scholarly journals Perioperative pregabalin for reducing pain, analgesic consumption, and anxiety and enhancing sleep quality in elective neurosurgical patients: a prospective, randomized, double-blind, and controlled clinical study

2016 ◽  
Vol 125 (6) ◽  
pp. 1513-1522 ◽  
Author(s):  
Nir Shimony ◽  
Uri Amit ◽  
Bella Minz ◽  
Rachel Grossman ◽  
Marc A. Dany ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Sleep Quality ◽  
Rating Scale ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Neurosurgical Patients ◽  
Duration Of Surgery

OBJECTIVE The aim of this study was to assess in-hospital (immediate) postoperative pain scores and analgesic consumption (primary goals) and preoperative anxiety and sleep quality (secondary goals) in patients who underwent craniotomy and were treated with pregabalin (PGL). Whenever possible, out-of-hospital pain scores and analgesics usage data were obtained as well. METHODS This prospective, randomized, double-blind and controlled study was conducted in consenting patients who underwent elective craniotomy for brain tumor resection at Tel Aviv Medical Center between 2012 and 2014. Patients received either 150 mg PGL (n = 50) or 500 mg starch (placebo; n = 50) on the evening before surgery, 1.5 hours before surgery, and twice daily for 72 hours following surgery. All patients spent the night before surgery in the hospital, and no other premedication was administered. Opioids and nonsteroidal antiinflammatory drugs were used for pain, which was self-rated by means of a numerical rating scale (score range 0–10). RESULTS Eighty-eight patients completed the study. Data on the American Society of Anesthesiologists class, age, body weight, duration of surgery, and intraoperative drugs were similar for both groups. The pain scores during postoperative Days 0 to 2 were significantly lower in the PGL group than in the placebo group (p < 0.01). Analgesic consumption was also lower in the PGL group, both immediately and 1 month after surgery. There were fewer requests for antiemetics in the PGL group, and the rate of postoperative nausea and vomiting was lower. The preoperative anxiety level and the quality of sleep were significantly better in the PGL group (p < 0.01). There were no PGL-associated major adverse events. CONCLUSIONS Perioperative use of twice-daily 150 mg pregabalin attenuates preoperative anxiety, improves sleep quality, and reduces postoperative pain scores and analgesic usage without increasing the rate of adverse effects. Clinical trial registration no.: NCT01612832 (clinicaltrials.gov)

scholarly journals Effect of Analgesia Administration Timing on Early Post-operative Period Characteristics: A Randomized, Double-blind, Controlled Study

2005 ◽  
Vol 33 (5) ◽  
pp. 483-489 ◽  
Author(s):  
Ö Mavioğlu ◽  
S Özkardełler ◽  
A Tałdöğen ◽  
M Akan ◽  
B Candüz
Keyword(s):  
Total Abdominal Hysterectomy ◽  
Abdominal Hysterectomy ◽  
Controlled Study ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Anaesthesia Care ◽  
Administration Timing ◽  
Verbal Stimulation

This study investigated the effect of time of analgesia administration in 64 patients undergoing total abdominal hysterectomy. Patients received standard general anaesthesia and were divided randomly into two equal groups. At the time of fascia closure, patients in the intra-operative (Iop) group received 0.5 mg/kg pethidine intravenously. On arrival in the post-anaesthesia care unit, the same dose of pethidine was given to patients in the post-operative (Pop) group. All patients then used a patient-controlled analgesia pump to administer pethidine analgesia as required. Times to extubation, response to verbal stimulation and orientation, post-operative pain scores and analgesic consumption were recorded. Times to extubation and response to verbal stimulation were significantly longer in the Iop group. Pain scores, analgesic consumption and additional analgesic requirements were significantly higher in the Pop group in the first 2 h post-operatively. In conclusion, intra-operative administration of pethidine provided better pain management than post-operative administration.

