scholarly journals The Effect of Incisional and/or Intraperitoneal Local Anesthetic Application on Postoperative Pain during Laparoscopic Cholecystectomy

2016 ◽  
Vol 1 (05) ◽  
Author(s):  
Oguz Ugur Aydin ◽  
Eda Uysal Aydin ◽  
Ozgur Dandin ◽  
Diğdem Ozer Etik ◽  
Nedım Cekmen ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Placebo Group ◽  
Postoperative Pain ◽  
Shoulder Pain ◽  
Postoperative Pain Control ◽  
Combined Application ◽  
Pain Scores ◽  
Group I ◽  
American Society ◽  
American Society Of Anesthesiologists

Objective - In this study, we aimed to determine the effect of levobupivacaine (LB) application by intraperitoneal, incisional, and both together on postoperative pain after laparoscopic cholecystectomy. Materials and Methods - One hundred ASA (American Society of Anesthesiologists) I-II patients undergoing laparoscopic cholecystectomy were recruited in the study. The patients were randomized into four groups: placebo group (P), incisional group (I), intraperitoneal group (IP), and the combined (incisional+intraperitoneal) group (C). In the postoperative period, pain in the patients during resting and coughing was evaluated after 30 min, 2, 4, 8, 12, and 24 hours by employing visual analogue scale (VAS) for pain. Applied analgesic quantity, shoulder pain, and the existence of nausea-vomiting were also recorded. Results - Pain scores during resting and coughing were significantly lower in the combined group compared with others. Pain scores were similar in the incision and intraperitoneal groups, whereas in the placebo group were significantly lower. The analgesic need was lowest in the combined group and highest in the placebo group. There was no shoulder pain either in the combined or intraperitoneal groups. Nausea-vomiting rates were similar in all groups. Conclusions - We conclude that combined application of 0.25 % levobupivacaine can be used as an effective and safe method for postoperative pain control after laparoscopic cholecystectomy.

scholarly journals Comparison in Sedative Effects between Dexmedetomidine and Midazolam in Dental Implantation: A Randomized Clinical Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Li Wang ◽  
Yi Zhou ◽  
Tiejun Zhang ◽  
Lili Huang ◽  
Wei Peng
Keyword(s):  
Vital Signs ◽  
Pain Scores ◽  
Dental Implantation ◽  
Group I ◽  
Random Manner ◽  
The Difference ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Adrenergic Receptor Agonist ◽  
Alternative Drugs

Dexmedetomidine refers to an α2-adrenergic receptor agonist causing potent sedative, analgesic, and minimal respiratory depression compared with alternative drugs. The present study was aimed at comparing the efficaciousness and safety of midazolam and dexmedetomidine as sedatives for dental implantation. We recruited 60 patients belonging to group I or II of the American Society of Anesthesiologists (ASA) and treated them with either midazolam or dexmedetomidine in a random manner. Patients’ duration of analgesia after surgery, surgeon and patient degrees of satisfaction, Observer’s Assessment of Alertness/Sedation Scale (OAAS) scores after drug administration, visual analogue scale (VAS) pain scores, and vital signs were recorded variables. Patients administered dexmedetomidine had significantly lower OAAS scores than those administered midazolam (p<0.05). Patients administrated dexmedetomidine had a significantly longer analgesia duration after the surgical procedure than those administered midazolam, and the difference was statistically significant (p<0.05). Dexmedetomidine had a significantly larger number of surgeons satisfied with the level of sedation/analgesia than midazolam (p<0.05). Accordingly, it is considered that dexmedetomidine can achieve better postoperative analgesia, surgeon satisfaction, and sedation than midazolam.

scholarly journals Effects of Gabapentin on Postoperative Pain and Total Analgesic Requirement After Laparoscopic Cholecystectomy

