scholarly journals A modern approach to pain relief in labour

Pain medicine ◽  
2021 ◽  
Vol 5 (4) ◽  
pp. 36-42
Author(s):  
Ye V Grizhymalskyi ◽  
A I Harha ◽  
Ye V Sulimenko

Until now, there are opposite points of view on the problem of pain in labour. The side effects of pain during labour can significantly affect the general condition of the woman and the fetus, the course of labour, and the prognosis. Pain relief in labour is based on the use of various pharmacological and non-pharmacological methods that reduce the level of psychological anxiety, relieve tension, and also block the conduction of pain impulse. For pain relief in labour, the full range of currently available pharmacological and non-pharmacological methods cannot be used, since many of them, simultaneously with pain relief, negatively affect the fetus and the process of childbirth. The use of neuraxial analgesia with local anaesthetic solutions at low concentrations is a safe method of pain relief during labour.

Author(s):  
Basant Kumar Pati

Background: Though laparoscopic gynaecological surgeries are less invasive and produces less post-operative pain, post-laparoscopy pain is still a concern. Intraperitoneal (IP) instillation of local anaesthetics has been shown to minimize the postoperative pain after laparoscopic surgeries. This study was conducted to compare the efficacy of intraperitoneal instillation of dexmedetomidine with bupivacaine and bupivacaine alone in reducing postoperative pain.Methods: 60 patients, enrolled for gynaecological laparoscopic surgeries were divided randomly into two groups of 30 each. Group B: Bupivacaine (30 ml, 0.25%) with 2 ml normal saline was instilled prior to removal of trocars, and Group BD: Bupivacaine (30 ml, 0.25%) with dexmedetomidine (1 mcg/kg, diluted to 2 ml) was instilled prior to removal of trocars. In postoperative period, Visual Analogue Score (VAS) was recorded up to 24 hours. Postoperative analgesic requirements, and side effects were recorded.Results: The Visual Analogue Score (VAS) during the first postoperative 24 hours was significantly lower in group BD compared to group B. Time to first analgesia required was delayed and total analgesic consumption was lower in group BD compared to group B which was statistically significant.Conclusions: Intraperitoneal instillation of dexmedetomidine with bupivacaine is an effective and safe method for reducing pain after laparoscopic gynaecological surgeries.


2012 ◽  
pp. 31-41
Author(s):  
Quang Thuy Phung ◽  
Ngoc Thanh Cao ◽  
Quang Vinh Truong

Background: Pain during labor as pain in the fracture is not treated, chronic pain, so pain is very essential issues to be studied. Epidural anesthesia (NMC) has many advantages over spinal anesthesia in constant pain. Study objectives: 1. Assessing the effects analgesia by epidural anesthesia during labor. 2. Assessing progress and final results of labor for pregnant women and fetuses. Materials and Methods: The study described 37 pregnant from 38 to less than 42 weeks had a positive phase of labor to pain relief by continuous epidural anesthesia method, with cervical dilation between 3 cm and 4 cm. Results: Women feel very satisfied (67.5%) on methods of natural pain relief during labor. Most women deliver normally (73%). Evolution of the cervix takes place smoothly. Duration of labor within the normal birth. Breast sucking good condition accounted for 86.5% rate, the reflecting normal 94.6%. Conclusions: This is the effective method of pain relief during labor birth. Duration of labor in normal limits. Side effects occur less and can be well controlled. Keywords: epidural anesthesia; relief pain on labor.


Author(s):  
Mu Xu ◽  
Jiajia Hu ◽  
Jianqin Yan ◽  
Hong Yan ◽  
Chengliang Zhang

Abstract Objective Paravertebral block (PVB) and thoracic epidural analgesia (TEA) are commonly used for postthoracotomy pain management. The purpose of this research is to evaluate the effects of TEA versus PVB for postthoracotomy pain relief. Methods A systematic literature search was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library (last performed on August 2020) to identify randomized controlled trials comparing PVB and TEA for thoracotomy. The rest and dynamic visual analog scale (VAS) scores, rescue analgesic consumption, the incidences of side effects were pooled. Results Sixteen trials involving 1,000 patients were included in this meta-analysis. The pooled results showed that the rest and dynamic VAS at 12, 24, and rest VAS at 48 hours were similar between PVB and TEA groups. The rescue analgesic consumption (weighted mean differences: 3.81; 95% confidence interval [CI]: 0.982–6.638, p < 0.01) and the incidence of rescue analgesia (relative risk [RR]: 1.963; 95% CI: 1.336–2.884, p < 0.01) were less in TEA group. However, the incidence of hypotension (RR: 0.228; 95% CI: 0.137–0.380, p < 0.001), urinary retention (RR: 0.392; 95% CI: 0.198–0.776, p < 0.01), and vomiting (RR: 0.665; 95% CI: 0.451–0.981, p < 0.05) was less in PVB group. Conclusion For thoracotomy, PVB may provide no superior analgesia compared with TEA but PVB can reduce side effects. Thus, individualized treatment is recommended. Further study is still necessary to determine which concentration of local anesthetics can be used for PVB and can provide equal analgesic efficiency to TEA.