Prospective, Double-blind Evaluation of Perioperative Intravenous Acetaminophen and Ketorolac for Postoperative Pain and Opioid Consumption After Endoscopic Carpal Tunnel Release

Hand ◽  
2020 ◽  
pp. 155894472090650
Author(s):  
Elizabeth C. Truelove ◽  
Eva Urrechaga ◽  
Carmella Fernandez ◽  
John R. Fowler
Keyword(s):  
Pain Management ◽  
Postoperative Pain ◽  
Carpal Tunnel ◽  
Carpal Tunnel Release ◽  
Opioid Consumption ◽  
Controlled Study ◽  
Opioid Use ◽  
Double Blind ◽  
Pain Scores ◽  
Endoscopic Carpal Tunnel Release

Background: The current opioid epidemic highlights the need for pain management strategies to decrease or eliminate postoperative use of opioid medications. The purpose of this study was to determine if perioperative administration of intravenous (IV) acetaminophen and/or IV ketorolac decreases postoperative pain and opioid consumption after endoscopic carpal tunnel release. Methods: In all, 44 subjects were enrolled in this randomized, double-blind, placebo-controlled study from October 2015 to April 2017 and divided into 4 treatment arms: placebo, IV acetaminophen, IV ketorolac, or both IV acetaminophen and IV ketorolac. Patients recorded pain at 8-hour intervals on an 11-point scale and daily opioid use for 7 days after surgery. Analysis of variance and Kruskal-Wallis tests were used to compare mean pain scores and opioid consumption. Results: Mean pain scores over the 7-day study period were lower in the placebo and IV acetaminophen groups. Patients in the placebo and acetaminophen groups reported less pain than those in the ketorolac and combination groups on postoperative days 6 and 7. Patients administered IV acetaminophen had lower daily mean opioid usage. In all, 50% of the patients did not take any opioids after surgery. Conclusions: There are small, statistically significant differences in postoperative pain and opioid consumption supporting the use of IV acetaminophen for pain control after endoscopic carpal tunnel release, though these results are likely not clinically relevant. We recommend continued investigation into multimodal pain management in upper extremity surgery as well as limiting the number and quantity of opioid prescriptions provided to patients postoperatively.

A Double-Blind, Randomized, Active-Controlled Study for Post-Hemorrhoidectomy Pain Management with Liposome Bupivacaine, a Novel Local Analgesic Formulation

2012 ◽  
Vol 78 (5) ◽  
pp. 574-581 ◽  
Author(s):  
Eric Haas ◽  
Erol Onel ◽  
Howard Miller ◽  
Madhu Ragupathi ◽  
Paul F. White
Keyword(s):  
Rating Scale ◽  
Area Under The Curve ◽  
Numeric Rating Scale ◽  
Controlled Study ◽  
Opioid Use ◽  
Double Blind ◽  
Local Infiltration ◽  
Pain Scores ◽  
Liposome Bupivacaine ◽  
Post Hoc

This randomized, active-controlled study evaluated the extent and duration of analgesia after administration of liposome bupivacaine (LB), a novel formulation of bupivacaine, compared with bupivacaine HCl given via local infiltration in excisional hemorrhoidectomy. One hundred patients were randomly assigned to receive a single dose of bupivacaine HCl 75 mg (0.25% with 1:200,000 epinephrine) or LB 66, 199, or 266 mg upon completion of hemorrhoidectomy. Postoperative pain intensity was assessed using a numeric rating scale at rest to calculate a cumulative pain score (area under the curve). Cumulative pain scores were significantly lower with LB at each study dose ( P < 0.05) compared with bupivacaine HCl 72 hours after surgery. Post hoc analysis showed that mean total postoperative opioid consumption was statistically significantly lower for the LB 266-mg group compared with the bupivacaine HCl group during the 12- to 72-hour postoperative period ( P = 0.019). Median time to first opioid use was 19 hours for LB 266 mg versus 8 hours for bupivacaine HCl ( P = 0.005). Incidence of opioid-related adverse events was 4 per cent for LB 266 mg compared with 35 per cent for bupivacaine HCl ( P = 0.007). Local infiltration with LB resulted in significantly reduced postsurgical pain compared with bupivacaine HCl in patients after hemorrhoidectomy surgery.

scholarly journals Effect of gabapentin premedication on preoperative anxiety and postoperative pain

2014 ◽  
Vol 11 (3) ◽  
pp. 254-259 ◽  
Author(s):  
L Pathak ◽  
A Chaturvedi
Keyword(s):  
Side Effects ◽  
Postoperative Pain ◽  
Open Cholecystectomy ◽  
Preoperative Anxiety ◽  
Controlled Study ◽  
Double Blind ◽  
Vas Scores ◽  
Group 2 ◽  
Induction Of Anaesthesia

