measure anxiety levels.  Besides, A Comfort Assessment Scale to assess children's numerical pain intensity and discomfort. Results: There are statistically significant differences in mean pain intensity scores were observed between the control and study groups on the second day after surgery and before discharge (p > 0.05). The mean anxiety scores were significantly lower in the study group compared to the control group in the day after surgery and before discharge (p < 0.05). Also, there were observed improvements in mean comfort scores between the study and the control group on the day after surgery scores and on the day of discharge with a statistically significant difference (p < 0.05). There were statistically significant differences at (p-value=0.000) between children in the control and study group regarding children's postoperative pain intensity, anxiety levels, and comfort scores. Conclusion: The application of expressive arts therapy interventions was positively improving comfort and reducing pain intensity and anxiety levels among children undergoing surgery in the study group compared to the controls, emphasizing the importance of using expressive arts therapy interventions for improving children's postoperative comfort.

Comparison of Analgesic Effect of Levobupivacaine with Dexmedetomidine and Levobupivacaine for Scalp Block before Supratentorial Craniotomy: A Randomized Controlled Trial

2020 ◽  
Vol 103 (10) ◽  
pp. 1028-1035
Keyword(s):  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Control Group ◽  
Study Group ◽  
Analgesic Requirement ◽  
Supratentorial Craniotomy ◽  
Numerical Rating ◽  
Fentanyl Consumption ◽  
Scalp Block

Background: Craniotomy causes acute and chronic pain. Uncontrolled postoperative pain may lead to adverse events. Perioperative scalp nerves block is not only effective in reducing intraoperative hemodynamic response, but it also reduces postoperative pain and postoperative analgesia requirement. Objective: To compare the benefits of adding dexmedetomidine to levobupivacaine in scalp nerves block before craniotomy for the duration of analgesia in supratentorial craniotomy. Materials and Methods: After approval by the Committee for Research, 50 supratentorial craniotomy patients were randomized into two groups. The control group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000, whereas the study group received 30 mL scalp nerves block with 0.25% levobupivacaine with adrenaline 1:200,000 plus dexmedetomidine 1 mcg/kg. The primary outcome was the time to first analgesic requirement postoperatively. The secondary outcomes included intraoperative fentanyl consumption, verbal numerical rating scale, tramadol consumption, and complications during the first 24 hours postoperatively. Results: Patients in the study group had significantly increase time to the first analgesic requirement in postoperative period and reduced intraoperative fentanyl consumption. The median time to first analgesic requirement was 555 (360 to 1,035) minutes in the study group versus 405 (300 to 520) minutes in the control group (p=0.023). Intraoperative fentanyl consumption 125 (75 to 175) mcg in the study group was significantly lower than 200 (150 to 250) mcg in the control group (p=0.02). The verbal numerical rating scale at 1, 4, 8, 12 and 24 hours postoperatively, tramadol consumption, and complications during the first 24 hours postoperatively were not statistically significant different. Conclusion: Preoperative scalp nerves block with 0.25% levobupivacaine with adrenaline (1:200,000) with dexmedetomidine 1 mcg/kg significantly increased the time to first analgesic requirement and reduced intraoperative fentanyl consumption compared to 0.25% levobupivacaine with adrenaline (1:200,000) without perioperative complications. Keywords: Scalp block, Dexmedetomidine, Post-craniotomy analgesia, Supratentorial tumor, Levobupivacaine

Postoperative analgesia by adding acupuncture to conventional therapy, a non-randomized controlled trial

2018 ◽  
Vol 16 (2) ◽  
Author(s):  
Ilana Levy ◽  
Samuel Attias ◽  
Lior Cohen ◽  
Nadav Stoppelmann ◽  
Dan Steinberger ◽  
...  
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Analgesic Effect ◽  
Pain Treatment ◽  
Standard Of Care ◽  
Acupuncture Group ◽  
Controlled Study ◽  
Control Group ◽  
Pain Level ◽  
Randomized Controlled

