scholarly journals Nefopam hydrochloride as a component of multimodal analgesia in the postoperative period

Pain medicine ◽  
2020 ◽  
Vol 5 (2) ◽  
pp. 68-75
Author(s):  
Andrii Semenenko
Keyword(s):  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Pain Syndrome ◽  
Multimodal Analgesia ◽  
Early Postoperative Period ◽  
Modern Approach ◽  
Surgical Interventions ◽  
Reduction Of Pain ◽  
Effective Drugs

The modern approach to the multimodal scheme of postoperative analgesia includes the mandatory use of drugs that have a small number of side effects and at the same time have a polymodal effect on the pathogenetic links of pain development. Nefopam hydrochloride is able to prevent the development of: opioid hyperalgesia, stop pain stimuli without respiratory depression, affect platelet aggregation and the condition of the mucous membrane and motility of the gastrointestinal tract, which distinguishes it from classical NSAIDs. Nefopam hydrochloride is characterized by a low risk of addiction with prolonged use, a pronounced anti-sensory effect, especially significant at the stage of awakening and in the early postoperative period. Postoperative analgesia based on nefopam hydrochloride as a component of multimodal analgesia is effective and safe in the absence of absolute contraindications. The planned use of nefopam hydrochloride for the correction of pain reduces complications in the postoperative period and improves the quality of life of patients. Nefopam hydrochloride is one of the most effective drugs for the correction of postoperative tremor syndrome. The use of nefopam hydrochloride as a drug, which is a part of premedication before surgical interventions and a component of multimodal analgesia, improves the quality of the postoperative period due to: reduction of pain syndrome, planned correction of postoperative tremor syndrome and correction of complications arising from inadequate treatment of pain syndrome.

scholarly journals Protocol of intravenous lidocaine infusion in the postoperative period in children operated on abdominal organs

2021 ◽  
Vol 15 (1) ◽  
pp. 41-47
Author(s):  
Evgeny Y. Felker ◽  
Dmitry V. Zabolotskii
Keyword(s):  
Postoperative Period ◽  
Pediatric Anesthesia ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Standards Of Care ◽  
World Federation ◽  
Intravenous Lidocaine ◽  
Surgical Interventions ◽  
Perioperative Analgesia ◽  
Abdominal Organs

BACKGROUND: Many studies indicate the effectiveness of intravenous lidocaine infusion for perioperative analgesia and treatment of intestinal paresis in adults. In the scientific literature, only a few publications focus on the intravenous infusion of lidocaine in pediatric practice. The purpose of the work is to increase the effectiveness of the treatment of pain syndrome after operations on abdominal organs in children by creating a protocol for intravenous lidocaine infusion. MATERIALS AND METHODS: In the development of the clinical protocol, publications included in the databases PubMed, Cochrane, American Society of Anesthesiologists, World Federation of Pediatric Intensive and Critical Care Societies, and American Academy of Pediatrics were considered. The recommendations and standards of care for this problem from the Committee on Pediatric Anesthesiology (Statement on Practice Recommendations for Pediatric Anesthesia, 2016), Society for Paediatric Anesthesia Anaesthesiology, and our own materials for our research performed at the St. Petersburg State Pediatric Medical University. RESULTS: The developed protocol includes 11 provisions, including indications and contraindications to the use of lidocaine infusion, preoperative examination, a list of necessary equipment, the method of infusion, methods of evaluation, and control of postoperative pain syndrome. CONCLUSIONS: A protocol for the management of children in the early postoperative period using intravenous lidocaine infusion, as an alternative to prolonged epidural blockade and systemic anesthesia, is developed. The authors express confidence that further implementation of the protocol in clinical practice will improve the quality of medical care for children after abdominal surgical interventions.

scholarly journals THE APPLICATION OF MAGNETIC FIELDS AND FLUCTUORIZATION IN THE EARLY POSTOPERATIVE PERIOD IN PATIENTS AFTER RADICAL MASTECTOMY

2019 ◽  
Vol 6 (3) ◽  
pp. 157-162
Author(s):  
Marina Yu. Gerasimenko ◽  
Inna S. Evstigneyeva ◽  
O. M Perfil’yeva ◽  
L. V Tumbinskaya
Keyword(s):  
Postoperative Period ◽  
Radical Mastectomy ◽  
Pain Syndrome ◽  
Shoulder Girdle ◽  
Early Postoperative Period ◽  
Physical Factors ◽  
Operative Interference ◽  
Group 2 ◽  
Magnetic Therapy

We conducted an objective and instrumental examination in 76 patients with radical mastectomy in the early postoperative period (2-4 days), after which the patients of the 1st group (n = 38) underwent a course of fluctuation of the muscles of the shoulder girdle and upper extremity from the side of operative interference without interruption. Group 2 (n = 38) after the course, the course of fluctuation of the muscles of the shoulder girdle and upper limb from the side of operative interference without interruption was carried out extended low-intensity magnetic therapy of the postoperative area and arm. It has been proved that with this combination, the patient notes an improvement in the quality of life, postoperative swelling decreases, pain syndrome decreases, lymphorrhea periods shorten. As a result of the study, the number of postoperative complications in the wound area decreased (inflammation, infectious processes, pain, seam divergence). There is an increase in the amount and quality of movements, reduced sensitivity disorders in the upper limbs. The results of remote infrared thermography showed that the positive dynamics remained only in patients from both groups who received the combined use of two factors, which proves the prolongation of the clinical effect. Thus, the combination of two physical factors in the early postoperative period, in patients after radical mastectomy, has broad functionality and allows to obtain a more pronounced and stable clinical result.