Background: In addition to chronic pain and anxiety disorders, few studies have found promising role of gabapentin in relieving acute postoperative pain as well as acute anxiety too. Objectives: To evaluate the effect of gabapentin premedication on preoperative anxiety and postoperative pain in patients undergoing elective open cholecystectomy. Methods: A prospective, randomized, double blind and placebo controlled study. Eighty adult patients of ASA I and II were divided into 2 groups of 40 each. Patients in group 1 and group 2 received capsules Gabapentin (1200mg) or identical placebo capsules 2 hours prior to surgery respectively. Preoperative anxiety and 12 hours postoperative pain was assessed using Anxiety and Pain VAS score respectively along with the observation of side effects. Postoperatively, intravenous pethidine 0.5 mg/kg was given when pain VAS > 40mm and time to first pethidine injection and total pethidine consumption in 12 hours was recorded. Results: Anxiety VAS scores after one hour of drug intake (35.75±20.11 versus 46.63±12.73) and just before induction of anaesthesia (45.75±30.27versus 68.13±29.84) along with postoperative Pain VAS scores were significantly lower in gabapentin group. Time to the first pethidine demand was significantly longer (145.34±194.54 min versus 26.30±51.02min) and cumulative pethidine consumption throughout study period was also significantly lower (35.91 ± 16.61 versus 57.84 ± 20.72mg) in gabapentin group. Conclusions: 1200 mg gabapentin premedication in open cholecystectomy patients significantly reduced preoperative anxiety, postoperative pain and total pethidine consumption with negligible side effects. DOI: http://dx.doi.org/10.3126/hren.v11i3.9642 Health Renaissance 2013;11(3):254-259

Effect of tonsillar fossa cooling with cold saline on early post-tonsillectomy pain: A randomized, double-blind controlled study

2021 ◽  
Vol 8 (2) ◽  
pp. 243-249
Author(s):  
Joseph Abraham Poonuraparampil ◽  
Kusuma R Halemani ◽  
Habib M R Karim ◽  
Meryl R John ◽  
Tuhin Mistry
Keyword(s):  
Postoperative Pain ◽  
Sore Throat ◽  
Statistical Tests ◽  
Pain Scale ◽  
Controlled Study ◽  
Double Blind ◽  
Tonsillar Fossa ◽  
Pain Scores ◽  
Valuable Adjunct ◽  
American Society

Postoperative pain following tonsillectomy is troublesome, and non-pharmacological methods can be a valuable adjunct to reduce the intensity of pain. Cooling can attenuate the damage done to tissues by hot dissection techniques.Thestudy was aimed to assess the effect of tonsillar fossa cooling on post-tonsillectomy pain. Forty patients aged 8-18 years of American Society of Anaesthesiologists physical status I and II scheduled for elective bilateral tonsillectomy with bipolar electrocautery under general anaesthesia were recruited. After obtaining consent and approval from the institutional ethical committee, they were randomly assigned to one of the two groups. At the end of tonsillectomy, the tonsillar fossa was packed for 10 minutes using gauze soaked in ice-cold 0.9% saline (5–10 ºC) in group T (test) and saline at room temperature in group C (control). The postoperative pain scores using Faces Pain Scale-Revised (FPS–R) and sore throat were evaluated at 15 minutes, 1 hour, 6 hours and 12 hours. All the data were analyzed using appropriate statistical tests. P &#60; 0.05 was considered significant.Pain scores were significantly lower in group T as compared to group C at all time points. (p&#60;0.05) The rescue analgesic consumption was lower in group T.(p&#60;0.05) There was no difference in of sore throat between two groups. Cooling of the tonsillar fossa with ice-cold 0.9% saline after hot dissection tonsillectomy is a useful adjunct in reducing postoperative pain without any significant complications.

scholarly journals Preoperative Rectal Indomethacin for Analgesia after Laparoscopic Sterilisation

1992 ◽  
Vol 20 (3) ◽  
pp. 337-340 ◽  
Author(s):  
S. Crocker ◽  
M. Paech
Keyword(s):  
Postoperative Pain ◽  
Controlled Study ◽  
Day Case ◽  
Double Blind ◽  
Double Blind Placebo ◽  
Pain Scores ◽  
Preoperative Administration ◽  
Subjective Pain ◽  
Clinical Benefits ◽  
Rectal Indomethacin