Abstract Background Postoperative pain is common in patients hospitalized in surgical departments, yet it is currently not sufficiently controlled by analgesics. Acupuncture, a complementary medical practice, has been evaluated for its benefits in postoperative pain with heterogeneous results. We tested the feasibility of a controlled study comparing the postoperative analgesic effect of acupuncture together with standard-of-care to standard-of-care only. Methods In this pilot non-randomized controlled study conducted at a tertiary medical center in Israel, patients received either acupuncture with standard-of-care pain treatment (acupuncture group) or standard-of-care treatment only (control group) following surgery. Visual Analogue Scale (VAS) ratings for pain level at rest and in motion were evaluated both at recruitment and two hours after treatment. Acupuncture-related side effects were reported as well. Results We recruited 425 patients; 336 were assigned to the acupuncture group and 89 to the control group. The acupuncture group exhibited a decrease of at least 40% in average level of pain both at rest (1.8±2.4, p<0.0001) and in motion (2.1±2.8, p<0.0001) following acupuncture, whereas the control group exhibited no significant decrease (p=0.92 at rest, p=0.98 in motion). Acupuncture's analgesic effect was even more prominent in reducing moderate to severe pain at baseline (VAS ≥4), with a decrease of 49% and 45% of pain level at rest and in motion respectively (p<0.001), compared with no significant amelioration in the control group (p=0.20 at rest, p=0.12 in motion). No major side effects were reported. Conclusion Integrating acupuncture with standard care may improve pain control in the postoperative setting.

scholarly journals Glisson’s capsule cauterisation is associated with increased postoperative pain after laparoscopic cholecystectomy: a prospective case–control study

2017 ◽  
Vol 99 (6) ◽  
pp. 485-489 ◽  
Author(s):  
F Basak ◽  
M Hasbahceci ◽  
A Sisik ◽  
A Acar ◽  
Y Ozel ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Case Control Study ◽  
Gallbladder Disease ◽  
Case Control ◽  
Control Group ◽  
Study Group ◽  
Pain Scores ◽  
Standard Laparoscopic Cholecystectomy ◽  
Control Study

INTRODUCTION Postoperative pain after laparoscopic cholecystectomy has three components: parietal, visceral and referred pain felt at the shoulder. Visceral peritoneal injury on the liver (Glisson’s capsule) during cauterisation sometimes occurs as an unavoidable complication of the operation. Its effect on postoperative pain has not been quantified. In this study, we aimed to evaluate the association between Glisson’s capsule injury and postoperative pain following laparoscopic cholecystectomy. METHODS The study was a prospective case–control of planned standard laparoscopic cholecystectomy with standardized anaesthesia protocol in patients with benign gallbladder disease. Visual analogue scale (VAS) abdominal pain scores were noted at 2 and 24 hours after the operation. One surgical team performed the operations. Operative videos were recorded and examined later by another team to detect presence of Glisson’s capsule cauterisation. Eighty-one patients were enrolled into the study. After examination of the operative videos, 46 patients with visceral peritoneal injury were included in the study group, and the remaining 35 formed the control group. RESULTS VAS pain score at postoperative 2 and 24 hours was significantly higher in the study group than control (P = 0.027 and 0.017, respectively). CONCLUSIONS Glisson’s capsule cauterisation in laparoscopic cholecystectomy is associated with increased postoperative pain. Additional efforts are recommended to prevent unintentional cauterisation.

scholarly journals The Effect of Subcutaneous and Intraperitoneal Instillation of Local Anesthetics on Postoperative Pain after Laparoscopic Varicocelectomy: A Randomized Controlled Trial

Children ◽  
2021 ◽  
Vol 8 (11) ◽  
pp. 1051
Author(s):  
Zenon Pogorelić ◽  
Tea Gaberc ◽  
Miro Jukić ◽  
Goran Tintor ◽  
Ana Nevešćanin Biliškov ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Pain Intensity ◽  
Randomized Clinical Trial ◽  
Local Anesthetic ◽  
Local Anesthetics ◽  
Control Group ◽  
Number Of Patients ◽  
Intraperitoneal Instillation ◽  
Time Point

