scholarly journals Comparative study in prolapse lumbar intervertebral disc (PLID) surgery by spinal vs general anaesthesia

2014 ◽  
Vol 23 (2) ◽  
pp. 47-50 ◽  
Author(s):  
Md Shahnewaz Chowdhury ◽  
Sabya Sachi Roy ◽  
Md Matiur Rahman ◽  
Md Mozaffer Hossain ◽  
SMA Alim
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Functional Recovery ◽  
Rating Scale ◽  
Operating Conditions ◽  
Lumbar Spine Surgery ◽  
Single Level ◽  
Spinal Group

Background Lumbar discectomy is most commonly performed under general anaesthesia, which can be associated with several perioperative morbidities including nausea, vomiting, atelectasis, pulmonary aspiration, and prolonged post-anaesthesia recovery. It is possible that fewer complications may occur if the procedure is performed under spinal anesthesia. Objective We have compared patient satisfaction between spinal versus general anaesthesia in patients for single level lumbar surgery. Methods Eighty consecutive patients of ASA grade I-II were recruited and randomized into two equal groups, with half of this patients receiving spinal anaesthesia (n-40) and the remainder general anaesthesia (n-40). A comprehensive postoperative evaluation was carried out documenting any anaesthetic complications, pace of physiological and functional recovery and patient satisfaction. Variables were recorded as pain level using a visual analogue scale (VAS) at 1, 6, 12 and 24 hours; patient level of satisfaction during the stay on the ward using verbal rating scale (VRS) as it was detected by A p-value < 0.05 were considered as significant. Results Spinal anaesthesia patients achieved the milestones of physiological and functional recovery more rapidly and reported less postoperative pain. Perioperative hypotension in 25 % of patients and none was hypertensive in spinal group and in G/A Group 05% of patients was hypotensive and 20% were hypertensive. Postoperative pain intensity more in G/A group than spinal group. Patient satisfaction in spinal group was more comparative to G/A group. Conclusion Spinal anaesthesia ensures better operating conditions, better postoperative pain control and a quicker postoperative recovery when compared to general anaesthesia for single level lumbar spine surgery DOI: http://dx.doi.org/10.3329/jbsa.v23i2.18173 Journal of BSA, 2009; 23(2): 47-50

“A COMPARATIVE STUDY TO EVALUATE THE EFFICACY OF DULOXETINE IN POSTOPERATIVE PAIN RELIEF IN PATIENTS IN UNDERGOING LUMBAR SPINE SURGERY ”

2021 ◽  
pp. 76-77
Author(s):  
Deepti Chauhan ◽  
Satyendra Yadav ◽  
Heena Sheikh ◽  
Ashish Mathur
Keyword(s):  
Lumbar Spine ◽  
Postoperative Pain ◽  
Pain Relief ◽  
General Anaesthesia ◽  
Spine Surgery ◽  
Postoperative Pain Relief ◽  
Lumbar Spine Surgery ◽  
Analgesic Requirement ◽  
Respiratory Parameters ◽  
Result Analysis

AIMS AND OBJECTIVES: To evaluate the efcacy of duloxetine in different doses in postoperative pain relief in patients undergoing lumbar spine surgery. MATERIALAND METHOD: 80 patients of ASA grade І & ІІ of either sex scheduled for lumbar spine surgery under general anaesthesia were divided into 2 groups (n=40 each) randomly.Group D (n=40) Patients who received a 60 mg duloxetine 1 hour before surgery and another tablet the following morning. Group 'P'(n=40) Patients who received a placebo tablet 1 hour before surgery and again the following morning. Pulse rate, blood pressure, respiratory rate and severity of pain on NRS scale was noted at 0 hr, 4 hr, 8 hr, 12 hr, 16 hr, 20 hr, 24 hr, 28 hr, 32 hr and 48 hr after surgery. And the presence or absence of adverse effects, such as headache, nausea, vomiting, dizziness, and drowsiness were noted. RESULT: Analysis revealed that time for rst analgesic requirement was signicantly longer with oral Duloxetine 60 mg than with placebo. Pre-emptive oral Duloxetine 60 mg decreases the severity of pain postoperatively but not signicantly as compared to placebo in patients posted for lumbar spine surgery under general anaesthesia. Oral Duloxetine 60 mg had no signicant effect on cardiovascular and respiratory parameters. Patients receiving duloxetine had higher incidence of nausea, vomiting. CONCLUSION:that time for rst analgesic requirement was signicantly longer with oral Duloxetine 60 mg than placebo.