A randomised, double-blind, placebo-controlled study was conducted among 56 day-case patients to determine the effect of the preoperative administration of rectal indomethacin on postoperative pain and opioid requirements after laparoscopic sterilisation. Outcome in women receiving indomethacin did not differ significantly from the placebo group, but there was a trend to lower subjective pain scores, reduction in early postoperative pain assessed objectively and lower parenteral pethidine requirements in the first three hours postoperatively. Indomethacin did not appear either to cause side-effects or to significantly reduce morbidity from the other postoperative sequelae of laparoscopy. Despite evidence for postoperative analgesic effect, the clinical benefits of premedication with rectal indomethacin were minor.

scholarly journals Effect of Chinese Herbal Compound LC09 on Patients With Capecitabine-Associated Hand-Foot Syndrome: A Randomized, Double-Blind, and Parallel-Controlled Trial

2020 ◽  
Vol 19 ◽  
pp. 153473542092846
Author(s):  
Ran Yu ◽  
Xuefeng Wu ◽  
Liqun Jia ◽  
Yanni Lou
Keyword(s):  
Treatment Group ◽  
Rating Scale ◽  
Completion Rate ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Chinese Herbal ◽  
Pain Scores ◽  
Herbal Compound ◽  
Hand Foot Syndrome

Background: LC09 is composed with 5 kinds of traditional Chinese herbal medicines ( Astragalus membranaceus, flowers carthami, lithospermum, geranium wilfordii, and radix angelicae) which are used in China and developed over several thousand years. Aim: To assess the effectiveness and safety of herbal compound LC09 on patients with capecitabine-associated hand-foot syndrome (HFS). Materials and Methods: In this randomized, double-blind, and parallel-controlled study, 156 patients that diagnosed with HFS were randomly assigned to a treatment group (n = 78) or control group (n = 78). Patients were evaluated every week by the National Cancer Institute (NCI) grade and Numerical Rating Scale (NRS) pain scores. The Dermatology Life Quality Index (DLQI) scale and Instrumental Activity of Daily Living (IADL) scale were used to assess the quality of life before the treatment, and at 1 week and after the treatment of 2 cycles. Results: At the baseline, no significant differences were observed between the 2 groups. After treatment, significant differences in NCI grade and NRS pain scores were observed between the 2 groups ( P < .01). In addition, HFS effectiveness rate and pain alleviation rate were significantly higher in the treatment group compared with the control group ( P < .01). Furthermore, the chemotherapy completion rate between 2 groups was significantly different ( P = .002). In addition, no adverse reactions were observed in either LC09 or control group. Conclusion: LC09 can decrease NCI grade and significantly alleviate pain in HFS patients. Besides, it can also increase chemotherapy completion rate.

scholarly journals Preoperative versus Postoperative Rectus Sheath Block for Acute Postoperative Pain Relief after Laparoscopic Cholecystectomy: A Randomized Controlled Study

2019 ◽  
Vol 8 (7) ◽  
pp. 1018 ◽  
Author(s):  
Hye-Won Jeong ◽  
Chan Sik Kim ◽  
Kyu Taek Choi ◽  
Sung-Moon Jeong ◽  
Doo-Hwan Kim ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Rectus Sheath ◽  
Controlled Study ◽  
Skin Closure ◽  
Analgesic Consumption ◽  
Post Surgery ◽  
Rectus Sheath Block

Background: Pain after laparoscopic cholecystectomy (LC) is multifactorial and usually not effectively treated. Rectus sheath block (RSB) has been proven to reduce the pain from midline abdominal incision and laparoscopic surgery. We investigated the preemptive analgesic effect of RSB after LC. Methods: In this prospective, randomized, single-center trial, 200 patients undergoing LC were randomized into preoperative RSB (pre-RSB) or postoperative RSB (post-RSB) group. An ultrasound-guided RSB was performed before skin incision in the pre-RSB group or after skin closure in the post-RSB group. The primary outcome was total rescue analgesic consumption at 24 h post-surgery. The secondary outcomes were cumulated rescue analgesic consumption and postoperative pain measured by numerical rating scale (NRS) at 0, 1, 2, 6, 9, 18, and 24 h post-surgery. Results: Total rescue analgesic consumption at 24 h post-surgery was significantly lower in the pre-RSB group than in the post-RSB group (p = 0.020). The cumulated rescue analgesic consumption was significantly lower in the pre-RSB group than in the post-RSB group at 1 h (p = 0.023), 9 h (p = 0.020) and 18 h (p = 0.002) post-surgery. NRS was significantly lower in the pre-RSB group than in the post-RSB group at 0 h post-surgery (p = 0.023). Conclusion: The pre-RSB reduced the analgesic requirements in patients undergoing LC compared with the post-RSB.

