scholarly journals Comparative Study on Efficacy of Ketorolac and Pethidine for Postoperative Pain Management

2019 ◽  
Vol 7 (1) ◽  
pp. 27-32
Author(s):  
Laxmi Shrestha ◽  
Bishal Joshi ◽  
Anjan Palikhey ◽  
Kushal Bhattarai
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Rating Scale ◽  
Analgesic Efficacy ◽  
Early Mobilization ◽  
Postoperative Pain Management ◽  
Sedation Score ◽  
Analgesic Effects ◽  
Postoperative Setting ◽  
Hourly Basis

INTRODUCTION: Postoperative pain management is essential for early mobilization and rehabilitation to enhance recovery and to reduce morbidity. Ketorolac and pethidine are two most common analgesics used in the postoperative setting for pain management. MATERIAL AND METHODS: Sixty patients (n=60) of age group 18-60 years who undergone various surgical procedures were divided randomly into two groups (T1 and T2). T1 group received inj. ketorolac 5 mg/kg IM and T2 group received pethidine 1.5 mg/kg IM body weight respectively on 6 hourly basis for 48 hours postoperatively. Patients were assessed in the recovery room for pain according to Visual Analogue Scale (VAS), Verbal Rating Scale (VRS) and Sedation Score after 1, 6, 12, 18, 24 and 48 hours of drug administration. Analgesic efficacy was measured using VAS and VRS. Safety of the drugs was assessed by using Sedation Score. RESULTS: Ketorolac showed equianalgesic effect as pethidine estimated by VAS score at 18th  and 48th  hour. In other periods of observation, pethidine exhibited better analgesic effects than ketorolac. However, ketorolac shows less incidence of sedation compared to pethidine. CONCLUSION: This study showed that postoperative pain during the first 48 hours can be relieved by either ketorolac or pethidine. Ketorolac appeared safer than pethidine while pethidine appeared more effective analgesic than ketorolac in the management of postoperative pain.

scholarly journals Postoperative Analgesic Effects of Laserpuncture and Meloxicam in Bitches Submitted to Ovariohysterectomy

2020 ◽  
Vol 7 (3) ◽  
pp. 94
Author(s):  
Rubia M. Tomacheuski ◽  
Marilda O. Taffarel ◽  
Guilherme S. Cardoso ◽  
Ana A. P. Derussi ◽  
Marcos Ferrante ◽  
...  
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Area Under The Curve ◽  
Postoperative Pain Management ◽  
Pain Scale ◽  
Rescue Analgesia ◽  
Analgesic Effects ◽  
Pain Scores ◽  
Chi Squared ◽  
Perioperative Pain Management

Background: This prospective, randomised and blind study investigated the efficacy of laserpuncture for postoperative pain management in dogs. Method: Sixteen bitches were sedated with acepromazine and randomly treated before ovariohysterectomy with meloxicam 0.2 mg·kg−1 intramuscular or laserpuncture (wavelength 904 mm, frequency 124 Hz, potency 10 Joules, 100 s in each acupoint). Anaesthesia was performed with propofol, isoflurane/O2, and fentanyl. The Glasgow Composite Measure Pain Scale (GCMPS) and Dynamic Interactive Visual Analog Scale (DIVAS) were used to evaluate postoperative pain before and for 24 h after surgery. Morphine was administrated as rescue analgesia when pain scores were ≥3.33 (GCMPS). Differences between treatments, time points, and amount of rescue analgesia between groups were investigated by the Mann–Whitney test and the area under the curve (AUC) for GCMPS, Friedman, and Chi-squared tests, respectively (p < 0.05). Results: Dogs treated with laserpuncture presented lower GCMPS AUC for 24 h and lower GCMPS scores at 2 and 4 h postoperatively (p = 0.04). Three dogs treated with meloxicam required postoperatively rescue analgesia against none treated with laserpuncture. Conclusions: In this preliminary study, laserpuncture mitigated postoperative pain in dogs following ovariohysterectomy, and the technique is a promising adjunct to perioperative pain management in dogs undergoing soft tissue surgery.

Regional anaesthesia for postoperative pain management after liver resection

2012 ◽  
Vol 19 (3) ◽  
pp. 126-129
Author(s):  
Darius Trepenaitis ◽  
Tadas Česnaitis ◽  
Andrius Macas
Keyword(s):  
Pain Management ◽  
Liver Resection ◽  
Postoperative Pain ◽  
Adverse Effects ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Postoperative Pain Management ◽  
Control Group ◽  
Wound Infiltration ◽  
Adequate Treatment

Background. Pain is the most common complication in the postoperative period. If adequate treatment is not taken, it can transform to chronic pain. Postoperative pain brings a lot of social, psychological and financial problems for patients and their families. Materials and methods. This prospective study included 30 patients after laparatomic liver resection operation. Patients were randomly assign­ ed to Infiltrated or Control groups. An infiltration of 40 ml levobupivacaine 0.25% solution to the operation cut edges was performed to the Infiltrated group. The pain was evaluated using the numerical rating scale after 2, 5, 12, 24, 48 hours and 1 month after the operation. Our aim was to determine the effect of local anesthesia in the operation wound. The total usage of morphine and any side effects were registered. Results. A statistically significant reduction in pain was observed in the Infiltrated group in all evaluation periods. Opioids usage was higher in the Control group almost by 4 times and adverse effects were 9 to 1 compared to the Infiltrated group. Conclusions. Surgical wound infiltration with local anesthetic for postoperative pain management after liver resection operations has a positive effect on postoperative pain reduction and leads to lesser usage of opioid analgetics. As a result, there is a less chance of opioids induced adverse effects.