scholarly journals Total Spinal Anaesthesia

1974 ◽  
Vol 2 (2) ◽  
pp. 158-163 ◽  
Author(s):  
T. I. Evans
Keyword(s):  
Abdominal Surgery ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Operating Conditions ◽  
Widespread Acceptance ◽  
Total Spinal Anaesthesia

One hundred patients were given total spinal anaesthesia for major intra-abdominal surgery. Operating conditions were excellent, superior to that provided by relaxant general anaesthesia and free from hiccough and other reflex phenomena. However, the technique developed in this study provided anaesthesia which is too inflexible for widespread acceptance at present.

scholarly journals Proportion of immediate severe postoperative pain in laparoscopic sterilization under general anaesthesia: A cross-sectional study (postoperative pain in laparoscopic sterilization)

2021 ◽  
Vol 43 (5-6) ◽  
pp. 111-116
Author(s):  
Girijanandan Menon ◽  
Manjit George
Keyword(s):  
Postoperative Pain ◽  
General Anaesthesia ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Post Operative Pain ◽  
Severe Postoperative Pain ◽  
Numerical Rating ◽  
Laparoscopic Sterilization

Background: Effective control of immediate post operative abdominal pain following laparoscopic sterilization is challenging. The objective of the study was to estimate the incidence of immediate severe postoperative pain following laparoscopic sterilization under general anaesthesia by the proportion of patients with the pain assessed on a numerical rating scale. Methods: A cross sectional study was conducted with the approval of institutional review board and ethics committee. Fifty seven participants with written informed consent underwent the study over a period of six months. Pain was assessed by a trained recovery nurse and data was collected and analyzed. The main outcome measure was immediate severe post operative pain on numerical rating scale (NRS). Results: Among the 57 participants, 14 (24.6%) had immediate severe post operative pain with median score of five in the inter quartile range of 0 to 5.75 and 43 (75.4%) participants had no severe pain. Conclusion: The incidence of immediate severe postoperative abdominal pain after laparoscopic sterilization under general anaesthesia is high. Therefore, the management of pain following laparoscopic sterilization requires individually based multimodal analgesia.

scholarly journals Bilateral lumbar Ultrasound-guided Erector Spinae Plane Block versus Local Anaesthetic Infiltration for Perioperative Analgesia in Lumbar Spine Surgery: A Randomized Controlled Trial

2021 ◽  
Author(s):  
Alessandro Vergari ◽  
Luciano Frassanito ◽  
Mariangela Muro ◽  
Roberta Nestorini ◽  
Angelo Chierichini ◽  
...  
Keyword(s):  
Postoperative Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Opioid Analgesic ◽  
Erector Spinae ◽  
Lumbar Spine Surgery ◽  
Control Group ◽  
Ultrasound Guided ◽  
Local Infiltration ◽  
Erector Spinae Plane Block

Abstract BackgroundLumbar spinal surgery is associated with severe postoperative pain. We examined the analgesic efficacy of bilateral lumbar ultrasound-guided erector spinae plane block (ESPB) with ropivacaine compared with local infiltration of ropivacaine.Methods Twenty-four patients undergoing elective lumbar arthrodesis were randomly divided into two groups. Control group received 0.375 % ropivacaine 40 ml through the wound, and ESPB group received preoperative bilateral ESPB with 0.375 % ropivacaine 40 ml. The primary outcome was postoperative pain intensity at rest using a Numeric Rating Scale (NRS). Secondary outcomes included difference in pain intensity between pre-intervention and defined timepoints, total amount of opioid analgesic requested by the patients at the same timepoints, the incidence of any adverse event, and the length of hospital stay (LOS) after surgery.Results After surgery we detected a NRS value of 1.9 + 1.6 in ESPB group and 6.0 + 1.7 in Control group (p<0.05). In the ESPB group we found a significant decrease (from 6.3 ± 1.6 to 1.9 ± 1.7) of NRS score after surgery compared to pre-surgery values. About the opioid consumption we found a total sufentanil tablets consumption of 17 ± 9 and 10 ± 2 at 48h for Control group and ESPB group, respectively. Concerning LOS all patients in the Control group and 9 of the ESPB group were discharged after 72 hours; 3 patients in the ESPB group left the ward after 48 hours. Conclusion Bilateral ultrasound-guided ESPB offers improved postoperative analgesia compared with local infiltration in patients undergoing lumbar spinal surgery.Trial Registration Number on Clinicaltrial.gov: NCT04123106

scholarly journals TP10.2.6Open appendicectomy under spinal anaesthesia – a valuable alternative during COVID-19

