Comparison of hemodynamic response and postoperative pain score between general anaesthesia versus combined general and epidural anaesthesia in patients undergoing major liver resection

Author(s):  
Irene Kouroukli
2019 ◽  
Vol 26 (08) ◽  
pp. 1359-1364
Author(s):  
Sara Jamil ◽  
Rizwan Jouhar ◽  
Dinaz Gandhi ◽  
Tayyaba Tahira ◽  
Jamshed Shaikh

Endodontic Pain if occurs after few hours or days after the treatment indicates a poor pathosis and a bad prognosis in long term, due to this a newer generation of instruments for canal treatment has been introduced from Ni-Ti alloy which has even better ability to shape narrow and curved root canals, without causing aberration. To compare the mean postoperative pain score after manual SS (stainless steel) K-files and mechanical Ni-Ti rotary path files in patients with irreversible pulpitis. Study Design: Randomized controlled trial. Setting: Department of Operative Dentistry, Altamash Institute of Dental Medicine, Karachi. Period: 6 months from 01-10-2017 to 30-03-2018. Materials and Methods: Total 60 patients of irreversible pulpitis with moderate pain score ≥5 were included and divided equally in manual stainless-steel k-files and mechanical Ni-Ti rotary path files groups. Treatment was started with local anesthesia. Patients were recalled after 24 hours and the level of postoperative pain was examined. T-test was applied to compare the outcome in both groups. Stratification was done using t-test and P value ≤0.05 was significantly considered. Results: The mean pre-treatment VAS in group-A and group-B was 7.16±1.44 and 7.86±1.38 respectively. Mean post-treatment VAS in group-A and group-B was 2.33±1.02 and 1.10±0.66 respectively. A significant difference between the pre and post op pain was noted between the two groups, when compared after 24hours by using VAS. Conclusion: Mean post-operative pain score was significantly less with NiTi rotary path files as compare to manual stainless steel K-files.


2017 ◽  
Vol 27 (2) ◽  
pp. 118-124 ◽  
Author(s):  
Jason Ju In Chan ◽  
Sze Ying Thong ◽  
Michelle Geoh Ean Tan

Background: Pain occurring in the post-anaesthesia care unit (PACU) is common, distressing to patients and remains a management challenge for staff. This study aims to identify the factors affecting pain severity and delay in discharge of patients from the PACU. Methods: Data from 590 consecutive postoperative patients in the PACU was collected over one month in 2012 at the Singapore General Hospital. Patient demographics, surgical, intraoperative anaesthetic and recovery data were collected. The primary outcome measured was postoperative pain score and secondary outcome was a delay in discharge. Univariate and multivariate logistic regression were performed to determine preoperative and intraoperative variables that may be associated with pain and delayed discharge. Results: The majority (67.6%) of patients reported no to mild pain while 32.3% reported moderate to severe pain; 65.4% of patients had delayed discharge and 28.3% of these were a result of uncontrolled pain. Factors associated with moderate to severe postoperative pain included younger age, same day admissions, duration of operation >2 h, abdominal, upper limb and spine surgeries and use of general anaesthesia. Factors associated with delay in discharge included higher body mass index, abdominal, spine and superficial surgeries, use of general anaesthesia, moderate to severe pain score and use of nurse controlled analgesia. Conclusions: This study identifies predictive factors for postoperative pain and delay in discharge from the PACU. Knowledge of these factors may help in better clinical judgment for postoperative pain management and can lead to quality improvement measures for patient management and work flow in the PACU.


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