Author(s):  
M. Shishatskii

Changed nature of international conflicts over the last decade has led to the doctrinal evolution of US, NATO, EU as well as of other key actors in the sphere of international security. Most of the recent doctrines are characterized by the intention to develop capacities for implementing the full range of military and other operation within the broader approaches to security. The author focuses on the main features of different actors’ contemporary points of view on conflict resolution.


2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Tomonori Tetsunaga ◽  
Tomoko Tetsunaga ◽  
Kazuo Fujiwara ◽  
Hirosuke Endo ◽  
Toshifumi Ozaki

Background. Various postoperative pain relief modalities, including continuous femoral nerve block (CFNB), local infiltration analgesia (LIA), and combination therapy, have been reported for total knee arthroplasty. However, no studies have compared CFNB with LIA for total hip arthroplasty (THA). The aim of this study was to compare the efficacy of CFNB versus LIA after THA. Methods. We retrospectively reviewed the postoperative outcomes of 93 THA patients (20 men, 73 women; mean age 69.2 years). Patients were divided into three groups according to postoperative analgesic technique: CFNB, LIA, or combined CFNB+LIA. We measured the following postoperative outcome parameters: visual analog scale (VAS) for pain at rest, supplemental analgesia, side effects, mobilization, length of hospital stay, and Harris Hip Score (HHS). Results. The CFNB+LIA group had significantly lower VAS pain scores than the CFNB and LIA groups on postoperative day 1. There were no significant differences among the three groups in use of supplemental analgesia, side effects, mobilization, length of hospital stay, or HHS at 3 months after THA. Conclusions. Although there were no clinically significant differences in outcomes among the three groups, combination therapy with CFNB and LIA provided better pain relief after THA than CFNB or LIA alone, with few side effects.


2005 ◽  
Vol 12 (03) ◽  
pp. 340-345
Author(s):  
ROBINA FIRDOUS

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.


2021 ◽  
Vol 5 (4) ◽  
pp. 1-6
Author(s):  
Tanudeep Kaur ◽  

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.


Author(s):  
V. V. Freize ◽  
L. V. Malyshko ◽  
G. I. Grachev ◽  
V. B. Dutov ◽  
N. V. Semenova ◽  
...  

The purpose of the study was to summarize data from foreign studies about the use of virtual reality (VR) technology in the treatment of patients with various mental disorders.Materials and methods: we selected and analyzed articles from MEDLINE / PubMed databases during the period from 2000 till 2020, as well as relevant references in the bibliography of the analyzed articles. 45 articles were included in further analysis from 575 English-language articles.Results: The use of VR technologies in the treatment of mental disorders appears to be one of the promising directions in psychiatry. The successfulness of these methods in patients with eating disorders, anxiety-phobic disorders, and obsessive-compulsive disorder is supported to be evidentiary information. There is evidence of the effectiveness of such methods in patients with schizophrenia, particularly, one of the most significant results is an increase in social functioning. The absence of side effects data makes it possible to consider t VR therapy as a safe method. It is needed to make further study the areas of application of VR therapy and conduct research to identify possible side effects of this method.Conclusion: The obtained results are important for drawing attention to the prospect of using VR technologies in Russian psychiatry and demonstrate the need for further study of this method.


2021 ◽  
Vol 11 (1) ◽  
pp. 11
Author(s):  
Ira Widjiastuti ◽  
Widya Saraswati ◽  
Annisa Rahma

Background: Inflammation of the pulp can lead to elicit pain. Pain in inflammation is induced by the cyclooxygenase-2 enzyme (COX-2) which induces prostaglandin E2 (PGE2) resulting in pain. Pain in the pulp can be relieved by eugenol. In its application, eugenol is toxic to pulp fibroblasts. Due to the side effect, it is worth considering other biocompatible materials with minimal side effects, such as propolis. Flavonoids and phenolic acids that contained in propolis can inhibit COX-2. Therefore, an analysis outlined in the literature review is needed to examine the results of research related to the role of propolis as pulp pain relief by inhibiting COX-2 expression. Purpose: To analyze the role of propolis in pulp pain by inhibiting COX-2 expression. Reviews: Propolis extract that extracted by ethanol, water, and hydroalcohol has pain relief properties in the pulp by inhibiting COX-2 by directly binding to the COX-2 receptors and by reducing the production of proinflammatory cytokines which are COX-2 inducers, proven through in vivo, in vitro, and in silico studies in various target cell organs. Conclusion: Propolis extract has high prospect as inflammatory pain inhibitor in the pulp by inhibit COX-2 expression.


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