scholarly journals The Effect of Preoperative Administration of Duloxetine on Postoperative Pain After Laparoscopic Myomectomy

2020 ◽  
Author(s):  
Maryam Hatami ◽  
Arezoo Kheirati ◽  
Shekoufeh Behdad ◽  
Atiye Javaheri ◽  
Sedighe Vaziribozorg
Keyword(s):  
Postoperative Pain ◽  
Laparoscopic Myomectomy ◽  
Control Group ◽  
Case Group ◽  
Hemodynamic Changes ◽  
Double Blind ◽  
Analgesic Consumption ◽  
Pain Scores ◽  
Preoperative Administration ◽  
Double Blind Clinical Trial

The purpose of this study was to evaluate the effect of preoperative administration of duloxetine on postoperative pain after laparoscopic myomectomy. In this double-blind clinical trial study, 57 patients aged 18-55 years with ASA I or II undergoing laparoscopic myomectomy involved. The case group received oral duloxetine 60 mg, and the control group received placebo 2 hours before the surgery. Pain scores, total analgesic consumption during 24 hours, recovery discharging time, nausea, vomiting, dizziness, and hemodynamic changes were recorded and compared between two groups. The pain severity was significantly lower in the case group at 2, 12, and 24 hours after the operation (P<0.05). There were no significant differences in dizziness, nausea, vomiting, systolic and diastolic blood pressure, and heart rate of patients between two groups before the surgery, 5 and 30 minutes after the induction, and after the recovery. Duloxetine administration prior to laparoscopic surgery myomectomy can reduce postoperative pain without inducing side effects in patients.

scholarly journals A prospective randomized controlled trial to study the effect of preoperative and intraoperative magnesium over postoperative ileus and postoperative pain in major non–laparoscopic abdominal surgeries

2019 ◽  
Vol 6 (9) ◽  
pp. 3182
Author(s):  
A. R. Vishal Varma Bathina ◽  
Rama Krishna Peetani ◽  
Viswa Teja Vaitla
Keyword(s):  
Postoperative Pain ◽  
Total Dose ◽  
Rating Scale ◽  
Numeric Rating Scale ◽  
Controlled Study ◽  
Control Group ◽  
Anesthetic Care ◽  
Analgesic Consumption ◽  
Randomized Controlled ◽  
Numeric Rating

Background: The objective of the study were postoperative pain on 1st postoperative hour and 2, 4, 12, 24th postoperative hour as per numeric rating scale (NRS); total dose of postoperative analgesic consumption; postoperatively time of first appearance of bowed sounds; postoperatively time of first passage of flatus.Methods: A randomized controlled study will be performed. Patients of ASA 1 and 2, scheduled for major abdominal (GI) surgery, were divided into magnesium group and control group. Serum magnesium levels are estimated in both groups. Magnesium group receives 40 mg/kg of magnesium sulfate in 100 cc NS 30 minutes before the induction* as Intravenous drip, followed by 10 mg/kg/hr during the intraoperative hours. Control group receives the same volume of isotonic saline solution. Intra-operative hemodynamic parameters are evaluated constantly by recording pulse rate, blood pressure and Spo2. Further, post- operative analgesic will be ensured by epidural top-up using bupivacaine and tramadol when patients complaints of pain or when monitored with numeric rating scale (NRS). Postoperative patient pain is going to be evaluated in post-anesthetic care unit (PACU)/ SICU by numeral rating scale (NRS) during 1st hour, 2nd hour, 4th hour, 12th hour and 1 day, total dose of post-operative analgesic consumption will be recorded.Results: Of the 60 patients studied, 30 belong to magnesium group for which pre-operative and intraoperative intravenous magnesium (cases). Remaining 30 were given equal amounts of preoperative and intraoperative normal saline given (controls).Conclusions: The results of present study suggests that pre and intra operative. Magnesium as an adjunct to epidural analgesia reduces postoperative pain pre-operative and intra operative IV mg reduces post-operative ileus duration.

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