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Dinh Van Chi Mai ◽  
Alex Sagar ◽  
Oliver Claydon ◽  
Ji Young Park ◽  
Niteen Tapuria ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Stated Preference ◽  
Case Series ◽  
Standard Of Care ◽  
District General Hospital ◽  
Complication Rates ◽  
Open Appendicectomy ◽  
Surgical Department

Abstract Introduction Concerns relating to COVID-19 and general anaesthesia prompted our department to consider that open appendicectomy under spinal anaesthesia (SA) avoids aerosolisation from intubation and laparoscopy. Whilst common in developing nations, it is unusual in the United Kingdom (UK). We present the first UK case series and discuss its potential role during and after this pandemic. Methods We prospectively studied patients with appendicitis at a British district general hospital who were unsuitable for conservative management and consequently underwent open appendicectomy under SA. We also reviewed patient satisfaction after 30 days. This ran for 5 weeks from 25th March 2020 until the surgical department reverted to laparoscopic appendicectomy as the standard of care. Main outcomes were 30-day complication rates and patient satisfaction. Results None of the included seven patients were COVID positive. The majority (4/7) had complicated appendicitis. There were no major adverse (Clavien-Dindo grade III to V) post-operative events. Two patients suffered minor post-operative complications. Two experienced intra-operative pain. Mean operative time was 44 minutes. Median length of stay and return to activity was 1 and 14 days respectively. Although four stated preference in hindsight for general anaesthesia (GA), the majority (5/7) were satisfied with the operative experience under SA. Discussion Although contraindications, risk of pain, and specific complications may be limiting, our series demonstrates open appendicectomy under SA to be safe, feasible and acceptable in the UK. The technique could be a valuable contingency for COVID suspected cases and patients with high-risk respiratory disease.

A Prospective Study to Compare the Effects of General Anaesthesia and Regional Anaesthesia among Patients Posted for Laparoscopic Appendicectomy, in SV Medical College, Tirupati, Andhra Pradesh

2021 ◽  
Vol 8 (26) ◽  
pp. 2333-2338
Author(s):  
Nirmala Devi B ◽  
Surisetty Sreenivasa Rao ◽  
Raju Bhukya
Keyword(s):  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Postoperative Analgesia ◽  
Postoperative Period ◽  
Postoperative Nausea ◽  
Regional Anaesthesia ◽  
Laparoscopic Appendicectomy ◽  
P Value ◽  
Medical College ◽  
Spinal Group

BACKGROUND We wanted to compare the effects of general anaesthesia and regional anaesthesia in cases posted for laparoscopic appendicectomy and also compare various parameters like hemodynamic changes, postoperative analgesia, and postoperative complications in both the techniques. METHODS After obtaining permission from scientific and ethical committee of SVMC, Tirupati, we conducted the study on 60 patients attending SV Medical College, Tirupati from September 2018 to August 2019, who were in ASA GRADE 1 & 2, and posted for laparoscopic appendicectomy. We divided them into two groups Group - S – those who received spinal anaesthesia & Group - G – those who received general anaesthesia. RESULTS 60 patients of ASA 1 and 2 were taken up for laparoscopic appendicectomy from September 2018 to August 2019. Out of 60 patients, 30 patients were grouped under Group - S, Other 30 patients grouped under Group - G. Intraoperative vitals, including blood pressure, heart rate, oxygen saturation, and respiratory rate and end-tidal CO2 levels, were within baseline values, whereas postoperative analgesia was better in Group - S than Group - G. There were 3 patients in the spinal group who developed postoperative hypotension and were managed with injection mephentermine sulphate. Out of 30 in each group, 11 patients in spinal, and 22 patients in GA group developed postoperative nausea and vomiting, which subsided with antiemetics. There were 4 patients in spinal, and 3 patients in the GA group who complained of shoulder tip pain in the postoperative period. Patients had minimal pain and no requirement of analgesia in the initial 3 hours of the postoperative period in the spinal group. CONCLUSIONS Patients who underwent laparoscopic appendicectomy under spinal anaesthesia (Group - S) showed significant postoperative analgesia (P - value < 0.05) and better haemodynamic stability than the patients who underwent laparoscopic appendicectomy under general anaesthesia (Group - G), But alertness for any emergency by anaesthesiologist was more needed in spinal anaesthesia than general anaesthesia because airway was not protected, and patient was taking spontaneous respirations. KEYWORDS RA - Regional Anaesthesia, SA - Spinal Anaesthesia, GA - General Anaesthesia, PONV (Postoperative Nausea & Vomiting)

scholarly journals Opioid-free anesthesia versus opioid-inclusive anesthesia for breast cancer surgery: a retrospective study

