scholarly journals Comparative Study in the Management of Postoperative Pain with High Dose Intravenous Paracetamol versus Tramadol

2021 ◽  
Vol 5 (4) ◽  
pp. 1-6
Author(s):  
Tanudeep Kaur ◽  
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Emotional Experience ◽  
Postoperative Pain Management ◽  
Economic Benefits ◽  
High Dose ◽  
Postoperative Patient ◽  
Intravenous Paracetamol

Pain is an unpleasant sensory and emotional experience causing agony and several side effects in a postoperative patient. Thus effective postoperative pain management has a humanitarian role with additional medical and economic benefits Paracetamol (PCM) has been widely used as an effective analgesic and antipyretic for over a century with an established safety profile, and Tramadol is a commonly used intravenous drug for postoperative pain relief.

scholarly journals Oral Oxycodone for Acute Postoperative Pain: A Review of Clinical Trials

2017 ◽  
Vol 2 (20;2) ◽  
pp. sE33-sE52 ◽  
Author(s):  
Chi-Wai Cheung
Keyword(s):  
Clinical Trials ◽  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Hospital Stay ◽  
Spine Surgery ◽  
Analgesic Efficacy ◽  
Postoperative Pain Management ◽  
Acute Postoperative Pain

Background: Opioids are the mainstay of pain management for acute postsurgical pain. Oral oxycodone is an opioid that can provide effective acute postoperative pain relief. Objectives: To evaluate the use of oral oxycodone for acute postoperative pain management. Study Design: This is a narrative review based on published articles searched in PubMed and Medline from 2003 to 2015 on oral oxycodone for acute postoperative pain management. Methods: Clinical trials related to the use of oral oxycodone for acute postoperative pain management were searched via PubMed and Medline from 2003 to 2015. The search terms used were “oral strong opioids,” “postsurgical,” “postoperative,” “post-surgical,” and “postoperative.” Treatment interventions were compared for analgesic efficacy, rescue medication use, side effects, recovery, length of hospital stay, and patient satisfaction. Results: There were 26 clinical trials included in the review. Oral oxycodone showed superior postoperative analgesic efficacy compared with placebo in patients undergoing laparoscopic cholecystectomy, abdominal or pelvic surgery, bunionectomy, breast surgery, and spine surgery. When compared with intravenous opioids, oral oxycodone provided better or comparable pain relief following knee arthroplasty, spine surgery, caesarean section, laparoscopic colorectal surgery, and cardiac surgery. One study of dental postsurgery pain reported inferior pain control with oral oxycodone versus rofecoxib. (withdrawn from the US market due to cardiac safety concerns). In many studies, the demand for rescue analgesia and total opioid consumption were reduced in the oxycodone treatment arm. Patients receiving oral oxycodone experienced fewer opioid-related side effects than those on other opioids, and had a similar occurrence of postoperative nausea and vomiting as patients on placebo. Furthermore, oral oxycodone did not prolong hospital stay and was associated with lower drug costs compared with epidural and intravenous analgesics. Oxycodone administered as part of a multimodal analgesic regimen produced superior pain relief with fewer side effects and a reduced hospital stay. Limitation: There is a limited number of randomized double blinded studies in individual surgical operations, thus making it more difficult to come up with definitive conclusions. Conclusion: Oral oxycodone appears to offer safe and effective postoperative analgesia, and is a well-accepted and reasonable alternative to standard intravenous opioid analgesics. Key words: Postoperative, pain, analgesia, oral oxycodone, opioid

Transdermal Buprenorphine- A novel Medication for Postoperative Pain Management Following Abdominal Hysterectomy for Benign Gynecological Conditions

2021 ◽  
Vol 17 ◽  
Author(s):  
Aarti Yevale ◽  
Jyothi Shetty ◽  
Vidyashree G Poojari ◽  
Vasudeva Guddattu
Keyword(s):  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Nausea And Vomiting ◽  
Postoperative Pain Management ◽  
Abdominal Hysterectomy ◽  
Postoperative Pain Relief ◽  
Safe Alternative ◽  
Intravenous Paracetamol ◽  
Semisynthetic Derivative ◽  
Time Frames