2019 ◽  
Vol 12 (2) ◽  
pp. 925-929
Author(s):  
Zaffar Abbas ◽  
Amina Bashir ◽  
Zaffar Abbas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Placebo Group ◽  
Postoperative Pain ◽  
Visual Analogue Scale ◽  
Analogue Scale ◽  
Analgesic Requirement ◽  
Matching Placebo ◽  
Pain Scores ◽  
Group A ◽  
To Receive

The aim of this study is to determine the effect of preoperative use of gabapentin on postoperative pain in patients undergoing laparoscopic cholecystectomy. Sixty adult patients listed for laparoscopic cholecystectomy were randomly allocated to two groups of 30 each to receive gabapentin 600 mg p.o. or a matching placebo 2 hours before surgery. Postoperative pain was monitored using 100 mm visual analogue scale (0 for no pain and 100 for worst imaginable pain) at 1, 2, 6, 12 and 24 hours. Diclofenac 75 mg IM was used as rescue analgesic and total analgesic requirement (mg/24hr) in first 24 hours following surgery was recorded. Postoperative pain scores and total analgesic requirement was significantly less in gabapentin group compared to placebo group. A single 600 mg dose of gabapentin given preoperatively decreased postoperative pain and total analgesic requirement following laparoscopic cholecystectomy. Preemptive use of gabapentin can be used to treat postoperative pain caused by laparoscopic cholecystectomy.

Preemptive Intravenous Morphine-6-glucuronide Is Ineffective for Postoperative Pain Relief

2000 ◽  
Vol 92 (2) ◽  
pp. 355-355 ◽  
Author(s):  
Cyrus Motamed ◽  
Xavier Mazoit ◽  
Khaldoun Ghanouchi ◽  
Frédéric Guirimand ◽  
Kou Abhay ◽  
...  
Keyword(s):  
Placebo Group ◽  
Side Effects ◽  
Postoperative Pain ◽  
Patient Characteristics ◽  
Skin Closure ◽  
Acute Postoperative Pain ◽  
Morphine Group ◽  
Intravenous Morphine ◽  
American Society ◽  
American Society Of Anesthesiologists

Background Morphine-6-glucuronide (M-6-G), a major metabolite of morphine, is reported to be more potent than morphine when administered intrathecally; however, its efficiency remains under debate when administered intravenously. This study was designed to assess the analgesic efficiency of intravenous M-6-G for the treatment of acute postoperative pain. Methods After informed consent was obtained, 37 adults (American Society of Anesthesiologists physical status I-II) who were scheduled for elective open knee surgery were enrolled in the study. General anesthesia was induced with thiopental, alfentanil, and vecuronium and was maintained with a mixture of nitrous oxide/isoflurane and bolus doses of alfentanil. At skin closure, patients were randomized into three groups: (1) morphine group (n = 13), which received morphine 0.15 mg/kg; (2) M-6-G group (n = 12), which received M-6-G 0.1 mg/kg; and (3) placebo group (n = 12), which received saline. At the time of extubation, plasma concentration of morphine and M-6-G was measured. Postoperative analgesic efficiency was assessed by the cumulative dose of morphine delivered by patient-controlled analgesia. Opioid-related side effects were also evaluated. Results No difference was noted in patient characteristics and opioid-related side effects. Morphine requirements (mean +/- SD) during the first 24 h in the M-6-G group (41+/-9 mg) and the placebo group (49+/-8 mg) were significantly greater (P&lt;0.05) compared with the morphine group (29+/-8 mg). Conclusion A single intravenous bolus dose of M-6-G was found to be ineffective in the treatment of acute postoperative pain. This might be related to the low permeability of the blood-brain barrier for M-6-G.

