POST-OPERATIVE PAIN RELIEF FOR LOWER ABDOMINAL SURGERY

The severity of post-operative pain and the lack of efforts in relievingit have led to the involvement of Anaesthesiologists in the management of post-operative and acute pain. Parenteralopiates have been utilized for post-operative pain management. The identification of the opioid receptors on substantiagelatinosa has provided an alternate route i.e 1 the epidural route - for administering opiates. Objectives: To evaluateand compare the efficacy and side effects of parenteral Buprenorphine with those of Extradural Buprenorphine.Setting: Department of Anaesthesia, District Headquarter Hospital, Faisalabad. Period: The data was collected duringthe last three and a half years. Materials and Methods: Sixty adult patients of either sex and ages ranging from 35-45years, who underwent lower abdominal surgery, were randomly selected for the study. They were equally divided intotwo groups. Group I patients were administered Buprenorphine 0.3 mg through the epidural catheter in extraduralspace. Group II patients were given Buprenorphine 0.3 mg intramuscularly. Results: Buprenorphine through theepidural route gives better analgesia with fewer side effects as compared with the parenteral route.

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

Reproductive Medicine Gynaecology & Obstetrics ◽

10.24966/rmgo-2574/100056 ◽

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.

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Intravenous Infusion of Acetaminophen Versus Nalbuphine as a Post-operative Pain Relief After lower Abdominal Surgery

International Journal of Pharma Research and Health Sciences ◽

10.21276/ijprhs.2016.04.10 ◽

2016 ◽

Vol 4 (4) ◽

pp. 1298-1304

Author(s):

Manal El-Hamamsy ◽

Helmy Mahmoud El-sayed El-Kawaly ◽

Mohamed Ahmed Abdel Aziz hegazy

Keyword(s):

Pain Relief ◽

Abdominal Surgery ◽

Intravenous Infusion ◽

Post Operative Pain

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Double blind randomized comparative study of transdermal fentanyl patch for post operative pain relief in major abdominal surgery as a component of multimodal analgesic therapy

International Journal of Basic & Clinical Pharmacology ◽

10.18203/2319-2003.ijbcp20160077 ◽

2016 ◽

pp. 13-20

Author(s):

Kalyani Sangineni ◽

Anuradha Deolalkar ◽

S. Parakh ◽

D. Rajuloo

Keyword(s):

Pain Relief ◽

Abdominal Surgery ◽

Comparative Study ◽

Major Abdominal Surgery ◽

Fentanyl Patch ◽

Transdermal Fentanyl ◽

Double Blind ◽

Analgesic Therapy ◽

Post Operative Pain ◽

Transdermal Fentanyl Patch

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Acute pain in the elderly

10.1093/med/9780199234721.003.0011 ◽

2011 ◽

Author(s):

Adrian Wagg ◽

Shashi Gadgil

Keyword(s):

Pain Management ◽

Side Effects ◽

Acute Pain ◽

Health Care Professionals ◽

The Elderly ◽

World Health ◽

Close Monitoring ◽

Who Analgesic Ladder ◽

Co Morbidity ◽

Pain In The Elderly

Physiological changes that occur with age affect the pharmacokinetics and pharmacodynamics of drugs used in acute pain management. Elderly patients are often reluctant to complain of pain and seek treatment and may sometimes be unable to express pain due to impaired cognition or language. Evidence suggests the elderly as a group that receive inadequate analgesia and are often in pain. Health care professionals are often reluctant to administer sufficient analgesia due to fear of encouraging addiction or inducing side effects. The approach to pain management in this group should follow the World Health Organization (WHO) analgesic ladder with close monitoring for potential side effects and with escalation of treatment till sufficient analgesia is achieved. Choice of drugs and the route of administration should be tailored to the individual patient and should consider the nature of their pain and any disability or co-morbidity that will affect their response to the chosen agent. Non-steroidal anti-inflammatory drugs (NSAIDs) should be used with extreme caution, monitoring for potential gastrointestinal (GI) and renal side effects and long-term use should be avoided if possible. Opioids are effective analgesics and should not be denied to the elderly but their use should be monitored carefully and side effects such as nausea and constipation anticipated and treated.