Background: Buprenorphine is a semisynthetic derivative of thebaine which is 75–100 times more potent than morphine and causes less respiratory depression. Efficacy and safety of transdermal buprenorphine have been well established in chronic pain, but data regarding acute postoperative pain relief are still limited. Aim: In this study we compared the efficacy of transdermal buprenorphine patch with injectable tramadol for the relief of postoperative pain (POP) following abdominal hysterectomy for benign gynecological conditions. Settings and design: three-year prospective observational study. Methods and material: One hundred patients undergoing abdominal hysterectomy were allocated to one of two groups. Buprenorphine group: we applied 10 mcg/hr transdermal buprenorphine patch on the lateral upper arm after surgery. The onset of relief from a patch is 8 to 16 hours. So, all patients were given diclofenac suppository 100mg before induction of anesthesia as preemptive analgesic to reduce postoperative pain. Injectable tramadol group : received intramuscular tramadol injections 50mg every 8 hours in the postoperative period. Patients were followed for two days to look for postoperative pain relief and adverse effects. If patients showed a visual analog pain (VAS) score >3, intravenous paracetamol was administered as rescue analgesic. Results: POP was assessed at different time frames: 12, 24, 36 and 48 hours after hysterectomy. Mean pain score at rest, in buprenorphine group was significantly lower than that of the tramadol group. Patients experienced less pain on mobility in the buprenorphine group compared with the tramadol group, which was statistically significant. Conclusion: We concluded that transdermal buprenorphine is an effective and safe alternative to injectable tramadol for providing postoperative analgesia. It provides a higher degree of pain relief, faster postoperative mobilization, lower incidence of postoperative nausea and vomiting and higher satisfaction scores starting 12 hours after surgery. However, for the first 12 post-operative hours, there is need for additional analgesia.

The Quality Test for Postoperative Pain Management using the American Pain Society Patient Outcome Questionnaire Revisied (APS-POQ-R) version Indonesia at Mohammad Hoesin Hospital in Palembang (A study of the quality level of postoperative pain management

2020 ◽  
Vol 1 (2) ◽  
pp. 41-45
Author(s):  
Malina Resta Maria Panjaitan ◽  
Dewi Arsinta ◽  
Rose Mafiana
Keyword(s):  
Patient Outcome ◽  
Pain Management ◽  
Postoperative Pain ◽  
Emotional Experience ◽  
Postoperative Pain Management ◽  
Education Level ◽  
Quality Level ◽  
Outcome Questionnaire ◽  
Post Operative Pain

A B S T R A C TPain is an unpleasant sensory and emotional experience associated with actual orpotential tissue damage, or described in terms of such damage. APS-POQ-R (RevisedAmerican Pain Society Patient Outcome Questionnaire) is a measuring tool for assessingthe quality of postoperative pain management by exploring patient experiences andoutcomes. This research aims to assess the quality of postoperative pain managementat Mohammad Hoesin Hospital Palembang and to determine the factors that influenceit. The Cross-sectional observational analytic study was conducted toward 51respondents. Data was collected primarily by using questionnares and interview. Datawas analyzed by using chi-square. The study showed that the quality of postoperativepain management at RSUP Mohammad Hoesin General Hospital Palembang has goodquality with a total of 27 patients (52.9%). From statistical analysis there wassignificant relationship between the quality of post-operative pain management withage (p=0,037), gender (p=0,027), ethnicity (p=0,039), education level (p=0,039), andeconomic level (p=0,005). So it can be concluded that was a significant relationshipbetween the quality of post-operative pain management with age, gender, ethnicity,education level, and economic level.

scholarly journals Continuous Fentanyl Background Infusion Regimen Optimised by Patient-Controlled Analgesia for Acute Postoperative Pain Management: A Randomised Controlled Trial