Preoperative Multimodal Analgesia for Laparoscopic Cholecystectomy

2018 ◽  
pp. 217-222
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Study Groups ◽  
Multimodal Analgesia ◽  
Double Blind Study ◽  
Double Blind ◽  
Same Day Discharge ◽  
Elective Laparoscopic Cholecystectomy ◽  
American Society ◽  
American Society Of Anesthesiologists

This case focuses on the use of local anesthesia, nonsteroidal anti-inflammatory or opioid drugs, for laparoscopic cholecystectomy by asking the question: Does prophylactic multimodal nociceptive blockade delay the onset of postoperative pain, decrease analgesic requirements, speed recovery, and facilitate same-day discharge in patients undergoing elective laparoscopic cholecystectomy? In this randomized, double-blind study, intraoperative anesthetic care and postoperative pain and nausea management were standardized for all patients. Study groups were similar in terms of patient age, gender, weight, American Society of Anesthesiologists class, baseline and preinduction pain and nausea scores, duration of surgery, and total dose of propofol received. This study demonstrated the benefit of preoperative multimodal analgesia on recovery and discharge.

scholarly journals Efficacy of Continuous S(+)-Ketamine Infusion for Postoperative Pain Control: A Randomized Placebo-Controlled Trial

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Luiz Eduardo de Paula Gomes Miziara ◽  
Ricardo Francisco Simoni ◽  
Luís Otávio Esteves ◽  
Luis Henrique Cangiani ◽  
Gil Fernando Ribeiro Grillo-Filho ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Pain Control ◽  
Controlled Trial ◽  
Intervention Group ◽  
Morphine Consumption ◽  
Postoperative Pain Control ◽  
Intravenous Anesthesia ◽  
Ketamine Infusion ◽  
Pain Scores

Aim.A double-blind, randomized, placebo-controlled trial was designed to evaluate the efficacy of continuous intraoperative infusion of S(+)-ketamine under intravenous anesthesia with target-controlled infusion of remifentanil and propofol for postoperative pain control.Methods.Forty-eight patients undergoing laparoscopic cholecystectomy were assigned to receive continuous S(+)-ketamine infusion at a rate of 0.3 mg·kg−1·h−1(n=24, intervention group) or an equivalent volume of saline at the same rate (n=24, placebo group). The same target-controlled intravenous anesthesia was induced in both groups. Pain was assessed using a 0 to 10 verbal numeric rating scale during the first 12 postoperative hours. Pain scores and morphine consumption were recorded in the postanesthesia care unit (PACU) and at 4 and 12 hours after surgery.Results.Pain scores were lower in the intervention group at all time points. Morphine consumption did not differ significantly between groups during PACU stay, but it was significantly lower in the intervention group at each time point after PACU discharge (P=0.0061). At 12 hours after surgery, cumulative morphine consumption was also lower in the intervention group (5.200±2.707) than in the placebo group (7.525±1.872).Conclusions.Continuous S(+)-ketamine infusion during laparoscopic cholecystectomy under target-controlled intravenous anesthesia provided better postoperative pain control than placebo, reducing morphine requirement.Trial Registration. This trial is registered with ClinicalTrials.govNCT02421913.

scholarly journals Does Premedıcatıon wıth Mıdazolam Reduce Preoperatıve Anxıety Through Menstrular Cycle Phases?

2021 ◽  
pp. 1-6
Author(s):  
Canan Çaldır Yıldız ◽  
◽  
Fadime Tosun ◽  
Buket Çağla Özbakış Akkurt ◽  
◽  
...  
Keyword(s):  
Menstrual Cycle ◽  
Postoperative Pain ◽  
Preoperative Anxiety ◽  
Reproductive Age ◽  
Pain Scores ◽  
Preoperative Test ◽  
Significant Difference ◽  
Vas Scores ◽  
American Society ◽  
American Society Of Anesthesiologists