scholarly journals The comparison of effectiveness of two variants of preventive anesthesia/analgesia in cancer surgery

Pain medicine ◽  
2018 ◽  
Vol 3 (3) ◽  
pp. 44-50
Author(s):  
I I Lisnyy
Keyword(s):  
Plasma Level ◽  
Pain Intensity ◽  
Postoperative Period ◽  
Perioperative Period ◽  
Multimodal Analgesia ◽  
Surgical Interventions ◽  
Perioperative Analgesia ◽  
Contentious Issue ◽  
Comparison Of Effectiveness

Despite modern drugs and technologies in medicine, the questions of adequate analgesia in the postoperative period remain quite relevant. The effectiveness of preventive analgesia in the perioperative period remains a contentious issue. The study included 53 oncosurgical patients. Gr.1 received dexketoprofen in combination with paracetamol for perioperative analgesia before the operation, Gr.2 the same medication was given before closing the operating wound. Anesthesia in both groups included an inhaled (Sevoran) and an extended epidural. The study showed that the pain intensity on ANI monitoring and the total dose of fentanyl was less in Gr.1, compared to Gr.2. Cortisol plasma level and the level of glycemia in the perioperative period were less in patients in Gr.1 than in Gr.2. Pain intensity after surgery during first postoperative day was lower in Gr.1, then in Gr.2. The administration of multimodal analgesia with paracetamol and dexketoprofen prior to the surgical interventions provides for the best quality of perioperative analgesia in oncological surgical interventions.

scholarly journals Efficiency and safety of pharmacotherapy for postoperative pain in cardiac surgery

2021 ◽  
Vol 20 (3) ◽  
pp. 2683
Author(s):  
D. A. Sychev ◽  
T. E. Morozova ◽  
D. A. Shatskiy ◽  
E. V. Shikh
Keyword(s):  
Cardiac Surgery ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Postoperative Period ◽  
Multimodal Analgesia ◽  
Early Postoperative Period ◽  
Current Review ◽  
Negative Effect ◽  
Safe Technique

Intraoperative injury with the formation of a sternotomy wound is inevitably accompanied by postoperative pain, which has a negative effect on the postoperative period and prognosis of patients. Today, moderate and severe pain affects at least half of patients in the early postoperative period after cardiac surgery. Inadequate pain relief in the early postoperative period can lead to chronic pain, which significantly reduces the quality of life of patients. The concept of multimodal analgesia with different painkillers is a priority, effective and safe technique both after cardiac surgery and in other areas of surgery. The current review article is devoted to the analysis of efficacy and safety of various drug groups for postoperative pain relief in cardiac surgery.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

Regional blockade for prolonged anesthesia in enucleation and evisceration

Reflection ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 47-55
Author(s):  
I.G. Oleshchenko ◽  
◽  
О.P. Mishchenko ◽  
М.А. Gasparyan ◽  
◽  
...  
Keyword(s):  
Postoperative Period ◽  
Choroidal Melanoma ◽  
Opioid Analgesics ◽  
Early Postoperative Period ◽  
Alternative Methods ◽  
Combined Method ◽  
Retrobulbar Anesthesia ◽  
Pterygopalatine Ganglion ◽  
Systemic Side Effects

Regional anesthesia is widely used in ophthalmology both as an independent method and in combination. Retrobulbar anesthesia has risks of complications and is undesirable in the surgical treatment of choroidal melanoma due to the risk of metastasis of tumor cells when it is performed. Therefore, it is necessary to search for alternative methods of regional blockades in order to create prolonged anesthesia. Purpose. To develop and evaluate the clinical efficacy of pterygopalatine blockade as a component of combined method of anesthesia for evisceration or enucleation of the eyeball. Methods. A comparative analysis of the effectiveness of intraoperative anesthesia and the course of postoperative period was carried out in patients of two clinical groups formed depending on the method of anesthesia. Results. Intraoperative monitoring of hemodynamics in the groups did not differ. The nature of pain in the patients of the compared groups in the postoperative period had significant differences in presence and intensity of pain on the scale of verbal sensations. Discussion. Use of pterygopalatine blockade with levobupivacaine in combination with dexamethasone as an adjuvant allows getting a prolonged analgesic, anti-inflammatory and decongestant effect. This makes it possible to avoid the use of opioid analgesics in the early postoperative period, that is, to avoid such systemic side effects as nausea, dizziness, and in rare cases vomiting, which generally improves the quality of the postoperative period. Conclusions. Use of pterygopalatine ganglion blockade with local prolonged-acting anesthetic levobupivacaine and dexamethasone as an adjuvant based on inhaled anesthesia with sevoflurane provides safe and effective anesthesia in patients with evisceration or enucleation of the eyeball, both in the intra- and postoperative period. Key words: enucleation; evisceration; pterygopalatine blockade; dexamethasone.

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