2020 ◽  
Vol 9 (1) ◽  
pp. 211 ◽  
Author(s):  
Jihoon Hwang ◽  
Sang Kee Min ◽  
Yun Jeong Chae ◽  
Gang Mee Lim ◽  
Han Bum Joe
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
Randomised Controlled Trial ◽  
Controlled Trial ◽  
Postoperative Pain Management ◽  
Patient Controlled Analgesia ◽  
Acute Postoperative Pain ◽  
Background Infusion ◽  
Randomised Controlled

Owing to a lack of studies investigating the effect of adjustments in fentanyl background infusion (BI) with patient-controlled analgesia (PCA) on postoperative analgesia, we evaluated three BI regimens with fentanyl PCA for acute postoperative pain management. This randomised controlled trial enrolled 105 patients, who were assigned to three parallel groups: constant rate BI of 2 mL/h (CRBI group); time-scheduled decremental BI of 6, 2 and 1 mL/h (TDBI group); and BI rates optimised to the demand of PCA (POBI group). The incidence of insufficient analgesia, visual analogue scale (VAS) pain score and side effects were evaluated. The incidence of insufficient analgesia in the post-anaesthesia care unit was lower in the TDBI and POBI groups than the CRBI group. Incidence of insufficient analgesia in the ward was lower in the POBI group than the CRBI group. Postoperative VAS scores were significantly lower in the TDBI and POBI groups for up to 4 h and 24 h, respectively, compared with the CRBI group. Side effects and infused fentanyl dose were highest in the CRBI group. Adjusting BI rate based on time or patient demands could improve postoperative analgesia and reduce side effects. Compared to a constant BI rate, PCA-optimised BI achieved higher patient satisfaction.

Postoperative analgesia after radical prostatectomy with high-dose intrathecal morphine and intravenous naloxone: A retrospective review

2018 ◽  
Vol 5 (6) ◽  
pp. 331-339 ◽  
Author(s):  
Annette Rebel, MD ◽  
Paul Sloan, MD ◽  
Michael Andrykowski, PhD
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Radical Prostatectomy ◽  
Respiratory Depression ◽  
Postoperative Analgesia ◽  
Intrathecal Morphine ◽  
Major Surgery ◽  
High Dose ◽  
The Mean

Background and methods: Intrathecal opioids (ITOs) have been used for decades to control postoperative pain. Intrathecal opioid dosing is limited, however, by opioid-related side effects, most importantly respiratory depression. To overcome these limitations, we combined intrathecal morphine with a continuous intravenous (IV) postoperative naloxone infusion to control opioid-related side effects. The purpose of this study is to document the efficacy and safety of high-dose intrathecal morphine combined with postoperative naloxone infusion to provide postoperative analgesia after major surgery. After IRB approval, a retrospective chart analysis was performed on 35 patients who had a radical prostatectomy from 2004 to 2006. All patients received a single injection of ITOs before anesthesia, a typical general anesthestic, followed by naloxone infusion at 5 μg/kg/h started 1 hour post-ITOs and continued for 22 hours postoperatively. The following information was collected: patient age, height, weight, anesthesia technique/time, and dose of ITOs given. Postoperative pain relief was assessed for 48 hours using the Visual Analog Score (VAS) for pain (0, no pain; 10, worst pain), perioperative opioid use, NSAID consumption, and ability of patient to ambulate. The safety of this novel treatment was assessed with opioid-related side effects and vital signs. All data are reported as mean (SD).Results: Mean ITOs given were morphine 1.3 (0.3) mg combined with fentanyl 56 (9) μg. The intrathecal morphine dose ranged from 0.8 to 1.7 mg. The mean worst pain VAS in the first 12 hours postoperatively was only 1.0 (1.7). The first NSAID dose was given 6.6 (3.1) hours post-ITOs. The first opioid on the floor was given an average of 22.6 (14.5) hours post-ITOs. A mean of only 5.7 (12.3) morphine equivalents were required on postoperative day 1 (POD 1). On POD 2, the mean worst pain VAS was only 2.6 (2.2) with only 5.7 (6.2) morphine equivalents needed to provide pain relief. On POD 1, 25 patients required no additional opioids for their entire hospital stay. Overall, 11 of 35 patients did not require any additional postoperative opioids. Thirtyfour patients (97 percent) were able to ambulate in the first 12 hours postoperatively. No opioid-induced respiratory depression was observed. Opioid-related side effects (pruritus, nausea) were infrequent and minor.Conclusions: High-dose ITOs combined with postoperative IV naloxone infusion provided excellent analgesia for radical prostate surgery. IV naloxone infusion appeared to control opioid side effects without diminishing the analgesia. No serious adverse effects were noted.