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Pia Di Benedetto ◽  
Massimiliano Pelli ◽  
Chiara Loffredo ◽  
Rosaria La Regina ◽  
Federico Policastro ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Patient Satisfaction ◽  
Retrospective Study ◽  
Postoperative Pain ◽  
Rating Scale ◽  
Postoperative Nausea And Vomiting ◽  
Numeric Rating Scale ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Anesthetic Technique

Abstract Background Breast cancer surgery is usually managed using opioid-inclusive anesthesia (OIA), although opioids are associated with several adverse events, including nausea, vomiting, and constipation. Multimodal opioid-free anesthesia (OFA) has been introduced to reduce the incidence of these side effects. In this single-center retrospective study, we investigated whether ketamine, combined with magnesium and clonidine, could effectively control postoperative pain in patients undergoing quadrantectomy, while reducing postoperative nausea and vomiting (PONV). Results A total of 89 patients submitted to quadrantectomy were included and divided into an OFA group (38 patients) and an OIA group (51 patients) according to the received anesthetic technique. Analgesia in the OIA group was based on an intraoperative infusion of remifentanil, and analgesia in the OFA consisted of an intraoperative infusion of ketamine and magnesium sulfate. Postoperative pain in both groups was managed with nonsteroidal anti-inflammatory drugs (NSAIDs) and paracetamol. Postoperative pain, assessed with the numeric rating scale (NRS), requirements for additional analgesics, the incidence of PONV, and patient satisfaction evaluated using a QoR-40 questionnaire were compared between the two groups. Levels of pain at 30 min and 6, 12, and 24 h after surgery; number of paracetamol rescue doses; and the incidence of PONV were lower in the OFA group (p <0.05). Patient satisfaction was comparable in the two groups. Conclusions A combination of ketamine, magnesium, and clonidine could be more effective than opioid-based analgesia in reducing postoperative pain and lowering PONV occurrence after quadrantectomy for breast cancer.

scholarly journals Transmuscular quadratus lumborum block for postoperative pain and recovery after laparoscopic adrenalectomy: a randomized controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Qing Yuan ◽  
Sufang Lu ◽  
Xulei Cui ◽  
Yuelun Zhang ◽  
Yi Xie ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Postoperative Pain ◽  
Laparoscopic Adrenalectomy ◽  
Rating Scale ◽  
Controlled Trial ◽  
Numeric Rating Scale ◽  
Postoperative Recovery ◽  
Single Shot ◽  
Quadratus Lumborum Block ◽  
Quadratus Lumborum

Abstract Background To investigate the role of transmuscular quadratus lumborum block (TMQLB) for postoperative pain control, patient satisfaction and recovery in laparoscopic adrenalectomy. Methods Seventy-two patients aged between 18 and 70 years with an ASA I-II and scheduled for laparoscopic adrenalectomy were randomized to receive a single-shot TMQLB with 0.4 ml/kg 0.5 % ropivacaine or 0.4 ml/kg 0.9 % saline as placebo. The primary endpoint was pain on movement at 12 h after surgery evaluated by the numeric rating scale (NRS, 0–10). P-values < 0.05 was considered statistically significant. The secondary outcomes included pain at rest and pain on movement evaluated by the NRS, and postoperative recovery related parameters. Results NRS on movement at 12 h after surgery was lower in the TMQLB group compared with the control (median 2 vs. 3, p = 0.024). Intraoperative fentanyl consumption was lower in the TMQLB group (247.08 ± 63.54 vs. 285.44 ± 74.70, p = 0.022). The rate of using postoperative rescue tramadol was also lower in the TMQLB group (5.6 vs. 27.8 %, p = 0.027). Similar incidences of nausea and vomiting were observed (11.1 vs. 25 %, p = 0.220). Patient satisfaction of pain service was better in the TMQLB group (83.3 vs. 25 %, p < 0.001) with shorter time to ambulation (16.5 vs. 21 h, p = 0.004) and flatus (18.5 vs. 23.5 h, p = 0.006). Conclusions TMQLB showed better control of postoperative pain on movement for laparoscopic adrenalectomy with improved patients’ satisfaction of anesthesia, shorter time to ambulation and flatus. Trial registration This study was registered at Clinicaltrials.gov (NCT03942237; registration date: 08/05/2019; enrollment date: 10/05/2019).