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Managing acute pain after abdominal surgery: examples from practice

Journal of Prescribing Practice ◽

10.12968/jprp.2020.2.2.78 ◽

2020 ◽

Vol 2 (2) ◽

pp. 78-83

Author(s):

Nurhayati Nurhayati ◽

Mayoora Madsiri

Keyword(s):

Pain Management ◽

Abdominal Surgery ◽

Acute Pain ◽

Assessment Tool ◽

Pain Treatment ◽

High Incidence ◽

Preoperative Information ◽

Delayed Recovery ◽

Pain At Rest ◽

Adequate Management

Following abdominal surgery, ischaemia and neuropeptide release cause pain at the trauma site, and there is a high incidence of moderate-to-severe pain. Inadequate pain management leads to complications, delayed recovery and prolonged hospitalisation, and thus, effective management is essential. This article describes an implementation of acute pain management after abdominal surgery. A multidimensional assessment tool collected data on demographics, medical history and surgical situation, as well as interventions used, their administration route and their side effects. Pain level was recorded on a scale of 0–10, both at rest and during physical activity, by postoperative day; patient participation and satisfaction were also recorded. Nine patients met the inclusion criteria for the study. Pharmacological analgesic interventions included opioids (morphine, fentanyl and tramadol) and paracetamol. Administration was either intravenous, epidural or via patient-controlled analgesia. These were combined with non-pharmacological interventions, specifically cold gel packs, massage therapy and music therapy. All patients achieved the adequate management goals of pain at rest below 3/10 and during activity below 4/10, and all participated in pain decision-making, were satisfied with pain treatment, and reported the usefulness of preoperative information. Pain management following abdominal surgery is vital, and the use of a combination of pharmacological and non-pharmacological techniques was effective.

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Evaluation of Dexmedetomidine Co-Administered with Neostigmine and Bupivacaine for Postoperative Epidural Analgesia in Lower Limb Orthopaedic Surgeries – A Study from Maharashtra, India

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/539 ◽

2021 ◽

Vol 10 (32) ◽

pp. 2634-2639

Author(s):

Parag Yashawant Dongre ◽

Aruna Vijay Chandak ◽

Amol P. Singam

Keyword(s):

Side Effects ◽

Epidural Analgesia ◽

Lower Limb ◽

Rescue Analgesia ◽

Post Surgery ◽

Group I ◽

Post Operative Pain ◽

Key Words Epidural ◽

Spinal Epidural

BACKGROUND Addition of adjuvants to the neuro axial blocked helps prolongate the duration and quality of analgesia and anaesthesia. The safety and efficacy of drugs dexmedetomidine and neostigmine have been less commonly studied. We wanted to compare post-operative analgesia, haemodynamics, and side effects if any in this study. METHODS Combined spinal - epidural anaesthesia was performed in 60 patients who underwent lower limb surgeries of less than 2 hrs. The patients were given the drug epidurally post-surgery. Group I, II and III were given 10 ml of 0.25 % bupivacaine alone, with 1 microgram per kg of neostigmine and with 0.5 milligram per kg of dexmedetomidine and 1 microgram per kg of neostigmine, respectively. 50 mg tramadol intravenous was kept as rescue analgesic. Parameters which predict haemodynamics, assessment of pain, period of analgesia, demand for rescue analgesia and the chances of side effects were noted over the next ten hrs. RESULTS To conclude, epidural analgesia is the most preferred analgesia these days in management of lower limb orthopaedic surgery’s post-operative pain. When bupivacaine was combined with neostigmine and dexmedetomidine as a neuraxial adjuvant, it prolonged the post-operative analgesia significantly without increasing the side effects of those drugs. The combination of two drugs proved better than the use of single drug alone. CONCLUSIONS Combination of neostigmine and dexmedetomidine when used as a neuraxial adjuvant, significantly prolonged the duration of post-operative analgesia by 274.13 4.539 in lower limb orthopaedic cases compared to neostigmine alone that was 176.23 ± 3.441. KEY WORDS Epidural, Neostigmine, Dexmedetomidine, Orthopaedic Surgeries, Post-Operative Analgesia

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

January 2018 - Pain Physician ◽

10.36076/ppj.2017.se52 ◽

2017 ◽

Vol 2 (20;2) ◽

pp. sE33-sE52 ◽

Cited By ~ 17

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

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Multimodal Pain Management in the Setting of Palliative Care

10.5772/intechopen.96579 ◽

2021 ◽

Author(s):

Marija V. Sholjakova ◽

Vesna M. Durnev

Keyword(s):

Palliative Care ◽

Pain Management ◽

Side Effects ◽

Pain Relief ◽

Additional Treatment ◽

Therapeutic Approaches ◽

Multimodal Pain Management ◽

Addictive Drugs ◽

Analgesic Therapy ◽

Good Organization

Pain as an integral part of palliative care (PC) is often present at the end of the life. Today, many different analgesics from opioids and non- opioids origin are in use. The integration of their use is the most effective method for pain relief. The aim of this chapter is to discuss different therapeutic approaches to pain management in palliative care. Palliative care is being confronted between the expectations and the possibilities to provide an efficient relief from the symptoms, the pain and the stress. The possibility to use opioids for pain management, with all side effects, and non-addictive drugs as additional treatment, improves the quality and the duration of life for the patients in palliative care. Since the origin of the pain is different, the use of analgesic therapy should be individualized and adapted to the real need of every person. Finally, only a good organization and institutionalization of palliative care in the society could allow for better prevention of suffering at the end of the life.

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