Background: The main goal of the present randomized clinical trial was to investigate the effects of subcutaneous administration of two different local anesthetics at trocar incision sites at the abdominal wall in combination with intraoperative intraperitoneal instillation of local anesthetics, on the character of postoperative pain, in adolescents who underwent laparoscopic varicocelectomy. Methods: A total of 60 patients with a median age of 16 years, who received laparoscopic varicocele repair, were included in this randomized clinical trial. The patients were randomly assigned to three study groups receiving 2% lidocaine, 0.5% levobupivacaine, or the control group. The Visual Analogue Scale (VAS) was used by a blinded nurse at four different time points (2, 6, 12 and 24 h after the surgery) to measure pain intensity. Results: The significant effect of time on the pain intensity (p = 0.001) was found. Additionally, the interaction between time and different local analgesics (p < 0.001) was observed. In patients in whom 0.5% levobupivacaine has been used, significantly lower VAS pain scores were recorded at each time point assessed, in comparison with the patients who received 2% lidocaine or the patients from the control group in whom no local anesthetic was applied (p < 0.001). Furthermore, in patients in whom 2% lidocaine was administrated, significantly lower pain levels according to VAS were reported than in those from the control group, except for the time point at 24 h after surgery when pain levels were comparable. Concerning the postoperative pain control, the number of patients who requested oral analgesics postoperatively was significantly lower in the group of patients in whom local anesthetic was administrated intraoperatively (2% lidocaine – n = 4, 20%; 0.5% levobupivacaine – n = 1, 5%) compared to the patients who did not receive any local anesthetic during the surgery (n = 13; 65%) (p < 0.001). Conclusion: A significant reduction in postoperative pain intensity and analgesics consumption in patients undergoing laparoscopic varicocelectomy who received intraoperative local anesthetic was observed. The best effect on postoperative pain intensity, according to the VAS score, was achieved by 0.5% levobupivacaine.

scholarly journals Comparative evaluation of postoperative pain intensity after single-visit and multiple-visit retreatment cases: a prospective randomized clinical trial

2018 ◽  
Vol 21 (1) ◽  
pp. 26 ◽  
Author(s):  
Hatice Miray Uyan ◽  
Keziban Olcay ◽  
Mutlu Özcan
Keyword(s):  
Postoperative Pain ◽  
Repeated Measures ◽  
Control Group ◽  
Periapical Lesions ◽  
Single Visit ◽  
Group 4 ◽  
Multiple Visit ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2

<p><strong>Objective:</strong> This study was designed to evaluate postoperative pain after endodontic retreatment. <strong>Material and Methods:</strong> Asymptomatic, multi-rooted molar &amp; premolar teeth requiring retreatment with 2–5 mm periapical lesions were included. Seventy-eight teeth were randomly placed in four groups (n=20): single-visit (control, group 1), Ledermix (group 2), metronidazole, ciprofloxacin, minocycline mixture (group 3), calcium hydroxide (group 4). The postoperative pain was recorded using a VAS at 6, 12, 24, and 48 h after retreatment. Statistical evaluation was performed using Two-Way Repeated Measures ANOVA and Tukey test. <strong>Results:</strong> Mild pain occurred in 67.5%, moderate in 30%, and flare-ups in 2.5%, and there was a significant difference between the groups (p&lt;0.01). Significantly lower postoperative pain was observed in TAP and CaOH<sub>2 </sub>groups(p&lt;0.05). In the 6, 12, and 24 h intervals, there was a significant difference in the pain levels (p&lt;0.05). <strong>Conclusion:</strong> TAP and CaOH<sub>2</sub> are effective for reducing postoperative pain after retreatment.</p><p><strong>Keywords</strong></p><p>Intracanal medicaments; Multiple-visit; Postoperative pain; Retreatment; Single-visit.</p>

scholarly journals Cryotherapy Reduced Postoperative Pain in Gynecologic Surgery: A Randomized Controlled Trial

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Apisada Chumkam ◽  
Densak Pongrojpaw ◽  
Athita Chanthasenanont ◽  
Junya Pattaraarchachai ◽  
Kornkarn Bhamarapravatana ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Statistical Difference ◽  
Controlled Trial ◽  
Exploratory Laparotomy ◽  
Gynecologic Surgery ◽  
Control Group ◽  
Study Group ◽  
Control Groups ◽  
Vas Score ◽  
And Control

Objective. To examine the effectiveness of cryotherapy for reducing postoperative pain in patients who underwent exploratory laparotomy for gynecologic surgery. Materials and Methods. Patients who had indication for an exploratory laparotomy gynecologic procedure were selected by attending physicians to undergo abdominal surgery via low transverse skin incision. The participants were randomized into study and control groups with simple random sampling methods. Cold packs were applied at two hours after operation for 6 hours. The visual analog scale (VAS) score was recorded at two, 6, and 12 hours after operation. Result. One hundred cases were recruited and then divided into study and control groups equally. The mean age of both groups was 43 years. There was no difference in demographics data of both groups. Half of the participants in both groups underwent hysterectomies. At two hours after surgery, both groups had similar VAS scores. The study group had a lower VAS score at 6 and 12 hours after surgery than the control group with statistical difference. Morphine consumption within 24 hours after surgery in both the study and control groups was 2.8±3.4 and 3.0±4.4 mg, respectively, with no statistical difference. However the registration time of the first morphine requirement in the study group was statistically more prolonged than that of the control group. The lengths of hospital stay in both groups were similar. There was no complication reported in this study. Conclusion. Cryotherapy can reduce postoperative pain. In this presented study the patients who underwent gynecologic surgery had improved pain relief and prolonged time for the first dose of the analgesic drug.