Aim: In this study, it was aimed to investigate and compare the effects of menstrual cycle phases on preoperative anxiety and postoperative pain scores in patients given midazolam for premedication before anesthesia. Methods: Septorhinoplasty, goiter surgery and laparoscopic cholecystectomy 126 female patients, aged 21-45, with American Society of Anesthesiologists (ASA) score I-II and with regular menstrual cycles, were included. Of the cases; The phase of the menstrual cycle was recorded according to the last menstrual period (SAT) and accordingly the patients were divided into 3 groups as Follicular phase, the Ovulatory phase, and the Luteal phase. Anxiety assessment was performed using the State-Trait Anxiety Inventory (STAI FORM TX-1) test. Anxiety scores were evaluated by performing a preoperative test 3 minutes before and 1 hour after intravenous (IV) administration of 0.02 mg/kg midazolam. Visual analog scale (VAS) was used for postoperative pain assessment. Results: Midazolam was found to decrease STAI FORM TX-1 scores the most during the ovulatory phase of the menstrual cycle, but there was no significant difference between the groups in terms of VAS scores. Conclusion: It has been observed that premedication with midazolam reduces preoperative anxiety in all phases of the menstrual cycle in women of reproductive age, but is most effective in the ovulatory phase. The effect of premedication with midazolam on postoperative pain does not change according to the phases of the menstrual cycle.

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 Effects of Gabapentinoids Premedication on Shoulder Pain and Rehabilitation Quality after Laparoscopic Cholecystectomy: Pregabalin versus Gabapentin

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Mohamed Said Nakhli ◽  
Mohamed Kahloul ◽  
Chawki Jebali ◽  
Walid Frigui ◽  
Walid Naija
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Placebo Group ◽  
Sleep Quality ◽  
Shoulder Pain ◽  
Onset Time ◽  
Postoperative Nausea And Vomiting ◽  
Standing Position ◽  
Postoperative Rehabilitation ◽  
Link Type ◽  
Postoperative Shoulder

Introduction. Gabapentinoids are increasingly used in preoperative premedication despite controversial results. The aim of our study was to evaluate the effects of preemptive use of gabapentin or pregabalin on postoperative shoulder pain and rehabilitation quality after laparoscopic cholecystectomy. Methods. This is a clinical trial comparing the effects of a preoperative premedication with 600 mg of gabapentin or 150 mg of pregabalin versus placebo on postoperative pain and recovery quality after laparoscopic cholecystectomy. Premedication was taken 2 hours before the surgery beginning. Ninety patients were included and randomized into 3 groups (gabapentin, pregabalin, and placebo). The anesthetic protocol was the same for all patients. Primary endpoint was the shoulder pain intensity at the 48th postoperative hour. Secondary endpoints were postoperative nausea and vomiting (PONV), sleep quality during the first night, and the onset time for the first standing position. Results. During the first 48 postoperative hours, the gabapentin and pregabalin groups had significantly lower shoulder pain than the placebo group (p<0.05). In gabapentinoids groups, the incidence of PONV was lower and the sleep quality during the first postoperative night was better with significant results. Mean Spiegel scores were 22.43 ± 1.45, 22.30 ± 1.44, and 17.17 ± 1.66, respectively, in pregabalin, gabapentin, and placebo groups (p<0.05). The delay for the first standing position was 14.9 ± 4.9 hours in the pregabalin group, 9.7 ± 3.6 hours in the gabapentin group, and 21.6 ± 2.1 hours in the placebo group. No superiority was found between gabapentin and pregabalin. Conclusion. Preemptive premedication with gabapentinoids can enhance postoperative rehabilitation quality after laparoscopic cholecystectomy by reducing postoperative shoulder pain, decreasing PONV incidence, and improving sleep quality during the first postoperative night. This trial is registered with ClinicalTrial.gov (NCT03241875).