Pain assessment and post-operative pain management in orthopedic patients

2017 ◽  
Vol 16 (1) ◽  
pp. 181-181
Author(s):  
W. Schmelling ◽  
J.N. Poulsen ◽  
L. Christrup ◽  
P. Gazerani
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Postoperative Pain ◽  
Potential Risk ◽  
Health Care Professionals ◽  
Sleep Disturbances ◽  
Pain Treatment ◽  
Early Mobilization ◽  
Postoperative Pain Management ◽  
Orthopedic Patients

Abstract Aims A fast-track based surgical treatment reduces morbidity and hospital stay by providing early mobilization. Sufficient postoperative pain management is mandatory for early mobilization and optimal utilization of rehabilitation measures. Insufficient postoperative pain management is however a widespread problem. Lack of knowledge about pain and pain treatment among health care professionals and general community has been considered as a major potential contributor in insufficient pain management. It has been suggested that severe postoperative pain might imply a potential risk of developing chronic pain. The purpose of this study was to examine this problem in acute and elective surgical patients in department of orthopedic surgery at Bispebjerg Hospital in order to identify obstacles and possibilities for future improvement. Methods Questionnaires were developed and distributed to patients consisted of 10 acute admitted and 10 elective orthopedic patients. The patients’ pain scores were recorded with a 0–10 NRS scale. The scores were obtained for current pain in rest, current pain in activity, and the highest and lowest pain intensity for the last 24 hours. Data were handled using descriptive statistics. Results The goal for sufficient pain treatment was patients with pain score at ≤ 3 NRS at rest and ≤ 5 in activity. For pain at rest 45% of the patients were within the goal range and 55% for the current pain in activity. For the mildest pain experienced in the last 24 h, 75% and for the worst pain experienced 30% of the patients reached the goal. Conclusions Corresponding to similar studies, half of the patients received a sufficient pain treatment at the time of examination. The consequences for insufficient pain management would be reduced effect of the physiotherapy, reduced ability to handle every day activity, sleep disturbances, and potential risk of developing chronic pain.

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 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

scholarly journals Epidural administration of ketamine or fentanyl with bupivacaine for postoperative analgesia – A comparative study

2014 ◽  
Vol 22 (1) ◽  
pp. 21-25
Author(s):  
Abdullah Al Maruf ◽  
Iqbal Hosain Chowdhury ◽  
Kazi Ashkar Lateef ◽  
Manzoorul Haq Laskar ◽  
Md Mustafa Kamal
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Postoperative Analgesia ◽  
Rating Scale ◽  
Postoperative Pain Management ◽  
Epidural Administration ◽  
Group A ◽  
Group B ◽  
Post Operative Nausea ◽  
Inguinal Surgery

The purpose of the study was to compare the analgesic effectiveness of epidural administration of ketamine mixed bupivacaine with fentanyl mixed bupivacaine in the management of postoperative pain. This prospective study was carried out in CMH, Bogra in one calendar year from July 2004 to June 2005. For postoperative pain management 100 patients of both sex, age ranging between 20 to 50 years, ASA physical status I and II scheduled for lower abdominal, pelvic and inguinal surgery were included in the study. All patients were divided into two groups. Epidural catheter was inserted in each patient through space between L3 to L2. Surgery was done under epidural anaesthesia in both groups. In group A (n=50) surgery was done with 0.5% bupivacaine and fentanyl (bupivacaine 1.5 ml/segment + fentanyl 2?g/ml). In group B (n=50) surgery was done with 0.5% bupivacaine and ketamine (bupivacaine 1.5ml/segment + ketamine 0.3mg/kg body weight). Epidural analgesia was continued in postoperative ward with 6 ml 0.25% bupivacaine + fentanyl 2?g/ml in group A and with 6 ml 0.25% bupivacaine + ketamine 0.3mg/kg bodyweight in group B, 4 hourly for 24 hours. The efficacy of analgesia was assessed by using Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS). Mean VAS and mean VRS were less than 3 in both groups, which proved adequate postoperative analgesia. Differences of mean VAS and mean VRS between two groups were statistically not significant. Haemodynamic parameters, respiration and oxygenation were within normal range in both groups. Postoperative complications, like inadequate analgesia, post operative nausea and vomiting (PONV), headache and vertigo were less in both groups. It was observed that epidural administration of both bupivacaine mixed with ketamine and bupivacaine mixed with fentanyl found safe, effective and tolerable for postoperative pain management. DOI: http://dx.doi.org/10.3329/jbsa.v22i1.18097 Journal of BSA, 2009; 22(1): 21-25

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