scholarly journals Postoperative analgesia with the use of peripheral nerve block of the foot and ankle

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0046
Author(s):  
Kelly Stéfani ◽  
Gabriel Ferraz
Keyword(s):  
Peripheral Nerve ◽  
Pain Intensity ◽  
Nerve Block ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Peripheral Nerve Block ◽  
Control Group ◽  
Study Group ◽  
Foot And Ankle ◽  
The Mean

Category: Basic Sciences/Biologics Introduction/Purpose: Peripheral nerve block in the foot and ankle is usually used for anesthesia in forefoot and midfoot surgeries. However, since the postoperative analgesia obtained is prolonged, we can expand its use, as an adjuvant after the end of the spinal or general anesthesia. The aim of this study was to evaluate the use of peripheral nerve block of the foot and ankle as a method of postoperative analgesia. Methods: A prospective, randomized, blinding study was performed. The study group included 30 patients (32 feet) submitted to peripheral anesthetic block after surgery with spinal anesthesia and the control group (30 patients, 31 feet) were patients not submitted to nerve block. The inclusion criterion was: patients submitted to foot and ankle surgery at our institution. Patients answered the questionnaire postoperatively, with the measurement of pain intensity by the Visual Analog Scale (VAS) and the time of onset of pain. All local peripheral block was performed by the same orthopedic team with 20 mL of Ropivacaine at a concentration of 7.5 mg / mL (0.75%). Results: The mean patient age was 52,5 years, and the majority of patients were women (66%). The results showed a statistically significant difference between the control group and the study group, with a longer time of postoperative analgesia (p <0.001) and lower pain intensity in the immediate postoperative period (p <0.001) in patients submitted to blockade anesthetic. There was no statistical difference between the two groups regarding pain intensity on the first and second postoperative day. Conclusion: In the study group, the mean postoperative pain (six hours after surgery) was lower when compared to the control group, with statistical significance. This result showed that the ankle block helped to control pain, in a safe and effective mode. The use of ropivacaine presents a sensitive block similar to bupivacaine, but with shorter motor block, allowing early initiation of rehabilitation. The study demonstrated that peripheral nerve block in the foot and ankle region can be used effectively in postoperative analgesia, reducing pain intensity in the immediate postoperative period and also prolonging analgesia and thus maximizing physiotherapy postoperative period.

scholarly journals The effectiveness of preoperative individual information on reducing anxiety and pain after hysterectomy: A randomized controlled trial

2019 ◽  
Vol 10 (1) ◽  
pp. 67
Author(s):  
Hrønn Thorn ◽  
Lisbeth Uhrenfeldt
Keyword(s):  
Randomized Controlled Trial ◽  
Postoperative Pain ◽  
Controlled Trial ◽  
Anxiety Level ◽  
Preoperative Anxiety ◽  
Control Group ◽  
Study Group ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Individual Information

Background and objective: Preoperative anxiety among gynecological patients is well-known and has a direct correlation with postoperative pain. By minimizing preoperative anxiety, the level of postoperative pain may decrease.  The purpose of this study was to evaluate the effect of preoperative structured information and dialogue on patients' anxiety and postoperative pain.Methods: A single-center non-blinded randomized controlled trial. Forty-six women scheduled for hysterectomy were allocated either to the study group or the control group.  The study group was given individual information at a preoperative consultation while the control group was given information at admittance. The main outcome was anxiety level and postoperative pain.Results: Forty participants (study group = 20; control group = 20) were analyzed. No statistically significant difference was found in anxiety level within the first 24 h postoperatively or in postoperative pain within four weeks between the groups.Conclusions: Preoperative individual information and dialogue did not result in significant effects in reducing anxiety level nor did it result in lower postoperative pain score.

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