Randomised clinical trial comparing the perioperative analgesic efficacy of oral tramadol and intramuscular tramadol in cats

2021 ◽  
pp. 1098612X2110404
Author(s):  
Sébastien H Bauquier
Keyword(s):  
Clinical Trial ◽  
Postoperative Pain ◽  
Analgesic Efficacy ◽  
Randomised Clinical Trial ◽  
Rescue Analgesia ◽  
Exact Test ◽  
Pain Scores ◽  
Significant Difference ◽  
American Society ◽  
Induction Of Anaesthesia

Objectives The aim of this study was to evaluate the analgesic efficacy of oral tramadol in cats undergoing ovariohysterectomy. Methods Twenty-four female domestic cats, American Society of Anesthesiologists class I, aged 4–24 months, were included in this positive controlled, randomised, blinded clinical trial. Cats admitted for ovariohysterectomy were allocated to group oral tramadol (GOT, n = 12) or group intramuscular tramadol (GIMT, n = 12). In GOT, tramadol (6 mg/kg) was given orally 60 mins, and saline was given intramuscularly 30 mins, before induction of anaesthesia. In GIMT, granulated sugar in capsules was given orally 60 mins and tramadol (4 mg/kg) intramuscularly 30 mins before induction of anaesthesia. In both groups, dexmedetomidine (0.007 mg/kg) was given intramuscularly 30 mins before induction of anaesthesia with intravenous propofol. Anaesthesia was maintained with isoflurane in oxygen, and atipamezole (0.037 mg/kg) was given intramuscularly 10 mins after extubation. The UNESP-Botucatu multidimensional composite scale was used to conduct pain assessments before premedication and at 20, 60, 120, 240 and 360 mins post-extubation or until rescue analgesia was given. To compare groups, the 60 min postoperative pain scores and the highest postoperative pain scores were analysed via a two-tailed Mann–Whitney test, and the incidences of rescue analgesia were analysed via a Fisher’s exact test; P <0.05. Results There was no significant difference between groups for the 60 min ( P = 0.68) pain scores. The highest postoperative pain score was higher for GIMT compared with GOT ( P = 0.04). Only two cats required rescue analgesia, both from GIMT. The incidence of rescue analgesia was not significantly different between groups ( P = 0.46). Conclusions and relevance In the present study, preoperative administration of oral tramadol at 6 mg/kg to cats provided adequate analgesia for 6 h following ovariohysterectomy surgery.

scholarly journals Effect of Intravenous Dexamethasone on Propofol Injection Pain: A Randomized Placebo Controlled Study

2020 ◽  
Vol 25 (1) ◽  
pp. 28-33
Author(s):  
Muhammad Sazzad Hossain ◽  
Md Afzalur Rahman ◽  
Mamunur Rashid ◽  
Monirul Islam ◽  
Anisur Rahman Babu ◽  
...  
Keyword(s):  
Normal Saline ◽  
Saline Group ◽  
Controlled Study ◽  
Injection Pain ◽  
Moderate Pain ◽  
Dexamethasone Group ◽  
Group I ◽  
Elective Surgical Procedure ◽  
American Society ◽  
American Society Of Anesthesiologists

Background and aim of study: Pain on propofol injection (POPI) is a common problem. None of the commonly used methods completely attenuate the pain. Inflammatory response to propofol contributes to the pain. This study was conducted to compare the efficacy of dexamethasone in attenuation of pain following intravenous injection of propofol. Materials and methods: A total of 80 adult patients were scheduled in this study with either sex, ASA (American Society of Anesthesiologists) grade I and II, for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 0.15 mg/kg of intravenous dexamethasone in 5 ml normal saline and Group II (placebo group) received 5 ml of 0.9% intravenous normal saline, following exsanguination and occlusion of the vein of the arm. This was followed by 0.5 mg/kg of propofol intravenously.The patients were asked to report their pain during injection of propofol according to the McCririck and Hunter scale. Results: The incidence of pain experienced in dexamethasone group was 45% patients and in saline group was 70% patients (p<0.05). The severity of POPI was also lower in dexamethasone group than the saline group (p<0.05). The incidence of mild and moderate pain in dexamethasone groups versus saline group was 30% versus 45% and 15% versus 25% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion: Pretreatment with intravenous dexamethasone (0.15 mg/kg) before injection of propofol is effective and safe in reducing the incidence and severity of pain on propofol injection (POPI). Bangladesh J Otorhinolaryngol; April 2019; 25(1): 28-33

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