Effect of Perioperative Electroacupuncture as An Adjunctive Therapy on Postoperative Analgesia with Tramadol and Ketamine in Prostatectomy: A Randomised Sham-Controlled Single-Blind Trial

2014 ◽  
Vol 32 (3) ◽  
pp. 215-222 ◽  
Author(s):  
Vagia Ntritsou ◽  
Christos Mavrommatis ◽  
Christos Kostoglou ◽  
Georgios Dimitriadis ◽  
Nikolaos Tziris ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Side Effects ◽  
Postoperative Pain ◽  
Adjunctive Therapy ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Sham Acupuncture ◽  
Control Group ◽  
Rescue Analgesia ◽  
Pressure Algometer

Objectives To study the analgesic effect of electroacupuncture (EA) as perioperative adjunctive therapy added to a systemic analgesic strategy (including tramadol and ketamine) for postoperative pain, opioid-related side effects and patient satisfaction. Methods In a sham-controlled participant- and observer-blinded trial, 75 patients undergoing radical prostatectomy were randomly assigned to two groups: (1) EA (n=37; tramadol+ketamine+EA) and (2) control (n=38; tramadol+ketamine). EA (100 Hz frequency) was applied at LI4 bilaterally during the closure of the abdominal walls and EA (4 Hz) was applied at ST36 and LI4 bilaterally immediately after extubation. The control group had sham acupuncture without penetration or stimulation. The following outcomes were evaluated: postoperative pain using the Numerical Rating Scale (NRS) and McGill Scale (SF_MPQ), mechanical pain thresholds using algometer application close to the wound, cortisol measurements, rescue analgesia, Spielberger State Trait Anxiety Inventory (STAI Y-6 item), patient satisfaction and opioid side effects. Results Pain scores on the NRS and SF_MPQ were significantly lower and electronic pressure algometer measurements were significantly higher in the EA group than in the control group (p<0.001) at all assessments. In the EA group a significant decrease in rescue analgesia was observed at 45 min (p<0.001) and a significant decrease in cortisol levels was also observed (p<0.05). Patients expressed satisfaction with the analgesia, especially in the EA group (p<0.01). Significant delays in the start of bowel movements were observed in the control group at 45 min (p<0.001) and 2 h (p<0.05). Conclusions Adding EA perioperatively should be considered an option as part of a multimodal analgesic strategy.

scholarly journals A Prospective Randomised Trial Comparing Spinal Anaesthesia using Hyperbaric Cinchocaine with General Anaesthesia for Lower Limb Vascular Surgery

1986 ◽  
Vol 14 (4) ◽  
pp. 373-380 ◽  
Author(s):  
P. T. Cook ◽  
M. J. davies ◽  
K. D. Cronin ◽  
P. Moran
Keyword(s):  
Vascular Surgery ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Lower Limb ◽  
Myocardial Infarct ◽  
Randomised Trial ◽  
Limb Amputation ◽  
Significant Difference ◽  
Spinal Group ◽  
General Anaesthesia Group

One hundred and one patients were randomly allocated to have their peripheral vascular surgery performed under general anaesthesia (51 patients) or spinal anaesthesia (50 patients). Intraoperative haemodynamic changes were markedly different between the two groups with a higher incidence of hypotension in the spinal group (72% vs 31%) and a higher incidence of hypertension in the general anaesthesia group (22% vs 0%). Blood loss was significantly less in the spinal group (560, SD 340, ml vs 792, SD 440, ml). Postoperatively three patients from the general anaesthesia group died from causes unrelated to the anaesthesia, and one had a myocardial infarct. Two patients in the spinal group had myocardial infarcts, both had been treated for bradycardia and hypotension intraoperatively, and one died. There was a significantly higher incidence of postoperative chest infection in the general anaesthesia group (33% vs 16%). There was no significant difference between the groups in the incidence of postoperative confusion, or lower limb amputation rate or need for further surgery prior to hospital discharge.

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