scholarly journals Effectiveness of Ketoprofen Suppositoria as Preemptive Analgesia for Postoperative Pain in Patients Undergoing Elective Surgery with General Anesthesia

2020 ◽  
Vol 2 (1) ◽  
pp. 20
Author(s):  
Lupi Lestari ◽  
Elizeus Hanindito ◽  
Arie Utariani
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Postoperative Pain ◽  
General Anesthesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Numeric Rating Scale ◽  
Preemptive Analgesia ◽  
Acute Postoperative Pain ◽  
Numeric Rating

Introduction: Effective postoperative pain management provides improved patient comfort and satisfaction, earlier mobilization, fewer pulmonary and cardiac complications, reduced risk deep vein thrombosis, fast recovery, and reduced cost of care. Preemptive analgesia, initiated before the surgical procedure to prevent pain in the early postoperative period, has the potential to be more effective than a similar analgesic treatment initiated after surgery. As a part of multimodal analgesia, the use of NSAIDs should always be considered for acute postoperative pain management. NSAIDs can be used preoperatively as a part of the preemptive regimen and for postoperative pain control to increase the efficacy of opioids and reduce its side effects. Material and Method: This research was experimental research with a case-control design of the study. The samples separated into two groups, the first group got ketoprofen suppository before the induction, and the second group didn’t get the ketoprofen suppository The intensity of pain measured with the Numeric Rating Scale (NRS) or Wong-Baker Faces Pain Scale was the variable studied at different postoperative times (30 min, 60 min, 120 min, 2-6 hours, 6-12 hours). The total amount of rescue analgesics (fentanyl) and side effects were other variables of this study. Result and Discussion: The result is ketoprofen suppository as preemptive analgesia administrations can reduce postoperative pain. Numeric Rating Scale was significantly lower in the ketoprofen group compared to the control group (p < 0,05) at 30 min, 60 min, 230 min, 2-6 hours, 6-12 hours. The number of postoperative analgesics needed in the recovery room was significant differences among both groups (p < 0,05). Conclusion: Preemptive analgesia in patients who underwent an operation with general anesthesia with ketoprofen suppository was effectively in blocking noxious stimuli and central sensitization, with subsequent prevention of acute postoperative pain.

scholarly journals Postoperative Analgesia following Cesarean Section: Intravenous Paracetamol vs Pethidine

2018 ◽  
Vol 20 (4) ◽  
pp. 144-149
Author(s):  
Astha Shrestha ◽  
B. Shrestha
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Cesarean Section ◽  
Diclofenac Sodium ◽  
Visual Analogue Score ◽  
Postoperative Pain Management ◽  
Pain Scores ◽  
Group I ◽  
Intravenous Paracetamol ◽  
Significant Difference

Effective analgesia is important after cesarean section. Intravenous paracetamol has been internationally accepted as a part of multimodal approach to pain management in post operative period. The purpose of the study was to compare the efficacy of intravenous paracetamol with pethidine in postoperative pain management in cesarean section. One hundred and eight patients undergoing cesarean section were studied over six months. The patients were divided into two equal groups. Group I received 900mg / 100 ml of intravenous paracetamol at the end of surgery and every 6 hrs for 24 hrs and group II received intramuscular 50 mg pethidine every 8 hours. Intramuscular Diclofenac sodium 75 mg was used as a rescue drug to both the groups. Visual analogue score was used to assess the pain level at 6, 12 and 24 hours postoperatively. The postoperative pain scores in both the groups were comparable. There was no significant difference in the consumption of additive analgesics. On the basis of current study we can reasonably recommend intravenous paracetamol in the postoperative pain management after cesarean section as it maintains a sustained and safe analgesic as it does not have side effects.

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